温肾宣痹汤治疗膝关节骨性关节炎的临床疗效观察

目的 观察口服温肾宣痹汤治疗膝关节骨性关节炎的临床疗效。方法 选取2018年9月～2019年12月江苏省中医院骨伤科门诊80例膝关节骨性关节炎患者作为研究对象,随机分成两组,治疗组40例,口服温肾宣痹汤加减治疗,对照组40例,口服痹祺胶囊治疗。两组经治疗2个疗程后,评估临床疗效,观察治疗后总有效率、视觉模拟疼痛评分(VAS)及WOMAC(包括疼痛、僵硬、活动度、有效性)评分方面的情况变化。结果 ①中医诊疗标准方面,治疗组总有效率92.50%,对照组75.00%,差异有统计学意义(P0.05);②两组患者VAS评分均降低,较治疗前差异有统计学意义(P0.05);治疗组VAS评分明显低于对照组,差异有统计学意义(P0.05);③与治疗前比较,两组患者在疼痛、僵硬、日常活动度、WOMAC总分方面均有改善,差异有统计学意义(P0.05),其中治疗组改善明显;尤其在疼痛评分方面,治疗组明显优于对照组,差异有统计学意义(P0.05),其他指标组间比较差异均无统计学意义(P0.05)。④两组在WOMAC评分改善方面比较差异无统计学意义(P0.05),但治疗组总有效率87.50%,明显高于对照组72.50%。结论 温肾宣痹汤治疗寒湿痹阻型膝关节骨性关节炎疗效确切,可显著缓解疼痛,改善膝关节活动度,总有效率优于痹祺胶囊,值得临床推广应用。     

骨痹汤治疗膝关节骨性关节炎126例疗效观察

目的观察骨痹汤治疗膝关节骨性关节炎的临床疗效。方法将252例膝关节骨性关节炎患者按就诊顺序分为治疗组和对照组各126例,治疗组采用骨痹汤内服、外洗,功能锻炼等康复治疗,对照组服用芬必得胶囊治疗。2周为1个疗程,连续治疗3个疗程后对2组患者疗效进行评定。结果治疗组总有效率为96.83%,对照组为88.89%。在控制疼痛、保持关节的活动功能、增强关节稳定性等方面治疗组明显优于对照组,2组总有效率比较差异有统计意义（P〈0.05）。结论骨痹汤治疗膝关节骨性关节炎疗效显著,对减轻疼痛、改善膝关节活动功能、增强关节稳定性、提高患者生活质量有重要意义,值得临床推广。     

针刺疗法配合隔物灸治疗膝关节骨性关节炎疗效观察

目的:观察针刺疗法配合隔物灸治疗膝关节骨性关节炎的临床疗效。方法:选取50例膝关节骨性关节炎患者,随机分为治疗组和对照组,每组患者各25例,治疗组采用针刺疗法配合隔物灸进行治疗,对照组单独针刺疗法治疗。每周为1个治疗周期(周日休息),3个周期后观察患者膝关节感觉及运动功能改善情况并统计临床疗效。结果:治疗3个周期后,两组的膝关节疼痛程度积分、临床症状积分及临床综合疗效均获得了改善,且治疗组的改善程度优于对照组。治疗组临床总有效率为96%,对照组临床总有效率为84%,两组疗效比较差异明显,有统计学意义(P0.05)。结论:针刺疗法配合隔物灸治疗膝关节骨性关节炎临床疗效良好,优于单一针刺治疗。     

针刺联合补正续骨丸治疗肝肾亏虚型膝骨性关节炎临床疗效

目的:探讨针刺联合补正续骨丸治疗肝肾亏虚型膝骨性关节炎的临床疗效。方法:选取医院收治膝骨性关节炎患者的108例,依据随机数字表法随机分为对照组和治疗组,各54例,对照组给予外用扶他林治疗,治疗组在对照组的基础上应用针刺联合补正续骨丸进行治疗,两组患者进行为期15 d的治疗。治疗结束后计算两组的临床总有效率,比较两组患者治疗前后中医症状积分,采用VAS评分评定患者膝骨性关节炎疼痛程度,采用WOMAC骨关节炎评分比较两组患者治疗前后日常活动度、晨起膝关节僵硬和膝痛评分。结果:治疗组临床总有效率为92.59%,对照组临床总有效率为77.78%,治疗组明显优于对照组(P0.05);治疗组治疗后较对照组患者症状积分降低幅度更大(P0.05);治疗组VAS评分较对照组下降幅度更显著(P0.05);两组患者治疗后日常活动度、晨起膝关节僵硬、膝痛均明显降低(P0.05),且治疗组变化程度更为明显(P0.05)。结论:针刺联合补正续骨丸,可以改善肝肾亏虚型膝骨性关节炎患者临床症状和体征,对于肝肾亏虚型膝骨性关节炎有较好的治疗效果,值得临床推广应用。     

中药熏洗配合手法按摩治疗膝关节骨性关节炎临床研究

目的:探讨中药熏洗配合手法按摩治疗膝关节骨性关节炎临床疗效。方法:将96例膝关节骨性关节炎患者随机分为观察组与对照组,对照组予双氯芬酸钠肠溶片治疗,观察组予中药熏洗配合手法按摩治疗,比较治疗后疗效及WOMAC积分、疼痛积分。结果:经治疗后观察组治疗总有效率为91.67%,明显高于对照组的77.08%,差异有统计学意义(P<0.05);2组WOMAC积分及疼痛积分有不同程度的下降(P<0.05),观察组优于对照组(P<0.05)。结论:中药熏洗配合手法按摩治疗膝关节骨性关节炎具有良好的治疗效果。     

针灸治疗膝关节骨性关节炎的临床疗效探析

目的研究针灸治疗膝关节骨性关节炎的临床疗效。方法将本院收治的膝关节骨性关节炎患者94例,随机分为对照组和治疗组。对照组给予布洛芬缓释胶囊口服,治疗组在对照组基础上加用针灸治疗。比较2组患者的临床疗效、不良反应、膝关节WOMAC评分以及QOL评分的差异。结果治疗组总有效率为95.74%,显著高于对照组的78.72%(P0.05);2组均未出现严重不良反应(P0.05)。治疗前,2组膝关节WOMAC评分、QOL评分比较,差异均无统计学意义(P0.05);治疗后,2组膝关节WOMAC评分和QOL评分均较治疗前显著改善(P0.05),且治疗组膝关节WOMAC评分较对照组降低更显著(P0.05),QOL评分则较对照组提高更显著(P0.05)。结论针灸治疗膝关节骨性关节炎有较好的临床疗效,可有效改善膝关节活动度、僵直情况,减轻疼痛,改善患者生活质量,值得推广。     

针刀骨减压合消痹颗粒治疗膝关节骨性关节炎46例

目的观察针刀骨减压联合中药内服治疗膝关节骨性关节炎的临床疗效。方法将92例膝关节骨性关节炎患者随机分为治疗组和对照组,每组各46例,治疗组予以骨减压联合消痹颗粒内服,对照组予以关节腔注射玻璃酸钠注射液。治疗5周后,观察并比较两组的临床疗效,并采用膝关节骨性关节炎症状分级量化评分、西安大略和麦克马斯特大学骨性关节炎指数(Western Ontario and McMaster Universities osteoarthritis index,WOMAC)和简式McGill疼痛问卷(short-form McGill pain questionnaire,SF-MPQ)评价两组的疗效。结果治疗组总体临床疗效显著优于对照组(P0.05),治疗组在降低膝关节骨性关节炎症状评分、WOMAC评分和SF-MPQ各维度评分方面显著优于对照组(P0.05,或P0.01)。结论针刀骨减压联合中药内服治疗膝关节骨性关节炎疗效显著,可改善症状、减轻疼痛、提高患者生活质量。     

四神煎合二仙汤加减配合三氧治疗骨性关节炎临床观察

目的:观察四神煎合二仙汤加减配合三氧对治疗骨性关节炎的临床效果。方法:选取骨性关节炎患者48例,随机分为治疗组和对照组两组,每组24例,治疗组口服四神煎合二仙汤加减同时配合三氧穴位痛点注射,对照组口服四神煎合二仙汤治疗。3周后,比较两组患者的疼痛评分和临床疗效。结果:治疗组的疼痛积分低于对照组,治疗组总有效率为95.83%,对照组总有效率为83.33%(P0.05),两组间的疗效差异有统计学意义。两组的治疗均可使患者的症状得到缓解和改善,但治疗组的疗效明显优于对照组。结论:四神煎合二仙汤加减配合三氧治疗骨性关节炎疗效显著。     

独活寄生汤用于膝关节骨性关节炎疼痛患者治疗中的临床研究

目的研究独活寄生汤用于膝关节骨性关节炎疼痛患者治疗中的临床效果。方法选取我院收治的100例膝骨性关节炎疼痛患者为研究对象,随机分成两组,其中试验组(50例)运用独活寄生汤干预治疗,对照组(50例)则运用常规西药干预,比较两组取得得到治疗结果。结果治疗后试验组取得的关节疼痛评分及关节功能评分均显著优于使用常规西药治疗的对照组,数据差异性显著(P0.05);试验组取得的治疗有效率98.0%显著高于对照组的84.0%,数据比较存在显著差异性(P0.05)。结论独活寄生汤与针刺联合干预的方法对于膝骨性关节炎疼痛患者来讲,疗效更为确切,可有效缓解患者的疼痛,提高膝关节功能恢复的效果,是一个较为理想的临床治疗方法,具有较高的临床推广价值。     

独活寄生汤联合热敷一号治疗膝关节骨性关节炎临床观察

目的:观察独活寄生汤联合热敷一号治疗膝关节骨性关节炎的临床疗效。方法:选取2016年11月至2017年7月许昌仁和骨科医院诊治的60例膝关节骨性关节炎患者作为研究对象,按照随机数字表法分为治疗组和对照组,各30例。治疗组给以独活寄生汤联合热敷一号治疗,对照组给予玻璃酸钠注射液膝关节腔内注射和依托考昔口服,疗程均为4周,观察治疗后两组患者视觉模拟评分(visual analogue scale,VAS)及Lequesne指数评分,评价临床疗效。结果:治疗组有效率为86.67%;对照组有效率为80.00%,两组比较,差异有统计学意义(P0.05);治疗后两组患者VAS评分和Lequesne评分均较治疗前降低,差异有统计学意义(P0.01);治疗后治疗组患者VAS评分和Lequesne评分均低于对照组,两组比较,差异有统计学意义(P0.01)。结论:独活寄生汤联合热敷一号治疗膝关节骨性关节炎具有较好的疗效,可有效缓解患者疼痛症状,改善膝关节功能。     

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…