益气化痰活血方治疗急性冠脉综合征临床观察

目的:探讨应用益气化痰活血方治疗急性冠脉综合征的临床效果.方法:观察120例急性冠脉综合征患者,随机分为治疗组(n=60)和对照组(n=60),治疗组应用益气化痰活血法+西医常规治疗,对照组单纯西医常规治疗,观察两组临床症状及西雅图心绞痛量表(SAQ)变化情况.结果:治疗2周后,治疗组中医证候总有效率(88.3%),明显高于对照组(65.0%),差异有统计学意义(P＜0.05).与对照组比较,治疗后治疗组躯体活动受限程度、心绞痛发作频率、治疗满意程度、主观感受有显著改善,差异有统计学意义(P＜0.05).结论:益气化痰活血方治疗急性冠脉综合征有良好临床疗效.     

自拟中药汤剂对痰浊型眩晕患者生活功能及躯体功能的影响

目的 观察平肝熄风、化痰止痉类中药配伍对痰浊型眩晕患者生活功能和躯体功能的影响.方法 将60例患者随机分为治疗组和对照组,各30例,治疗组采用半夏白术天麻汤加减治疗,对照组用盐酸倍他司汀片治疗.观察2组治疗前后眩晕单项症状评分、眩晕残障程度评定量表(DHI)及生存质量评定表(SF-36表)改善情况.结果 治疗组在改善眩晕程度、降低眩晕发作频率方面均优于对照组(P＜0.05);2组DHI、SF-36评分均优于治疗前(P＜0.05),且治疗组优于对照组(P＜0.05).结论 半夏白术天麻汤治疗痰浊型眩晕,能显著改善患者的生活功能及躯体功能,减轻临床症状.     

益气活血化痰通络汤治疗急性脑梗死60例

目的 观察益气活血化痰通络汤治疗急性脑梗死的优势.方法 60例住院病人,随机分为2组,治疗组30例,对照组30例,治疗组为西医基础治疗十益气活血化痰通络汤,对照组为西医基础治疗,疗程1个月,观察中医证候疗效及神经功能缺损评分、日常生活活动能力量表评分的变化.结果 治疗组临床疗效总有效率明显优于对照组(P＜0.05);2组治疗后神经功能缺损评分均优于治疗前(P＜0.05),治疗组优于对照组(P＜0.05);治疗组半身不遂、气短乏力、舌质暗淡等主症改善明显优于对照组(P＜0.05);2组治疗后BI指数较治疗前明显改善(P＜0.01),治疗组优于对照组(P＜0.05).结论 中西医联合治疗急性脑梗死疗效明显优于单独西医治疗.     

益肾活血降浊中药结肠透析与护理对慢性肾衰竭患者肾功能的影响

目的 探讨益肾活血降浊中药结肠透析对慢性肾衰竭患者肾功能的影响.方法 选取110例慢性肾衰竭患者,采用随机数字表法随机分为2组,各55例,对照组采取常规治疗及护理,治疗组在常规治疗基础上加用益肾活血降浊中药结肠透析,并配合中医护理.2组均治疗8周,观察2组中医症状积分,血肌酐(Scr)、血尿素氯(BUN)、内生肌酐清除率(Cor)等指标改善情况,计算2组临床疗效.结果 实验组总有效率90.90％,明显高于对照组的72.72％ (P ＜0.05);2组治疗前后中医症状积分均有所改善,且治疗组优于对照组(p＜0.05);2组Scr、BUN、Ccr等指标变化,均有所降低,且治疗组改善更明显(P＜0.05).结论 益肾活血降浊中药透析,具有清热活血,益肾降浊的作用,改善临床症状及肾功能指标,提高患者生活质量.     

通心络胶囊治疗心脏X综合征的临床研究

目的观察通心络胶囊治疗心脏X综合征的疗效.方法本院确诊的心脏X综合征患者32例随机分为常规治疗组(对照组)和加服通心络胶囊治疗组(治疗组),服药4周,观察典型心绞痛发作频率、心电图运动试验缺血型ST段压低幅度和血浆内皮素-1(ET-1)浓度变化.结果与对照组比较,治疗组心绞痛发作频率显著减少、心电图运动试验结果改善和血浆Er-1浓度显著降低(P＜0.01);与治疗前比较,治疗组治疗后心脏X综合征患者的心绞痛发作频率和血浆ET-1浓度亦显著下降(P＜0.01),心电图运动试验结果显著改善(P＜0.01);对照组治疗后心绞痛发作频率减少、心电图运动试验结果改善(P＜0.05),但血浆ET-1浓度无显著下降.结论通心络胶囊治疗心脏X综合征效果显著.     

活血化痰法治疗冠心病心绞痛

目的 探究活血化痰法治疗冠心病心绞痛的临床疗效.方法 选取冠心病心绞痛患者90例,采用随机数字表随机分为2组,对照组45例,给予阿司匹林、立普妥等常规药物治疗;治疗组45例,在常规治疗的基础上应用中医活血化痰法(党参、黄芪、瓜蒌、丹参等)治疗.2组均21 d为1疗程,治疗2疗程.检测心电图和血液流变学,对比治疗前后心电图及血液流变学的改善情况.结果 治疗后2组心电图ST段均有所回升,T波倒置均变浅,但治疗组较对照组改善明显,差异有统计学意义(P＜0.05);治疗后2组血液流变学指标均有听下降,且治疗组较对照组降低更为明显,差异有统计学意义(P＜0.05).结论 活血化痰法能够增加心肌供缸能力,改善心电图,显著降低血液流变学指标,有效治疗因冠心病心绞痛引发的各种症状.     

血液滤过联合机械通气治疗重症急性胰腺炎致急性呼吸窘迫综合征

目的 探讨血液滤过联合机械通气治疗重症急性胰腺炎致急性呼吸窘迫综合征的疗效.方法 将重症急性胰腺炎致急性呼吸窘迫综合征80例患者随机分为观察组及对照组,每组40例.对照组采用机械通气进行常规治疗,观察组采用血液滤过联合机械通气进行治疗,比较2组患者有创通气时间、总机械通气时间、ICU住院时间、呼吸机相关肺炎(VAP)发生率和病死率,呼吸频率(RR)、心率(HR).结果 观察组患者有创通气时间、总机械通气时间、ICU住院时间均短于对照组(P＜0.05);VAP发生率和病死率显著低于对照组(P＜0.05);治疗后2组的RR、HR比治疗前均显著降低,但观察组降低程度优于对照组(P＜0.05).结论 血液滤过联合机械通气可以有效减少重症急性胰腺炎致急性呼吸窘迫综合征患者的通气时间,改善缺氧症状,临床效果优于传统的机械通气.     

金水宝胶囊联合补肺活血胶囊治疗慢性阻塞性肺疾病稳定期的临床观察

目的:观察金水宝胶囊联合补肺活血胶囊治疗慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效.方法:采用随机单盲研究方法,将101例符合纳入标准的对象随机分成治疗组(51例)和对照组(50例),治疗组按GOLD方案加金水宝胶囊和补肺活血胶囊,对照组按GOLD方案治疗.观察2组在治疗前后的中医证候疗效、肺功能及BODE评分、急性发作次数.结果:中医证候疗效治疗组总有效率88.23％,对照组为72.00％ (P ＜0.05);肺功能方面,治疗组在稳定与改善患者肺通气功能方面优于对照组;BODE评分方面,治疗组的BODE评分改善明显优于对照组;明显减少急性发作次数.结论:金水宝胶囊联合补肺活血胶囊能提高COPD患者治疗中医证候的疗效,延缓肺功能下降,改善生活质量,增强机体免疫力,减少急性发作次数.     

治未病理念在肥胖高血压患者早期肾损害中的应用

目的:观察活血潜阳方辅以耳穴及恬淡疏息法对肥胖高血压患者早期肾损害的干预作用。方法:将60例伴早期肾损害的肥胖高血压患者随机分为对照组及治疗组,每组30例。2组患者在原治疗方案的基础上均进行健康宣教,治疗组则予活血潜阳方辅以耳穴及恬淡疏息法干预3个月。干预前后采集患者一般资料、诊室血压、动态血压,中医证候积分、糖脂代谢、早期肾损害等指标进行比较。结果:治疗组患者体重、腰围、BMI均较治疗前显著下降(P0.05);治疗组收缩压及舒张压均较治疗前显著下降(P0.05),治疗组降压有效率70.0%显著优于对照组(P0.01);18例对照组患者及17例治疗组患者完成了动态血压监测,治疗组24 h平均收缩压(24 h SBP)及夜间平均收缩压(n SBP)均较治疗前显著下降(P0.05);治疗组中总胆固醇(TC)、甘油三酯(TG)、空腹胰岛素(FIN)、HOMA-IR均较治疗前显著下降(P0.05);治疗组尿MA/尿肌酐较治疗前显著下降(P0.05);治疗组中医证候积分较前显著下降(P0.01),治疗有效率为76.7%优于对照组(P0.05)。以上结果对照组治疗前后无显著变化(P0.05)。结论:活血潜阳方辅以耳穴及恬淡疏息法治疗3个月可显著改善肥胖高血压患者早期肾损害。     

活血通络法配合西医治疗小儿哮喘发作期（热型）300例

目的通过临床观察活血通络中药对小儿哮喘发作期(热型)治疗前后的变化,旨在探讨中药治疗小儿哮喘发作期(热型)的有效方剂.方法按标准选择小儿哮喘发作期(热型)60例,采用简单随机法分为治疗组和对照组各30例,治疗组加用中药"喘通康"治疗,观察两组临床疗效.结果①治疗组在起效时间、咳嗽消失时间、哮鸣音消失时间、喘息消失时间优于对照组(P＜0.05);②治疗组在肺功能(PEF)改善方面优于对照组(P＜0.05);③治疗组总疗效优于对照组(P＜0.05).结论加用活血通络中药治疗哮喘发作的疗效明显优于单纯西药治疗.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.