梅花针叩刺与西药结合治疗男性雄激素源性脱发的临床研究

【目的】观察梅花针叩刺脱发区、生发穴、大椎穴与口服西药非那雄胺片及外涂米诺地尔酊联合治疗男性雄激素源性脱发(AGA)的临床效果。【方法】将80例男性雄激素源性脱发患者随机分为治疗组和对照组各40例,对照组脱落2例,最终对照组38例完成治疗,治疗组全部完成治疗。对照组给予单纯口服非那雄胺片及外涂米诺地尔酊治疗,治疗组在对照组治疗基础上给予梅花针叩刺脱发区、生发穴、大椎穴治疗。于治疗前后观察记录2组脱发、瘙痒、油腻性、脱屑程度,并评价2组疗效。【结果】(1)治疗组痊愈率、总有效率分别为47.50%和97.50%,对照组分别为7.89%和78.95%;治疗组的总体疗效(秩和检验)及痊愈率、总有效率(χ2检验)均优于对照组,差异均有统计学意义(P0.05或P0.01)。(2)治疗组脱发、瘙痒、油腻性和脱屑程度等指标的评分值减少率均显著优于对照组,差异均有统计学意义(P0.01)。【结论】梅花针叩刺脱发区、生发穴及大椎穴治疗男性雄激素源性脱发,可提高西药治疗的疗效,开拓了中西医结合治疗男性雄激素源性脱发的新领域。     

CO2点阵激光联合5%米诺地尔酊和非那雄胺治疗雄激素性脱发的临床疗效评价

目的：探讨CO₂点阵激光联合外用5%米诺地尔酊及口服非那雄胺治疗雄激素性脱发的疗效。方法：将60例BASP分级为M1、M2的雄激素性脱发的男性患者随机分组为对照1组、对照2组及试验组,每组各20例。对照1组单纯外用5%米诺地尔酊治疗;对照2组外用5%米诺地尔酊联合口服非那雄胺治疗;试验组每月一次点阵激光治疗,联合外用5%米诺地尔酊及口服非那雄胺治疗,治疗6个月后评估各组疗效。结果：三组痊愈均为0例;试验组显效4例,对照2组显效1例,对照1组显效0例;试验组有效13例,对照2组有效11例,对照1组有效8例;试验组无效3例,对照2组无效8例,对照1组无效12例(P<0.05)。三组治疗后毛发密度及毛干直径均较治疗前增加,三组间各指标比较均有统计学差异(P<0.05),且试验组的毛发密度增加量及毛干直径增加量均显著高于对照1组和对照2组(P<0.05)。治疗过程中三组均无严重不良反应。结论：CO₂点阵激光联合外用5%米诺地尔酊及口服非那雄胺治疗雄激素性脱发安全有效,可供临床参考。     

和血汤和养精通络汤序贯治疗联合雌孕激素周期治疗人工流产后月经过少30例

目的 观察养血和血、养精通络中药序贯治疗联合雌孕激素周期治疗人工流产后月经过少的临床疗效。方法 将70例人工流产后月经过少患者随机分成中西医结合组（30例,予中药序贯治疗联合雌孕激素周期治疗）、中药组（20例,予中药序贯治疗）和西药组（20例,予雌孕激素治疗）,疗程均为2个月经周期。治疗前后分别观察3组行经时间、子宫内膜厚度和卵泡早期性激素水平。结果 中西医结合组临床疗效以及行经时间和子宫内膜厚度改善程度均明显优于中药组和西药组（P<0.05）。中药组治疗前后性激素水平无明显变化（P>0.05）;而中西医结合组和西药组卵泡刺激素显著降低（P<0.05）,黄体生成素、雌二醇、孕酮均显著升高 （P<0.05）,但两组治疗前后差值比较,差异均无统计学意义 （P>0.05）。结论 养血和血、养精通络中药序贯治疗联合雌孕激素周期治疗人工流产后月经过少能显著提高疗效。     

滋阴凉血化瘀止血方辨证加味治疗小儿过敏性紫癜性肾炎37例

目的 观察滋阴凉血化瘀止血基本方辨证加味治疗小儿过敏性紫癜性肾炎（Henoch Schnlein purpura nephritis,HSPN）的临床疗效及其对患者凝血功能的影响。方法 将67例小儿HSPN患者随机分为中药组（n=37）和西药组（n=30）,中药组患者口服滋阴凉血化瘀止血基本方的辨证加味方,西药组患者接受常规西药治疗。连续治疗30 d后,观察两组临床疗效及凝血功能的变化。结果 中药组临床疗效显著优于西药组（P<0.05）;中药组不同证型的疗效比较,差异无统计学意义（P>0.05）。治疗后两组血小板（platelet,PLT）计数、血浆纤维蛋白原（fibrinogen,Fib）均显著降低（P<0.05）,凝血时间（clotting time,CT）、血浆前凝血酶原时间（prothrombin time,PT）和活化部分凝血活酶时间（activated partial thromboplastin time,APTT）均显著升高（P<0.05）。治疗组CT变化率大于对照组（P<0.05）,PT变化率小于对照组（P<0.05）,两组PLT、APTT、Fib变化率比较,差异均无统计学意义（P>0.05）。结论 在滋阴凉血化瘀止血基础上辨证治疗小儿HSPN,其临床疗效优于西医常规疗法,两者对凝血功能的改善作用相当。     

鼻炎愈合剂联合鼻腔冲洗对儿童慢性鼻窦炎的疗效观察

目的 探讨院内制剂鼻炎愈合剂联合鼻腔冲洗治疗儿童慢性鼻窦炎的临床疗效。方法 按随机数字表法将120例慢性鼻窦炎患儿分为中药组和西药组，每组60例。中药组患儿给予鼻炎愈合剂口服+生理海盐水鼻腔冲洗，西药组患儿给予西药口服+生理海盐水鼻腔冲洗，疗程均为2周。比较两组患儿的临床疗效、鼻窦CT影像Lund-Mackay评分（Lund-Mackay score，LMS）及临床症状视觉模拟量表（visual analogue scale，VAS）评分。结果 两组总有效率比较，差异无统计学意义（P>0.05），两组显效率比较，西药组低于中药组（P<0.05）；鼻窦CT影像LMS比较，两组患儿治疗后LMS相较治疗前均有所降低（P<0.05），中药组治疗后鼻窦CT影像LMS低于西药组治疗后（P<0.05）；VAS评分比较，治疗后两组患儿VAS评分均较治疗前降低（P<0.05），中药组患儿鼻塞、流涕、咳嗽、头痛VAS评分均低于西药组（P<0.05），两组患儿嗅觉减退VAS评分比较，差异无统计学意义（P>0.05）。结论 院内制剂鼻炎愈合剂联合鼻腔冲洗治疗儿童慢性鼻窦炎临床疗效明显，能更好缓解慢性鼻窦炎患儿鼻塞、流涕、咳嗽及头痛等临床症状。     

自拟透骨侧柏方治疗湿热型雄激素性秃发的疗效观察

目的 观察自拟透骨侧柏方治疗湿热型雄激素性秃发（AGA）的临床疗效。方法 180例符合纳入标准的湿热型雄激素性秃发患者分为治疗组1（自拟透骨侧柏方口服）、治疗组2（自拟透骨侧柏方口服加外洗）和对照组（外涂5%米诺地尔酊），每组各60例。监测记录各组治疗6个月前后及3个月后回访时的毛发镜下毛囊、毛干状况及症状评分，最后进行疗效判定。结果 与治疗前相比，三组患者在治疗完成时及回访时毛发状况均有一定程度改善，治疗组1和对照组临床疗效相仿（P＞0.05），治疗组2临床疗效优于对照组(P＜0.05)；治疗组1和治疗组2在疗效维持上均优于对照组(P＜0.05)，且治疗组2更佳(P＜0.05)。结论 自拟透骨侧柏方口服外洗对湿热型雄激素性秃发疗效确切，透骨草-侧柏叶的药对配伍也值得进一步研究。     

补肾生发方联合非那雄胺治疗脂溢性脱发临床疗效分析

目的观察补肾生发方联合非那雄胺治疗脂溢性脱发的临床疗效。方法将127例患者随机分为两组,治疗组63例给予补肾生发方联合非那雄胺片治疗,对照组64例给予六味地黄丸和非那雄胺片治疗。结果治疗组显著改善13例,中度改善19例,轻度改善27例,无变化4例,总有效率93.65%;对照组显著改善9例,中度改善12例,轻度改善24例,无变化19例,总有效率70.31%,两组总有效率比较差异有统计学意义(P0.05)。对治疗前后两组头发油腻程度、头皮屑数量以及头痒等伴随症状改善情况进行比较,治疗组均明显优于对照组,差异有统计学意义(P0.05)。结论补肾生发方联合非那雄胺治疗脂溢性脱发在临床疗效及伴随症状改善方面均明显优于对照组,差异有统计学意义,值得临床推广。     

生发酊联合当归苦参丸治疗雄激素源性脱发的临床观察

目的观察生发酊联合当归苦参丸治疗雄激素源性脱发的疗效、安全性及患者满意度。方法将125例患者随机分为生发酊组(A组)62例和生发酊联合当归苦参丸组(B组)63例。A组外用生发酊,每日2次,用药后局部按摩10 m in。B组在A组治疗的基础上口服当归苦参丸,每日2次,每次6 g。观察两组患者的秃发区治疗前后毛发的数量、伴随症状的改善程度与不良反应情况,治疗12个月后根据毛发再生数量判断疗效,根据综合评分的改善程度评价满意度,根据不良事件发生率评判安全性。结果治疗6个月后,B组疗效与A组比较,各项指标差异无统计学意义(P0.05);治疗12个月后,B组疗效和患者满意度均高于A组(P0.05);B组的不良事件发生率低于A组(P0.05)。两组比较,差异有统计学意义。结论生发酊联合当归苦参丸是治疗雄激素源性脱发有效、安全的方法。     

化瘀散结法对子宫内膜息肉术后雌孕激素受体和Ki-67的影响观察

目的：观察宫腔镜子宫内膜息肉切除术(TCRP)术后应用中药化瘀散结法分期治疗对子宫内膜的雌激素受体(ER)、孕激素受体(PR)和增殖细胞相关抗原Ki-67表达的影响。方法：2015年6月-2016年6月在浙江中医药大学附属宁波市中医院住院行TCRP且术后病理诊断为子宫内膜息肉的患者147例,以随机单盲法分为三组,49例术后予中药化瘀散结法分期治疗（中药组）,49例术后予妈富隆片周期性治疗（西药组）,49例术后不予任何药物治疗（对照组）,疗程为3个月,用免疫组化法检测ER、PR及Ki-67在子宫内膜的表达,比较三组在3个月前后ER、PR及Ki-67的变化情况。结果：①ER表达：治疗前后三组组内比较：差异无统计学意义（P>0.05）,治疗后三组比较：差异无统计学意义（P>0.05）;②PR表达：治疗前后三组组内比较：中药组及西药组PR表达升高,有显著差异(P<0.01);对照组差异无统计学意义（P>0.05）;治疗后三组比较：有显著差异(P<0.01);两两比较：中药组PR表达升高最明显;③KI-67表达：治疗前后三组组内比较：中药组与西药组Ki-67表达明显下降,有显著差异(P<0.01),对照组差异无统计学意义（P>0.05）;治疗后三组比较：有显著差异(P<0.01);两两比较：中药组Ki-67表达下降最明显。结论：TCRP术后应用中药化瘀散结分期治疗可提升PR表达,抑制Ki-67表达,达到防治子宫内膜息肉复发的治疗效果,值得临床推广。     

域发微针联合红光治疗雄激素性脱发的临床疗效分析

目的 观察域发微针联合红光治疗雄激素性脱发（AGA）的临床疗效。方法 选取2021年1月—2022年6月西南医科大学附属医院皮肤科就诊的90例AGA患者,随机分为微针组（域发微针治疗）、红光组（红光治疗）、联合组（域发微针联合红光治疗）,每组30例。比较各组治疗前后主观症状评分、毛发镜指标;比较各组临床疗效、患者满意度及不良反应。结果 联合组治疗前后油腻、瘙痒、头屑、脱发评分差值的变化程度均高于微针组、红光组（P <0.05）。联合组治疗前后毳毛比例、毛发密度、毛干直径差值的变化程度均高于微针组、红光组（P <0.05）。联合组总有效率、满意度高于微针组、红光组（P <0.0125）。各组脂溢性皮炎、头皮瘙痒、头屑增加、头皮感染、耳后淋巴结肿大、湿疹发生率比较,差异均无统计学意义（P>0.05）。结论域发微针及红光联合治疗AGA可有效改善患者症状,提高临床疗效及满意度,促进毛发生长,增加毛发密度、毛干直径,且安全可靠。     

轴型头皮瓣扩张在修复大面积瘢痕性秃发中的应用及并发症的防治

目的:探索一种新型头皮扩张方法修复大面积瘢痕性秃发,总结减少头皮扩张术并发症发生的方法。方法:应用轴型头皮瓣扩张修复大面积瘢痕性秃发9例。结果:术后形态均满意,无严重并发症发生。结论:经过充分术前设计、防止并发症发生的情况下,扩张轴型头皮瓣是修复大面积瘢痕性秃发较理想的方法。     

Asthma increase among farmers: a 12-year follow-up

Respiratory disease is a well known health hazard for farmers, but the long-term prognosis is less well known. This is a 12-year follow-up of an investigation of Swedish farmers, most of them dairy farmers. A questionnaire was mailed to all 418 farmers who were alive of the farmers originally participating in 1982. They were invited to an interview, spirometry, and blood sampling. Ninety-one per cent (380) of the farmers, 321 men and 59 women, responded to the questionnaire. The mean age was 56 years for the men and 55 years for the women. Of the group, 10% were smokers, 25% ex-smokers, and 65% had never smoked. The population estimate for asthma in the farmers was 8.9% in 1994 compared to 2% in 1982, and to 5.4%–6.6% in the general population in the region in 1982. Of the asthmatic subjects, one-third had positive RAST tests (radioallergosorbent tests). Almost 90% of the new onset asthma cases since 1982 had non-IgE-mediated asthma. Most of the IgE-mediated asthmatics had had symptoms for many years, while 70% of the non-IgE-mediated asthmatic farmers had no or only wheezing with colds 1982. Two new cases of hypersensitivity pneumonitis were identified, and 7.3% had experienced inhalation fever during the last 12 years. In general, individuals with asthma and chronic bronchitis who had left farming were in better health in 1994 as compared to 1982. In conclusion, farmers have an enhanced risk to develop asthma increasing with age. Asthma in farmers is often non-IgE-mediated.     

Sheehan's syndrome presenting as psychosis: a rare clinical presentation

Sheehan''s syndrome (SS) refers to the occurrence of varying degree of hypopituitarism after parturition (1). It is a rare cause of hypopituitarism in developed countries owing to advances in obstetric care and its frequency is decreasing worldwide. However, it is still frequent in underdeveloped and developing countries. Sheehan''s syndrome is often diagnosed late as it evolves slowly (2,3). Reports of psychoses in patients with Sheehan''s syndrome are rare. Herein, a case report of psychosis in a 31 year old woman who developed Sheehan''s syndrome preceded by postpartum haemorrhage is presented. Treatment with thyroxine and glucocorticoids resulted in complete remission after attaining euthyroid and eucortisolemic state.     

乙酸盐预处理对MPTP诱导亚急性帕金森病小鼠的神经保护作用

目的 初步探索乙酸盐(Ace)对1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)诱导亚急性帕金森病小鼠的神经保护作用及可能机制.方法 将24只小鼠随机分为对照组、MPTP组、MPTP+Ace组,每组8只,对照组和MPTP组饮用正常饮用水,MPTP+Ace组饮用水中添加1 mol/L Ace,连续7 d后,MPT...     

帕金森病小鼠模型行为学检测方法的比较研究

目的比较目前常用的5种帕金森病(PD)小鼠模型行为学检测方法在PD研究中的作用。方法用MPTP建立C57BL小鼠PD模型,通过行为学检测(自主活动计数、滚轴实验、游泳实验、爬杆实验、悬挂实验)、免疫组织化学和荧光分光光度法,对比5种行为学检测方法的平均数与变异系数,观察MPTP对PD小鼠模型的行为学、黑质多巴胺(DA)神经元和纹状体酪氨酸羟化酶免疫反应阳性(TH-ir)神经纤维以及纹状体DA水平的影响。结果给与MPTP后,小鼠行为学计数降低,爬杆实验未能得到检测结果,悬挂实验变异系数很高,结果有明显的偶然性,滚轴实验结果变异系数中等,平均数呈现一定的上升趋势,自主活动计数中移动与站立和游泳实验的平均数则呈现明显的下降趋势,变异系数很低,而黑质DA神经元数目减少约58%,纹状体TH-ir神经纤维密度减低,纹状体DA水平明显降低约88%,两组相比差异有显著性(P<0.01)。结论MPTP所致的C57BL小鼠的神经病理、生化改变与PD患者近似,自主活动计数和游泳实验优于其他行为学检测方法。     

口服长压啶治疗男型秃发疗效观察

本文报道口服长压啶治疗男型秃发,采用对照观察的方法,结果长压啶组63例显效率56%;对照组120例显效率20.8%,经统计学处理有显著差异,说明长压啶治疗男型秃发是有效的。     

Frequency of cognitive impairment and depression in Parkinson's disease: A preliminary case-control study

Background:

This study aimed to determine the frequency of cognitive impairment and depression in our Parkinson''s Disease (PD) and their relationship with disease severity and disability.

Patients and Methods:

A total of 40 PD patients and 40 age-, sex-, and educationally matched controls were studied. The Unified Parkinson Disease Rating Scale (UPDRS) Motor and Activities of Daily Living (ADL) scores and the Hoehn and Yahr (HY) stage were documented. Depression was assessed using the Zung Self-Rating Depression Scale (ZSDS), while cognition was evaluated using a composite score of the mini-mental state examination (MMSE) score and category fluency score.

Results:

A total of 55% (22/40) of PD and 10% (4 of 40) of controls had depression (P<0.001). A total of 60% of PD (24/40) and 5% of controls (2/40) had cognitive impairment (P<0.001). Both NMS coexisted in 16 of 40 PD (40%) compared with none of the controls (P<0.001). UPDRS (motor and ADL) scores and HY stage were significantly worse with impaired ZSDS scores - P 0.001. UPDRS ADL was significantly impaired by the presence of cognitive impairment. Coexisting depression and cognitive impairment were associated with significant worsening of all scores of severity and disability.

Conclusion:

Cognitive impairment and depression accompany our PD and are related to disability and worsening disease severity.     

Parkinson's disease and primate research: past, present, and future

Scientific research involving non-human primates has contributed towards many advances in medicine and surgery. This review discusses its role in the progress made towards our understanding of Parkinson's disease and its treatment. Established medical treatments like dopamine agonists continue to need primate models to assess their efficacy, safety, and mechanism of action. The recently developed treatment of deep brain stimulation of the subthalamic nucleus required validation in primates before entering the clinic. Controversies surrounding future treatments such as gene therapy show the need for properly evaluated preclinical research using appropriate animal models before progression to clinical trials. Research on primates has played--and continues to play--a crucial part in deepening our understanding of Parkinson's disease, improving current therapies, and developing new treatments that are both safe and effective. In animal research, the "three Rs" of humane technique--reduction, refinement, and replacement--should be adhered to.