气滞胃痛颗粒联合枸橼酸莫沙必利治疗胃轻瘫疗效观察

目的:探讨中药制剂气滞胃痛颗粒联合枸橼酸莫沙必利治疗糖尿病性胃轻瘫的临床疗效。方法:62例糖尿病胃轻瘫患者随机分为治疗组与对照组,每组31例患者。两组均给予降糖药物及饮食控制血糖,使血糖达标,在此基础上,对照组加用枸橼酸莫沙必利,治疗组采用气滞胃痛颗粒联合枸橼酸莫沙必利进行治疗。两组治疗4周后,比较临床疗效、临床症状评分、胃排空率,并观察不良反应情况。结果:经过4周的治疗,治疗组的治疗有效率为93.55%,明显高于对照组(P<0.05)。治疗组治疗后的临床症状评分明显低于对照组,胃排空率明显高于对照组,差异均具有统计学意义(P<0.05)。结论:气滞胃痛颗粒联合枸橼酸莫沙必利治疗糖尿病胃轻瘫疗效满意,不但可较好的改善糖尿病性胃轻瘫患者的临床表现,还能改善胃肠蠕动功能及增加胃排空率。     

枸橼酸莫沙必利联合四磨汤治疗老年糖尿病胃轻瘫临床观察

目的观察枸橼酸莫沙必利与四磨汤联合治疗老年糖尿病性胃轻瘫的临床疗效。方法将84例老年糖尿病胃轻瘫患者随机分为两组,均给予常规降糖治疗,对照组加用枸橼酸莫沙必利,治疗组在对照组基础上加用四磨汤口服液治疗。连续治疗6周,对比两组患者血糖控制情况、胃排空时间、有效率、不良反应发生率以及半年内复发率。结果治疗组有效率显著高于对照组(P0.01);两组治疗前空腹血糖(FPG)、餐后2h血糖(2h PG)及胰岛素抵抗指数(IRI)比较无显著差异(P0.05),治疗后均较治疗前显著改善(P0.05);两组治疗前胃排空时间比较无统计学差异(P0.05),治疗后两组胃排空时间均显著缩短(P0.01),且治疗后治疗组胃排空时间显著短于对照组(P0.01);两组不良反应发生率比较无统计学差异(P0.05);治疗组半年内复发率为4.8%,显著低于对照组的28.6%(P0.01)。结论枸橼酸莫沙必利联合四磨汤用于老年糖尿病胃轻瘫患者的治疗,可有效改善患者的症状,促进胃肠蠕动能力,缩短胃排空时间,改善胃肠道内分泌,提高胃肠道消化功能,且复发率较低,安全可靠,值得推广。     

莫沙必利联合氟哌噻吨美利曲辛对伴焦虑抑郁状态FD患者的胃排空功能、胃肠激素水平及精神状态的影响

目的 探究莫沙必利联合氟哌噻吨美利曲辛对功能性消化不良(FD)伴焦虑抑郁状态患者的胃排空功能、胃肠激素水平及精神状态的影响。方法 选取我科2017年10月至2019年10月期间89例伴焦虑抑郁状态的FD患者,根据随机数字表法分组。对照组44例予以莫沙必利治疗,观察组45例予莫沙必利联合氟哌噻吨美利曲辛治疗,观察两组患者的临床疗效、胃排空功能、胃肠激素水平、精神状态及不良反应。结果 治疗后观察组VIP水平、SAS、SDS、胃底气体评分低于对照组,MTL、SP水平、总有效率、胃排空率高于对照组,有统计学意义(P<0.05)。观察组不良反应发生率8.89%高于对照组6.82%,无统计学意义(P>0.05)。结论 莫沙必利联合氟哌噻吨美利曲辛对伴焦虑抑郁状态FD患者治疗,可有效降低焦虑抑郁情绪,改善胃肠激素水平和胃肠排空功能,提升临床疗效,药物安全性高。     

莫沙必利对功能性消化不良及近端胃舒张和胃排空功能的疗效研究

目的：探讨莫沙必利治疗功能性消化不良（FD）及近端胃舒张和胃排空功能的临床疗效。方法选择在该院治疗的FD患者102例,随机分为莫沙必利组（观察组）和吗丁啉多潘立酮片组（对照组）各51例,观察两组的临床疗效,采用LOGIQ‐GE‐200型诊断仪检测治疗前、后近端胃舒张和胃排空功能。结果观察组临床有效率为86．27％,明显高于对照组的64．71％,两组比较差异有统计学意义（P＜0．05）;观察组胃底气体评分和近端胃排空率均显著优于对照组（P＜0．05）;观察组服药后近端胃排空明显优于对照组（P＜0．05）;观察组不良反应发生率为3．9％,与对照组比较差异无统计学意义（P＞0．05）。结论莫沙必利治疗FD临床效果优于吗丁琳,且能显著改善患者的近端胃舒张以及胃排空功能。     

枸橼酸莫沙必利治疗儿童功能性消化不良疗效及安全性观察

目的评价枸橼酸莫沙必利治疗儿童功能性消化不良(FD)的疗效及安全性。方法60例FD患儿随机分为2组,治疗组予以枸橼酸莫沙必利0.2mg/kg,3次/d;对照组予多潘立酮0.3mg/kg,3次/d。疗程均为4周。结果4周后,2组FD患儿的症状均明显改善,与治疗前相比,差异均有统计学意义(P均<0.05);治疗组总效率为86.7%,对照组为63.3%,2组疗效差异有统计学意义(P<0.05)。2组不良反应发生率无显著性差异(P>0.05)。结论枸橼酸莫沙必利是治疗儿童FD安全有效的药物。     

莫沙必利治疗功能性消化不良疗效及安全性分析

目的 探讨莫沙必利治疗功能性消化不良的疗效及安全性,并与西沙必利比较其在功能性消化不良治疗中的疗效及安全性.方法 整群选取2014年5月—2015年1月该学校附属医院确诊为功能性消化不良的患者216例分为观察组和对照组,各108例,观察组给予莫沙必利5 mg/次,3次/d,餐前服用,对照组给予西沙必利5 mg/次,3次/d,餐前服用,疗程均为4周,观察并比较两组患者治疗前后症状改善、胃排空改善、不良反应发生情况及QTC间期检查情况.结果 观察组中所有症状在治疗2周和治疗4周后均有显著改善(P<0.05);对照组中,除呕吐在治疗2周(P=0.3907)和治疗4周(P=0.0520)改善不明显外,其余症状在治疗2周和治疗4周后均有显著改善(P<0.05);治疗后,观察组总症状改善率、 胃排空改善率、 不良反应发生率分别为74.07%、87.04%、4.63%,与对照组(73.15%、83.33%、6.48%)比较差异无统计学意义(P>0.05);两组均未发现治疗后QTC间期延长超过440 ms.结论 莫沙必利治疗功能性消化不良疗效确切,安全性高,值得临床推广使用.     

西沙必利、盐酸多塞平联合治疗功能性消化不良的疗效观察

目的观察西沙必利、盐酸多塞平联合应用对功能性消化不良(FD)的治疗作用。方法76例FD患者随机分为两组,治疗组予以西沙必利5mg,盐酸多塞平12.5mg,3次/d;对照组予以西沙必利5mg;3次/d,疗程均为4周。结果治疗组痊愈率、总有效率分别为57.9%及86.8%;对照组痊愈率、总有效率分别为15.8%及60.5%,两组对比差异均有显著性(P<0.01)。随访3个月后治疗组与对照组复发率分别为12.1%和34.5%,两组对比差异有显著性。两组治疗后不良反应均较轻微,不影响治疗。结论西沙必利、盐酸多塞平联合应用是治疗FD安全有效的药物。     

45例功能性消化不良胃排空研究

目的　建立国人胃排空正常值 ,探讨口服不透X线银环标记物胶囊方法对功能性消化不良 (FD)患者的胃排空研究价值。方法　通过受试者于早 8时随标准试餐吞服一粒含 2 4枚银环标记物的胶囊 ,于 4h小时后摄仰卧位腹部平片 1张 ,记数胃内残留的标记物数 ,按公式计算 4小时胃排空率。对胃排空延迟的FD患者给予西沙必利口服治疗 4周后复查 4小时胃排空率 ,比较服药前后的变化。结果　正常人 4h胃排空率为 (94 .5± 5 .2 ) % ;4 5例FD患者中有 31例 (6 8.9% )胃排空延迟 ,服用西沙必利 4周后 2 4例 (78% )患者的胃排空缩短至正常 ,服药前后比较有显著性差异(P <0 .0 1)。结论　口服不透X线银环胶囊方法测定FD患者胃排空操作简便、准确可靠。FD患者有胃排空延迟的动力学特点 ,服用促动力药物治疗FD患者疗效显著     

口服莫沙必利治疗功能性消化不良的随机对照试验

目的　观察新型促胃肠动力药莫沙必利 (胃 5 HT4受体促进剂 )对功能性消化不良 (FD)的随机对照试验。方法　FD患者 42例 ,随机分为试验组 (2 1例 ,服枸橼酸莫沙必利片 )和对照组 (2 1例 ,服吗叮啉片 )。采用GCP标准 ,双盲法观察 ,在实验开始前、服药第 1 4、2 8天记录症状变化及副作用发生情况。随机抽取部分患者于实验开始前和结束时做99MTc胃排空试验。结果　莫沙必利对FD症状的疗效与吗叮啉组相当 (P >0 .0 5 )。99MTc胃排空测定发现莫沙必利组治疗后的半排时间 (45 .0 5± 1 2 .2 1 )min缩短 ,1 2 0min残留率 (2 9.73%± 8.5 1 % )减少 (P <0 .0 5 ) ,两组病例未发现毒副反应。结论　莫沙必利对于FD疗效良好 ,对胃排空延迟有良好疗效 ,安全度高。     

实时B型超声观察西沙比利与胃排空的关系

目的　观察西沙比利治疗FD的临床疗效 ,并探讨其作用机制。方法　采用二维实时超声诊断仪 ,检测 6 0例各亚型FD患者的胃排空情况 ,并以 4 5名健康者作对照。随机将FD患者分为两组 :西沙比利组、安慰剂组。于治疗前后进行B超胃排空检测 ,同时对两组进行疗效观察。结果　获得正常人B超胃动力学指标 :MI为 :136 6 .73± 4 6 9.0 6 ;T1/ 2 为 :2 6 10± 5 .0 1(分 ) ;T为 :4 6 .6 2± 7.87(分 )。FD患者 (主要为运动障碍型及反流样型 )胃排空较正常对照组明显延迟。治疗 2周末、4周末 ,西沙比利组各项胃动力学指标及症状评分均较治疗前有显著改善 (P <0 .0 1,P <0 .0 0 1) ;而安慰剂组则无明显改善 (P >0 .0 5 )。结论　实时B超胃排空检测所获得的各项胃动力学指标结果可靠 ,可作为评价FD疗效的客观依据 ;西沙必利具有选择性地促进全胃肠动力的作用 ,可明显改善FD患者的胃动力状态 ,缓解临床症状     

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.