拉米夫定联合扶正化瘀胶囊治疗肝纤维化的临床观察

目的:观察拉米夫定联合扶正化瘀胶囊治疗慢性乙型肝炎和代偿期肝硬化患者抗肝纤维化的临床疗效.方法:选择98例慢性乙型肝炎和代偿期肝硬化患者,随机分为两组.对照组50例采用单一拉米夫定治疗,治疗组48例采用拉米夫定联合扶正化瘀胶囊治疗.观察两组治疗前后患者的主要症状、体征及肝功能和肝纤维化指标[透明质酸(HA)、层黏蛋白(LN)、IV型胶原(IV C)、Ⅲ型前胶原(PC Ⅲ)]的变化.结果:治疗组较对照组明显改善慢性乙型肝炎和代偿期肝硬化患者症状、体征及肝功能.两组治疗后肝纤维化4项指标比较,差异有显著性(P＜0.05).结论:联合治疗抗慢性乙型肝炎和代偿期肝硬化的纤维化疗效明显优于单用对照组.     

拉米夫定片联合扶正化瘀胶囊治疗慢性乙型肝炎疗效观察

目的 评价拉米夫定片联合扶正化瘀胶囊治疗慢性乙型肝炎的疗效及安全性.方法 将45例慢性乙型肝炎患者随机分成治疗组(30例)和对照组(15)例,治疗组接受拉米夫定联合扶正化瘀治疗,对照组单用拉米夫定,疗程均为6个月.两组患者在治疗前后均行血清纤维化、肝功能、血清病毒学指标检测.结果 拉米夫定片联合扶正化瘀胶囊治疗的患者在治疗结束时,在改善主要症状和体征、肝功能、血清肝纤维化指标方面优于单用拉米夫定片治疗的患者(P<0.05),但两组HBV-DNA转阴率和血生化指标的改善差异无显著性意义(P>0.05).结论 拉米夫定片联合扶正化瘀胶囊治疗慢性乙型肝炎能明显改善患者的症状、体征、血清肝纤维化、肝功能、血清病毒学指标,且比单用拉米夫定片治疗慢性乙型肝炎在血清肝纤维化方面疗效更好.     

替比夫定联合扶正化瘀胶囊治疗慢性乙肝纤维化效果观察

目的探讨替比夫定联合扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化的临床效果。方法 72例慢性乙型肝炎患者分为研究组和对照组,各36例。对照组给予替比夫定治疗,研究组则给予替比夫定联合扶正化瘀胶囊进行治疗,对比两组患者治疗前后的肝功能、HBV-DNA以及血清肝纤维化指标的变化情况。结果两组患者经治疗后肝功能指标均有所改善,研究组的改善程度明显优于对照组;研究组患者的肝纤维化指标改善亦明显优于对照组(P<0.05),在HBV-DNA转阴情况对比,无显著差异(P>0.05)。结论替比夫定联合扶正化瘀胶囊治疗慢性乙型肝炎抗纤维化效果显著,能有效改善慢性乙肝肝纤维化患者的病情及预后情况,值得在临床上推广应用。     

中药两头尖提取物抗慢性乙型肝炎肝纤维化67例临床观察

目的探讨中药两头尖提取物抗慢性乙型肝炎肝纤维化的临床疗效。方法选取67例慢性乙肝肝纤维化患者,随机分为治疗组与对照组。对照组33例在护肝治疗基础上,单用甘草酸二铵胶囊,疗程12周。治疗组34例在对照组基础上加服两头尖提取物,疗程12周。分别于治疗前后观察两组患者的症状体征,肝脏组织病理,测定肝功能及血清肝纤维化指标4项:透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)。结果治疗组和对照组总有效率分别为82.35%、69.70%,治疗组疗效优于对照组(P0.05);与治疗前比较,治疗组患者治疗后肝脏组织病理、肝功能、肝纤维化指标均有明显改善(P0.05)。结论两头尖提取物具有改善肝功能,抗慢性乙型肝炎肝纤维化的良好作用。     

扶正化瘀胶囊联合阿德福韦酯治疗慢性乙型肝炎肝纤维化疗效观察

目的观察扶正化瘀胶囊联合阿德福韦酯治疗慢性乙型肝炎肝纤维化疗效。方法将128例病毒性肝炎乙型慢性患者随机分成两组,对照组给予阿德福韦酯胶囊口服,同时常规给予维生素、肌苷片,治疗组在对照组的基础上给予扶正化瘀胶囊,疗程12个月。结果扶正化瘀胶囊联合阿德福韦酯能改善患者的胁痛、乏力、纳差、腹胀、目黄症状和体征;改善肝功能,ALT、TBIL下降显著两组比较差异有意义（P〈0.05）;血清纤维化指标的改善显著,两组比较差异有意义（P〈0.05）。结论扶正化瘀胶囊联合阿德福韦酯治疗慢性乙型肝炎肝纤维化有协同抗肝纤维化作用。     

Influence of silybin on hepatic fibrosis indexes in patients with chronic hepatitis B

目的 观察水飞蓟宾治疗对慢性乙型肝炎患者肝纤维化指标的影响.方法 89例慢性乙肝患者随机分为对照组(n=44)和观察组(n=45),对照组采取一般保肝治疗和拉米夫定抗病毒治疗,观察组在此基础上加用水飞蓟宾卵脂复合物胶囊,治疗前后检测肝功能,用放射免疫法检测血清纤维化指标Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CIV)、透明质酸(HA)、层粘蛋白(LN).结果 观察组治疗后血清PCIII、CIV、HA、LN水平较治疗前及对照组治疗后均显著降低(P<0.05).结论 水飞蓟宾治疗对慢性乙型肝炎患者具有抗肝纤维化的作用,值得临床推广.     

水飞蓟宾治疗对慢性乙型肝炎患者肝纤维化指标的影响

目的观察水飞蓟宾治疗对慢性乙型肝炎患者肝纤维化指标的影响。方法 89例慢性乙肝患者随机分为对照组(n=44)和观察组(n=45),对照组采取一般保肝治疗和拉米夫定抗病毒治疗,观察组在此基础上加用水飞蓟宾卵脂复合物胶囊,治疗前后检测肝功能,用放射免疫法检测血清纤维化指标Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CIV)、透明质酸(HA)、层粘蛋白(LN)。结果观察组治疗后血清PCIII、CIV、HA、LN水平较治疗前及对照组治疗后均显著降低(P<0.05)。结论水飞蓟宾治疗对慢性乙型肝炎患者具有抗肝纤维化的作用,值得临床推广。     

异甘草酸镁联合扶正化瘀胶囊治疗慢性乙型肝炎疗效观察

目的 观察异甘草酸镁注射液联合扶正化瘀胶囊治疗慢性乙型肝炎肝功能及肝纤维化指标的影响.方法 随机选取100例慢性乙型肝炎病人,50例为治疗组,50例为对照组,两组在性别、年龄、病程、HBV标记物、肝功能检验等方面均无统计学差异(p<0.05).治疗组用异甘草酸镁注射液联合扶正化瘀胶囊,对照组用还原性谷胱甘肽注射液,疗程两组均为四周,观察其肝功能及肝纤维化指标的变化.结果 治疗组对肝功能及肝纤维化指标方面明显优于对照组(p<0.05).结论 异甘草酸镁注射液联合扶正化瘀胶囊治疗慢性乙型肝炎患者具有良好的抗纤维化疗效.     

扶正化瘀胶囊合复方丹参注射液治疗老年慢性肝炎60例临床分析

目的：应用扶正化瘀胶囊联合复方丹参注射液治疗60例老年慢性肝炎患者,观察治疗前后肝纤维化四项、肝功能临床症状及体征变化。方法：传统老年慢性肝炎病人1005例,分为治疗组（60例）和对照组（45例）,两组均给予基础保肝治疗。治疗组则给予扶正化瘀胶囊,复方丹参注射液＋葡萄糖注射液静滴,疗程个月。观察血肝纤维化指标、肝功能复常率、临床症状及体征。结果：两组症状比较有明显差异（P〈0.01）,治疗组优于对照组。肝功能复常治疗组93%,对照组50%,两组对比差异明显。降低血清ALT及总胆红素含量,提高血清白蛋白含量及白/球蛋白比值,显著降低患者血清中MAO活性、TIMP、PⅢP、Ⅳ-C、HA、IN含量,治疗组优于对照组。结论：应用扶正化瘀胶囊联合复方丹参注射可明显降低老年慢性肝损伤所致肝纤维化程度,明显改善老年人肝脏血液供应,增加免疫机能,促进肝功能较快恢复。     

扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化疗效观察

目的：观察扶正化瘀胶囊治疗慢性乙型肝炎（CHB）肝纤维化的临床疗效。方法：对照组45例采用α-2b干扰素及一般保肝治疗，治疗组46例在对照组用药的基础上加用扶正化瘀胶囊，治疗时间两组均为6个月。结果：治疗组及对照组患者肝功能、乙肝病毒标志物及肝纤维化指标均有改善，但在部分指标上，治疗组优于对照组。结论：扶正化瘀胶囊对CHB肝纤维化不但有改善肝功能、抗肝纤维化的作用，而且具有调整机体免疫功能的作用，并促进HBV在肝脏内的有效清除。     

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…