儿童再发性腹痛138例临床病因及治疗体会

目的探讨儿童再发性腹痛(RAP)的病因、临床表现及治疗方法,为临床选择辅助检查及治疗提供依据。方法对138例RAP进行病因、临床表现、诊断和治疗方法进行分析。结果82例(59.4%)为器质性疾病,以肠系膜淋巴结炎为首位,慢性胃炎次之。功能性再发性腹痛56例(40.5%);采用健脾止痛汤治疗,126例患儿腹痛症状消失,随访半年未复发;10例患儿腹痛症状减轻,次数减少;无效2例,总有效率98.6%。结论小儿RAP多为器质性疾病所致。要诊断功能性RAP,必须首先排除器质性疾病;健脾止痛汤治疗小儿再发性腹痛有较好疗效。     

中医药治疗小儿再发性腹痛临床研究进展

小儿再发性腹痛(RAP)是学龄儿童最常见的慢性腹痛。其诊断标准最早由Apley和Naish提出[1]:是指发生在3岁以上的儿童的一种反复发作性腹痛。病程超过3个月,发作次数>3次,严重时可影响患儿的正常生活。常规治疗经常得不到理想疗效,使患儿身心健康及其家庭生活受到影响。笔者就近10年国内运用中西医等方法治疗小儿再发性腹痛的文献综述如下。     

疏肝柔肝法治疗小儿再发性腹痛28例临床观察

再发性腹痛（RAP）,即发作性的腹痛,病程至少3个月以上,有3次以上的腹痛发作,发作严重时可影响小儿正常的活动,而在发作间歇期表现正常。相当于西医的功能性腹痛,占腹痛患儿的50％～70％。近年来,笔者用疏肝柔肝法治疗此病28例,获效颇佳。     

小儿再发性腹痛360例临床分析

目的探讨小儿再发性腹痛(RAP)的病因,临床表现,为临床选择辅助检查及诊治提供依据。方法对360例RAP进行病因、临床表现、辅助检查,诊断进行分析;结果 249例为器质性疾病(69.2%),以肠系膜淋巴结炎为首位,慢性胃炎次之。功能性再发性腹痛111例(30.8%)。结论小儿再发性腹痛与以往的结论功能性疾病占多数有所不同。而本文临床分析结果,器质性疾病249例(69.2%),功能性疾病111例(30.8%)。     

杜克宽运用“五脏三层辨证法”辨治小儿再发性腹痛经验

<正>小儿再发性腹痛(RAP)是3岁以上儿童常见的临床症状之一,以反复发作性腹痛为主要特征[1]。再发性腹痛是病因隐匿、体征不显、症状突出的腹部综合征。它表现为病程超过3个月以上,每个月均有发作,且次数至少3次以上,发作间歇期表现如常,其中功能性约占再发性腹痛90%[2]。其腹痛可引起儿童痛苦不适,难以忍受,严重时可影响患儿的正常活动及生长发     

蒙医疗法结合针灸治疗肠易激综合征

肠易激综合征（IBS）是一种以腹痛、腹泻、腹部不适伴排便习惯改变为特征的功能性肠病，须经排除可引起这些症状的器质性疾病。本病是最常见的一种功能性肠道疾病。有IBS症状者欧美国家报道为10％-20％，亚洲10％，我国发病率15％，50岁以后首次发病者少见，男女比例约1：2。本病属蒙医慢性肠道疾病范畴。     

腹痛灵贴剂治疗小儿痉挛性肠绞痛的临床研究

痉挛性肠绞痛是小儿最为常见的急性腹痛。在学龄儿童中发生率约为10％。我们根据中医学内病外治理论,研制腹痛灵贴剂治疗本病取得较为满意的效果。现总结如下。     

中医药治疗痛经临床研究进展

痛经是指妇女经期或经行前后出现小腹疼痛或痛引腰骶，甚至剧痛晕厥，又称“经行腹痛”。痛经分为原发性痛经和继发性痛经，前者又称功能性痛经，是指生殖器官无器质性病变。据统计，50％以上青春期后的女性会发生痛经，10％～20％症状相当严重，影响了正常的生活、工作和学习。西医多采用镇痛、镇静、解痉以及激素制剂等疗法，虽能暂时缓解疼痛，     

理气通降法治疗功能性消化不良48例

功能性消化不良(FD)是指具有上腹痛、上腹胀、早饱、嗳气，食欲不振、恶心、呕吐等上腹不适症状，经检查，排除了引起这些症状的器质性疾病的一些临床综合症状，可持续或反复发作，病程一般超过1个月，FD是一种常见病、多发病，一般认为患病率高达20％-40％，发病率在1％以上。占消化门诊的50％左右。FD在中医根据临床症状不同而分别称谓痞满、胃痛等。     

痛经的防治

1 痛经是怎么回事 月经期或行经前后出现下腹部疼痛、坠胀,伴有腰酸痛或其他不适,影响日常生活与工作者,称为痛经.中医学又称“经行腹痛”、“经期腹痛”、“经痛”等.痛经分为原发性与继发性两类,原发性痛经指生殖器官无器质性病变的痛经,占痛经的90％以上;继发性痛经是指盆腔器质性病变引起的痛经。     

薏苡附子败酱散治疗妇科疾病验案3则

薏苡附子败酱散出自《金匮要略》,原方由薏苡仁（十分）、附子（二分）、败酱草（五分）组成,杵为末,水煎服。本方具有利湿排脓、破血消肿之功效,主治“腹皮急,按之濡……腹内有痈脓”。本方药用薏苡仁甘寒利湿,败酱草苦寒解毒排脓,更用小剂量辛热之附子“破积聚,血瘕寒湿”,《神农本草经》,以其辛热助阳行血,破散瘕瘕而内消肠痈。笔者师其方义,适当加重附子用量,加强温阳补肾之作用,用于治疗妇科疾病属寒湿内积者,疗效颇佳,现举验案3则如下。     

Clinical Research on Abdominal Acupuncture plus Conventional Acupuncture for Knee Osteoarthritis

To probe the therapeutic effect of abdominal acupuncture plus conventional acupuncture on knee osteoarthritis. Methods： PEMS3.1 software was used. The 105 patients with knee osteoarthritis were randomly divided into an abdominal acupuncture group, a conventional acupuncture group and a combined group （abdominal acupuncture plus conventional acupuncture）. For the abdominal acupuncture group, the abdominal acupuncture was performed at Zhongwan （CV 12）, Guanyuan （CV 4）, Wailing （ST 26）, Daheng （SP 15）, Lower Rheumatism point and Qipang with needles retained for 30 minutes. For the conventional acupuncture group, the acupuncture was practiced at Neixiyan （EX-LE4） and Dubi （ST 35） of the affected limb, Yanglingquan （GB 34）, Liangqiu （ST 34）, Xuehai （SP 10） and Xiyangguan （GB 33）. For the combined group, both methods were applied. Treatment was given once a day, 6 times a week, for 4 weeks. Lysholm knee scoring scale was used to score the functions of knee before and after treatment. Results： Of 35 cases in the abdominal acupuncture group, 8 cases were remarkably relieved, 10 cases relieved, 14 cases improved, and 3 cases failed, the total effective rate was 91.4%. Of 35 cases in the conventional acupuncture group, 7 cases were remarkably relieved, 8 cases relieved, 16 cases improved, and 4 cases failed, the total effective rate was 88.6%. Of 35 cases in the combined group, 13 cases were remarkably relieved, 16 cases relieved, 5 cases improved, and 1 cases failed, the total effective rate was 97.1%. There was a remarkable difference in the effect among 3 groups （P〈O.05）. The difference in scores of Lysholm knee scoring scale for knee joint after treatment among 3 groups was very significant （P〈0.01）. Conclusion： Abdominal acupuncture has reliable effect for knee osteoarthritis and it has the synergized function when combined with conventional acupuncture.     

Effects of feeding tyrosine and phenylalanine on the accumulation of phenylethanoid glycosides to Cistanche deserticola cell suspension culture

AIM： To investigate the effects of feeding phenylalanine （Phe） and tyrosine （Tyr） on the accumulation of total phenolic compounds and four phenylethanoid glycosides （PeGs） to a cell suspension culture of the parasitic plant Cistanche deserticola.METHOD： A cell suspension culture of C. deserticola was established and precursors of different concentrations were fed. In each group, the cell was sampled at the 24^th day after inoculation. The content of total phenolic compounds and four PeGs compounds were determined using the Folin-Ciocalteu method and an HPLC method, respectively.RESULTS： In the Phe fed cells, the maximum PeGs yield was achieved when Phe was fed at 1.5 mmol·L^-1 and the yield reached 1.13 times the control cell concentration. In the Tyr fed cells, the maximum yield of PeGs was 1.60 times of control when 0.75 mmol·L^-1 Tyr was fed to the cells. Furthermore, it was found that the salidroside yield was 4.01 times of control group when 5 mmol·L^-1 Tyr was fed.CONCLUSION： Tyr is a better precursor for PeGs accumulation compared with Phe, and the rate limiting enzymes might be involved in the Tyr branch.     

分消走泄法治疗非霍奇金淋巴瘤并肺纤维化反复发热案1则

分消走泄法是叶天士《温热论》中提出的治疗湿热病的主要方法之一。叶氏指出:"邪留三焦,亦如伤寒中少阳病也。彼则和解表里之半,此则分消上下之势,随证变法,如近时杏、朴、苓等类,或如温胆汤之走泄。"笔者在临床上应用该方法治疗1例非霍奇金淋巴瘤合并肺纤维化导致的反复发热,取得了满意疗效,现介绍如下。1病案实录     

Capillary blood flow in patients with dysmenorrhea treated with acupuncture

OBJECTIVE; To observe capillary blood flow at acu- points during acupuncture treatment of primary dysmenorrhea and gain new insights into its anal- gesic mechanism. METHODS： Patients with primary dysmenorrhea were enrolled and randomly assigned to a treat- ment or control group. Subjects＇ symptoms were differentiated into various Traditional Chinese Medi- cine （TCM） syndromes and treated for 10 sessions with puncturing acupuncture or self-pressing right-hand Hegu （LI 4）, adding other acupoints based on syndrome. Laser speckle was used tocompare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu （LI 4） be- fore and during the treatment. Each subject was re- quired to finish the period pain symptoms observa- tion form, verbal rating scales, numerical rating scale, pain rating index, face rating scale, Zung self-rating depression scale, Zung self-rating anxi- ety scale, and numerical rating scale before and af- ter treatments. RESULTS： After 10 sessions, the symptom scores, pain index （PI）, and visual analog scale （VAS） de- creased significantly in treatment group. The vol- ume of blood flow in Hegu （LI 4） declined slightly. No significant evidence supported that needling caused capillary contraction, but the capillary vaso- motor amplitude at Hegu （LI 4） increased remark- ably. CONCLUSION： Acupuncture can increase the capil- lary blood flow, thus promoting the flow of Qi and blood in terms of TCM theory, which facilitates pain relief.     

DT-13, a saponin of dwarf lilyturf tuber,exhibits anti-cancer activity by down-regulating C-C chemokine receptor type 5 and vascular endothelial growth factor in MDA-MB-435 cells简

AIM： To investigate the anticancer activity of DT-13 under normoxia and determine the underlying mechanisms of action. METHODS： MDA-MB-435 cell proliferation, migration, and adhesion were performed to assess the anticancer activity of DT-13, a saponin from Ophiopogonjaponicus, in vitro. In addition, the effects of DT-13 on tumor growth and metastasis in vivo were evaluated by orthotopic implantation of MDA-MB-435 cells into nude mice; mRNA levels of vascular endothelial growth factor （VEGF）, C-C chemokine receptor type 5 （CCR5） and hypoxia-inducible factor 1a （HIF-1a） were evaluated by real-time quantitative PCR; and CCR5 protein levels were detected by Western blot assay. RESULTS： At 0.01 to 1 umol·L -1, DT-13 inhibited MDA-MB-435 cell proliferation, migration, and adhesion significantly in vitro. DT-13 reduced VEGF and CCR5 mRNAs, and decreased CCR5 protein expression by down-regulating HIF-1 a. In addition, DT-13 inhibited MDA-MB-435 cell lung metastasis, and restricted tumor growth slightly in vivo. CONCLUSION： DT-13 inhibited MDA-MB-435 cell proliferation, adhesion, and migration in vitro, and lung metastasis in vivo by reducing VEGF, CCR5, and HIF-la expression.     

Combinatorial effects of conception and governor vessel electroacu- puncture and human umbilical cord blood-derived mesenchymal stem cells on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion

OBJECTIVE： To investigate the combinatorial ef- fects of conception and governor vessel electroacu- puncture （EA） and human umbilical cord blood-de- rived mesenchymal stem cells （HUCB-MSCs） on pathomorphologic lesion and cellular apoptosis in rats with cerebral ischemia/reperfusion. METHODS： With the HUCB-MSCs isolated, cultured and identified and the models of cerebral isch- emia-reperfusion established, the HUCB-MSCs of passage three were intracranially transplanted andthe EA at conception and governor vessels was ap- plied. The pathomorphologic lesion by hematoxy- lin-eosin staining and the cellular apoptosis by ter- minal deoxynucleotidyl transferase-mediated nick-end labeling method around the ischemic fo- cus were observed. RESULTS： The cultured adherent HUCB-MSCs ex- hibited a spindle shape and expressed MSC-specif- ic markers, with the cell purity and proliferation rate significantly increasing after the primary pas- sage. HE staining showed that there were no patho- logical changes observed in the sham surgery group. However, in the PBS transplantation group, degeneration and necrosis of a great number of nerve cells were seen. In both the HUCB-MSCs transplantation group and the HUCB-MSCs trans- plantation ＋ EA group, reparative changes of the pathomorphism of the tissue were found. Both combination treatment and simple MSCs treat- ment were able to improve the pathomorphorlogic lesion following cerebral ischemia and reduce the abnormal TUNEL-positive numbers, with former better than latter. CONCLUSION： HUCB-MSCs improve pathological lesions and inhibit the cellular apoptosis around the cerebral ischemic area. EA at conception and governor vessels also improve pathological lesion and inhibit the cellular apoptosis in rats treated with HUCB-MSCs transplantation, which effects were superior to that of simple HUCB-MSCs trans- plantation.     

王氏保赤丸治疗消化系统疾病概述

王氏保赤丸系根据清代道光年间通州著名中医王胪卿祖传九世秘方配制,并由其嫡孙王绵之教授监制的纯中药制剂。该药由大黄、黄连、制天南星、川贝母等组成。方中大黄苦寒,攻积导滞,泻火凉血,行瘀通经;黄连苦寒,清热燥湿,泻火解毒;制天南星苦凉,化痰熄风定惊;川贝母苦寒,化痰止咳,清热散结。王氏     

Curative effect of Xuebijing injection on severe pulmonary contu- sion

OBJECTIVE： To investigate the curative effects of Xuebijing （XBJ） injection, a Chinese patent medi- cine, on severe pulmonary contusion （PC）. METHODS： Sixty-three patients with PC were ran- domized to conventional therapy plus XBJ injec- tion （n=33） or conventional therapy alone （n=30）. Between groups differences in corticosteroid treat- ment, immune regulation therapy, hemofiltration, infusion volume, transfusion volume and antibiotic period were measured, as were intensive care unit（ICU）-free time, ventilation time, 28-day mortality rate and incidence of ventilation-associated pneu- monia （VAP）. Serum concentrations of procalcito- nin （PCT）, tumor necrosis factor-a （TNF-a）, interleu- kin （IL）-6, and 11_-10, white blood cell （WBC） counts and percentages of human leukocyte antigen DR/ CD14＋ （HLA-DR/CD14＋） peripheral blood mononu- clear cells were compared. Markers of ventilation were determined by blood gas analysis and ventila- tor parameters. RESULTS： WBC counts and serum concentrations of PCT, TNF-a, 11.-6 and IL-10 were reduced signifi- cantly more quickly, and CD14＋ percentage was in- creased significantly earlier, in the XBJ group than in the control group （P〈0.05 each）. The level of ven- tilation and oxygenation index were ameliorated earlier in the XBJ than in the control group （P〈 0.05）. XBJ treatment significantly reduced ICU-free time, ventilation time and incidence of VAP （P〈0.05 each）, but had no effect on 28-day mortality rate （P〉0.05）. CONCLUSION： XBJ treatment can shorten ICU-free and ventilation times and reduce the incidence of VAP, improving outcomes in patients with severe PC. XBJ may act by regulating inflammation and im- munity, alleviating systemic inflammatory response syndrome induced by trauma.