Effects of the Clearing the Lung and Dissipating Phlegm Method in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Objective: The objective of this study is to evaluate the efficacy and safety of the clearing the lung and dissipating phlegm method in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD) and to provide evidence for the treatment of the disease. Materials and Methods: Literature was searched from the United States National Library of Medicine(PubMed), Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database(Wanfang), and the Full?Text Database of Chinese Scientific and Technical Periodicals(VIP).A comprehensive collection was made of randomized controlled trials(RCTs) before June 2018, in which the treatment groups used either the clearing the lung and dissipating phlegm formulas only or combined it with routine Western medicine therapy, and the control group adopted routine Western medicine therapy only for the acute exacerbation of COPD. The Cochrane risk of bias method was used to evaluate the quality of the literature. The data were analyzed and retrieved independently by two reviewers before meta?analysis was carried out with RevMan 5.3 software to evaluate the primary outcome measures, including the total clinical effective rate, and the secondary outcome measures such as the pulmonary function(forced vital capacity [FVC], forced expiratory volume in the 1 s [FEV1], percentage of FEV1 [FEV1%], and FEV1/FVC)and blood gases(PaO_2 and PaCo_2). Results: A total of 13 RCTs involving 990 patients(496 in the treatment group and 494 in the control group)were included in this study. Meta?analysis revealed significant difference in the efficacy of the group that adopted solely the routine Western medicine method and the group that combined the Western medicine with the clearing the lung and dissipating phlegm method. Outcome measures including the pulmonary function(FVC, FEV1, FEV1%, and FEV1/FVC) and the blood gases(PaO_2 and PaCo_2) were significantly improved as compared to the control group(P 0.00001). However, adverse effects in the treatment group using combined traditional Chinese medicine were not reported due to the short observation time of the study. Conclusion: The clearing the lung and dissipating phlegm method can improve the efficacy in the treatment of acute exacerbation of COPD, the outcome measures of the pulmonary function and the blood gases,as well as the life quality of the patients. However, due to the fact that the existing studies are generally of poor quality in which randomization and its implementation were not properly carried out, more high?quality RCTs are necessary to confirm the findings of this study.     

穿刺技术的改进和创新是穴位埋线疗法的第三次飞跃

穴位埋线是长效针灸,是在传统针具和针法基础上建立和发展起来的,是针灸技术的发展和延伸,穴位埋线的核心技术是穿刺技术,穴位埋线的三大要素中,针具、埋藏物、穿刺技巧之间是互相影响、互相促进的。针具的改进成功实现了穴位埋线疗法的第一次飞跃,埋藏物的改进成功实现了穴位埋线疗法的第二次飞跃,穿刺技术的改进和创新是穴位埋线疗法的第三次飞跃。     

新型冠状病毒核酸检测在眼科医院疫情防控中的实践与有效性研究

目的:探索以系统化、标准化的新型冠状病毒核酸检测为核心和重要组成部分,建立适合于眼科医院新冠疫情精准防控切实可行的防控体系。方法:系列病例研究。自2020年2月24日至3月2日期间,以标准化病毒核酸检测联合血常规、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)等检测作为所有眼科手术患者术前筛查常规检测项目,同时也为返岗员工提供病毒核酸检测。设计调查问卷了解受检者对鼻咽拭子采样的接受度以及核酸检测结果对其心理状态的影响。结果:99例患者血液学检测结果有一定的异常比例,其中SAA检测结果增高13例,淋巴细胞计数减低12例、增高5例,白细胞计数增高11例、减低1例,CRP增高2例,新型冠状病毒核酸检测均阴性。33例本院职工新型冠状病毒核酸检测均阴性。12%的受访者对鼻咽拭子采样接受度评分较低。受检者在核酸检测前后思想压力评分较高的比例分别为46.7%和6.7%。结论:该项举措一方面为术前新冠病毒肺炎筛查及鉴别诊断提供了客观依据,很大程度上排除了隐性无症状感染者传播的可能,有利于减少二次传播的风险,降低院内交叉感染的概率;另一方面,核酸检测阴性结果有利于调整患者术前的心理状态并缓解医护人员在疫情防控期间的心理压力。