芪龙通络汤内服配合灌肠治疗血瘀证输卵管阻塞性不孕症疗效观察

目的：观察芪龙通络汤内服配合灌肠治疗血瘀证输卵管阻塞性不孕症的临床疗效。方法：将100例患者随机分为治疗组和对照组各50例,治疗组采用芪龙通络汤配合灌肠治疗,对照组单纯采用灌肠治疗。观察2组的疗效及患者的卵巢动脉血流情况。结果：临床疗效总有效率、中医证候疗效总有效率治疗组均优于对照组,差异均有显著性意义（P〈0.05）。治疗前后治疗组卵巢动脉血流搏动指数、阻力指数改善显著,与治疗前比较,差异有显著性意义（P〈0.05）;与对照组比较,差异有显著性意义（P〈0.05）。结论：芪龙通络汤内服配合灌肠对血瘀证型输卵管阻塞性不孕症有显著的治疗作用。     

温针灸配合内服中药治疗膝关节骨关节炎38例疗效观察

目的：观察温针灸配合内服中药治疗膝关节骨关节炎的临床疗效。方法：将76例符合膝骨关节炎诊断标准的患者按就诊顺序随机分为治疗组38例（温针灸配合内服中药）、对照组38例（温针灸配合口服布络芬缓释胶囊）,两组均治疗2个疗程,治疗结束后采用关节主症疼痛量表（VAS）、膝关节骨关节炎严重性指数（ISOA）量表评估临床疗效。结果：2组患者治疗后关节疼痛、严重性指数的改善均明显优于治疗前（P〈0．01）、治疗后治疗组止痛效果、病情严重性指数的变化均优于对照组（P〈0．05）。治疗组临床基本痊愈率为42．1％,对照组临床基本痊愈率为28．9％,两组疗效比较差异有显著性意义（P〈0．05）。结论：温针灸配合内服中药治疗膝关节骨关节炎的临床疗效优于温针灸配合口服布络芬缓释胶囊。     

针灸配合中药治疗输卵管阻塞性不孕症临床研究

目的观察针灸配合中药活血化瘀综合疗法治疗输卵管阻塞性不孕症的临床效果。方法将输卵管性不孕症200例患者随机分为2组,各100例。治疗组采用针灸同时配合口服活血化瘀中药、灌肠及外敷联合的方法治疗;对照组采用单一西药通管治疗。观察并记录治疗前后输卵管通畅情况,随访并记录患者3个月、6个月、1a、2a内的妊娠率。结果输卵管改善情况治疗组6个月总有效率为90％,对照组为68％。2组比较有显著性差异（P〈0．05）。治疗组妊娠率65％,对照组妊娠率38％,2组比较有显著性差异（P〈0．05）。治疗组腹痛、经量、经色、舌苔、脉象等症状改善情况较对照组更为明显。结论针灸配合中药治疗输卵管阻塞性不孕症有良好疗效,能提高受孕率。     

化瘀通管汤配合直肠滴注给药治疗输卵管阻塞性不孕症74例临床观察

目的：观察中药内服配合直肠滴注给药治疗输卵管阻塞性不孕症的疗效。方法：150例输卵管阻塞性不孕症患者随机分为中药组74例和西药组76倒，中药组以化癞通管汤内服配合直肠滴注给药，西药组使用抗生素配合微波治疗，观察比较两组有效率。结果：中药组总有效率为81．08％，西药组为40．79％。结论：两组治疗后总有效率比较P〈0．01，有非常显著的统计学意义，证明中药内服配合直肠滴注联合应用效果显著，值得临床推广应用。     

中西医结合治疗输卵管阻塞性不孕128例

目的 观察中西医结合治疗输卵管阻塞性不孕症的疗效。方法 输卵管阻塞性不孕症160例随机分两组，治疗组128例，以中药坤复康胶囊口服配合输卵管通液治疗，对照组32例仅做输卵管通液治疗。结果 治疗组治愈72例，治愈率56．25％，总有效率78．13％，与对照组比较有显著性差异（P〈0．01）。结论 坤复康胶囊内服配合输卵管通液治疗输卵管阻塞性不孕，疗效优于单纯输卵管通液治疗，值得进一步研究。     

中西医结合治疗梗阻性输卵管不孕症94例临床观察

目的：观察中药内服灌肠配合通液术治疗梗阻性输卵管不孕症的临床疗效。方法：选符合标准的梗阻性输卵管不孕症患者188例，随机分为治疗组及对照组各94例。治疗组予中药口服灌肠并配合输卵管通液术。对照组单纯采用输卵管通液治疗。结果：治疗组治愈69例，有效14例，无效11例，总有效率为88．3％（95％CI=81．8％～94．8％）；对照组治愈43例，有效22例，无效29例，总有效率为69．1％（95％CI=59．8％～78．4％）；两组综合疗效比较，差异有显著性（u=3．5053，P=0．0007）；且两组总有效率的95％CI范围不重叠。结论。中药内服、灌肠配合通液术治疗梗阻性输卵管不孕症临床疗效优于单纯通液治疗。其收益OR=0．30（959≤CI=0．14～0．64），NNT=5（95％CI=3．2～13．4）。     

中药内服加通液术治疗输卵管阻塞不孕症92例

输卵管阻塞是导致不孕症的常见病因之一,临床疗效欠佳。我们采用自拟中药通管汤内服配合复方丹参注射液等药物进行输卵管灌注疗法治疗输卵管阻塞性不孕９２例,取得了较好的效果,现报道如下。１临床资料 １９９４－１９９９年对我院收治的１３１例输卵管阻塞不孕者进行前瞻性研究,全部病例随机分为两组。１３１例患者均经输卵管造影或２次输卵管通液以上证实,双侧输卵管阻塞者１０３例,单侧输卵管阻塞者２８例;全部病例均确诊为输卵管炎及炎症引起的不孕,并排除其他不孕因素。中药通管汤内服配合复方丹参注射液宫腔灌注组（中药组）…     

疏管灵治疗输卵管阻塞性不孕52例临床观察

目的 观察疏管灵治疗输卵管阻塞性不孕症的临床疗效并探讨其作用机理.方法 将确诊为输卵管阻塞性不孕的患者随机分3组,每组各52例.治疗组用疏管灵内服加灌肠治疗;对照组甲服血府逐瘀口服液,配合康妇消炎栓直肠给药;对照组乙服血府逐瘀口服液,配合阴道穹窿穿刺给药.3个月后评价疗效,同时检测治疗组用药前后盆腔血流、血液黏度及血浆胶原酶、血浆纤维蛋白原及纤溶活性.结果 治疗组输卵管的通畅率、妊娠率明显优于两对照组(P＜0.01).治疗组用药前后子宫左侧动脉最大流速、卵巢左侧动脉搏动指数及阻力指数、右侧阻力指数显著升高(P＜0.05);血浆胶原酶、纤维蛋白原及纤溶活性差异均有显著性(P＜0.05);全血黏度、血浆比黏度、红细胞压积均显著降低(P＜0.05).结论 疏管灵能改善盆腔血流,降低血液黏度,提高血浆纤维蛋白溶解活性和胶原酶活性,消除炎性组织粘连,促进炎症的吸收,是治疗输卵管阻塞性不孕症的理想药物.     

中药结合介入治疗输卵管阻塞性不孕症49例

目的：巩固输卵管再通术的疗效，提高不孕症的妊娠率。方法：将92例输卵管阻塞性不孕症患者随机分为试验组49例和对照组43例。试验组术后用中药内服外敷治疗，对照组单纯行介入再通术，不予中药治疗。观察术后24个月宫内妊娠情况。结果：试验组妊娠率46．94％，对照组妊娠率34．88％，两组疗效有显著性差异（P〈0．05）。结论：输卵管再通术后配合中药内服、外敷，利于保持输卵管畅通，提高妊娠率。     

慢性盆腔炎中药治疗前后盆腔血流动力学分析

目的探讨盆腔血流动力学作为慢性盆腔炎中药疗效分析的客观指标。方法60例慢性盆腔炎患者,采用自拟方盆炎平治疗30天,治疗前后在月经干净3～7天后用彩色多普勒超声诊断仪观察血流动力学变化。结果治疗后卵巢左侧动脉搏动指数及阻力指数,右侧阻力指数,子宫左侧动脉最大流速和时间流速积分改善,与治疗前比较,差异有显著性（P〈0．05）。结论盆腔血流动力学可为中药活血化瘀、清热解毒法治疗慢性盆腔炎的疗效评定提供一个客观指标。     

OBSERVATION ON CLINICAL THERAPEUTIC EFFECT OF MRI-AIDED ENCLOSURE NEEDLING IN THE TREATMENT OF STROKE AND ITS INFLUENCE ON BLOOD RHEOLOGY

Objective: To observe clinical therapeutic effect of magnetic resonance imaging (MRl)-aided enclosure needling in the treatment of stroke patients and changes of the related blood rheology. Methods: A total of 61stroke patients were randomized into MR I-aided enclosure needling group (MRI-aided acupuncture group) (n = 31 ) and conventional acupuncture group (n= 30). For patients of MRl-aided acupuncture group, acupuncture needles were inserted into the subcutaneous tissues around the focus-projection scalp area displayed by MRI, with the needle tips toward the center of the projection region and with two needles being about 2 crn apart, combined with other acupoints according to the concrete syndromes or symptoms. For patients of conventional acupuncture group, Motor Area (MS 6)and Sensory Area (MS 7) on the contralateral side of the focus were punctured. The treatment was conducted once daily, continuously for 30 days. Results: After treatment, of the 31 cases in MRl-aided acupuncture group, 20 werecured basically, 10 responded with significant improvement of symptoms and signs, one case had some improvement.While in conventional acupuncture group, of the 30 cases, 11 were cured basically, 15 responded with striking amelioration of symptoms and signs and 4 had some amelioration. Ridit analysis showed that the therapeutic effect of MRI-aided acupuncture group was significantly superior to that of conventional acupuncture group (P ＜ 0.05). After treatment,the whole blood viscosity, plasma viscosity, hematocrit, whole blood reduction viscosity, hemagglutination index, and the total score of the two groups all decreased significantly in comparison with those of pre-treatment of each group,while whole blood viscosity, hematocrit, vascular sclerosis index and the total score of MRl-aided acupuncture group were obviously lower than those of conventional acupuncture group ( P＜ 0.05- 0.01 ), suggesting that the effect of theformer group in bettering blood rheology was pronouncedly superior to that of conventional acupuncture group. Conclusion: MRl-aided acupuncture group is obviously superior to that of conventional acupuncture group in improving clinicalsymptoms and signs and blood rheology in stroke patients.     

Effects of different directions of moxibustion therapy on hemorheology in rats with blood stasis due to cold retention

Objective

To investigate the effects of different directions of moxibustion therapy on hemorheology in rat models with blood stasis due to cold retention.

Methods

A total of 32 Wistar rats were randomly divided into 4 groups, based on the random digits table, including a normal group, a model group, a moxibustion along the meridian group, and a moxibustion against the meridian group, with 8 rats in each group. Except the normal group, the other 3 groups were used to make the rat models with blood stasis due to cold retention. Rats in the moxibustion along and against the meridian groups accepted moxibustion therapy in different directions on the trunk segment of the Bladder Meridian after successful modeling. Moxibustion for 10 min every day, and 7 d as a course of treatment. Two courses of treatment (a total of 14 d) were carried out. Quantitative score of signs and symptoms change was observed once a week, with a total of 7 times. Hemorheological indexes of rats were detected when the treatment finished.

Results

The quantitative scores of signs and symptoms in the model, moxibustion along the meridian and against the meridian groups were significantly higher than those in the normal group after modeling (P<0.05). When the treatment finished, the quantitative score of signs and symptoms in the model group was significantly higher than that in the normal group (P<0.05); the quantitative scores of signs and symptoms of rats in the moxibustion along and against the meridian groups were significantly lower than that in the model group (P<0.05); the quantitative score of signs and symptoms in the moxibustion along the meridian group was significantly lower than that in the moxibustion against the meridian group (P<0.05); the whole blood viscosity and erythrocyte aggregation index in the model group were significantly higher than those in the normal group (P<0.05), however the increases of erythrocyte hematocrit and erythrocyte sedimentation rate were not obvious (P>0.05); whole blood viscosity and erythrocyte aggregation index in the moxibustion along and against the meridian groups were significantly lower than those in the model group (P<0.05), while there were no statistically significant differences between the moxibustion along the meridian group and moxibustion against the meridian group (P>0.05).

Conclusion

Moxibustion along and against the meridian both showed different degrees of improvement for hemorrheology and symptoms of blood stasis due to cold retention. Improvement for symptoms of blood stasis due to cold retention was better in the moxibustion along the meridian group than that in the moxibustion against the meridian group. The influence on rat hemorrheology showed no significant difference between moxibustion along the meridian and moxibustion against the meridian.

     

热敏灸治疗血管性痴呆的疗效及作用机制探讨

目的:观察热敏灸治疗血管性痴呆的疗效并探讨其作用机制.方法:将70例血管性痴呆(VD)患者随机分为观察组和对照组,每组35例.对照组予吡拉西坦治疗,观察组在对照组基础之上加用热敏灸治疗.共治疗8周.治疗前后进行简易精神状态量表(MMSE)、日常生活能力(ADL)量表及中医证候评分,测定患者血浆乙酰胆碱(Ach)和同型半胱氨酸(Hcy)水平,并于治疗后进行疗效评价.结果:观察组有效率明显高于对照组(P<0.05).治疗后,观察组患者的MMSE评分及ADL评分均明显降低,且低于对照组(均P<0.05);观察组的中医证候评分明显降低(P<0.05),对照组评分变化不显著(P>0.05);观察组血浆Ach水平明显升高(P<0.05),Hcy水平明显降低(P<0.05),且观察组血浆Ach和Hcy水平与对照组均有统计学差异(均P<0.05).结论:热敏灸加吡拉西坦治疗VD疗效确切,能显著改善患者痴呆症状,提高患者生活自理能力,可能与纠正血浆Ach和Hcy水平有关.     

日常天灸与三伏天灸对阳虚质哮喘患者的疗效及体质影响的研究

目的:观察日常天灸与三伏天灸治疗阳虚质支气管哮喘的疗效及其对患者体质的影响。方法:选取2014年5月至2016年10月期间在广州新海医院中医科门诊就诊的支气管哮喘,处于慢性持续期或临床缓解期的患者63例,其中日常组32例,三伏组31例,分别于"三伏天"以外的日常时间和"三伏天"进行天灸贴药治疗,2组所用药物及选穴均相同,贴药3次为1个疗程;观察2组治疗前、后哮喘症状评分、哮喘控制评分(ACT)、阳虚体质转化分数的变化。结果:1)2组均取得良好的疗效,2组疗效比较差异无统计学意义(P0.05);2)2组的哮喘症状评分、ACT评分治疗前后组内比较差异均有统计学意义(P0.05),治疗后组间比较差异无统计学意义(P0.05);3)2组的阳虚体质转化分数治疗后均有明显改善,三伏组的改善优于日常组,差异有统计学意义(P0.05)。结论:日常天灸与三伏天灸均能有效治疗阳虚体质哮喘,且疗效相当,但三伏天灸在改善阳虚体质方面要优于日常天灸。     

活血通络汤治疗痰瘀阻络型缺血性脑卒中临床研究

目的:探讨活血通络汤治疗痰瘀阻络型缺血性脑卒中的临床疗效和安全性。方法:选取82例痰瘀阻络型缺血性卒中患者作为研究对象,按照其治疗方法分为对照组40例和观察组42例,对照组予以常规西药治疗,观察组患者在对照组治疗基础上予以活血通络汤治疗,两组患者均治疗2周,治疗结束后比较两组患者临床疗效、中医症候积分、神经功能、日常生活能力、血液流变学指标水平及不良反应。结果:经治疗2周后,观察组患者临床治疗总有效率为97.62%,显著高于对照组临床总有效率82.50%(P<0.05); 两组患者治疗前中医症候积分、NIHSS及BI评分比较,差异无统计学意义,治疗后两组患者中医症候积分和NIHSS评分均较治疗前下降,而BI评分显著上升,但治疗后观察组患者中医症候积分和NIHSS评分下降和BI评分上升程度均显著高于对照组患者(P<0.05); 两组患者治疗前全血高切黏度、全血低切黏度、纤维蛋白原及血浆黏度水平比较,差异无统计学意义,治疗后两组患者全血高切黏度、全血低切黏度、纤维蛋白原及血浆黏度水平均较治疗前明显下降,但治疗后观察组患者血液流变学指标水平均低于对照组患者,差异有统计学意义(P<0.05); 两组患者均未出现不良事件。结论:活血通络汤可提高痰瘀阻络型缺血性脑卒中患者临床疗效,改善其症状体征、神经功能及血液状态,提高日常活动能力。     

肺心胶囊治疗肺心病患者60例

目的:探讨肺心胶囊对慢性肺源性心脏病(CPHD)患者的治疗效果及作用机制。方法:将120例患者随机分为治疗组和对照组,每组60例,两组均给予西医常规治疗,治疗组在此基础上以肺心胶囊口服,每次4粒,每日3次,2个月后观察两组患者的主要症状、体征及并发症,测定患者的血气分析及血液流变学指标。结果:治疗组总有效率91.67%,显著优于对照组80.00%(P<0.05);治疗后两组患者主要症状体征消失或减轻,但治疗组改善明显优于对照组(P<0.01或P<0.05);治疗后两组患者氧分压(PaO2)均提高,CO2分压(PaCO2)均降低,治疗组在改善缺O2、纠正CO2潴留等方面均优于对照组(P<0.01或P<0.05);两组的血液黏度、血浆黏度及红细胞压积与治疗前比较均有下降(P<0.01或P<0.05),治疗组改善明显优于对照组(P<0.05)。结论:肺心胶囊治疗CPHD效果确切,临床应用安全,不良反应少,值得临床推广应用。     

隔姜灸配合针刺治疗寒凝血瘀型原发性痛经的疗效分析

目的:观察隔姜灸配合针刺治疗原发性寒凝血瘀型痛经的临床疗效,并进行总结分析。方法:将符合纳入标准的原发性痛经(Primary Dysmenorrhea,PD)患者,随机分为观察组(50例)与对照组(50例)。观察组进行隔姜灸(关元、神阙、气海、双侧子宫)配合针刺(三阴交、合谷、内关)进行治疗,对照组口服双氯酚酸钠肠溶片(北京诺华制药有限公司生产,国药准字H11021640),25 mg/12 h;观察两组有效率、疼痛视觉模拟评分量表(Visual Analogue Scale,VAS)评分、前列腺素(Prostaglandin,PG)F2a、全血粘度及血浆粘度。结果:两组患者评价即时有效率,差异无统计学意义(P>0.05),VAS评分P>0.05;治疗结束后评价近期有效率,差异具有统计学意义(P<0.05),治疗后PGF2a均下降,变化幅度有差异(P<0.05);全血粘度及血浆粘度治疗后对比,P<0.05;随访结束后评价远期有效率,差异具有显著统计学意义(P<0.05),VAS评分,P<0.05。结论:隔姜灸配合针刺治疗寒凝血瘀型原发性痛经获得良好的临床效果,治疗过程安全,可推广应用。     

艾灸及艾烟对载脂蛋白E基因敲除小鼠血清MDA、SOD水平的影响

目的:观察艾灸及艾烟对载脂蛋白E基因敲除(Apolipoprotein E-deficient,Apo E~(-/-))小鼠氧化应激相关指标的影响。方法:38只8周龄Apo E~(-/-)小鼠随机分为5组:模型组(n=6)、假艾灸组(n=6)、香烟组(n=8)、艾烟组(n=9)、艾灸组(n=9),13只同龄C57BL/6小鼠作为正常对照,正常组与模型组小鼠暴露于玻璃缸中,艾灸与假艾灸组均对小鼠关元穴进行艾灸,假艾灸组艾条不点燃,艾烟组小鼠暴露于10~15 mg/m3的艾烟环境,香烟组小鼠暴露于10~15 mg/m3的香烟环境,各组小鼠每天干预20 min,连续干预12周,每周干预6 d,于12周末检测小鼠血清氧化应激指标丙二醛(Malondialdehyde,MDA)、超氧化物歧化酶(Superoxide Dismutase,SOD)的表达水平。结果:艾灸组及艾烟组血清MDA含量较模型组显著降低(P0.05),且艾灸组显著低于假艾灸组(P0.05),艾烟组显著低于香烟组(P0.05)。艾灸组及艾烟组血清SOD含量较模型组显著升高(P0.05),艾灸组显著高于假艾灸组(P0.05),艾烟组显著高于香烟组(P0.05)。结论:艾灸和艾烟是通过调节机体MDA、SOD水平,发挥抗氧化作用,保护血管内皮改善AS。     

温针灸对脑梗死恢复期气虚血瘀型患者炎性因子、神经因子及高凝状态的影响

目的:探讨温针灸在脑梗死恢复期气虚血瘀型患者治疗中的应用价值,观察其对炎性因子及神经因子的影响。方法:将脑梗死恢复期气虚血瘀型的90例患者纳入研究,用随机数字表法分组。对照组45例采用西医治疗,观察组45例温针灸联合西药,治疗4周后比较疗效。结果:治疗后观察组血浆IL-1β、Hcy、PAF低于对照组,相比较差异有统计学意义(P<0.05)。治疗后观察组血浆BDNF、VEGF高于对照组(P<0.05)。治疗后观察组全血低切黏度、全血高切黏度、纤维蛋白原均低于对照组(P<0.05)。治疗后2周、4周时观察组NIHSS评分低于对照组(P<0.05)。观察组总有效率93.33%,高于对照组的75.56%,差异有统计学意义(P<0.05)。观察组不良反应总发生率24.44%,对照组22.22%,组间比较差异无统计学意义(P>0.05)。结论:对于脑梗死恢复期气虚血瘀型患者而言联合温针灸可减轻炎症反应,保护神经功能,促进侧支循环形成。     

崇明地区急性脑梗死患者中医辨证分型特点及与血黏度的相关性

目的:观察崇明地区急性脑梗死(ACI)中医各证型中的分布特点,探讨各证型与血黏度的关系.方法:314例ACI患者,按照中医辨证分型标准分为风火上炎证、风痰瘀阻证、痰热腑实证、气虚血瘀证和阴虚风动证,计算各组所占的比例,人院第2天进行血黏度水平测定.结果:ACI患者中风痰瘀阻证117例、气虚血瘀证76例,分别占总人数的37.3％,24.2％,明显高于其他各组(P＜0.05).各证型中血黏度水平与对照组比较,均有显著性差异(P ＜0.05或P＜0.01),其中风痰瘀阻、气虚血瘀为主的证型与其他各组比较,差异尤为明显(P＜0.05).结论:崇明地区ACI中医分型以风痰瘀阻证,气虚血瘀证为主,血黏度可作为ACI风痰瘀阻、气虚血瘀分型研究的客观依据.