手法复位加中药熏洗治疗旋前外展型踝关节骨折效果探讨

目的：分析研究手法复位加中药熏洗治疗旋前外展型踝关节骨折的临床应用价值。方法：选取2008年8月至2012年8月在该院接收的旋前外展型踝关节骨折患者一共有56例，对56例患者采取手法复位加中药熏洗治疗，对其临床治疗效果给予分析。结果：56例患者，其中优43例（76.79％）；良10例（17.86％）；差3例（5.36％），优良率为94.64％，临床手术以后跟踪随访6个月～3年，病人全部治愈。结论：旋前外展型踝关节骨折采取手法复位加中药熏洗治疗，可以使相关症状得到明显改善，使临床治疗效果进一步提高，具有临床推广价值。     

Tribulus terrestris versus placebo en el tratamiento de la disfunción eréctil: un estudio aleatorizado,prospectivo y doble ciego

ObjectivesTo evaluate the possible effects of Tribulus terrestris herbal medicine in the erectile dysfunction treatment and to quantify its potential impact on serum testosterone levels.Design and methodsProspective, randomized, double-blind and placebo-controlled study including thirty healthy men selected from 100 patients who presented themselves spontaneously complaining of erectile dysfunction, ≥ 40 years of age, nonsmokers, not undergoing treatment for prostate cancer or erectile dysfunction, no dyslipidemia, no phosphodiesterase inhibitor use, no hormonal manipulation and, if present hypertension and/or diabetes mellitus should be controlled. International Index of Erectile Function (IIEF-5) and serum testosterone were obtained before randomization and after 30 days of study. Patients were randomized into two groups of fifteen subjects each. The study group received 800 mg of Tribulus terrestris, divided into two doses per day for thirty days and the control group received placebo administered in the same way.ResultsThe groups were statistically equivalent in all aspects evaluated. The mean (SD) age was 60 (9.4) and 62.9 (7.9), P = .36 for intervention and placebo groups, respectively. Before treatment, the intervention group showed mean IIEF-5 of 13.2 (5-21) and mean total testosterone 417.1 ng/dl (270.7-548.4 ng/dl); the placebo group showed mean IIEF-5 of 11.6 (6-21) and mean total testosterone 442.7 ng/dl (301-609.1 ng/dl). After treatment, the intervention group showed mean IIEF-5 of 15.3 (5-21) and mean total testosterone 409.3 ng/dl (216.9-760.8 ng/dl); the placebo group showed mean IIEF-5 of 13.7 (6-21) and mean total testosterone 466.3 ng/dl (264.3-934.3 ng/dl). The time factor caused statistically significant changes in both groups for IIEF-5 only (P = .0004), however, there was no difference between the two groups (P = .7914).ConclusionsAt the dose and interval studied, Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone.     

Impact of mulberry leaf extract on type 2 diabetes (Mul-DM): A randomized,placebo-controlled pilot study

AimsMulberry leaves have been used anecdotally in Asia to treat many disease states, including glucose abnormalities. Animal and human studies illustrate potential benefit of mulberry leaf extract (MLE) in type 2 diabetes mellitus (DM2). The purpose of this study is to evaluate the glycemic and safety effects of MLE in patients with DM2.Materials & methodsThis randomized, double-blind, placebo-controlled pilot study evaluated MLE (1000 mg standardized) versus matching placebo given three times daily with meals. Patients (n = 24) were included if they had DM2 on single or combination oral therapy with a stable hemoglobin A1C (A1C). A 2-week placebo run-in (baseline) was followed by initiation of randomized medication for 3 months. Primary endpoints were change in A1C and self-monitoring blood glucoses (SMBG). Safety was also evaluated.ResultsOf 24 patients enrolled, 17 patients completed the study. Post-prandial SMBG was significantly decreased at 3 months in the MLE group versus baseline (16.1%; p < 0.05). This improvement in post-prandial SMBG persisted when compared to placebo (18.2%; p < 0.05). A1C decreased from 7.30% at baseline to 6.94% in the MLE group but did not reach statistical significance (p = 0.079). There was no difference in A1C between MLE and placebo. A significant 15% increase occurred in serum creatinine when the MLE group was compared to baseline or placebo (p < 0.05 for both). There was no significant effect on weight, fasting SMBG, blood pressure, hypoglycemia, or other safety evaluation markers.ConclusionsThese results suggest that mulberry leaf extract may be a useful complementary mealtime glucose option for patients with DM2.ClinicalTrials.gov Identifier NCT00795704.     

Drug- and Herb-Induced Liver Injury in Clinical and Translational Hepatology: Causality Assessment Methods,Quo Vadis?

Drug-induced liver injury (DILI) and herb-induced liver injury (HILI) are typical diseases of clinical and translational hepatology. Their diagnosis is complex and requires an experienced clinician to translate basic science into clinical judgment and identify a valid causality algorithm. To prospectively assess causality starting on the day DILI or HILI is suspected, the best approach for physicians is to use the Council for International Organizations of Medical Sciences (CIOMS) scale in its original or preferably its updated version. The CIOMS scale is validated, liver-specific, structured, and quantitative, providing final causality grades based on scores of specific items for individual patients. These items include latency period, decline in liver values after treatment cessation, risk factors, co-medication, alternative diagnoses, hepatotoxicity track record of the suspected product, and unintentional re-exposure. Provided causality is established as probable or highly probable, data of the CIOMS scale with all individual items, a short clinical report, and complete raw data should be transmitted to the regulatory agencies, manufacturers, expert panels, and possibly to the scientific community for further refinement of the causality evaluation in a setting of retrospective expert opinion. Good-quality case data combined with thorough CIOMS-based assessment as a standardized approach should avert subsequent necessity for other complex causality assessment methods that may have inter-rater problems because of poor-quality data. In the future, the CIOMS scale will continue to be the preferred tool to assess causality of DILI and HILI cases and should be used consistently, both prospectively by physicians, and retrospectively for subsequent expert opinion if needed. For comparability and international harmonization, all parties assessing causality in DILI and HILI cases should attempt this standardized approach using the updated CIOMS scale.     

痛泻要方加味配合太宁栓治疗慢性溃疡性直肠炎临床观察

根据慢性溃疡性直肠炎的病因病机和中医辨证与辨病、整体与局部相结合的原则，采用自拟痛泻要方加味口服，配合太宁栓纳肛治疗慢性溃疡性直肠炎37例（治疗组），并与西药柳氮磺吡啶口服配合甲硝唑等保留灌肠治疗的38例（对照组）进行疗效比较。结果显示，治疗组治愈率、总有效率分别为67．6％和100％；对照组分别为36．8％和94．7％。两组治愈率差异有统计学意义（P〈0．05），总有效率差异无统计学意义（P〉0．05）。随访1年，治疗组治愈率、总有效率分别为62．1％和86．5％，对照组治愈率、总有效率分别为21．1％和55．3％；两组差异均有统计学意义（P〈0．01）。结果表明，痛泻要方加味配合太宁栓治疗慢性溃疡性直肠炎具有较好疗效。     

Garcinia cambogia,Either Alone or in Combination With Green Tea,Causes Moderate to Severe Liver Injury

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熏洗治疗的研究进展

熏洗疗法是传统中医外治法的重要组成部分,是根据中医辩证论治方法,选择适宜中药煎煮,或熏蒸,或洗浴全身、局部治疗疾病的方法。熏洗疗法具有温经散寒、行气活血、祛风除湿、清热解毒等作用,可用于治疗临床大多数疾病,近年来随着对透皮技术及自动化熏洗仪的研究,与现代科技相结合的熏洗技术已不同于几千年前,疗效也获得越来越多的肯定,现将近年来中药熏洗疗法的研究概况综述如下。     

黄芪对免疫损伤性肝纤维化大鼠的治疗作用

目的:研究中药黄芪的抗肝纤维化作用,对比观察中药861合剂及其组分之一黄芪对肝纤维化的治疗作用。方法:采用大鼠白蛋白免疫损伤性肝纤维化动物模型,通过光镜、电镜观察、胶原免疫组化染色及胶原蛋白生化测定。结果,黄芪可使大鼠肝纤维化程度及超微结构的病理改变明显减轻,减少总胶原及Ⅰ、Ⅱ、Ⅴ型胶原在肝内的沉积,随着疗程的延长,作用更为显著。同时以肝总胶原蛋白含量为指标,黄芪的抗肝纤维化作用不如中药861合剂。结论:黄芪与其它成份组成中药复方可加强抗纤维化作用。