中医辨证维持治疗晚期结直肠癌的临床研究

目的评价中医辨证在晚期结直肠癌维持期的疗效。方法将符合晚期结直肠癌维持治疗诊断标准的120例患者随机分为中药组60例和卡培他滨组各60例。卡培他滨组按照每日总剂量（常规用量每日2000mg／m2）分早晚各1次饭后0．5h吞服,连用2周间隔1周。中药组以“证素”为基础,参考《大肠癌病证规律及中医证素诊疗规范化探讨》进行中医辨证汤剂治疗。2组均持续用药至肿瘤进展或出现无法耐受的不良反应为止。结果中药组的中位无疾病进展时间（PFS）为5．4个月,卡培他滨组中位PFS为2个月,2组比较差异有统计学意义（P=0．021〈0．05）;与卡培他滨组比较,中药组可以明显提高晚期结直肠癌患者的NK细胞及CD4／CD8（P〈0．05）,可以明显改善患者的卡氏评分（P〈0．01）。结论中医辨证维持治疗具有延长患者PFS、改善免疫功能、提高生活质量的作用。     

滋补汤联合卡培他滨维持治疗一线化疗后气血两虚证晚期结直肠癌的研究

目的观察滋补汤联合卡培他滨维持治疗一线化疗后气血两虚证晚期结直肠癌的疗效。方法将135例一线化疗后气血两虚证晚期结直肠癌患者随机分为3组,中西医结合组45例给予滋补汤联合卡培他滨治疗,中药组45例仅给予滋补汤治疗,对照组45例给予卡培他滨维持治疗。3组持续用药至肿瘤进展或出现无法耐受的不良反应为止。评估3组治疗前及治疗2个月后中医症状评分,治疗2个月后中医症状疗效及生活质量,统计3组无进展生存期(PFS)、疾病控制期(DDC)及毒副反应发生情况。结果中西医结合组和中药组治疗后中医症状评分明显低于治疗前及对照组(P均<0.05),生活质量提高比例明显高于对照组(P均<0.05);中西医结合组PFS时间明显长于中药组和对照组(P均<0.05),但3组DDC及不良反应发生情况比较差异均无统计学意义(P均>0.05)。结论滋补汤联合卡培他滨维持治疗气血两虚证晚期结直肠癌患者,能改善临床症状,提高生活质量,延长PFS。     

晚期结直肠癌辨证中药维持性治疗的临床观察

目的 观察对晚期结直肠癌患者应用辨证中药进行维持治疗的临床疗效.方法 选择2009年1月-2010年12月北京中医医院肿瘤科门诊及住院且应用中药及卡培他滨作为维持治疗的晚期结直肠癌患者40例.按照服药情况分为中药组22例,卡培他滨组18例.回顾性分析患者的治疗情况,对比患者治疗前后疾病的进展时间、功能状态评分、中医症状...     

康力欣胶囊联合辨证中药维持治疗晚期结直肠癌的临床观察

目的:评价康力欣胶囊联合辨证中药维持治疗晚期结直肠癌的疗效和安全性。方法:对69例经过一线标准治疗后达到完全缓解、部分缓解或稳定的晚期转移性结直肠癌患者,采用区组随机化方法,将符合标准患者按1∶1比例分为治疗组与对照组,其中治疗组(35例)应用康力欣胶囊联合辨证中药维持治疗,对照组(34例)单用辨证中药维持治疗,观察患者无进展生存期及生活质量变化。结果:治疗组和对照组的中位无疾病进展生存期(Progression Free Survival,PFS)分别为7个月和5个月,治疗组无疾病进展生存时间优于对照组(P=0.023)。结论:对于晚期结直肠癌患者,康力欣胶囊维持治疗能延长患者PFS,辨证中药联合康力欣胶囊口服可作为晚期结直肠癌维持治疗选择之一。     

当归补血汤联合卡培他滨节拍化疗治疗高龄晚期结直肠癌

目的探讨当归补血汤(Danggui Buxue Decoction,DBD)联合卡培他滨节拍化疗(Metronomic Chemotherapy)治疗高龄晚期结直肠癌的临床疗效及其对血清二胺氧化酶(DAO)水平的影响。方法选取2015年1月—2018年1月我科住院治疗的高龄晚期结直肠癌患者共41例,采用随机分组方法分为两组,当归补血汤联合卡培他滨节拍化疗组(DBD加MCG)21例,给予当归补血汤(当归6 g,黄芪30 g)和卡培他滨500 mg,日2次口服,28 d为1周期。卡培他滨组(MCG)20例,仅给予卡培他滨500 mg,日2次。比较两组患者的近期临床疗效、不良反应、生存时间及相关血液指标的变化情况。结果当归补血汤联合卡培他滨节拍化疗组有效率28.6%,疾病控制率71.4%;卡培他滨组有效为20.0%,疾病控制率为65.0%;结果提示当归补血汤联合卡培他滨节拍化疗组中位无疾病进展生存期为9.9个月;卡培他滨组7.8个月;两组患者发生不良反应的概率及反应级别都较低,其中当归补血汤联合卡培他滨节拍化疗组较卡培他滨组在乏力的发生率方面明显较低(P 0.05),具有统计学差异;两组患者治疗后血清二胺氧化酶水平均有所上升,但当归补血汤联合卡培他滨节拍化疗组平均血清二胺氧化酶仅为(2.11±0.52),而卡培他滨组为(3.31±0.66)(P 0.05),具有统计学差异。结论当归补血汤联合卡培他滨节拍化疗在高龄晚期结直肠癌患者的维持治疗中安全可行,能够减轻不良反应,并改善肠黏膜屏障功能,一定程度上延长患者生存时间。     

吉西他滨联合卡培他滨方案治疗晚期乳腺癌临床观察

目的探讨吉西他滨联合卡培他滨治疗晚期乳腺癌的有效性和安全性,为改善患者预后提供参考依据。方法回顾性分析60例晚期乳腺癌患者的临床资料,根据不同用药方案分为观察组和对照组各30例,对照组应用表柔比星联合多西他赛治疗,观察组应用吉西他滨联合卡培他滨治疗,比较2组患者近期临床疗效和不良反应发生情况。结果观察组总有效率显著低于对照组(P0.05);2组临床获益率比较差异无统计学意义(P0.05);观察组脱发、血红蛋白减少发生率均显著低于对照组,手足综合征发生率显著高于对照组,2组比较差异均有统计学意义(P均0.05)。结论晚期乳腺癌患者应用吉西他滨联合卡培他滨方案治疗能够维持病灶稳定,且不良反应轻微。     

卡培他滨或氟尿嘧啶联合奥沙利铂治疗结直肠癌疗效观察

目的观察卡培他滨或氟尿嘧啶联合奥沙利铂治疗结直肠癌的临床疗效。方法将结直肠癌患者138例采用数字随机法分为2组,对照组69例采用氟尿嘧啶联合奥沙利铂治疗,观察组69例采用卡培他滨联合奥沙利铂治疗,采用生活质量综合评定问卷(GQOL-74)评定患者治疗前后的生活质量,比较2组临床疗效、不良反应情况。结果治疗后,2组患者心理功能评分、物质生活评分、躯体功能评分、社会功能评分、总体生活质量评分均显著增加。观察组患者心理功能评分、物质生活评分、躯体功能评分、社会功能评分、总体生活质量评分、总有效率均明显高于对照组(P均0.05),观察组不良反应发生率明显低于对照组(P0.05)。结论卡培他滨或氟尿嘧啶联合奥沙利铂均是治疗结直肠癌的有效方法,其中卡培他滨联合奥沙利铂的治疗效果更为显著,可显著提高患者的生活质量,不良反应少且安全性高,值得临床推广使用。     

奥沙利铂联合卡培他滨治疗晚期直肠癌24例临床观察

目的:观察奥沙利铂和卡培他滨联合应用治疗晚期直肠癌患者的临床疗效。方法:选取晚期直肠癌患者47例,随机分为对照组(n=23)和观察组(n=24)。对照组采用奥沙利铂联合5-FU治疗,观察组采用奥沙利铂联合卡培他滨治疗,对比两组晚期直肠癌治疗有效率、不良反应率。结果:观察组晚期直肠癌治疗总有效率为79.16%,显著高于对照组的47.83%(P<0.05);观察组的不良反应率为41.7%,对照组为47.8%,两组比较差异无统计学意义(P>0.05)。结论:奥沙利铂联合卡培他滨治疗晚期直肠癌临床疗效较好,值得临床应用推广。     

中医药辅助卡培他滨片维持治疗结直肠癌临床疗效Meta分析

目的系统评价中医药辅助卡培他滨片维持治疗结直肠癌的临床疗效。方法检索Pubmed、Embase、Cochrane Library、中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(维普网)及中国重要会议论文全文数据库中医药辅助卡培他滨片维持治疗结直肠癌随机对照试验(RCT),检索时间范围为建库至2018年11月。采用Cochrane偏倚风险评估工具对纳入研究进行质量评价,应用RevMan5.3进行Meta分析。结果共纳入13项RCT,涉及患者964例。Meta分析结果显示:与对照组比较,试验组明显提高卡氏评分(RR=0.35,95%CI[0.26,0.49],P0.00001),改善手足综合征(RR=0.55,95%CI[0.38,0.79],P=0.001),减少白细胞降低(RR=0.66,95%CI[0.49,0.89],P=0.006),减轻恶心呕吐(RR=0.51,95%CI[0.36,0.72],P=0.000 2),减轻腹泻(RR=0.49,95%CI[0.35,0.68],P0.000 1),增加CD3+、NK细胞计数(RR=5.62,95%CI[3.08,8.16],P0.05;RR=7.18,95%CI[5.31,9.06],P0.05)。试验组对瘤体有效率与对照组比较差异无统计学意义(RR=0.78,95%CI[0.57,1.05],P=0.10)。结论中医药辅助卡培他滨片维持治疗晚期结直肠癌患者疗效优于单纯化疗,可改善患者生活质量,减轻化疗毒副作用,提高机体免疫力,但尚需更多大样本高质量的RCT验证。     

中药治疗卡培他滨相关性手足综合征临床观察

目的：观察中药内服外洗治疗卡培他滨相关性手足综合征的疗效。方法：将卡培他滨相关性手足综合征大肠癌术后患者82人,随机分为中药组与对照组各41例。对照组进行化疗同时配合口服大剂量VitB6,治疗组在化疗同时配合中药内服、外洗。比较2组患者手足综合征分级和卡培他滨调整剂量及停止用药例数。结果：治疗组中因严重手足综合征而永久停药发生率4.8%,明显低于对照组21.9%（P〈0.05）;治疗组中有70.0%患者能以原量完成全部6程化疗,而对照组为58.2%,2组比较,差异无显著性意义（P〉0.05）。结论：中药外洗治疗卡培他滨相关性手足综合征,提高了患者对卡培他滨的耐受性和化疗通过率,改善了卡培他滨化疗患者的生活质量。     

微波消解-电感耦合等离子体质谱法测定脉络宁注射液中25种矿物质元素

目的建立微波消解-电感耦合等离子体质谱(ICP-MS)直接稀释测定脉络宁注射液中25种矿物质元素(Mg、Ca、Fe、Cu、Zn、Mn、Al、B、Ba、Co、Cr、K、Li、Mo、Na、Ni、P、Pb、Sr、Th、Ti、V、As、Cd和Hg)的方法。方法分别对微波消解条件和测试条件进行考察;样品经微波消解后,采用电感耦合质谱仪测定25种矿物质元素,并对测定方法学进行考察。结果确定最佳消解条件为3步缓慢升温:400 W 80℃升温10 min,保留5 min;600 W 120℃升温10 min,保留5 min;900 W 200℃升温20 min,保留20 min;25种矿物质元素在各自的线性范围内线性关系良好,r≥0.999 6,精密度、稳定性和重复性试验的RSD均符合定量分析要求;加标回收率为94.7%~106.1%,RSD在0.34%~2.79%。脉络宁注射液中检测出Mg、Ca、Fe、Cu、Zn、Mn、Al、B、Ba、Co、Cr、K、Li、Mo、Na、Ni、P、Pb、Sr、Th、Ti、V,未检出As、Cd和Hg。结论该方法简便、迅速、准确,适用于脉络宁注射液中25种矿物质元素的同时测定。     

Die Lateralität und Lateralitätsinstabilität in der Diagnostik und Therapie

The disturbance and instability of laterality are obstacles to diagnostics and therapy. Correction prior to starting therapy is required. They also predispose toward defined health problems and unspecific diseases. Numerous research activities provide evidence of the relevance of undisturbed laterality in diagnostics and therapy. Techniques of testing and therapeutic corrections will allow for optimized therapy success.     

Yerba Mate or Paraguay Tea

正Beverages based on Ilex paraguariensis A.St.-Hil.are used in the south Brazil and other Latin American countries located at the so-called southern cone.It is known as chimarro or mate in south and southeast Brazil,tererêin     

Journal of Acupuncture and Tuina Science Instructions for Authors

The Journal of Acupuncture and Tuina Science, a journal with an international scope （IS SN 1672-3597, CN 31-1908/R, Bimonthly）, is embodied by ＇Springer Verlag＇ Database, Index Copernicus （IC） and Chinese Scientific and Technical Paper and Citations Data （CSTPCD）. You can search full text on http：//www, springerlink, com/content/1672 -3597.     

Ethnopharmacologic study of chinese rhubarb

This paper deals with an interdisciplinary study covering historic, botanical, phytochemical, pharmacological and clinical aspects of rhubarb and related species, to lay stress on the correlation between plant phylogeny, chemical constituents and purgative activity.

It was found that the official rhubarbs were exclusively restricted in the Sect. Palmata e.g. Rheum palmatum R. palmatum var. tanguticum R. officinale; the following criteria may serve as their standard, viz., the presence of sennoside derivatives and rhein, the occurrence of the reduced form of rhein and aloe-emodin, the leaves with any kind of palmate incision. Comprehensive multivariate analyses showed that there is a very close relationship between the leaf incision, existence of sennosides or rhein and purgative activity.     

基于ICP-MS法的加味左金丸中无机元素分析

目的 通过电感耦合等离子体质谱（inductively coupled plasma mass spectrometry,ICP-MS）法建立加味左金丸中Cd、Pb、As、Hg、Co、V、Ni、Cu、Li、Sb、Ba、Mo、Sn、Cr、Na、Mg、Al、Ca、Ti、Mn、Fe、Zn、Ga、Se、Sr、Tl共计26种无机元素的测定方法。方法 加味左金丸通过微波消解法处理后,根据相对分子质量的大小选择内标物,其中⁷Li、²³Na、²⁴Mg、²⁷Al、⁴⁰Ca、⁴⁸Ti、⁵¹V、⁵²Cr、⁵⁵Mn、⁵⁶Fe、⁵⁸Ni、⁵⁹Co、⁶³Cu、⁶⁶Zn、⁷⁰Ga、⁷⁵As、⁷⁷Se、⁸⁶Sr以⁷²Ge作为内标;⁹⁵Mo、¹¹⁴Cd、¹¹⁸Sn、¹²¹Sb、¹³⁷Ba以¹¹⁵In作为内标;²⁰²Hg、²⁰⁵Tl、²⁰⁸Pb以²⁰⁹Bi作为内标。对标准品溶液、空白溶液与供试品溶液进行分析,采用标准曲线法进行定量分析。通过ICP-MS法进行测定。结果 26种无机元素线性的相关系数r ≥ 0.999 6,检出限为0.001~1.500μg/L,定量限为0.01~5.00 μg/L,精密度与重复性试验的RSD均小于5%,平均回收率在82.64%~106.44%,RSD均小于5%。对3个厂家的12批样品进行了测定,26种元素的含量差异较大,其中Na、Mg、Ca、Fe 4种元素的含量比较高,均大于500 μg/g,Cd、Pb、As、Hg、Co、Li、Sb、Mo、Sn、Cr、Se、Tl的含量比较低,均小于1 μg/g。由结果可知,人体的常量元素,如Na、Mg、Ca的含量比较高,Cd、Pb、As、Hg等有害元素含量比较低。根据《中国药典》2020年版一部的要求,本品中Cd、Pb、As、Hg与Cu均符合规定。结论 该方法快速、准确,可以用于加味左金丸中无机元素的测定。     

Wirksamkeit der Akupunktur bei der Therapie von idiopathischen Schmeckstörungen: Eine randomisierte Placebo-kontrollierte Studie

Background

At present, the state-of-the-art medication in treating idiopathic taste disorder (gustatory dysfunction) is zinc. If zinc medication was unsuccessful, not tolerated or if it is contraindicated the persons affected can hardly be helped.

Objectives

In a randomized placebo-controlled clinical trial an attempt was made to determine the efficacy of acupuncture.

Methods

The treatment group was treated with acupuncture needles, the placebo group with an inactive acupuncture-laser. Endpoints of the study were changes in the taste test, the quality of life and the severity of symptoms of depression (BDI) as well as mood changes (ZMS). Satisfaction with the success of the respective therapy was also evaluated. Data were collected before and after therapy and again for the treatment group 10 weeks after completion of the treatment period.

Findings

Treatment with real acupuncture showed a significant improvement in gustatory function as well as a significant improvement in psychological symptoms. Greater satisfaction with the treatment results was evident in the treatment group. The treatment results of acupuncture remained stable over a period of ten weeks after completion of the treatment.

Conclusion

Acupuncture was effective in the therapy of idiopathic taste disorders and therefore it is an effective alternative when zinc medication is not tolerated or unsuccessful. But it is also suitable as a therapy of first choice. Acupuncture can be considered as an extension of the therapeutic spectrum in the difficult treatment of taste disorders.     

Erstaunliches Ergebnis einer Schädelakupunktur nach Yamamoto bei Hemihypsarrhythmie rechts

A girl, three and a half years old at the respective date, premature in 25th week of gestation, had been presented. On day three after birth, she had had a IVH III° right and left with severe involvement of parenchyma and other multiple complications, e. a. infant respiratory distress syndrome up to the 42nd day postpartum, and epileptic attacks with apnoeic events.     

Veränderungen der Herzratenvariabilität (HRV) während Low Level Lasernadelakupunktur: Placebokontrollierte Studie an 19 herzgesunden Probanden

Background

Experimental and clinical studies postulate a neurobiological mechanism of acupuncture by modulating central pain systems, neurohormones and -transmitters. It seems to be quite likely that the autonomic nervous system (ANS) plays an important mediating role in this neuromodulation.

Aim

In measuring heart rate variability (HRV), as a non-invasive approach to the ANS-function, the object of this study was to monitor probable acupuncture-induced changes of autonomic balance. The innovative technology of laser-needle acupuncture offers for the first time a stimulation method which fulfils the demands on a placebo-controlled acupuncture trial not requiring controversial sham acupuncture.

Method

19 healthy voluntary subjects underwent 3 treatments in randomized sequence, consisting of placebo-, 1-point- (PC 6) and simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle-stimulation over 20 minutes. Before, during and after placebo-/verum laser-needle acupuncture, HRV-data for normalized HF(high frequency)- and LF(low frequency)-Power (nHF, nLF) and their quotient nLF/nHF obtained by power spectrum analysis (FFT), were measured and analyzed statistically at 5 different time points (ANOVA repeated measures, p < 0,05).

Results

During both verum applications, the 1-point- (PC 6) as well as the simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle stimulation, significant changes of the ANS-activity were found in comparison to the placebo application. The most significant modification of HRV was an increase of nHF (p < 0,05 (PC 6), p < 0,0001 (PC 6, LR 3, SI 3)) as an expression of growing vagal activity during acupuncture.

Conclusion

Laser-needle acupuncture causes in 1-point-stimulation (PC 6) as well as in simultaneous 3-point-stimulation (PC 6, LR 3, SI 3) significant changes in HRV in comparison to placebo application. HRV-monitoring seems to be a suitable approach in exploration of acupuncture-induced changes of ANS and could possibly be established in combination with laser needle acupuncture as a standard for further scientific and clinical acupuncture investigations which are greatly needed.