复方薤白胶囊治疗慢性支气管炎急性发作期Ⅲ期临床研究

目的：评价复方薤白胶囊治疗痰热郁肺型慢性支气管炎急性发作期的有效性和安全性。方法：采用随机、双盲双模拟、阳性药平行对照临床试验设计。480例慢性支气管炎急性发作患者按3∶1随机进入复方薤白胶囊组(试验组,n=360)和芩暴红止咳胶囊组(对照组,n=120),疗程10 d。以慢性支气管炎急性发作期疗效、中医证候疗效、气喘起效时间和控制时间评价有效性,以不良反应、实验室检查和心电图评价安全性。结果：试验组慢支炎急性发作期疗效、中医证候疗效非劣于对照组;治疗5 d的中医症状,治疗10 d的气喘起效时间和控制时间、肺部罗音的改善均优于对照组(P＜0.05)。两组不良反应发生率分别为1.40%和1.69%,差异无统计学意义(P=1.00)。结论：复方薤白胶囊治疗慢性支气管炎急性发作期痰热郁肺证安全有效。     

急性气管炎的中医治疗方法及效果评估

目的运用中医治疗急性气管炎的方法以及治疗效果。方法主要的研究对象是我院随机抽取的100例急性气管炎的患者,把这100例患者按照就诊顺序分成两组,对照组的50例患者的治疗方法是服用复方甘草片,观察组的50例患者治疗方法采用中医的宣清润燥法,对其治疗效果进行对比。结果对比观察组和治疗组之间的最终效果,观察组的总效率在90.0%,而治疗组的总效率在58.0%,更为理想的治疗效果是观察组,对比两组的治疗效果差异,具有统计学意义(P <0.05);对两组咳嗽进行治疗之前进行差异对比没有统计学意义;经过治疗之后,对比分析两组的咳嗽症状,观察组明显比对照组效果好,对比分析两组咳嗽症状的差异具有统计学意义(P <0.05);对观察组进行治疗发现其缓解是时间在(2.2±2.7)d,而对对照组进行治疗发现其缓解的时间在(4.0±1.8)d,从而可以发现其观察组的咳嗽缓解时间明显的短而有效,对比两组的咳嗽缓解时间差异,具有统计学意义(P <0.05)。结论急性气管炎运用中医进行治疗效果更加显著,对于临床的各种症状进行改善,临床方面值得推广应用。     

中西医结合治疗慢性肺心病急性发作期40例临床疗效观察

慢性肺源性心脏病(CPHD),属中医"肺胀"范畴,多由久病肺虚、痰浊潴留、肺气胀满不能敛降所致,并逐渐损及脾肾与心,每因复感外邪诱使病情发作或加剧.病理因素主要为痰与瘀互为影响,兼见同病,病理性质多属本虚标实,常因感邪而急发,病情复杂危重,临床治疗颇为棘手.     

频谱仪照射治疗老年急性气管炎的疗效观察及护理对策

急性气管炎是老年患者常见的呼吸系统疾病，以咳嗽、咳痰、呼吸不畅等为主要临床症状。在临床治疗观察中发现，在应用常规药物治疗急性气管炎的同时，配合频谱仪照射胸前区治疗，能够快速改善临床症状，缩短治疗时间，且对老年患者急性气管炎的治疗有显著疗效，现报告如下：     

慢性阻塞性肺疾病急性加重期采用宽胸理肺汤联合三子养亲汤治疗的疗效分析

<正>我国中医将慢性阻塞性肺疾病归为"肺胀"范畴,认为该疾病出现的主要原因在于肺气壅阻、痰浊潴留。急性发作期炎症、喘、痰以及咳会明显加重,治疗上应该严格遵循祛瘀立法、化痰、理肺的原则~([1])。为了改善慢性阻塞性肺疾病急性加重期患者预后,本研究在该疾病治疗中联合应用宽胸理肺汤与三子养亲汤,报告如下。1资料与方法1.1临床资料:从2016年8月至2017年8月在我院接受治疗的慢性阻塞性肺疾病急性加重期患者中选取80例,纳入标准:①知情同意;②不存在用药禁忌证;③符合中医痰浊壅肺证的诊断标准;④病情属于急性加重期。排除标准:①正在参     

咳喘宁口服液治疗慢性气管炎100例

近年来 ,我院应用自行配制的咳喘宁口服液结合临床证型加减治疗慢性气管炎 10 0例 ,获得满意的效果 ,现报告如下。1　临床资料10 0例均属门诊患者 ,其中男 5 9例 ,女 41例 ;年龄最大6 9岁 ,最小 2 5岁。X线胸透提示双肺纹理均有不同程度的增粗 ,临床均表现为咳嗽、咳痰、气急等症状。根据中医分型 ,咳嗽、痰白而清 ,舌质淡红 ,苔薄白 ,脉浮紧 ,属寒邪袭肺型 40例 ;咳嗽 ,痰黄而稠 ,舌质淡红 ,苔薄微黄 ,脉浮数 ,属风热犯肺型 40例 ;咳嗽 ,痰黄白相兼 ,舌质淡红 ,苔厚黄而腻 ,脉滑 ,属痰湿壅肺型 2 0例。2　药物组成与配制药物组成 :麻黄 ,…     

支气管炎

中医对急性支气管炎可分风寒咳嗽或风温咳嗽。对慢性支气管炎则归纳为咳嗽的范畴。一、病因病机:急性支气管炎多由肺卫不固,在天气寒暖突变的情况下,以致感受风寒或风热(风温)等外邪而发病。邪从口鼻吸入,首犯皮毛肺卫,肺气宣降失调,则发寒热咳嗽。若外感咳嗽日久不愈,或素体虚弱,反复感邪,咳嗽屡作,肺气暗伤,变成内伤咳嗽,或久咳肺热,痰浊内蕴,则成慢性支气管炎。     

中药复方治疗慢性阻塞性肺病的研究进展

目的探讨中药复方对慢性阻塞性肺病的疗效。方法通过查阅相关资料，总结了慢性阻塞性肺病急性加重期和稳定期的病机、中医证候及中药复方的应用，介绍了慢性阻塞性肺病的现代病理研究及临床用药情况。结果中药复方结合西医常规治疗慢性阻塞性肺痛，具有疗效确切、治疗时间缩短、副作用小等特点。结论中西医结合治疗慢性阻塞性肺病，值得临床推广。     

复方五指柑胶囊治疗急性胃肠炎的多中心临床研究

目的 观察复方五指柑胶囊治疗急性胃肠炎的疗效及安全性。方法 采用多中心、随机、双盲、阳性平行对照试验方法,治疗组120例口服复方五指柑胶囊,2粒/次,3次/d。对照组120例口服复方五指柑片,4片/次,3次/d。两组患者均治疗3 d。观察两组的临床综合疗效、中医证候疗效、单个中医证候疗效。结果 治疗后,治疗组和对照组临床综合疗效总有效率分别为98.32%、98.31%,两组比较差异无统计学意义。治疗组和对照组中医证候疗效总有效率分别为98.32%、98.31%,两组比较差异无统计学意义。两组均可显著改善便次改变、便质改变、排便异常、脘腹胀痛、恶心呕吐等主症,两组的主症疗效差异均无统计学意义。结论 复方五指柑胶囊治疗急性胃肠炎疗效确切,安全性良好。     

急性肺血栓栓塞症的中医证型和证素分布规律研究

目的探讨急性肺血栓栓塞症中医证型和证素分布规律。方法采集河北省沧州中西医结合医院住院治疗的急性肺血栓栓塞患者178例,对急性肺血栓栓塞症中医证型和病性证素进行提取,并做统计学分析。结果急性肺血栓栓塞症中医证型症候分布排序为瘀血内阻证>气虚血瘀证>痰浊闭阻证>气滞心胸证>痰瘀互结证>气阴两虚证>正虚阳脱证>寒凝心脉>水凌心肺证。病性证素分布排序为血瘀>痰>气虚>气滞>阴虚>脱>寒>饮。结论急性肺血栓栓塞症中医证型以瘀血内阻证、气虚血瘀证、痰浊闭阻证为主。中医证素以血瘀、痰、气虚为主。     

麻黄碱联合丙泊酚抑制芬太尼咳嗽反射的临床研究

目的:研究麻黄碱联合丙泊酚对芬太尼咳嗽反射(fentanyl-induced cough,FIC)的抑制作用.方法:选择320例择期手术接受全麻的患者,根据计算机随机数字表随机进入4组:Ⅰ组(对照组)静脉注射2 mL生理盐水;Ⅱ组(麻黄碱组)静脉注射6 mg麻黄碱;Ⅲ组(丙泊酚组)静脉注射0.8 mg/kg丙泊酚;Ⅳ组(丙泊酚联合麻黄碱组)静脉注射0.8 mg/kg丙泊酚加6 mg麻黄碱.给予治疗药物2 min后,经外周静脉快速注射2 μg/kg芬太尼.观察并记录患者的血压、心率、脉博血氧饱和度等生命体征,并由一位医师按照盲法观察注射芬太尼后1 min内是否出现咳嗽,记录咳嗽发生的次数,并且根据咳嗽发生次数进行严重程度分级.结果:Ⅱ组、Ⅲ组和Ⅳ组患者的FIC发生率和严重程度均较Ⅰ组明显降低,而且Ⅳ组患者的血流动力学更加平稳.结论:麻醉诱导时联合应用麻黄碱和丙泊酚对FIC的抑制效果更好,患者血流动力学更加稳定,是临床上一个简单、有效的防治FIC的办法.     

培哚普利治疗急性心肌梗塞236例的效果观察

目的 :观察培哚普利治疗急性心肌梗塞的疗效。方法 :治疗组患者入院后给予口服培哚普利4mg,qd ,连用4wk。结果 :治疗组236例患者中33例死亡 ,占13 98 % ;未用培哚普利的对照组160例患者中55例死亡 ,占34 38 % (X2=22.94 ,P<0.01) ;培哚普利尚有改善左室射血分数、小轴缩短率 ,减少左室内径的作用。结论 :培哚普利对治疗急性心肌梗塞有利     

Neuropilin-1及其配体SemaphorinIII在AML和正常人骨髓中的表达初探

目的 :了解neuropilin_1基因及其配体semaphorinIII在急性髓性白血病 (AML)骨髓中的表达情况。方法 :利用逆转录_聚合酶链反应扩增20例急性髓性白血病病人骨髓单个核细胞中的neuropilin_1基因及其配体semaphorinIII基因 ,了解其表达情况。14例非血液病患者的骨髓标本作为对照。结果 :急性髓性白血病骨髓单个核细胞中的neuropilin_1基因表达率为15 0% ,semaphorinIII基因表达率为60 0% ,分别与相应正常对照(7 1 % ,57 1% )相比较无显著性差异。结论 :参与调控骨髓基质细胞的neuropilin_1基因及其配体semaphorinIII可表达于AML和正常人的骨髓细胞中 ,该结果为进一步了解此两类基因在造血中的调节作用提供了基础资料     

Influence of amifostine on toxicity of CHOP in elderly patients with aggressive non-Hodgkin's lymphoma--a phase II study

Due to concerns about toxicity, many elderly patients with aggressive non-Hodgkin's lymphoma (NHL) are not considered candidates for standard chemotherapy with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP). The cytoprotective agent amifostine has the potential to reduce toxicity when added to chemotherapy. The purpose of the current study was to examine the toxicity of CHOP combined with amifostine in elderly patients with aggressive NHL. A prospective phase II study was performed in patients aged 60 years and older. Patients with stage I/II disease received 4 cycles of CHOP followed by involved-field irradiation. Patients with stage III/IV received 6-8 cycles of CHOP. Amifostine (740 mg/m(2)) was administered as a 15-min i.v. infusion immediately before chemotherapy. Forty-one (median age 69.5 years, range 60-87) of 49 consecutive previously untreated patients, aged 60 years and older, with aggressive NHL seen in our center were included in the study. Twenty-one patients had stage I/II disease and 20 had stage III/IV disease. The patients received a total of 207 cycles of amifostine-CHOP. Infusion of amifostine caused mild to moderate transient side effects, including a drop of systolic blood pressure >20 mmHg in 54 cycles and nausea/vomiting in 36 cycles. Hematotoxicity of CHOP consisted of leukopenia grade 4 in only 15.4% of cycles. There were two cases of grade 3 anemia. No thrombocytopenia higher than grade 2 occurred. Febrile neutropenia was rare, occurring in 4.3% of cycles. One patient died after the first CHOP administration because of anthracycline-related acute cardiomyopathy (corresponding to a toxic death rate of 2.4%). The complete response rates were 85 and 75% in stage I/II and stage III/IV patients, respectively. After median follow-up of 33 months (range 17-50 months) the median overall survival was not reached in patients with stage I/II and was found to be 32 months in patients with stage III/IV. At 2 years, 76% of patients with stage I/II and 70% with stage III/IV were alive. Twelve of the 15 patients who died were aged older than 70. Amifostine pre-treatment was associated with a low toxicity of CHOP in elderly patients with aggressive NHL treated with curative intent. Treatment outcomes appeared not to be impaired by the addition of amifostine to CHOP. This schedule merits further testing in a randomized trial.     

乌司他丁治疗急性胰腺炎的临床疗效评价

目的 :观察乌司他丁 (UTI)治疗各型急性胰腺炎 (AP)的临床疗效。方法 :将 10 2例急性胰腺炎患者随机分成 2组 ,对照组 5 1例 (轻症 38例、重症I型13例 ) ;治疗组 5 1例 (轻症 38例、重症I型 13例 )。对照组采用综合基础治疗 ,治疗组在综合基础治疗的基础上加用乌司他丁。按痊愈、显效、有效和无效四级评定疗效。结果 :治疗组轻症有效率为92 .1% ,重症I型为 84 .6 % ;对照组轻症有效率为71.1% ,重症I型为 38.5 % ,两组有显著差异性 (P<0 .0 5 ) ,治疗组对腹痛、血尿淀粉酶、白细胞和TB等的恢复明显优于对照组 (P <0 .0 5 )。结论 :乌司他丁用于治疗急性水肿型胰腺炎和重症I型均有较好疗效 ,不良反应较少     

Surgical treatment of hepatocellular carcinoma with cirrhotic esophageal varices and hypersplenism:a 184 case report

In treating hepatocellular carcinoma (HCC) patients with advanced cirrhosis, one of the most difficult problems is concomitant esophageal varices and hypersplenism. Whether these conditions should be treated surgically in association with HCC resection is still in debate. To elucidate whether esophageal devascularization or splenectomy is beneficial when simultaneously performed with liver resection in HCC patients with both varices and hypersplenism, HCC patients (n = 184) with esophageal varices and hypersplenism received one of the three treatments: simultaneous liver resection and esophageal devascularization (Group I, n = 41); simultaneous liver resection and splenectomy (Group II, n = 61); liver resection only (Group III, n = 82). The incidences of postoperative complications of the three groups were 31.7%, 29.5% and 24.4%, respectively, with no significant difference among them. The 5-year tumor-free survival rates for the group I, group II and group III were 34.1%, 36.1% and 37.8%, respectively. Variceal bleeding caused death by only 4.2% in group I, but by 14.3% in group II and 23.2% in group III. The survival rates in the group I and the group II were comparable to those in the group III, however, the recurrences of postoperative fatal variceal bleeding in group I and group II were significantly lower than those in group III. The results suggest that HCC patients with esophageal varices and hypersplenism should undergo hepatic resection plus esophageal devascularization or splenectomy if radical resection of HCC can be expected.     

美罗培南治疗脓毒症休克合并急性肾功能不全的临床研究

目的探讨美罗培南对脓毒症休克合并急性肾功能不全治疗的临床疗效及安全性。方法选择78例脓毒症休克合并急性肾功能不全患者为研究对象,以随机数字表法均分为对照组与观察组;对照组实施常规治疗方案,观察组加用美罗培南治疗,对2组患者治疗后的疗效、血清学指标变化和细菌清除情况进行观察。结果观察组治疗有效率为87.18%,较对照组的有效率71.79%略高(P<0.05);治疗前2组血清学指标无差异,经治疗后2组均出现变化,且观察组与对照组差异有统计学意义(P<0.05);观察组细菌清除率为89.74%,对照组细菌清除率为74.36%(P<0.05)。结论脓毒症休克合并急性肾功能不全患者采取美罗培南治疗可取得与肾脏替代疗效相同的效果,能促进病情恢复,清除细菌感染。     

各种剖宫产术式的比较

目的 研究不同术式剖宫产对产妇的影响.方法 组1(50例),皮肤横切口不缝腹膜的新式剖宫产术.组2(48例),皮肤横切口缝合腹膜的常规剖宫产术.组3(36例)皮肤纵切口的腹膜外剖宫产术3组手术分别进行比较.结果 胎儿娩出时间组1＜组2＜组3(P＜0.01),手术时间组1＜组2＜组3,(P＜0.01).术中出血量组1＜组2 ≈组3,(P＜0.01,p＞0.05).术后肛门排气时间组1＜组3＜组2,(P＜0.01).术后疼痛率组1≈组2＜组3,(P＞0.05,P＜0.01).术后病率组3＜组1＜组2,(P＜0.01).切口感染组3＜组1 ≈ 2,(P＜0.01,P＞0.05).术后排尿困难组1＜组2＜组3(P＜0.01),术中膀胱损伤组2＜组1＜组3(P＜0.01).结论 新式剖宫产术具有手术时间短,出血量少,术后肠功能恢复快,疼痛少的特点,值得推广.腹膜外剖宫产术能明显降低术后病率及切口感染率,是剖宫产术的必要补充.     

急性白血病患儿感染细小病毒B19的血常规和临床体征分析

目的 通过检测新发现的急性白血病患儿和接受过化疗的急性白血病患儿体内细小病毒B19DNA及其血清中的特异性抗体,探讨细小病毒B19感染对患儿血常规和临床体征的影响.方法 将2011年1月-2013年1月住院的95名急性白血病患儿分为两组.第一组：50名接受过化疗的急性白血病患儿;第二组：45名新发现、未接受化疗的急性白血病患儿.两组采用PCR法检测细小病毒B19DNA,以ELISA法检测血清细小病毒B19-IgG和B19-IgM抗体.结果 ①第一组检测细小病毒B19病毒DNA阳性率为32.0％,第二组为46.7％,对照组为零.②第一组当前感染的患儿有显著的血红蛋白和中性粒细胞水平下降及淋巴细胞增多;第二组当前感染的患儿有显著的中性粒细胞减少、血小板减少以及淋巴细胞增多.③临床体征方面,两组当前感染患儿都有明显的肝脾、淋巴结肿大和发热.结论 不管有无接受过化疗,细小病毒B19感染都是急性白血病患儿血细胞减少的重要原因.此外,细小病毒B19的感染与显著的肝脾、淋巴结肿大有一定的相关性.     

The effect of local administration of N-acetylcysteine in perforated rat tympanic membrane: an experimental study in myringosclerosis.

Myringosclerosis (MyS) is a common sequela of acute and chronic otitis media and ventilation tube treatment of serous otitis media. We aimed to study the effect of topical administration of N -acetylcysteine (NAC) on MyS by assessment of otomicroscopic evaluation, lipid peroxidation and nitric oxide (NO) (nitrite/nitrate) levels in experimental myringotomized rat tympanic membrane. Thirty adult rats were used and the upper posterior quadrant of the tympanic membranes of rats was myringotomized. Thereafter, they were divided into four groups. Group I received no treatment, group II was treated with saline, groups III and IV were treated with topical NAC (0.1 ml of 6 and 12 mg ml(-1), respectively). The levels of nitrite/nitrate and malondialdehyde (MDA) were measured in serum samples. In the otomicroscopic evaluation, non-treated and saline treated ears (controls) showed extensive occurrence of myringosclerotic plaques. Groups III and IV showed fewer occurrences of sclerotic plaques. There was no significant difference between groups III and IV regarding the development of MyS. The development of myringosclerotic lesion was found to be significantly different between NAC treated groups (III and IV) and the control groups (I and II). The levels of nitrite/nitrate of both groups III and IV were significantly lower than the control groups. The levels of MDA of these groups were also significantly lower than the control group. The relationship between groups III and IV was not statistically significant for the levels of nitrite/nitrate and MDA. We conclude that the topical treatment of NAC reduces the levels of MDA and NO products in rats. These results suggest that topical NAC application may be useful for the prevention of MyS.