脾胃病临证治法心得

脾胃病常表现为本虚标实，或虚实夹杂，往往以脾胃虚弱为本，水湿、湿热、瘀血、浊毒为标，且有升降失常、寒热相兼的特点。故笔者治疗脾胃病，常采用多种治法，并结合辨证分型，灵活用药，获满意疗效，现分述如下。     

肠易激综合征患者的睡眠特征

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.     

卡介菌多糖核酸注射液联合依巴斯汀治疗慢性荨麻疹疗效观察

目的探讨使用卡介菌多糖核酸注射液联合依巴斯汀治疗慢性荨麻疹疗效,以供临床参考。方法卡介菌多糖核酸注射液与口服依巴斯汀治疗慢性荨麻疹并与单纯口服依巴斯汀对照观察。结果治疗组患者总有效率为81.39%;对照组患者总有效率为52.38%。治疗组总有效率明显优于对照组,P<0.05。结论采用卡介菌多糖核酸注射液联合依巴斯汀治疗慢性荨麻疹疗效较好,不良反应较少,值得在临床推广使用。     

HPLC测定圣济鳖甲丸中二苯乙烯苷的含量

目的 建立高效液相色谱法测定圣济鳖甲丸中制何首乌的2,3,5,4′-四羟基二苯乙烯-2-Ο-β-D-葡萄糖苷(简称二苯乙烯苷)的含量。 方法 采用高效液相色谱法,色谱柱为Agilent Extend-C₁₈(250 mm×4.6 mm,5 µm),流动相为乙腈-水(14∶86),检测波长为320 nm,流速为1.0 mL·min^-1。结果 二苯乙烯苷在48.64~243 2 ng内线性关系良好(r＝1.000)。平均回收率为100.22%(RSD=0.45%,n＝7)。结论 该方法简单、快速、重复性好,可作为圣济鳖甲丸的质量控制方法。     

司帕沙星致光敏性药疹20例临床分析

[目的]探讨司帕沙星引起光敏性药疹的临床特点及治疗。[方法]对司帕沙星引起光敏性药疹20例进行回顾性分析。[结果]此类光敏性药疹皮损局限于暴光部位,停服司帕沙星,口服抗组胺药物有效。[结论]司帕沙星引起光敏性药疹潜伏期1d-7d左右,停药、避光,按一般光敏性皮炎处理,预后良好。     

老年病人便秘的有效护理方法

便秘是严重危害老年人身心健康的常见多发病之一,老年人以慢性功能性便秘多见,常表现为排便次数1周内少于2～3次,大便量少,干燥坚硬,排出困难,患者不仅有腹胀不适,食欲不振,心烦失眠等症状,严重便秘的老年人还发生粪便嵌顿、痔疮、肛裂,甚至导致急性心梗和猝死的发生.我科自2005年10月至2006年10月对60例便秘患者进行了针对性治疗与护理,收到了满意的效果.     

茶碱缓释片联合短期甲基泼尼松龙治疗支气管哮喘急性发作的临床观察

目的比较茶碱缓释片(舒弗美)单独与联合短期甲基泼尼松龙(甲强龙)对支气管哮喘急性发作治疗的临床效果。方法将78例临床确诊为支气管哮喘急性发作的患者随机分为两组,每组39例,治疗组接受茶碱缓释片(舒弗美)联合甲基泼尼松龙治疗,对照组单独接受舒弗美治疗。比较用药前、用药3天后两组患者肺功能及临床症状改善情况。结果治疗组临床控制26例,显效7例,有效4例,无效2例,总有效率94.9%;对照组临床控制24例,显效8例,有效3例,无效4例,总有效率89.7%;总有效率两组比较差异无统计学意义(χ2=0.675,P=0.377)。在胸闷、呼吸困难及低氧等症状评分减少方面,治疗组优于对照组(93.7±14.3 vs 82.1±14.8,P=0.025)。在肺功能方面,两组治疗后较治疗前均有改善,但治疗组FVC改善更明显(1.52±0.51 vs 2.01±0.45,P=0.044)。结论舒弗美联合短期甲强龙可明显改善支气管哮喘患者的气道阻塞,缓解临床症状,缩短住院时间,疗效显著。     

清开灵注射液配合针灸治疗小儿上呼吸道感染发热60例分析

目的观察清开灵配合针刺大椎穴治疗小儿上呼吸道感染伴发热的临床疗效。方法 120例上呼吸道感染伴发热的患儿随机分为观察组和对照组各60例,两组均给予支持治疗,对照组给予清开灵静滴,观察组在对照组用药基础上配合针刺大椎穴加拔火罐治疗,1日1次;疗程3～5d。结果观察组有效率93.3%,明显高于对照组(P<0.05);观察组的退热时间和症状体征消失时间也明显优于对照组(P<0.05)。结论清开灵配合针刺大椎穴治疗小儿上呼吸道感染伴发热疗效显著,患儿恢复快且不良反应少,值得在临床推广。     

菱形切口外剥内扎术治疗混合痔126例

混合痔是肛肠科多发病,主要症状是便血、脱出、坠痛等。目前,治疗混合痔的方法甚多,各有所长。外剥内扎术治疗混合痔临床应用广泛,也在不断地被改良。我院2009年12月至2011年10月采用菱形切口外剥内扎术治疗混合痔126例,获得满意疗效,报道如下:1临床资料1.1一般资料本组126例均为Ⅲ、Ⅳ期混合痔患者,部分伴有直肠黏膜内脱和乳头肥大。手术禁忌证:伴有妊娠、     

慢性阻塞性肺疾病患者继发真菌感染84例临床分析

目的:探析临床慢性阻塞性肺疾病(COPD)继发肺部真菌感染患者发病的相关因素与临床疗效.方法 对我院2009年2月～ 2011年2月收治的84例COPD继发肺部真菌感染患者的临床资料进行回顾性分析.结果 导致COPD发病的相关因素有:真菌培养结果以酵母菌为主,其中白色念珠菌29株,热带念珠菌27株,曲霉菌13株,光滑假丝酵母菌15株;发病原因为滥用抗生素和长期使用糖皮质激素,以及低蛋白血症等.治愈68例,显效4例,无效4例,死亡8例.总有效率85,71％.结论 确诊继发肺部真菌感染患者应积极治疗原发病,及时调整抗生素.对长期使用广谱抗生素和糖皮质激素患者应及早诊断治疗,可有效降低肺部真菌感染的发病率.