美沙拉嗪肠溶片治疗中青年肠易激综合征的临床疗效分析

肠易激综合征是一种比较常见的内科疾病，主要表现为腹痛、腹泻以及便秘等临床症状。肠易激综合征是一种慢性疾病，迁延不愈，给患者的生活和工作等带来严重的负担，但是目前，临床上对于肠易激综合征的病因和发病机理尚无十分清楚的认识，因此也就没有形成有效的治疗规范。因此，临床上对肠易激综合征的患者进行治疗时，往往根据患者的具体情况采取对症的治疗方法，而不能根治。研究表明，美沙拉嗪肠溶片对于肠易激综合征的治疗疗效显著，因此，本研究对美沙拉嗪治疗中青年肠易激综合征的临床应用价值进行了探讨，现报告如下。     

难治性肠易激综合征诊治的研究进展

肠易激综合征是临床常见的功能性胃肠病之一，病理机制复杂，临床采用单一治疗模式多难以奏效，部分患者病情迁延成为难治性肠易激综合征。目前国内外对难治性肠易激综合征并无准确定义和诊断标准，亦无统一的治疗方法。本文就目前国内外难治性肠易激综合征的诊断标准及治疗进展做一概述，以期为难治性肠易激综合征的临床诊治提供指导，使更多患者获益。     

肝郁脾虚型肠易激综合征桂枝汤合痛泻要方加减治疗的临床疗效

目的:对应用桂枝汤与痛泻要方联合对患有肝郁脾虚型肠易激综合征的患者进行治疗的临床效果进行研究分析。方法:抽取92例患有肝郁脾虚型肠易激综合征的患者,将其分为对照组和治疗组,平均每组46例。对照组患者采用蒙脱石散进行治疗;治疗组患者采用桂枝汤与痛泻要方联合进行治疗。结果:治疗组患者肠易激综合征治疗效果明显优于对照组;治疗期间不良反应率和治疗后病情复发率明显低于对照组。结论:应用桂枝汤与痛泻要方联合对患有肝郁脾虚型肠易激综合征的患者进行治疗的临床效果非常明显。     

中医药治疗肠易激综合征用药规律分析

目的：分析基于1994—2013年期刊文献的中药治疗肠易激综合征用药规律。方法：将收集到的486篇中医药治疗肠易激综合征文献录入到Microsoft Access 2010数据库中,运用Microsoft Excel数据透视表对其进行统计分析。将肠易激综合征中药治疗分为辨证治疗与专方治疗两大类,每类又分为肠易激综合征综合型、腹泻型与便秘型3个亚型,分别统计分析其处方用药规律,并与最新中医诊疗标准进行比较。结果：肠易激综合征腹泻型发病以脾虚为核心病机,肠易激综合征便秘型发病则以大肠津亏为核心病机,肠易激综合征综合型兼顾腹泻型与便秘型,但辨证处方用药的针对性不及前两者。肠易激综合征专方治疗文献的辨证分型不全,用药方面可以补充辨证治疗的不足。如肠易激综合征腹泻型患者罹病日久,健脾渗湿法多有不应,止泻常用固涩、温阳之品;肠易激综合征便秘型患者用药常酌加种子或果仁类药物,取其润肠通便之效。结论：通过与目前肠易激综合征中医诊疗标准比较,辨证分型、处方、用药3个方面均存在一定差异。     

针灸治疗腹泻型肠易激综合征临床价值分析

目的研究针灸治疗腹泻型肠易激综合征的临床价值。方法本次选择对象为腹泻型肠易激综合征患者,时间在2017年12月至2018年8月,根据电脑随机分配的原则将100例腹泻型肠易激综合征患者分为两组,其中包括对照组和观察组,分别行常规药物治疗、针灸治疗,对比两组治疗效果和主要症状积分。结果观察组腹泻型肠易激综合征患者治疗总有效率(98.00%)高,与对照组相比,差异有统计学意义(P0.05)。观察组腹泻型肠易激综合征患者主要症状积分均低于对照组,差异有统计学意义,P 0.05。结论针灸治疗腹泻型肠易激综合征效果显著,值得研究。     

谷氨酰胺颗粒治疗肠易激综合征的临床效果观察

目的对消化内科就诊患者肠易激综合征的发病和临床治疗效果进行观察和分析。方法将消化内科收治的256例肠易激综合征患者进行随机分组，各128例；对照组采用常规方法治疗；试验组在对照组治疗基础上，采用谷氨酰胺颗粒治疗。结果试验组治疗总有效率为93.8％，明显高于对照组68.8％，差异具有统计学意义（P〈0.05）。结论对消化内科肠易激综合征患者采用谷氨酰胺颗粒治疗，具有非常好的治疗效果，有效地改善患者的症状，提高患者的生活质量，值得在临床上进行推广和应用。     

浅谈健脾温肾法治疗腹泻型肠易激综合征的临床效果观察

目的：探讨健脾温肾法治疗腹泻型肠易激综合征的临床效果。方法：选取2013年1月～2014年1月我院收治的100例腹泻型肠易激综合征患者,并将其随机均分成观察组和对照组。对照组接受常规的西医治疗;观察接受健脾温肾疗法进行治疗,观察并对照两组在腹泻型肠易激综合征治疗效果上的效果。结果：对照组治疗有效例数为39例,治疗有效率为78％;观察组治疗有效例数为45例,治疗有效率为90％,观察组患者腹泻型肠易激综合征的治疗效果明显优于对照组,两组临床疗效差异显著（P＜0.05）。结论：健脾温肾疗法治疗腹泻型肠易激综合征的临床疗效十分显著,并且能够有效缓解或者是消除腹泻型肠易激综合征患者的临床症状,减轻患者的病痛。     

浅谈健脾温肾法治疗腹泻型肠易激综合征的临床效果观察

目的:探讨健脾温肾法治疗腹泻型肠易激综合征的临床效果。方法:选取2013年1月~2014年1月我院收治的100例腹泻型肠易激综合征患者,并将其随机均分成观察组和对照组。对照组接受常规的西医治疗;观察接受健脾温肾疗法进行治疗,观察并对照两组在腹泻型肠易激综合征治疗效果上的效果。结果:对照组治疗有效例数为39例,治疗有效率为78%;观察组治疗有效例数为45例,治疗有效率为90%,观察组患者腹泻型肠易激综合征的治疗效果明显优于对照组,两组临床疗效差异显著(P<0.05)。结论:健脾温肾疗法治疗腹泻型肠易激综合征的临床疗效十分显著,并且能够有效缓解或者是消除腹泻型肠易激综合征患者的临床症状,减轻患者的病痛。     

蒙古族地区肠易激综合征发病病因的调查研究

目的本研究旨在探讨蒙古族地区肠易激惹综合征发病病因进行调查研究,以便为临床治疗提供客观指引。方法收集我院确诊为肠易激惹综合征的患者2000例,对患者病史采用回顾性分析,其饮食、神经内分泌情况、胆汁酸吸收障碍情况、精神心理因素、感染因素、肠道动力学因素和饮酒因素进行统计分析,从而探讨肠易激惹综合征发病主要病因。结果大量饮酒为蒙古族地区肠易激惹综合征主要病因,本组发病860例,占43%,其次为感染和精神心理异常,分别占26.45%、17.7%。结论蒙古族特有的生活习性决定了肠易激惹综合征的主要诱因,其治疗过程应引导患者养成良好的生活习惯。     

丽珠肠乐、安定、谷维素合用治疗腹泻型肠易激综合征的临床分析

目的探讨应用丽珠肠乐、谷维素、安定三种药物联合治疗腹泻性肠易激综合征的临床效果。方法抽取74例患有腹泻性肠易激综合征的患者病例,将其分为对照组和治疗组,平均每组37例。对照组患者采用丽珠肠乐进行治疗;治疗组患者采用丽珠肠乐、谷维素、安定三种药物联合进行治疗。结果治疗组患者肠易激综合征控制效果明显优于对照组;两组患者在治疗期间均未出现任何药物不良反应。结论应用丽珠肠乐、谷维素、安定三种药物联合对患有腹泻性肠易激综合征的患者进行治疗的临床效果非常明显。     

Cancer complementary and alternative medicine research at the US national cancer institute

The United States National Cancer Institute(NCI) supports complementary and alternative medicine(CAM) research which includes different methods and practices (such as nutrition therapies) and other medical systems(such as Chinese medicine). In recent years,NCI has spent around $120 million each year on various CAM-related research projects on cancer prevention,treatment,symptom/side effect management and epidemiology.The categories of CAM research involved include nutritional therapeutics, pharmacological and biological treatments,mind-body interventions,manipulative and body based methods,alternative medical systems,exercise therapies,spiritual therapies and energy therapies on a range of types of cancer.The NCI Office of Cancer Complementary and Alternative Medicine(OCCAM) supports various intramural and extramural cancer CAM research projects.Examples of these cancer CAM projects are presented and discussed.In addition,OCCAM also supports international research projects.     

Complementary and Alternative Medicine Therapies for Chronic Pain

Pain afflicts over 50 million people in the US, with 30.7% US adults suffering with chronic pain. Despite advances in therapies, many patients will continue to deal with ongoing symptoms that are not fully addressed by the best conventional medicine has to offer them. The patients frequently turn to therapies outside the usual purview of conventional medicine(herbs, acupuncture, meditation, etc.) called complementary and alternative medicine(CAM). Academic and governmental groups are also starting to incorporate CAM recommendations into chronic pain management strategies. Thus, for any physician who care for patients with chronic pain, having some familiarity with these therapies—including risks and benefits—will be key to helping guide patients in making evidence-based, well informed decisions about whether or not to use such therapies. On the other hand, if a CAM therapy has evidence of both safety and efficacy then not making it available to a patientwho is suffering does not meet the need of the patient. We summarize the current evidence of a wide variety of CAM modalities that have potential for helping patients with chronic pain in this article. The triad of chronic pain symptoms, ready access to information on the internet, and growing patient empowerment suggest that CAM therapies will remain a consistent part of the healthcare of patients dealing with chronic pain.     

一项利用健康理念问卷对巴尔干地区国家保健专业人员和学生进行补充和替代医学认知的横断面调查

Objective

To conduct a study on attitudes, knowledge, and use of complementary and alternative medicine (CAM) therapies in Serbia. Available data about CAM therapies in the region are scarce, opinions lacking from health sector. Balkan region countries had a delay in issuing national policies on CAM therapies.

Methods

The questionnaire used was based on previously validated CAM Health Belief Questionnaire (CHBQ), formulated as 5-item Likert type scale, adjusted for local environment. Health care students and professionals were evaluated. The questionnaire comprehended 10 closed questions on attitudes, knowledge and use of CAM therapies. This survey was conducted in eight cities of Serbia, January 2010–July 2011. A total of 797 participants was included. The second group of participants was 145 healthcare professionals (50 academic staff, 64 clinical staff, 19 pharmacists, 6 other clinical branch specialists and 6 nurses). Data were collected by an interview. Examinees could acquire maximum of 70 points, 35 representing neutral attitude.

Results

Students of dentistry (54.65±6.07) were better informed on CAM therapies than medicine students (50.26±7.92). Pharmacy students (51.16±7.10) accepted low-scientific CAM. Pharmacists scored better than university professors (55.12±6.55 vs. 50.29±9.50). Primary health care professionals had better awareness than pharmacists in dispensing pharmacies. Both groups of participants preferred use of vitamins over any other CAM therapy.

Conclusion

These pioneering efforts in the region exposed weaknesses in CAM attitudes of current and future health care professionals. Nevertheless, awareness on alternative medicine treatment choices is growing among Balkan prescribers. Supportive legal framework would facilitate dissemination of CAM medical practices.     

Does Use of CAM for Specific Health Problems Increase With Reduced Access to Care?

The objective of this paper was to determine predictors of complementary and alternative medicine (CAM) use among individuals with specific health problems. Data were derived from the 1998 Medical Expenditure Panel Survey (MEPS). After adjustment for potential confounders, individuals with perceived barriers to obatining care were more likely to use any CAM treatment (OR 2.16), herbal therapy (OR 2.70) and spiritual care (OR 3.99) for a specific health problem. Individuals dissatisfied with their familys access to care were more likely to use acupuncture (OR 3.43). Dissatisfaction with quality of care was associated with increased use of spiritual therapy (OR 4.74). Perceptions of inadequate access to health care may contribute to utilization of CAM therapies; such therapies in this instance appear to be used as an alternative to mainstream medicine.     

Irritable bowel syndrome: Common integrative medicine perspectives

Previous reviews have highlighted complementary and alternative medicine therapies that are used to treat irritable bowel syndrome(IBS) based on published clinical trial data.Here the author describes and comments on a number of potentially relevant factors that have been commonly emphasized by practitioners who treat IBS and patients who have the disease.They include gluten and other food allergies,the Candida syndrome and biofilm,interference fields and post-infectious IBS, as well as mind-body factors.     

补充和替代医学在儿童哮喘治疗中的应用

补充和替代医学为主流医学之外能补充主流医学不足的其他医学。在西方国家主流医学即指西医。儿童哮喘是儿童时期主要慢性呼吸系统疾病之一,哮喘处理不当可导致哮喘患者长期患病,发展为成人哮喘,也是导致哮喘死亡的一个主要原因。近年来,除了主流医学疗法外,国际上也主张对儿童哮喘进行一些补充和替代医学疗法的治疗,通过常规疗法与补充和替代医学疗法相结合可能使儿童哮喘得到更好的控制。     

基于5-羟色胺治疗肠易激综合征的中西医研究进展

肠易激综合征（IBS）是一种非胃肠道结构损害和生化异常的胃肠功能紊乱性疾病，其致病机制尚不十分清楚，西医采用多种药物、心理疗法、调节饮食等方式进行治疗，但效果欠佳。近年中医药治疗IBS受到广泛关注，尤其是便秘型与腹泻型，众多研究中针对5-羟色胺（5-HT）信号通路的中医药研究居多，且多获良效，故本文总结中医药基于5-HT治疗IBS的主要机制及成果，为后续研究提供参考。     

Complementary therapies: the appeal to general practitioners

Pragmatism--among consumers seeking a cure and among general practitioners seeking clinical results and more patients--is not a complete explanation for the burgeoning of complementary and alternative medicine (CAM) in Western societies. Instead, this growth is substantially a result of pervasive and rapid social change, alternatively termed 'globalisation' and 'postmodernisation'. Globalisation and postmodernisation are creating a new social reality, of which a prominent characteristic is the proliferation of consumer choice. GPs are enmeshed in this social change and subject to the trend to greater choice--both their patients' and their own. On the one hand, GPs are reacting to social change as "economic pragmatists", responding to consumers' increasing demand for CAM. On the other hand, GPs themselves are acting as agents of social change by acknowledging the limitations of orthodox biomedical treatments and promoting CAM as part of their service delivery. Lack of scientific validation of CAM has not prevented GPs' use of such therapies. The phrase "clinical legitimacy" can be seen as a trump card that overrides "scientific legitimacy". It is the shibboleth of a postmodern movement among GPs towards healing and the "art" of medicine, as opposed to the "science" of medicine per se.     

补充替代医学治疗在妊娠相关下腰痛患者中应用的研究进展

妊娠相关下腰痛（PLBP）是指妊娠引起的第十二肋骨与臀折区域之间的疼痛,其发生率高达50%。PLBP可导致孕妇躯体功能障碍、睡眠障碍,增加不良分娩结局和产后抑郁发生风险等。采取具有针对性的干预措施对预防和缓解PLBP具有重要意义。由于妊娠期用药特殊性,补充替代医学（CAM）在妊娠相关疾病的治疗中发挥着重要作用。本文对CAM治疗PLBP相关研究进行综述,分别阐述运动疗法、手法治疗、针灸疗法、物理因子疗法等对PLBP预防及干预策略的研究进展,旨在为国内开展预防和缓解PLBP的研究提供借鉴。     

CAM practitioners and "regular" doctors: is integration possible?

Integrated clinics have already been established in response to community demand. The growing evidence base for complementary and alternative medicine (CAM) and its widespread community use compels doctors to understand complementary therapies and to refer patients to CAM practitioners where appropriate. Most general practitioners have patients with chronic illness who could benefit from the services of CAM practitioners, and virtually all CAM practitioners have patients who require access to mainstream diagnosis and therapy. Collaboration requires shared respect and trust, and education. Dangers of not integrating care include delaying or depriving patients of safe and effective management, and the potential for harmful interactions. Integration is currently being supported by government initiatives such as the new MedicarePlus package, as well as by initiatives from organisations such as the Australian Medical Association, the Royal Australian College of General Practitioners and the Australasian Integrative Medicine Association.