补肾壮骨汤联合阿仑膦酸钠治疗绝经后妇女骨质疏松症临床研究

目的:探讨补肾壮骨汤联合阿仑膦酸钠治疗绝经后妇女骨质疏松症的临床疗效。方法:选取114例绝经后妇女骨质疏松症患者,随机分为对照组和观察组。两组均予阿仑膦酸钠及钙尔奇治疗,观察组再予补肾壮骨汤治疗。观察两组治疗前后骨密度、雌二醇(estradiol,E2)、中医证候积分的变化,评估其安全性和临床疗效。结果:治疗后两组骨密度水平均高于治疗前(P0.05),且观察组高于对照组,差异有统计学意义(P0.05)。治疗后对照组E2水平与治疗前比较无统计学意义(P0.05),而观察组E2水平高于治疗前(P0.05),且高于对照组(P0.05)。治疗后两组患者中医主要证候积分均低于治疗前(P0.05),且观察组低于对照组,差异有统计学意义(P0.05)。对照组有效率为78.9%,观察组为93.0%,两组比较,差异有统计学意义(P0.05)。两组治疗过程中未见严重不良反应。结论:补肾壮骨汤联合阿仑膦酸钠治疗绝经后妇女骨质疏松症,安全可靠,疗效显著,可有效改善患者临床症状,提高骨密度及血清中E2水平。     

益气疏风通络方联合阿托伐他汀治疗2型糖尿病合并冠状动脉粥样硬化性心脏病疗效观察

目的:观察益气疏风通络方联合阿托伐他汀治疗2型糖尿病合并冠状动脉粥样硬化性心脏病的临床疗效。方法:70例2型糖尿病合并冠状动脉粥样硬化性心脏病患者随机分为对照组和观察组。对照组给予阿托伐他汀,观察组在对照组治疗基础上给予益气疏风通络方。比较两组患者的临床疗效,生存质量评分,血清血管抑素(angiostatin,AS)、内皮抑素(endostatin,ES)水平,中医证候积分及不良反应情况。结果:治疗前两组患者血清AS、ES、中医证候积分、生存质量评分比较,差异均无统计学意义(P0.05);治疗后两组患者血清AS、ES、中医证候积分均明显下降,差异具有统计学意义(P0.05);观察组治疗后以上指标均明显低于对照组治疗后,差异具有统计学意义(P0.05);与治疗前比较,治疗后两组患者生存质量评分均明显上升,差异有统计学意义(P0.05),且观察组明显高于对照组,差异具有统计学意义(P0.05)。观察组有效率为94.29%,对照组有效率为74.29%,两组比较,差异具有统计学意义(P0.05);观察组的不良反应发生率为5.71%,对照组为20.00%,两组比较,差异有统计学意义(P0.05)。结论:益气疏风通络方联合阿托伐他汀治疗2型糖尿病合并冠状动脉粥样硬化性心脏病疗效确切,可有效降低患者血清AS、ES水平,减少不良反应的发生。     

阿托伐他汀与阿仑膦酸钠联合用药在中老年骨质疏松治疗中的应用

目的:观察阿托伐他汀与阿仑膦酸钠联合用药在中老年骨质疏松治疗中的应用效果。方法:将2016年1月—2018年9月本院收治的176例中老年骨质疏松患者,依据随机数表法分为对照组和观察组,每组88例。对照组使用阿仑膦酸钠治疗,观察组在对照组基础上使用阿托伐他汀联合治疗。对比分析两组患者的疗效、骨密度变化、疼痛程度及用药安全性。结果:治疗6个月后,对照组总有效率及骨密度均低于观察组,不良反应总发生率及VAS评分均高于观察组,差异具有统计学意义(P<0.05)。结论:使用阿托伐他汀联合阿仑膦酸钠治疗骨质疏松症,可以显著提升治疗效果,改善患者骨密度,明显降低不良反应发生率,减轻疼痛程度。     

益肾强骨合剂治疗中老年肾阳虚型骨质疏松症临床研究

目的观察益肾强骨合剂治疗肾阳虚型骨质疏松症的临床研究。方法将我院脊柱骨科180例肾阳虚型骨质疏松症患者随机分为治疗组与对照组各90例对照组给予单纯口服碳酸钙D_3片,治疗组给予口服益肾强骨合剂联合碳酸钙D3片治疗。比较两组患者总有效率、中医证候积分、骨密度值、视觉模拟评分法(VAS)评分及骨标记物指标水平。结果治疗组总有效率明显优于对照组(P0.01);治疗后,两组中医证候积分、骨密度值、VAS评分及骨标记物指标均较前明显改善且治疗组较对照组改善更为显著(P0.05)。结论益肾强骨合剂联合钙尔奇治疗能够改善中老年肾阳虚型骨质疏松症症状提高患者生活质量。     

补肾化瘀方对老年性骨质疏松症肾虚血瘀证证候积分及预后的改善作用

目的 探讨补肾化瘀方对老年性骨质疏松症肾虚血瘀证证候积分及预后的改善作用.方法 以2014年3月至2016年3月我院风湿病科收治的84例老年性骨质疏松症患者为研究对象,随机数字表法均分为2组各42例,对照组给予阿法骨化醇软胶囊及强骨胶囊治疗,观察组另给予补肾化瘀方治疗,观察治疗后2组临床疗效、血液生化指标[血清碱性磷酸酶(ALP)、L-L4骨密度(BMD)、血钙(Ca2+)]、肾虚血瘀证证候积分、预后效果[膝关节功能(HSS)评分]及药物安全性.结果 治疗后观察组总有效率88.10％较对照组64.29％具有统计学意义(P＜0.05);治疗后2组ALP、肾虚血瘀证证候积分较治疗前显著降低,BMD、Ca2+、HSS评分显著升高,且治疗后观察组ALP、肾虚血瘀证证候积分较对照组降低显著,BMD、Ca2+、HSS评分升高显著,具有统计学意义(P＜0.05).结论 补肾化瘀方对老年性骨质疏松症患者临床疗效显著,是一种疗效确切、预后效果佳安全性高的中药组方,有较广泛的推广应用价值.     

补阳还五汤联合吡拉西坦治疗气虚血瘀型脑出血的效果

目的:探讨补阳还五汤联合吡拉西坦治疗气虚血瘀型脑出血的效果。方法:选取56例气虚血瘀型脑出血患者为研究对象,按照随机数字表法分为观察组和对照组,每组28例。两组均予常规治疗,对照组予吡拉西坦治疗,观察组在对照组基础上予补阳还五汤治疗。比较两组疗效,治疗前后中医证候积分、神经功能缺损评分(NIHSS)、格拉斯哥昏迷量表(GCS)评分及血清可溶性细胞黏附分子(sICAM-1)、血清胰岛素样生长因子-1(IGF-1)水平。结果:观察组总有效率为92.86%,高于对照组的71.43%,差异有统计学意义(P<0.05);观察组中医证候积分评分、NIHSS评分均低于治疗前,且观察组低于对照组,GCS评分高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组血清IGF-1水平高于治疗前,且观察组高于对照组,血清sICAM-1水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:补阳还五汤联合吡拉西坦治疗气虚血瘀型脑出血效果较佳,可进一步缓解患者症状,改善血清IGF-1、sICAM-1水平。     

阿托伐他汀治疗绝经期女性骨质疏松患者的应用效果评估

目的:研究阿托伐他汀在治疗绝经期女性骨质疏松患者的应用效果评估.方法:选取2018年1月～2019年4月于安徽理工大学第一附属医院诊治的绝经期女性骨质疏松患者126例.将患者随机分成观察组和对照组两组,观察组服用阿托伐他汀进行治疗,对照组不使用药物治疗,进行空白对照.主要观察指标为Ⅰ型胶原C端肽(C TX)、抗酒石酸酸性磷酸酶(TRACP)、血清骨钙素(BGP)、骨保护蛋白(OPG)、钙(CA)、血清碱性磷酸酶(ALP)、磷(P).观察组给予他汀类药物阿托伐他汀,口服20 mg/d,夜间20:00服用,疗程设定为3个月.结果:治疗3个月后,观察组骨代谢指标:CTX、TRACP水平均显著低于对照组,而OPG、BGP、CA、P、ALP表达水平显著高于对照组,经统计学分析显示差异均有统计学意义(P<0.01).结论:阿托伐他汀可以改善骨密度和骨代谢,对于骨质疏松患者有良好的治疗效果.     

华佗夹脊穴排刺温针法联合补脾益肾法在脾肾亏虚型骨质疏松症康复治疗研究

目的:探讨华佗夹脊穴排刺温针法联合补脾益肾法在脾肾亏虚型骨质疏松症康复治疗中的作用。方法:选取辽宁中医药大学附属医院中符合脾肾亏虚型骨质疏松症患者74例,随机分为2组,各37例。两组均给与常规康复治疗,对照组患者给予补脾益肾法治疗,每日1剂,水煎服;试验组患者在对照组的基础上联合华佗夹脊穴排刺温针法进行治疗,每日1次,所有患者均以4周为1个疗程。治疗前后对比中医证候评分、临床疗效、骨密度、血清中钙含量、骨钙素含量、疼痛视觉模拟评分、生活质量及不良反应状况。结果:与治疗前比较,两组中医证候积分及总积分均降低,BMD T值降低,血清钙、BGP水平升高,VAS评分降低,Barthel评分以及SF-36评分升高(P0.05);与对照组比较,试验组治疗后中医证候积分及总积分较低,临床总有效率较高,BMD T值较低,血清钙、BGP水平较高,VAS评分较低,Barthel评分以及SF-36评分较高(P0.05)。两组间总不良反应率对比无统计学差异(P0.05)。结论:华佗夹脊穴排刺温针法联合补脾益肾法能明显改善脾肾亏虚型骨质疏松症的中医临床症状,提高骨密度,疗效确切。     

阿托伐他汀对高血压病患者胰岛素样生长因子-1及胰岛素抵抗的影响

目的:探讨阿托伐他汀对高血压病患者胰岛素样生长因子-1(IGF-1)及胰岛素抵抗的影响。方法:2级或2级以上高血压病患者110例,随机分为对照组和阿托伐他汀治疗组各55例,前者给予常规降压治疗,后者除常规降压治疗外还给予阿托伐他汀20 mg/d治疗4周,治疗前后分别检测IGF-1、血糖、胰岛素及血脂水平。结果:与治疗前相比,治疗4周后两组病人收缩压和舒张压明显下降,阿托伐他治疗组血清总胆固醇(TC)、低密度脂蛋白(LDL-C)、IGF-1均明显降低(均P<0.01).而高密度脂蛋白(HDL)和胰岛素敏感指数(ISI)明显增高(P<0.05);治疗4周后与对照组相比.阿托伐他治疗组血清TC、LDL-C和IGF-1明显下降(均P<0.01),ISI明显增高(P<0.01)。结论:阿托伐他汀能显著降低高血压病患者血清IFG 1和血脂水平,并改善胰岛素抵抗。     

复方淫羊藿口服液治疗原发性骨质疏松症临床研究

目的:观察复方淫羊藿口服液辅助治疗原发性骨质疏松症肾阳虚证的临床疗效及其作用机制。方法:将118例原发性骨质疏松症(肾阳虚证)患者随机分为对照组和观察组,每组58例。对照组,在进行健康宣教育的基础上给予钙尔奇D片,每次1.5g,每天1次;阿仑膦酸钠,每次70 mg,每周1次,晨起顿服。观察组在对照组的基础加服复方淫羊藿口服液,每次10 m L,每天3次。疗程:两组患者均连续观察12个月。两组均采用双能X线骨密度测量仪测量治疗前后股骨颈、髓部关节和腰椎L2~4的骨密度;检测治疗前后骨碱性磷酸酶(bone alkaline phosphatase,BALP)、I型原胶原N-端前肽(type I procollagen n-propeptide,PINP)和血清I型胶原交联C-末端肽(serum type I collagen cross-linked C-terminal peptide,S-CTX)、碱性磷酸酶(alkaline phosphata,ALP)、骨钙素(bone gla protein,BGP)水平;进行治疗前后生活质量量表评分和中医证候评分。结果:观察组有效率为94.12%,高于对照组的76.00%,差异有统计学意义(χ2=6.553,P0.05);治疗后观察组股骨颈、髓部关节和腰椎L2~4的骨密度高于对照组,差异有统计学意义(P0.01);治疗后观察组患者BALP、S-CTX、PINP和ALP水平均低于对照组,BGP水平高于对照组,差异有统计学意义(P0.01);治疗后观察组OQOLS量表疾病、生理、社会、心理和满意度评分均明显升高,并高于对照组,差异有统计学意义(P0.01);观察组第3月、第6月、第9月、第12月中医证候评分均低于对照组,差异有统计学意义(P0.01)。结论:复方淫羊藿口服液治疗原发性骨质疏松证肾阳虚证患者能改善临床症状,提高骨密度,调节骨代谢和骨转换,能提高骨质疏松症临床疗效。     

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…