基于仝小林院士脏腑风湿理论探讨新型冠状病毒肺炎康复期的中药治疗

仝小林院士将新型冠状病毒肺炎定名为"寒湿疫"，并以此理论为基础制定了初期、中期、重症期及恢复期的中医治疗方案，同时基于仝院士学术理论体系中的"脏腑风湿"理论，根据恢复期 "余毒未清，正虚邪恋"的病机特点，探讨其符合具备脏腑风湿行成3个基本要素：即外受寒湿裹挟戾气为必要外因；脏腑内虚为重要基础；邪疫伏留胶着，正邪交争为致病关键。故在辨证施治中可应用脏腑风湿理论以调理脾胃，化湿透邪，补益肺脾，顾护阳气，养阴生津。     

Poncet病(病例报告及文献复习)

目的 探讨Poncet病的诊断与治疗。方法 通过病例报告及献复习，综述了Poncet病的发病机理、临床表现。结果 提高对Poncet病的认识。结论 临床上对风湿性或类风湿性关节炎病人均应与本病鉴别。     

HPLC法测定辣椒风湿膏中辣椒素的含量

目的:建立辣椒风湿膏中辣椒素的含量测定方法.方法:选用C18柱,稀磷酸(PH=3.1～3.5)溶液-乙腈(50:50)为流动相,检测波长207nm.结果:此方法线性关系良好,平均加样回收率为98.1%,RSD为0.84%(n=5).结论:方法简便,结果准确,灵敏度高,重复性好,可用于辣椒风湿膏的质量控制.     

Section 2 The comparison of four non-steroidal antirheumatic agents in the treatment of rheumatic diseases

Summary

A comparative open study was made of the effectiveness of four antirheumatic agents in the treatment of 69 hospitalised patients with rheumatic diseases who had failed to respond satisfactorily to previous therapies. Simple subjective and objective assessments showed that approximately half the patients treated with ibuprofen, oxyphen-butazone or mefenamic acid showed improvement, but that fewer did so with flufenamic acid. Full therapeutic effect of the drugs was evident in approximately 3 weeks.     

Criteria for assessing pain and nonarticular soft-tissue rheumatic disorders of the neck and upper limb

OBJECTIVE: To critically review the criteria used to diagnose nonarticular soft-tissue rheumatic disorders of the neck and upper limb. METHODS: An extensive search of the literature, including a search of Medline and EMBASE, authoritative recent reviews, and relevant textbooks, was completed. The diagnostic criteria used in epidemiologic studies were compared and the reliability and validity of these criteria were assessed. RESULTS: Altogether, the search identified 117 relevant research articles, among which 69 included a physical examination component, but few specified diagnostic criteria. Evidence supported respectable levels of between-observer repeatability regarding: symptom questionnaires (kappa, 0.52 to 0.79); measurement of shoulder range of motion with a goniometer (intraclass coefficients > 0.70); tests for carpal tunnel syndrome (Tinel's and Phalen's kappa, 0.53 to 0.80); and demonstration of neck tenderness (kappa = 0.43). The Katz hand diagram, and combinations of physical signs of carpal tunnel syndrome, show reasonable sensitivity and specificity for that diagnosis but only among patients referred to specialists with that putative diagnosis; no such validity has been shown among the general population. Only 1 diagnostic examination schedule has published data on both the reliability and the validity of its criteria and diagnoses. For the remaining soft-tissue upper-limb disorders, diagnostic criteria rely apparently on face and content validity and reliability data have not been published. CONCLUSION: Classification of specific disorders of the neck and upper limb requires a back to basics approach. At present, the diagnosis of most of these conditions relies heavily on the clinical opinions of investigators and there are insufficient data to indicate that these criteria are repeatable, sensitive, or specific. Recent European initiatives offer scope to follow a more disciplined approach, but more work is urgently required.     

系统应用糖皮质激素患者的FRAX骨折风险评估分析

目的 通过使用糖皮质激素（glucocorticoid,GC）校正的骨折危险性评估工具（fracture risk assessment tool,FRAX）,评估系统应用GC对风湿病患者群体骨折风险的影响。方法 纳入2019年1月至2020年1月于解放军总医院第四医学中心就诊且行髋部和腰椎骨密度检测的风湿病患者180例和同期健康体检者180名,风湿病患者均系统性使用GC治疗超过3个月,按照日均GC剂量（等同于醋酸泼尼松）分为GC≤7.5 mg组,7.5 mg＜GC＜30 mg组和≥30 mg组,并对剂量超过7.5 mg的两组进行骨折风险校正,使用FRAX评估系统评估未来10年主要骨质疏松性骨折（PMOF）和髋部骨折（PHF）发生概率,并比较组间的差异。结果 ①激素使用组PMOF和PHF高于健康对照组,且差异有统计学意义（P＜0.05）;②按GC使用时间分为＞2年组和≤2年组,GC使用＞2年组PMOF和PHF均高于≤2年组,且差异有统计学意义;③FRAX校正前GC≤7.5 mg组的PMOF与PHF高于另外两组,差异有统计学意义;④FRAX校正后GC≤7.5 mg组PMOF与PHF仍高于另外两组,与GC≥30 mg组相比差异有统计学意义;⑤按骨质疏松治疗阈值PMOF 20 %、PHF 3 %计算,激素使用组达到PMOF和PHF治疗阈值者分别为0例和9例（5 %）;按2017年GIOP推荐的骨质疏松治疗阈值PMOF 10 %、PHF 1 %计算,达治疗阈值者分别为8例（4.44 %）和41例（22.78 %）。结论 经GC校正后可提高基于FRAX计算出的风湿病患者的骨折风险,且校正后增加了达到骨质疏松治疗阈值的人数,能更有效的预测使用GC的风湿病群体骨折概率,尽早实施预防骨质疏松,从而降低骨折概率。     

Section 3 The activity and tolerance of ibuprofen in patients with rheumatism and associated conditions

Summary

Ibuprofen, in a daily dosage range of 600?mg. to 1200?mg., was given to 100 patients suffering from a variety of rheumatic conditions for periods ranging from 1 to 3 months. The drug was found to be effective and well-tolerated by the majority of patients, even by those with associated conditions such as gastro-intestinal disorders which often make treatment difficult with other antirheumatic agents. Side-effects were reported in only 4 patients.     

Further studies on glucametacin in rheumatoid arthritis and in other chronic types of rheumatism

Summary

Twenty-three patients with rheumatoid arthritis and 9 patients with other forms of rheumatic diseases were treated for 20 days with 420?mg glucametacin per day, given as three 140?mg capsules. The treatment produced anti-inflammatory effects which were rated as good in about half the cases, with improvement of the majority of the clinical parameters studied. There were mild digestive side-effects. One patient with gallstones developed biliary colic, but the relationship of this to glucametacin treatment was not clear. The results obtained in the 32 patients treated with 140?mg glucametacin capsules were very similar to those which the same authors had observed in a very extensive case series of patients with rheumatic diseases treated with the same daily dose, but given as 70?mg capsules. It is suggested that the new preparation, which halves the number of capsules taken each day, is to be preferred to the smaller dose capsules.     

汕头地区农村人群软组织风湿病流行病学调查

目的了解汕头地区农村人群软组织风湿病(STR)的流行情况,探讨STR的相关危险因素。方法流行病学调查采用亚太地区风湿病学会联合会(APLAR)社区控制风湿病规划(COPCORD)委员会的《软组织风湿病调查表》(草案),按COPCORD程序对汕头市澄海区某乡2 350名16岁以上居民进行调查。采用Logis-tic回归分析,观察年龄、性别、体重指数、腰臀比、职业等因素对STR的影响。结果STR患病率为5.74%,男女患病率分别为3.50%及7.88%;校正后患病率分别为男3.39%,女6.82%,总患病率为5.22%。患病率随年龄增加呈升高趋势。肱骨外上髁炎、回旋肌套腱炎、跖痛症、指屈肌腱鞘炎、足底筋膜炎为常见的STR,患病率分别为0.98%,0.89%,0.72%,0.68%,0.68%;仅发现2例纤维肌痛综合征。Logistic回归分析显示,年龄、性别、职业(手工劳动者)是STR的相关危险因素。结论汕头地区农村人群STR常见,但纤维肌痛综合征少见。年龄、性别、职业可能是STR的危险因素。