痹祺胶囊联合塞来昔布治疗膝骨性关节炎的临床研究

目的探讨痹祺胶囊联合塞来昔布治疗膝骨性关节炎的临床疗效。方法选取2013年10月—2016年8月天津中医药大学第一附属医院收治的膝骨性关节炎患者85例,根据治疗方式的不同将患者分为对照组(42例)和治疗组(43例)。对照组患者口服塞来昔布胶囊,1粒/次,2次/d;治疗组患者在对照组的基础上口服痹祺胶囊,2粒/次,2次/d。两组患者治疗时间均为8周。评价治疗后两组患者临床疗效,同时比较治疗前后两组Lequesnse指数、WOMAC评分和血清炎症指标变化。结果治疗后,对照组的总有效率为73.81%,显著低于治疗组的90.70%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者Lequesnse指数和WOMAC评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者Lequesnse指数和WOMAC评分下降更显著,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清超敏C-反应蛋白(hs-CRP)、白细胞介素-1(IL-1)、IL-6水平较治疗前均明显降低(P0.05);且治疗后治疗组患者hs-CRP、IL-1、IL-6水平显著优于对照组(P0.05)。结论痹祺胶囊联合塞来昔布治疗膝骨性关节炎临床疗效较好,能够显著改善膝关节功能,并降低血清炎症因子水平,具有一定的临床推广应用价值。     

芪骨胶囊联合骨瓜提取物注射液治疗中老年不稳定型桡骨远端骨折的疗效观察

目的探讨芪骨胶囊联合骨瓜提取物注射液治疗中老年不稳定型桡骨远端骨折的临床疗效。方法选取2015年10月—2016年12月高唐县人民医院收治的中老年桡骨远端骨折患者116例,随机分为对照组和治疗组,每组各58例。对照组静脉滴注骨瓜提取物注射液,50 mg加入5%葡萄糖溶液250 m L中,1次/d;治疗组在对照组的基础上口服芪骨胶囊,3粒/次,3次/d。两组均持续治疗4周。观察两组的临床疗效,同时比较两组治疗前后VAS评分、肿胀程度及其疼痛缓解、肿胀消除和骨折愈合的时间。结果治疗后,两组总有效率比较差异不具有统计学意义。治疗1、4周后,两组患者VAS评分和肿胀程度评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗1周后治疗组的上述评分明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组疼痛缓解时间、消肿时间以及骨折愈合时间均较对照组明显缩短,两组比较差异具有统计学意义(P0.05)。结论芪骨胶囊联合骨瓜提取物注射液治疗中老年不稳定型桡骨远端骨折能有效减轻患者疼痛和肿胀情况,缩短止痛、消肿以及骨折愈合的时间,具有一定的推广应用价值。     

穴位注射腺苷钴胺治疗腰椎间盘突出症的疗效观察

目的观察穴位注射腺苷钴胺治疗腰椎间盘突出症的临床疗效。方法选取2015年12月—2016年11月到天津市南开医院康复科就诊的腰椎间盘突出症患者58例,随机分为对照组和治疗组,每组各29例。对照组患者给予电针治疗,5次/周,10次为1个疗程。治疗组在对照组治疗基础上给予穴位注射注射用腺苷钴胺,5次/周,10次为1个疗程。两组患者均连续治疗2个疗程。观察两组的临床疗效,比较两组治疗前后JOA评分、VAS评分、Oswestry功能障碍指数(ODI)的变化情况。结果治疗后,对照组和治疗组的总有效率分别为82.76%、93.10%,两组比较差异具有统计学意义(P0.05)。治疗1、2个疗程后,两组患者JOA主观症状评分、JOA临床体征评分均较治疗前显著升高,VAS评分、ODI指数均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗1个疗程后,治疗组JOA主观症状评分高于对照组,VAS评分、ODI指数低于对照组;治疗2个疗程后,治疗组JOA主观症状评分、JOA临床体征评分高于对照组,VAS评分低于对照组,两组比较差异具有统计学意义(P0.05)。结论穴位注射腺苷钴胺治疗腰椎间盘突出症具有较好的临床疗效,可显著改善患者临床症状,具有一定的临床推广应用价值。     

前列舒通胶囊联合坦索罗辛治疗IIIB型前列腺炎的疗效观察

目的探讨前列舒通胶囊联合坦索罗辛治疗IIIB型前列腺炎的临床疗效。方法以2015年8月—2016年8月在南阳市中心医院进行治疗的88例ⅢB型前列腺炎患者为研究对象,根据治疗方案的差别分为对照组和治疗组,每组各44例。对照组口服盐酸坦索罗辛缓释胶囊,1粒/次,1次/d。治疗组在对照组基础上口服前列舒通胶囊,3粒/次,3次/d。两组患者均连续治疗6周。观察两组的临床疗效,比较两组NIH-CPSI评分、白细胞、最大尿流率的情况。结果治疗后,对照组、治疗组总有效率分别为79.55%、95.45%,两组总有效率比较差异有统计学意义(P0.05)。治疗后,两组疼痛不适、排尿症状、生活质量评分和NIH-CPSI评分总分均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组降低得更显著,两组比较差异有统计学意义(P0.05)。治疗后,两组前列腺液中白细胞显著降低,最大尿流率显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论前列舒通胶囊联合盐酸坦索罗辛缓释胶囊治疗IIIB型前列腺炎效果显著,可明显改善患者临床症状,值得临床推广应用。     

Effects of vitamin D supplementation as an adjuvant therapy in coronary artery disease patients*

Objectives: Low vitamin D status has been shown to be associated with coronary artery disease. We planned to research the effects of vitamin D₃ supplementation on the severity of coronary artery disease. Design: We investigated the effect of 0.5 μg vitamin D₃ per day in a randomized, placebo-controlled, double-blind study in 90 stable coronary artery disease patients residing in Beijing. Coronary angiography was performed before and after 6 months of treatment that took place between January and June. 25-Hydroxyvitamin D was measured by chemiluminescence assay. Coronary artery disease severity was assessed by using the SYNTAX scores. Results: In vitamin D supplementation group, there was a significant increase in mean 25-hydroxyvitamin D levels from baseline (19.9?±?9.8 ng/ml) to 6 months (35.8?±?12.1 ng/ml; p?<?0.001). At 6 months, the primary end point, a difference in the fall of SYNTAX score between the groups was ?2.5 (95% CI ?5.1 to ?0.5; p?<?0.001) under intention to treat analysis. Compared with the control group, patients treated with vitamin D₃ also had greater decreases in high sensitivity C-reactive protein and renin-angiotensin system activity (p?<?0.05). Conclusions: Vitamin D supplementation has beneficial effects on coronary artery disease; it can be an adjuvant therapy for patients with coronary artery disease.     

On the road to precision,there is more practical medicine to be implemented

Estimates are that of the annual global burden of 1.5 million new cases of breast cancer, two-thirds have hormone receptor positive tumors; a majority of these women come from low- and middle-income countries. For adjuvant patients with hormone receptor positive tumors, a major goal is identification of a “precision medicine”, implying a genomic, test whose application will allow identification of those whose systemic treatment can be hormonal therapy alone. Such tests in current use are very expensive and thus in the foreseeable future are out of reach of most women who pay out of pocket.For some time it has been evident that quantitative scoring of tumors for intensity and prevalence of tumor-cell staining for estrogen or progesterone receptor (ER or PR) expression (the commonest system was first described by Allred and thus provides “Allred” scores) gives an inexpensive measure of likelihood of response to hormonal therapies – a different predictive, precision medicine tool. Majorities of hormone receptor positive tumors (one third of all patients) have “Allred” scores of 6–8 (versus scores of 3–5) for both ER and PR and these tumor-bearing patients benefit significantly more from hormonal treatments than their lowering scoring-afflicted women. When ER and PR quantitative intensity and prevalence scoring is combined with Her-2/neu testing and careful tumor histologic grading, luminal A and B type tumors can be well-defined and gene-expression testing adds little practical predictive information.For women with hormone receptor positive tumors, high quality, cost-effective “precision medicine” is available without tumor gene-expression testing.     

Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Count and Plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study

BackgroundThrombocytopenia has been shown to predict mortality. We hypothesize that platelet indices may be more useful prognostic indicators. Our study subjects were children one month to 14 years old admitted to our hospital.AimTo determine whether platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) and their ratios can predict mortality in hospitalised children.MethodsChildren who died during hospital stay were the cases. Controls were age matched children admitted contemporaneously. The first blood sample after admission was used for analysis. Receiver operating characteristic (ROC) curve was used to identify the best threshold for measured variables and the ratios studied. Multiple regression analysis was done to identify independent predictors of mortality.ResultsForty cases and forty controls were studied. Platelet count, PCT and the ratios of MPV/Platelet count, MPV/PCT, PDW/Platelet count, PDW/PCT and MPV × PDW/Platelet count × PCT were significantly different among children who survived compared to those who died. On multiple regression analysis the ratio of MPV/PCT, PDW/Platelet count and MPV/Platelet count were risk factors for mortality with an odds ratio of 4.31(95% CI, 1.69–10.99), 3.86 (95% CI, 1.53–9.75), 3.45 (95% CI, 1.38–8.64) respectively. In 67% of the patients who died MPV/PCT ratio was above 41.8 and PDW/Platelet count was above 3.86. In 65% of patients who died MPV/Platelet count was above 3.45.ConclusionThe MPV/PCT, PDW/Platelet count and MPV/Platelet count, in the first sample after admission in this case control study were predictors of mortality and could predict 65% to 67% of deaths accurately.     

心理疏导联合健康宣教对高位复杂肛瘘术后患者换药时切口疼痛的效果评价

目的：探讨心理疏导联合健康宣教对高位复杂肛瘘术后患者换药时切口疼痛的效果。方法将77例行肛肠外科手术治疗的高位复杂性肛瘘患者根据其术后护理方法分为对照组（n＝38）与观察组（n＝39）。对照组采用常规护理,观察组在此基础上采用心理疏导联合健康宣教。比较2组患者换药时及换药后10 min视觉模拟评分（ VAS评分）、健康教育达标率及护理工作满意度、换药后生活自理能力。结果（1）2组患者换药后10 min VAS评分与换药时比较差异有统计学意义（P＜0．05）,且从术后第2天开始,观察组患者换药后10 min VAS评分均显著小于对照组患者换药后10 min VAS评分,差异有统计学意义（P＜0．05）;（2）观察组患者健康教育达标率及护理工作满意度（94．84％,100％）均显著高于对照组（86．84％,89.47％）,差异有统计学意义（P＜0．05）;（3）观察组患者换药后生活自理能力优良率（89．74％）高于对照组（81.58％）,差异有统计学意义（P＜0．05）。结论心理疏导联合健康宣教可有效缓解高位复杂肛瘘术后患者换药时切口疼痛,改善患者生活质量,提高护理满意度及生活自理能力。     

生脉胶囊联合米力农注射液治疗缺血性心肌病的临床研究

目的探讨生脉胶囊联合米力农注射液治疗缺血性心肌病的临床效果。方法选取2015年7月—2017年7月南阳市中心医院收治的缺血性心肌病患者106例,随机分为对照组(53例)和治疗组(53例)。对照组在1~7 d静脉注射米力农注射液,首次负荷剂量为50μg/kg,5~10 min缓静注完,再以0.5μg/(kg·min)进行维持治疗,最大剂量≤1.13 mg/(kg·d)。治疗组在对照组基础上口服生脉胶囊,0.9 g/次,3次/d。两组患者均连续治疗2周。评价两组患者临床疗效,同时比较治疗前后两组患者临床症状积分、血清炎性因子和血浆脑钠肽(BNP)水平及心功能指标。结果治疗后,对照组和治疗组临床有效率分别为73.58%和92.45%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者各项症状积分均显著减少(P0.05),且治疗组临床症状积分明显低于对照组(P0.05)。治疗后,两组血清C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α和血浆BNP水平较治疗前均显著降低P0.05),且治疗后治疗组明显低于对照组(P0.05)。治疗后,两组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)值均显著降低(P0.05),左室射血分数(LVEF)值显著增加(P0.05),同时,治疗组治疗后心功能指标明显优于对照组(P0.05)。结论生脉胶囊联合米力农注射液治疗缺血性心肌病更能迅速缓解患者症状体征,减轻机体炎性损伤,提高心功能。     

胆康胶囊联合头孢哌酮钠舒巴坦钠治疗慢性胆囊炎的临床研究

目的探讨胆康胶囊联合头孢哌酮钠舒巴坦钠治疗慢性胆囊炎患者的临床效果。方法选取2016年7月—2017年7月国药东风花果医院收治的慢性胆囊炎患者175例,随机分成对照组(87例)和治疗组(88例)。对照组患者静脉滴注注射用头孢哌酮钠舒巴坦钠,4.0 g加入5%葡萄糖注射液100 mL,2次/d。治疗组患者在对照组的基础上口服胆康胶囊,4粒/次,3次/d。两组患者均治疗2周。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状积分、VAS评分、SF-36评分、肿瘤坏死因子-α(TNF-α)、β-内啡肽(β-EP)和超氧化物歧化酶(SOD)水平及不良反应情况。结果治疗后,对照组和治疗组临床有效率分别为82.76%和95.45%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者右腹部疼痛,腹胀,恶心、厌油等症状积分均显著下降(P0.05),且治疗组患者各项症状积分比对照组降低的更明显(P0.05)。治疗后,两组患者VAS比治疗前均显著降低(P0.05),SF-36评分显著升高(P0.05),同时治疗组患者VAS和SF-36评分比对照组患者改善更明显(P0.05)。治疗后,两组患者TNF-α和β-EP水平显著降低(P0.05),SOD血清水平显著升高(P0.05),同时治疗组患者TNF-α、β-EP和SOD血清水平明显优于对照组患者(P0.05)。治疗期间,对照组患者不良反应发生率为18.39%,显著高于治疗组的5.68%,两组患者比较差异具有统计学意义(P0.05)。结论胆康胶囊联合头孢哌酮钠舒巴坦钠治疗慢性胆囊炎患者临床疗效显著,并可改善患者的临床症状,降低不良反应发生率。