潮气呼吸肺功能在临床中的应用及影响因素

目的 通过潮气呼吸肺功能对毛细支气管炎和肺炎患儿进行检测,了解其在临床中的应用,并探讨其影响因素.方法 毛细支气管炎患儿30例和支气管肺炎患儿30例纳入本次研究.患儿镇静后进行潮气呼吸肺功能检测,主要测定参数为每公斤体重潮气量(VT)、达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE).结果 毛细支气管炎组与肺炎组每千克体重潮气量(VT)差异无统计学意义(P>0.05).毛细支气管炎组达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE)低于肺炎组,差异具有统计学意义(P<0.05).结论 潮气呼吸肺功能测定是一项很好的检测婴幼儿肺功能的技术,可评价喘息患儿气道阻塞程度,但在测定过程中,应注意对可能影响肺功能测定的因素加以控制,否则将影响测定结果 .     

潮气呼吸流量-容积曲线检测在重症毛细支气管炎儿童中的运用

目的观察重症毛细支气管炎患儿潮气呼吸流量-容积曲线的情况并探讨其临床意义。方法收集2010年1月～2011年12月本院儿童呼吸内科住院的100例毛细支气管炎患儿,患儿镇静后进行潮气呼吸流量-容积曲线检测,主要测定参数为每公斤体重潮气量(VT)、达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE)。结果重症毛细支气管炎组与轻症组每千克体重潮气量(VT)差异无统计学意义(P>0.05)。重症毛细支气管炎组达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE)明显低于轻症组,差异有统计学意义(P<0.01)。结论潮气呼吸流量-容积曲线测定对评估毛细支气管炎气道阻塞的情况以及病情的严重程度有较高的价值,其中TPEF/TE及VPEF/VE为重要指标。     

潮气肺功能和呼出气一氧化氮检测在毛细支气管炎中的作用

目的 探讨潮气肺功能、呼出气一氧化氮(fractional exhaled nitric oxide,FeNO)检测在毛细支气管炎中的作用。 方法 收集2016年1月—2017年2月郑州大学附属郑州中心医院收治的毛细支气管炎患儿69例为研究对象,依据就诊时病情严重程度分为轻度组(24例)、中度组(26例)以及重度组(19例);德国JAEGER公司生产的MasterScreen肺功能仪监测3组潮气量、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)、呼吸频率,Sunvou-D100纳库仑(无锡尚沃医疗)一氧化氮分析仪检测3组患儿FeNO,采用受试者工作特征曲线(ROC)分析潮气肺功能联合FeNO评估毛细支气管炎病情严重程度的价值,Pearson相关系数分析毛细支气管炎患儿FeNO与潮气肺功能的关系。 结果 轻度组、中度组、重度组的潮气量比较差异无统计学意义(P>0.05);但轻度组TPTEF/TE、VPEF/VE较中度组、重度组明显升高,且中度组也明显高于重度组(均P<0.05);轻度组、中度组呼吸频率明显低于重度组(均P<0.05),但轻度组、中度组比较差异无统计学意义(P>0.05);轻度组、中度组、重度组FeNO依次升高(均P<0.05)。ROC曲线分析提示,TPTEF+VPEF+FeNO联合检测评估支气管炎病情严重程度的ROC曲线下面积较三者单一检测高,支气管炎患者FeNO水平与其肺功能指标TPTEF/TE、VPEF/VE呈负相关关系(r=-0.385、-0.314,均P<0.05)。 结论 潮气肺功能结合呼出气一氧化氮(FeNO)检测可有效反映毛细支气管炎病情严重程度,两者联合检测或可作为毛细支气管炎病情程度的有效评估方案。      

青金栀汤对小儿急性毛细支气管炎肺功能及炎症因子水平的影响

目的:观察青金栀汤治疗小儿急性毛细支气管炎患儿的临床疗效,并观察其对肺功能及炎症因子水平的影响。方法:88例小儿急性毛细支气管炎患儿随机平均分为对照组合观察组。对照组给予西医常规治疗;观察组在对照组治疗基础上给予青金栀汤。比较两组患儿治疗前后肺功能指标,包括达峰容积比、达峰时间比、潮气量及吸呼比;治疗前后两组患儿炎症因子水平,包括白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及超敏C反应蛋白(high-sensitivity c-reactive protein,hs-CRP)水平;比较两组治疗后临床疗效,治疗期间不良反应。结果:对照组有效率为81.82%,观察组有效率为97.73%,两组比较,差异有统计学意义(P0.05);与治疗前比较,治疗后两组患儿肺功能指标达峰容积比、达峰时间比、潮气量及吸呼比均明显改善(P0.05),且观察组改善程度较对照组显著(P0.05);两组患儿炎症因子IL-6、TNF-α及hs-CRP水平较治疗前均显著降低(P0.01),且观察组下降幅度较对照组显著(P0.01);两组患儿不良反应发生率比较,差异无统计学意义(P0.05)。结论:青金栀汤治疗小儿急性毛细支气管炎疗效显著,能有效改善患儿肺功能,降低患儿血清炎症因子水平,疗效确切,且安全可靠。     

吸入性糖皮质激素对毛细支气管炎患儿肺功能的影响与疗效

目的:探讨吸入性糖皮质激素在治疗小儿毛细支气管炎方面的临床效果及对肺功能的影响。方法:我院收治的100例毛细支气管炎患儿随机分为对照组与观察组各50例,两组组患儿均给予抗感染、祛痰等治疗方案,同时,观察组在接受常规治疗的基础上给予布地奈德雾化吸入,疗程为期3个月,随后观察2组的临床疗效、症状体征消失时间及肺功能的改变等数据。结果:观察组治疗总有效率(96.0%)显著高于对照组(70.0%)(P0.05);观察组咳嗽、喘憋、哮鸣音消失时间及住院时间均显著早于对照组(P0.05);治疗后观察组潮气量、达峰时间比(tPTEF/tE)和达峰容积比(VPTEF/VE)显著优于对照组(P0.05)。结论:毛细支气管炎患儿采用吸入糖皮质激素治疗可促进病情恢复,改善肺功能,具有较大临床推广价值。     

毛细支气管炎患婴不同体位潮气肺功能测定的比较

目的观察不同体位对毛细支气管炎患婴潮气肺功能测定的影响。方法对45例毛细支气管炎患婴分别测定仰卧位、侧卧位的潮气肺功能,比较潮气量(tidal volume,VT)、呼吸频率(respiratory rate,RR)、吸呼比(Ti/Te)、达峰时间比(TPTEF/TE)及达峰容积比(VPTEF/VE)的差异。结果右前倾侧卧位呼吸频率低于仰卧位,差异有显著性意义;右前倾侧卧位潮气量、达峰容积比、达峰时间比明显高于仰卧位,差异有极显著性意义。结论右前倾侧卧位肺功能指标优于仰卧位,毛细支气管炎急性期采取侧卧位有利于临床治疗。     

潮气呼吸肺功能联合支气管舒张实验及哮喘预测指数在5岁以下儿童哮喘诊断中的应用

目的 通过潮气呼吸肺功能联合支气管舒张实试验检测、哮喘预测指数判断的数据进行分析,探讨诊断5岁以下儿童哮喘的特异性检测方法.方法 选取0~5岁患儿115例,分为哮喘组55例,肺炎组60例.记录比较急性期两组患儿潮气呼吸肺功能(每公斤体重潮气量、达峰时间比、达峰容积比)值、支气管舒张试验阳性率、哮喘预测指数(API)阳性率;记录比较缓解期两组患儿潮气呼吸肺功能(每公斤体重潮气量、达峰时间比、达峰容积比)值,进行统计学分析.结果 两组急性期潮气呼吸肺功能(每公斤体重潮气量、达峰时间比、达峰容积比)值比较,差异无统计学意义(P>0.05),对支气管舒张试验阳性率和API阳性率的比较差异有统计学意义(P<0.05);两组缓解期潮气呼吸肺功能(每公斤体重潮气量、达峰时间比、达峰容积比)值比较差异有统计学意义(P<0.05).结论 对于5岁以下反复喘息儿童,利用潮气呼吸肺功能支气管舒张试验或API均可特异性诊断哮喘.     

毛细支气管炎潮气呼吸功能在治疗前后变化分析

目的 观察毛细支气管炎患儿的潮气呼吸肺功能在治疗前后的变化并探讨其临床意义.方法 应用婴幼儿肺功能仪对38例毛细支气管炎患儿治疗前、后肺功能进行测量,主要测量每公斤体重潮气量、吸气时间、呼气时间、吸呼比、达到峰流速的时间与呼气时间之比、达到呼气峰流速时呼出的气体容积与呼气容积(潮气量)的比值,并应用统计学分析相关数据....     

盐酸消旋山莨菪碱注射液联合氨溴特罗口服液治疗毛细支气管炎患儿的临床效果

目的观察盐酸消旋山莨菪碱注射液联合氨溴特罗口服液治疗毛细支气管炎患儿的临床效果。方法选取2018年2月至2019年4月项城市妇幼保健院收治的96例毛细支气管炎患儿,根据给药方案分为对照组和观察组,各48例。给予对照组氨溴特罗口服液治疗,观察组在对照组治疗基础上加用盐酸消旋山莨菪碱注射液治疗。比较两组疗效、临床症状(湿啰音、咳嗽、喘憋)消失时间、住院时间以及治疗前后肺功能指标(潮气量、达峰时间比、呼吸频率)。结果观察组治疗总有效率为97.92%(47/48),高于对照组81.25%(39/48),差异有统计学意义(P<0.05);观察组湿啰音、咳嗽、喘憋症状消失时间及住院时间均短于对照组,差异有统计学意义(均P<0.05);治疗后,两组潮气量、达峰时间比均高于治疗前,呼吸频率低于治疗前,且观察组潮气量、达峰时间比均高于对照组,呼吸频率低于对照组,差异有统计学意义(均P<0.05)。结论盐酸消旋山莨菪碱注射液联合氨溴特罗口服液治疗毛细支气管炎效果确切,能显著改善患儿临床症状,改善肺功能。     

血清Periostin及TGFβ1表达水平在呼吸道合胞病毒毛细支气管炎患儿中的临床意义

目的研究呼吸道合胞病毒（RSV）毛细支气管炎患儿血清骨膜蛋白（Periostin）及转化生长因子β1（TGF-β1）的表达水平,分析二者关系,评估其临床意义。方法选取2019年11月至2020年11月在广州医科大学附属第一医院及中山市博爱医院儿科住院的RSV毛细支气管炎患儿72例为毛细支气管炎组,按病情严重程度分为轻度组(（印）n（正）=27)、中度组(（印）n（正）=25)及重度组(（印）n（正）=20)。另以同期正常健康体检的婴幼儿25例作为对照组。ELISA法检测研究组患儿急性期、恢复期以及正常对照组的血清Periostin及TGF-β1水平,Pearson相关分析二者的相关性。结果急性期毛细支气管炎组血清Periostin与TGF-β1水平均显著高于对照组(（印）P（正）<0.01),恢复期毛细支气管炎组血清Periostin仍高于对照组(（印）P（正）<0.01),但血清TGF-β1水平与对照组比较差异无统计学意义(（印）P（正）>0.05)。恢复期毛细支气管炎组血清Periostin与TGF-β1水平较急性期均显著下降(（印）P（正）<0.01)。毛细支气管炎重度组急性期血清的Periostin、TGF-β1水平最高,均显著高于轻、中度患儿(均（印）P（正）<0.01);毛细支气管炎重度组恢复期血清的Periostin仍持续高水平,均显著高于轻、中度患儿(均（印）P（正）<0.01);但恢复期毛细支气管炎三组及对照组之间血清TGF-β1水平比较差异无统计学意义(均（印）P（正）>0.05)。相关性分析表明,毛细支气管炎组患儿急性期血清Periostin与TGF-β1水平均呈正相关(（印）r（正）=0.717,（印）P（正）<0.01)。结论检测血清Periostin与TGF-β1水平有助于对RSV所致毛细支气管炎患儿病情严重程度及治疗后转归的判断;TGF-β1仅参与了RSV所致毛细支气管炎的急性过程,而血清Periostin高表达水平在RSV所致毛细支气管炎中持续时间可能更长。     

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…     

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.     

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.     

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.     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.