按压手法加中药热敷治疗肿痛型痔病的疗效观察

目的观察按压手法加中药热敷治疗有肿痛症状痔病的临床疗效。方法将238例有肿痛症状的痔病患者随机分为两组,治疗组120例,对照组118例。治疗组采用按压手法加中药热敷技术,对照组采用传统的中药熏洗疗法,两组采用相同的外用中药,观察两组的临床疗效。结果治疗结束后,两组显愈率差异有统计学意义（P〈0．05）。治疗组治疗后第1天、第4天、第7天疼痛和肛缘水肿积分分别低于对照组（P〈0．05）。治疗组治疗后不同时间段疼痛和肛缘水肿积分依次比较,差异均有统计学意义（P〈0．05）。对照组治疗后第4天、第7天疼痛和肛缘水肿积分分别低于治疗前和第1天（P〈0．05）,第7天疼痛和肛缘水肿积分均低于第4天（P〈0．05）。结论中药熏洗治疗肿痛型痔病有一定的疗效;按压手法加中药热敷治疗肿痛型痔病疗效显著。     

手法加热敷治疗巨大型腰椎间盘突出症疗效研究

目的：探讨手法加热敷治疗巨大型腰椎间盘突出症的临床疗效。方法：回顾性分析2004年5月-2009年5月汕头市中医院收入的30例巨大型腰椎间盘突出症患者,所有患者为随机选取,治疗中以手法加热敷治疗为主,结合其他中医疗法进行治疗。记录与分析患者病程中的各项临床数据。结果：治疗前后的VAS和JOA的评分结果比较,t值分别为12.931、5.160,而腰椎活动度各项指标比较差异也有统计学意义（P〈0.05）。VAS评分的改善率为（28.33±21.38）%,结果为显效;JOA评分的改善率为（36.64±26.88）%,结果为显效。结论：手法加热敷治疗对巨大型腰椎间盘突出症患者的疗效较为显著,值得在临床治疗中应用与推广。     

中医临床技术、管理方法与疗效评价研究简况

中医特色临床诊疗技术整理和研究形成由专家委员会和数据管理中心对重点环节监控、技术持有者和单位作为主体组织临床验证和推广的研究管理模式,达到提高第三方验证的科学性、客观性和研究水平和管理效率的目的,初步形成了中医临床诊疗技术遴选、评价和管理的工作程序包括诊疗技术作用机理、推广形成机制、日常诊疗方法(足浴、贴敷与热熨、刮痧、拨罐、施炙)、康复阶段中医调理、等。临床疗效评价存在诸多不足,正确评价临床疗效关键环节是建立中医干预措施有效性和应用科学方法检验的假说,注意把握中医理论与临床治疗基本特点,采用现代临床研究科学方法。     

艾盐包热熨中脘穴治疗卵巢癌化疗后恶心呕吐疗效观察

目的观察艾盐包热熨中脘穴治疗卵巢癌化疗后恶心呕吐的临床疗效。方法将104例卵巢癌化疗患者随机分为治疗组53例和对照组51例。在化疗期间,对照组采用单纯止吐药物治疗,治疗组在对照组治疗基础上采用艾盐包热熨中脘穴治疗。结果治疗组总有效率为94.3%,对照组为70.6%,两组比较差异具有统计学意义(P0.05)。结论艾盐包热熨中脘穴是一种治疗卵巢癌化疗引起恶心呕吐的有效方法。     

热软膏的薄层色谱鉴别

目的对热软膏鉴别方法进行研究。方法采用薄层层析法,对药品中所含的桉叶油进行鉴别。结果制定的鉴别方法排除了药品中其它成份对被检成份的干扰,专属性强,重现性好。结论本法可用于热软膏的质量控制。     

丹皮酚的镇痛作用

目的:观察丹皮酚的镇痛作用.方法:采用醋酸扭体法和热板法观察丹皮酚的镇痛作用. 结果:小鼠连续3天灌胃给予丹皮酚50.27mg/kg、25.14mg/kg和12.57mg/kg,均能明显减少醋酸所致小鼠的扭体反应次数,使热刺激所致小鼠疼痛的痛阈值明显提高.结论:丹皮酚具有镇痛作用.     

The menopausal hot flush-Anything new?

Although the hot flush is generally recognised by women and the medical profession as the most characteristic and often a very distressing symptom of the climacteric, it remains an enigma. The physiological changes associated with the hot flush are different from any other flushing condition, with an increased peripheral blood flow, increased heart rate and in particular a decrease in galvanic skin resistance, which is unique to the flush. Flushing occurs as a result of disturbance of the temperature regulating mechanism situated in the hypothalamus, and probably a reduction in the thermoneutral zone, within which fluctuations of basal body temperature do not provoke compensatory vascular responses. Many factors have been implicated, including hormone releasing factors, gonadotrophins and neurohumorals. However, the role of oestrogen is critical and the clinical value of oestrogen therapy is well established and has been confirmed by a Cochrane review. Nevertheless, the precise mechanism by which reduced circulating levels of oestrogen are involved in causing the flush has not yet been established. Priming with oestrogen seems to be an essential pre-requisite for flushing, as young women with ovarian dysgenesis and very low circulating levels of oestrogen never have hot flushes unless they are given oestrogen replacement therapy, which is later discontinued. Oestrogen antagonist activity by selective oestrogen receptor modulators such as tamoxifen and raloxifene can also cause flushing. A link with gonadotrophins is demonstrated by a temporal association of flushes with the pulsatile release of luteinising hormone (LH). However, if LH pulses are eliminated by GnRH analogue, the frequency of flushing is not altered, which confirms that LH is merely associated with the flush rather than being causative. It is probable that the flush is initiated by a supra-pituitary mechanism which is influenced by the hypothalamic factors responsible for pulsatile LH release. A variety of chemical pathways have been proposed involving serotonin, noradrenalin and dopamine. Trials of drugs that selectively inhibit the re-uptake of serotonin and noradrenalin have shown some beneficial effects, as also has gabapentin, but often the results have been disappointing, and certainly less than the response seen with oestrogen or tibolone. The prevalence of hot flushes varies considerably around the world and is less in the Far East than in the west. Differences in diet and in particular the intake of phytoestrogens has been implicated and many studies have tried to establish whether dietary supplementation with phytoestrogens might be a suitable alternative to conventional hormone replacement therapy (HRT). So far, the results are disappointing. Other lifestyle measures such as avoiding alcohol, caffeine and spicy foods, keeping the core body temperature cool, paced respiration, taking exercise and even acupuncture may help. Hot flushes remain a major cause of reduced quality of life in a large proportion of menopausal women, but perhaps because they are not fatal and are usually self-limiting, there has been rather limited research or clinical interest. However, for the increasing number of women being treated with tamoxifen for breast cancer, and for whom oestrogen will usually be contra-indicated or unsuitable, there is an urgent need to identify the underlying mechanism so that appropriate, specific and safe non-oestrogen therapy can be offered to improve their quality of life.     

Effective and clinically meaningful non-hormonal hot flash therapies

Although many non-hormonal compounds have shown statistically significant benefit over placebo in hot flash randomized controlled trials (RCTs), these studies have varied considerably in basic methodology making it challenging to deduce which compounds have the greatest potential to provide clinically meaningful benefit. This review used evidence-based methodology closely mirroring the FDA and EMEA guidelines as a template to identify "well-designed" RCTs from which effective and clinically meaningful non-hormonal hot flash therapies could be identified. In addition, pertinent safety information was reviewed. Out of 3548 MEDLINE citations and abstracts, 51 well-designed hot flash RCTs were identified. From these trials, gabapentin, oxybutynin ER, desvenlafaxine, soy-derived isoflavones and black cohosh each showed a clinically meaningful treatment effect in at least 1 RCT. Among these 5 compounds, only gabapentin demonstrated consistent and statistically significant benefit over placebo in all of its well-designed RCTs. Desvenlafaxine, soy-derived isoflavones, and black cohosh demonstrated statistically significant benefit over placebo in 75%, 21%, and 17% of the well-designed RCTs for each compound, respectively. There was only 1 well-designed RCT using oxybutynin ER, which showed it to have a robust and clinically meaningful benefit. In terms of safety, there have been cardiovascular risks associated with desvenlafaxine use in postmenopausal women with hot flashes. The use of anticonvulsants, in general, has been associated with an absolute 0.21% increase in suicidal thoughts and behavior. Further research is needed with several of these nonhormonal compounds to replicate these findings and to also directly compare their efficacy and tolerability with those of hormone replacement therapy.     

Phytoestrogens for menopausal symptoms: a review

Objective

To review the evidence that isoflavones are effective treatments for menopausal symptoms and to present the safety data.

Methods

The databases Scopus, ScienceDirect and Primo Central Index were searched and preference was given to systematic reviews and meta-analyses.

Results

The available evidence suggests that isoflavones do not relieve menopausal vasomotor symptoms any better than placebo. Long-term safety studies suggest that women who consume a diet high in isoflavones may have a lower risk of endometrial and ovarian cancer.

Conclusions

Isoflavones cannot be recommended for the relief of hot flushes.     

微波萃取技术在食用植物油与潲水油中胆固醇含量测定的应用

目的:建立植物油类物质(火锅油、潲水油、地沟油及食用植物油)中胆固醇含量测定前处理的快捷方法,并采用超高液相-串联四极杆质谱(UPLC-MS/MS)技术定量分析。方法:采用微波萃取技术对植物油类物质进行皂化处理,再用石油醚-乙醚(1∶1)提取后,以2,2,3,4,4,6-d6胆固醇为内标,采用UPLC-MS/MS法,大气压化学电离源(APCI)正离子模式,多反应检测方式测定胆固醇浓度。结果:与传统水浴加热皂化方法前处理植物油类物质比较,微波萃取皂化前处理方法简变、快捷、高效、低污染等优点,测得胆固醇的含量几乎无显著性差别,方法回收率为98%。结论:微波萃取皂化前处理方法可用于植物油类物质中胆固醇含量测定。