调肝运脾化浊方联合电针治疗非酒精性脂肪肝

目的 观察调肝运脾化浊方联合电针治疗非酒精性脂肪肝的临床疗效.方法 将非酒精性脂肪肝的120例患者随机均分为对照组和治疗组,各60例.对照组予多烯磷脂酰胆碱胶囊口服,每次456 mg,每日3次;治疗组予调肝运脾化浊方汤药口服,并配合电针治疗.12周为1个疗程,1个疗程后观察中医证候积分、主要临床症状积分、肝脏酶谱指标、血脂检测指标、肝/脾CT比值、生存质量评分的变化.结果 疗程结束后,治疗组临床疗效总有效率(86.7％,52/60)优于对照组(73.3％,44/60)(P＜ 0.05);治疗组中医症状总积分以及主要中医症状积分改善均较对照组明显(P＜ 0.05);与对照组比较,治疗组ALT、AST、GGT、TBil、TC、TG、LDL-C水平均明显降低,HDL-C水平明显升高,治疗组肝/脾CT比值好转明显优于对照组(P＜0.05);治疗组生存质量评分改善程度优于对照组(P＜0.05).结论 调肝运脾化浊方联合电针治疗非酒精性脂肪肝具有显著疗效.     

痛风方治疗急性痛风性关节炎的临床研究

目的 探讨痛风方治疗急性痛风性关节炎的疗效.方法 将151例急性痛风性关节炎患者分为治疗组和对照组,对照组服用美洛昔康片,治疗组服用痛风方,疗程均为1周.结果 两组总有效率差异无统计学意义（P＞0.05）;治疗后两组各实验室指标均较治疗前下降,且治疗组较对照组下降明显（均P＜0.05）;治疗1周后两组各主要症状积分均低于治疗前,且治疗组疼痛积分低于对照组（均P＜ 0.05）,关节功能及全身症状积分亦低于对照组（均P＜ 0.05）.治疗组未发生药物不良反应;对照组出现25例胃脘部不适,5例肝功能损害,1例急性间质性肾炎,3例皮疹.结论 痛风方治疗急性痛风性关节炎疗效显著,安全可靠.     

调中消痞汤治疗功能性消化不良60例疗效观察

目的 观察调中消痞汤治疗功能性消化不良的临床疗效.方法 将120例功能性消化不良患者随机分为2组,对照组60例采用多潘立酮治疗,治疗组60例采用中药调中消痞汤治疗.2组均以2周为1个疗程,1个疗程后比较2组的临床疗效及主要症状积分.结果 治疗组痊愈率为56.67％,总有效率为93.34％;对照组痊愈率为43.33％,总有效率为83.33％.2组痊愈率及总有效率比较,差异有统计意义(P＜0.05),表明治疗组临床疗效显著优于对照组.治疗后2组患者主要症状积分均较同组治疗前显著下降(P＜0.05或P＜0.01);治疗组餐后饱胀、上腹痛、嗳气、食欲不振的改善程度尤为显著,与对照组比较,差异有统计意义(P＜0.05).结论 调中消痞汤治疗功能性消化不良临床疗效显著,可明显改善患者的临床症状.     

益肾调肝方治疗乳腺癌患者类更年期综合征肝肾阴虚证的临床研究

目的观察益肾调肝方对乳腺癌患者类更年期综合征证候群的治疗作用及安全性。方法将60例符合入选标准的乳腺癌患者,随机分为治疗组和对照组。治疗组予益肾调肝方口服,对照组予更年安胶囊口服。比较两组病人更年期综合征症状积分、临床主症症状积分、生活质量、雌激素水平、卵泡刺激素水平以及药物不良反应等指标。结果治疗组与对照组在治疗后更年期综合征症状、临床主症、生活质量改善方面均优于治疗前(P<0.05),但治疗组效果优于对照组(P<0.05);治疗组在临床主症的改善方面以潮热汗出、烦躁易怒尤为明显,改善率分别为96.67%和93.33%;两组患者治疗前后雌激素及卵泡刺激素水平均无明显变化(P>0.05)。两组治疗前后白细胞、血小板、血红蛋白计数比较均无统计学差异(P>0.05),两组均未出现明显肝肾功能、心电图方面异常。结论益肾调肝方治疗乳腺癌合并类更年期综合征疗效肯定,无明显不良反应。     

百岁方颗粒剂对脑梗死患者认知功能障碍的干预作用

目的:探讨百岁方颗粒剂对脑梗死患者认知功能障碍的干预作用.方法:选择脑梗死患者160例,随机分为治疗组80例,对照组80例,分别服用百岁方及尼莫地平,疗程为2个月.观察治疗前后患者的简易智力状态检查表(MMSE)、中医症状、神经功能缺损中国中风量表(CSS)的积分改变及血液流变学、纤维蛋白原等各项指标.结果:临床观察表明,百岁方能提高脑梗死患者MMSE积分,降低中医症状积分,降低CSS积分,改善血液流变学.两组中医症状疗效比较,治疗组总有效率为76.25%,对照组总有效率为58.75%,治疗组明显优于对照组(P＜0.05);治疗组的中医症状积分、CSS积分、血黏度高切均优于对照组(P＜0.01).结论:百岁方颗粒剂是改善脑梗死患者认知功能的有效中药制剂.     

清热利胆解毒方联合驱铜治疗对Wilson病患者神经系统症状及肝纤维化指标的影响

目的 观察清热利胆解毒方联合驱铜治疗对Wilson病患者神经系统症状及肝纤维化指标的影响.方法 80例Wilson病患者随机分为清热利胆解毒方中药联合西药治疗组(观察组)和西药治疗对照组(对照组),共治疗62 d.观察两组治疗前后神经系统症状积分、24h尿铜及肝纤维化指标变化.结果 2组患者治疗后神经系统症状积分、24 h尿铜均有显著改善(P＜0.01),观察组改善较对照组更为明显(P＜0.05);2组患者肝纤维化指标治疗前后无变化(P＞0.05).结论 清热利胆解毒方能明显改善Wilson病患者神经系统症状及降低24 h尿铜水平.     

清热化痰运脾消积法治疗小儿急性支气管炎痰热夹滞证30例

目的 观察清热化痰、运脾消积法治疗小儿急性支气管炎痰热夹滞证的临床疗效。方法 将60例急性支气管炎痰热夹滞证患儿随机分为治疗组与对照组,每组各30例。治疗组采用清金化痰汤加运脾之品临证化裁治疗,对照组予小儿消积止咳口服液治疗,连续治疗7 d。结果 治疗组临床疗效明显优于对照组（P＜0.05）。治疗组在改善咳嗽、咳痰、肺部啰音、不思乳食、腹胀腹痛、口干口渴、口臭、大便不调和脉象方面明显优于对照组（P<0.05）。两组治疗后主症积分、次症积分、症状总积分均较治疗前明显降低（P＜0.05）,治疗组治疗后主症积分、次症积分、症状总积分下降值显著大于对照组（P＜0.05）。结论 清热化痰、运脾消积法治疗小儿急性支气管炎痰热夹滞证疗效确切。     

补肾调肝方治疗黄体功能不全性不孕50例的体会

目的:观察补肾调肝方治疗黄体功能不全性不孕(肾虚型)的临床疗效.方法:将50例本病患者分为两组:治疗组30例,用补肾调肝方治疗;对照组20例,单纯用补肾方治疗；观察2组治疗前后的疗效情况.结果:治疗组的总有效率为93.4％,对照组的总有效率为85.0％,治疗组和对照组比较,差异有显著性意义(P＜0.05).结论:补肾调肝方和补肾方对提高患者黄体功能均有明显疗效,但补肾调肝方在改善临床症状方面明显优于补肾方.     

健脾温肾法治疗腹泻型肠易激综合征40例

目的评价健脾温肾法治疗腹泻型肠易激综合征(IBS-D)脾肾阳虚证的临床疗效和安全性。方法 80例符合纳入标准的IBS-D患者随机分为治疗组40例和对照组40例,治疗组服用中药温补脾肾方,对照组服用得舒特治疗,2组服药时间均为4周。观察并记录治疗前后IBS-D症状、体征积分变化以及治疗前后相关检验指标的变化。结果在总有效率及愈显率方面,治疗组优于对照组(P0.01)。2组治疗后症状总积分较治疗前均显著下降(P0.01),治疗组治疗后症状总积分改善明显优于对照组(P0.01)。治疗组在远期疗效方面明显优于对照组(P0.01)。治疗组及对照组治疗后均未出现任何不良反应,2组患者治疗前后分别检测血常规、尿常规、粪常规及ALT、BUN、Scr水平均未发现异常。结论健脾温肾法治疗IBSD临床疗效显著,具有良好安全性。     

泄浊解毒方联合美沙拉嗪治疗溃疡性结肠炎90例临床疗效观察

目的观察泄浊解毒方联合美沙拉嗪治疗溃疡性结肠炎(UC)的临床疗效。方法将90例UC患者随机分为治疗组和对照组,每组45例。对照组口服美沙拉嗪肠溶片治疗,治疗组采用泄浊解毒方联合美沙拉嗪口服,美沙拉嗪服用方法与对照组相同。观察两组治疗前后的临床症状、腹痛程度、大便次数、肠镜表现、血清白细胞介素1β(IL-1β)、白细胞介素10(IL-10)、血常规及肝、肾功能情况。结果治疗后,治疗组临床症状改善及肠镜表现均优于对照组(P 0. 05),治疗组大便次数及腹痛积分均低于对照组(P 0. 05)。治疗组患者治疗后IL-1β及IL-10水平较对照组改善明显,差异均有统计学意义(P 0. 05)。两组血常规及肝、肾功能治疗前后均未见异常。结论泄浊解毒方联合美沙拉嗪治疗UC疗效显著,且安全性好,值得临床推广。     

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.     

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…     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.