左乙拉西坦与卡马西平治疗卒中后癫痫对疗效及认知功能的影响

目的：评估左乙拉西坦和卡马西平治疗卒中后癫痫的疗效及认知功能差异。方法：回顾性分析了106例48～75岁卒中后癫痫患者的临床资料,分为对照组（卡马西平治疗,53例）和观察组（左乙拉西坦治疗,53例）,评估治疗前后的癫痫发作次数、发作持续时间、认知功能（MMSE）、生活质量（QOLIE-31）、血清神经元特异性烯醇酶（NSE）浓度以及不良反应情况。结果：与治疗前相比,两组患者的癫痫发作次数、发作持续时间、QOLIE-31评分、NSE浓度均显著改善（P均＜0.05）;在治疗结束时,观察组的MMSE评分、QOLIE-31评分、NSE浓度改善均显著优于对照组（P均＜0.05）;两组间的癫痫发作次数、发作持续时间及不良反应发生率无统计学差异（P均＞0.05）。结论：左乙拉西坦与卡马西平治疗卒中后癫痫的疗效一致,左乙拉西坦对神经的保护作用要优于卡马西平。     

舒肝解郁胶囊治疗心血管神经症的临床研究

目的 探讨舒肝解郁胶囊在治疗心血管神经症的临床应用价值.方法 将50例心血管神经症患者随机分为研究组和对照组,各25例.对照组应用谷维素、镇静剂、β-受体阻滞剂等常规治疗,研究组应用在常规治疗基础上加用舒肝解郁胶囊,以躯体化症状自评量表(SSS)于治疗前、治疗6周后分别对两组进行评分,比较两组患者SSS量表得分情况.结果 治疗6周后研究组SSS量表得分较治疗前显著下降(P＜0.01),较对照组亦有显著下降(P＜0.01).治疗6周后研究组治愈率为72％,对照组为24％,研究组显著高于对照组(P＜0.05).结论 舒肝解郁胶囊能显著改善或缓解心血管神经症患者症状,疗效显著优于传统常规治疗.     

成年癫痫患者生活质量的研究

目的探讨成年癫痫患者的生活质量(QOL)及其影响因素.方法采用癫痫患者生活质量量表-31(QOLIE-31)对68例临床确诊的成年癫痫患者和40名正常对照者进行评定.结果 QOLIE-31评分癫痫组[(53.7±16.8)分]较对照组[(77.3±15.6)分]明显降低(P＜0.01).不同性别、病程、用药数量及发作频率的患者比较,性别及病程方面差异无显著性(P＞0.05),单药较多药治疗者QOL分高(P＜0.05),高发作频率较中、低发作频率者QOL分低(P＜0.05).相关分析显示QOL与用药数量呈负相关(P＜0.01),与发作频率呈负相关(P＜0.01).结论成年癫痫患者QOL明显降低.用药和发作频率对QOL影响较大,合适的药物控制痫性发作是提高成年癫痫患者QOL的关键.     

抗癫痫药对癫痫患儿骨代谢及生活质量的影响

目的:探讨抗癫痫药物对癫痫患儿骨代谢及生活质量的影响。方法:选择采用抗癫痫药物治疗的癫痫患儿49例作为观察组;同时选择我院未接受抗癫痫药物治疗的患儿32例作为对照组,观察两组患儿治疗前和治疗后6个月患儿血钙(Ca~(2+))、血磷(P~(5+))、血清碱性磷酸酶(ALP)、骨碱性磷酸酶(BAP)和骨密度(BMD)等骨代谢指标,采用生活质量评定量表(QOLIE-31)对生活质量进行评分。结果:观察组患儿治疗前血清Ca~(2+)、P~(5+)、ALP、BAP、BMD与对照组比较无明显差异(P>0.05),治疗后6个月血清Ca~(2+)、BMD与对照组比较有明显降低(P<0.05),BAP与对照组比较有明显提高(P<0.05),其余指标与对照组比较无明显差异(P>0.05);观察组治疗后6个月QOLIE-31生活质量评分较治疗前明显提高(P<0.05),与对照组比较差异显著(P<0.05)。结论:抗癫痫药物对癫痫患儿骨代谢有一定影响,BAP可作为骨代谢敏感指标用于指导抗癫痫药物的正确应用,抗癫痫药物治疗能够提高患儿的生活质量。     

延续性护理对癫痫患者遵医行为及自我效能的影响

目的 探讨延续性护理应用于癫痫患者的效果。方法 选取我院癫痫患者70例(2018年6月～2019年5月),2018年6月～2018年12月34例为对照组,接受常规护理干预,2019年1月～2019年5月36例为观察组,在对照组基础上接受延续性护理干预。比较两组出院后6个月遵医率、癫痫发作情况、出院前、出院后6个月自我效能感量表(GSES)评分、癫痫生活质量量表-31(QOLIE-31)评分。结果 出院后6个月,观察组遵医率94.44%高于对照组73.53%,癫痫发作率8.33%低于对照组29.41%(P＜0.05);出院后6个月,观察组GSES、QOLIE-31评分高于对照组(P＜0.05)。结论 延续性护理应用于癫痫患者,可改善遵医行为,提升自我效能,降低癫痫发作率,提高生活质量。     

盐酸帕罗西汀治疗成年癫痫患者并发抑郁的临床观察

目的 观察盐酸帕罗西汀治疗癫痫并发抑郁患者的疗效和安全性.方法 42例PHQ-9＞15分癫痫患者,加用盐酸帕罗西汀治疗（20 mg/d）.比较治疗前、治疗12周后癫痫发作频率、抑郁症情况等.结果 37例完成试验患者抑郁症状明显改善,PHQ-9评分、癫痫发作频率均下降（均P＜0.05）.结论 盐酸帕罗西汀可以明显改善癫痫患者的抑郁症状,并可使癫痫发作次数减少,且安全性好.     

氟西汀联合舒肝解郁胶囊治疗伴有失眠的抑郁症疗效及安全性观察

目的探讨氟西汀联合舒肝解郁胶囊治疗伴有失眠症状的抑郁症患者的疗效及安全性。方法选择轻-中度伴失眠的抑郁症患者58例,随机分为观察组和对照组,每组29例。观察组患者给予氟西汀分散片联合舒肝解郁胶囊治疗,对照组仅给予氟西汀分散片治疗,共6周。应用汉密尔顿抑郁量表(HAMD)和匹兹堡睡眠质量指数(PSQI)评定2组患者疗效,不良反应量表(TESS)评价2组患者不良反应情况。结果治疗6周末,观察组患者治疗有效率为93.1%(27/29),对照组患者治疗有效率为82.2%(24/29),2组比较差异有统计学意义(P<0.05)。治疗前2组患者HAMD评分比较差异无统计学意义(P>0.05),治疗2、4、6周时,观察组患者HAMD评分较对照组显著降低,减分率较对照组显著升高(P<0.05)。治疗前观察组和对照组患者PSQI评分差异无统计学意义(P>0.05),治疗2、4、6周时,观察组患者PSQI评分较对照组显著降低,减分率较对照组显著升高(P<0.05)。观察组不良反应发生率(27.6%)与对照组(31.0%)比较差异无统计学意义(P>0.05)。结论与单用氟西汀相比,氟西汀联合舒肝解郁胶囊治疗伴有失眠的轻-中度抑郁症患者疗效更显著,起效更快,对失眠症状效果更好,且不增加不良反应发生率。     

丙戊酸镁联合拉莫三嗪治疗癫痫的效果

目的观察丙戊酸镁联合拉莫三嗪治疗癫痫的临床效果。方法选取2017年1月至2018年3月临颍县人民医院收治的82例癫痫患者,按照随机数表法分为对照组和观察组,每组41例。对照组接受丙戊酸镁治疗,观察组在对照组基础上加用拉莫三嗪。比较两组患者不同时间点癫痫发作频率、持续时间和生活质量[癫痫患者生活质量评定量表(QOLIE-31)评分],统计两组患者治疗效果和不良反应发生率。结果治疗后1～3个月和4～6个月,两组平均癫痫发作频率和持续时间均较治疗前降低,且观察组平均癫痫发作频率和持续时间均低于对照组,差异有统计学意义(均P<0.05)。治疗后3、6个月,两组QOLIE-31评分均较治疗前升高,且观察组QOLIE-31评分均高于对照组,差异有统计学意义(均P<0.05)。观察组治疗总有效率为92.68%,高于对照组的73.17%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论丙戊酸镁联合拉莫三嗪治疗癫痫临床效果较好,可有效降低癫痫发作频率和持续时间,改善患者生活质量。     

舒肝解郁胶囊联合西酞普兰治疗脑卒中后抑郁

目的探讨舒肝解郁胶囊联合西酞普兰治疗脑卒中后抑郁(PSD)的效果,以及对神经功能缺损症状、日常生活能力的影响。方法将64例脑卒中后抑郁患者随机均分为舒肝解郁胶囊联合西酞普兰组(观察组)和西酞普兰组(对照组),在治疗前和治疗后1、2、4、6周分别用汉密尔顿抑郁量表(HAMD)评分评定其疗效,美国国立卫生研究院卒中量表(NIHSS)和日常生活活动能力Barthel指数评分并加以比较。结果观察组和对照组总有效率分别为70.1%和61.3%,观察组疗效优于对照组(P0.05)。对照组与观察组均未见明显不良反应,差异无统计学意义(P0.05)。结论舒肝解郁胶囊联合西酞普兰对改善脑卒中后抑郁及神经功能缺损症状和日常生活能力效果较明显,优于单一药物治疗。     

舒肝解郁胶囊与西酞普兰治疗产后抑郁症的对比

目的探讨舒肝解郁胶囊对产后抑郁症的临床疗效及安全性。方法将66例产后抑郁症患者分为舒肝解郁胶囊组(观察组)和西酞普兰组(对照组),在治疗前和治疗后1、2、4、6周分别用HAMD评分量表评定其疗效,并观察两者的不良反应。并以TESS量表评定其不良反应。结果与对照组比较,观察组HAMD评分的减分率相当(P>0.05),但不良反应明显减少(P<0.01)。结论舒肝解郁胶囊治疗产后抑郁症疗效显著,临床不良反应少,适合产后抑郁症的治疗。     

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.     

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.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…