《千金要方》哮喘选穴配方特点探析

《千金要方》记载了针灸治疗哮喘共11个处方。并从处方组成，功效，适应症，手法以及疗程方面作了详尽的阐述，为探求临床治疗哮喘选穴配方的规律和思路，特对11个千金哮喘方的特点进行了归纳总结。供临床参考。     

7例原发性气管恶性肿瘤与支气管哮喘的鉴别诊断

目的：了解气管肿瘤与支气管哮喘的鉴别。方法：对7例误诊为哮喘的气管肿瘤患者的临床表现和相关检查进行分析。结果：7例患者误诊时间平均5个月。与支气管哮喘的不同点有：1）呼吸困难以吸气时明显，哮鸣音多不典型，以上肺部和喉部为最响。（2）病人以喉部痰多，喉部多闻及痰鸣音。（3）咳喘随着病程的延长而逐渐加重。结论：及早对可疑病人行纤维支气管镜检查可明确诊断。     

哮喘患者血浆白细胞介素-18水平测定及其临床意义的研究

目的探讨白细胞介素(IL)-18在支气管哮喘发病机制中的作用。方法收集30例哮喘患者和15名健康对照者的血浆,采用酶联免疫吸附试验(ELISA)检测血浆中IL-18、IL-12和IL-13的水平。结果哮喘组血浆IL-18、IL-13水平明显高于对照组,IL-12水平则显著低于对照组,差异有显著性(P<0.01)。哮喘组IL-18和IL-13呈显著正相关(P<0.05)。结论IL-18可能参与了哮喘的发病过程,它通过调节Th1/Th2的活性及细胞因子的产生,在哮喘的发病过程中发挥作用。     

太子健对哮喘豚鼠白细胞介素-5 P-选择素的影响

目的　观察太子健 对反复诱发哮喘的哮喘豚鼠血中白细胞介素 (IL) - 5、黏附分子 P-选择素的影响。方法　将豚鼠随机分为正常组、模型组、地塞米松组、太子健 高剂量和低剂量组 5组 ,后 4组分别用卵蛋白致敏 15 d后 ,再用卵蛋白反复诱发哮喘 ,正常组用生理盐水代替 ,同时 ,正常组和模型组灌服生理盐水 ,其余 3组分别灌服地塞米松、高剂量和低剂量太子健 ,予以治疗 ,连续 15 d。结果　太子健 可减少血中 IL- 5、黏附分子 P-选择素的含量。结论　太子健 可以影响 IL- 5、P-选择素对炎症细胞的调节作用 ,从而减轻气道慢性变应性炎症 ,具有一定的抗哮喘复发的作用。     

Growth of asthmatic children is slower during than before treatment with inhaled glucocorticoids

Reports on the influence of inhaled glucocorticoids on growth have been controversial. We studied the growth of prepubertal asthmatic children prior to and during glucocorticoid therapy. We collected retrospectively the notes of 201 asthmatic children aged 1–11 years receiving inhaled beclomethasone dipropionate or budesonide. We calculated their height and height velocity standard deviation scores (HSDS and HVSDS, respectively) before the treatment and up to 5 years during the treatment and compared those with the growth of healthy peers. The dose of the medication was calculated and the severity of asthma was assessed. The asthmatic children grew similarly to their healthy peers before treatment with inhaled glucocorticoids: the mean HSDS was +0.02 and the mean HVSDS +0.01 for boys and -0.16 and +0.13 for girls, respectively. Growth retardation took place soon after the start of the treatment, the most profound decrease in the growth velocity (the change in the mean HVSDS from +0.05 to -0.88) occurring during the first year of treatment. The growth-retarding effect of inhaled glucocorticoids was not dose dependent. In the covariance analysis the increasing severity of asthma had a significant interaction with repeated measurements, showing more growth retardation along with more severe asthma, especially during long-term treatment. Asthma per se does not impair growth, but inhaled glucocorticoids may do so. Careful monitoring of the growth of all asthmatic children receiving inhaled glucocorticoids is necessary because the growth-retarding effect of the medication is not dose dependent. Individual sensitivity might explain the differences seen in the growth patterns of children receiving inhaled glucocorticoids.     

六君子汤加黄芪增强肝癌化疗栓塞术后患者细胞免疫功能和疗效观察

六君子汤加黄芪增强肝癌化疗栓塞术后患者细胞免疫功能和疗效观察程惠华，郑立昇，陈樟树，涂小煌，吴昌信，王雯，戴西湖近年来，肝动脉化疗栓塞术（ＴｒａｎｓｃａｔｈｅｔｅｒＡｒｔｅｒｉａｌＣｈｅｍｏｅｍｂｏｌｉｚａｔｉｏｎ，ＴＡＣＥ）已成为非手术治疗肝癌，特...     

Outcome of children with respiratory symptoms without objective evidence of asthma: a two-year, prospective, follow-up study

This study evaluated the outcome of 33 children with asthma-like symptoms without objective evidence of asthma, and the role of certain factors in predicting the development of clinical asthma in these children. Data on symptom histories, lung functions (flow-volume spirometry, free running test and methacholine inhalation challenge test) and atopic sensitization (skin prick tests and markers of eosinophilic inflammation) were collected twice with an interval of 2 y, and the diagnoses were re-evaluated after the follow-up period. Based on the results, it was concluded that one-third of the children with prolonged or recurrent lower airway symptoms, such as cough or wheeze, either have mild asthma or will develop asthma in the near future. Children who had a significant response [≥ 10% fall in forced expiratory volume in 1 s (FEV1)] in the free running test formed a risk group for active asthma, whereas other baseline characteristics seemed not to predict the outcome.     

Influence of inhaled corticosteroids on growth: a pediatric endocrinologist''s perspective

Given the increasing advocacy for the use of inhaled corticosteroids as a treatment of choice for persistent asthma, growing numbers of children are being exposed to the possible growth-suppressing effects of glucocorticoids. Recent evidence strongly suggests that, when consistently administered at moderate doses, inhaled corticosteroids (IC) are capable of slowing growth in children. Whether such growth suppression would persist and ultimately affect final adult height remains unknown. Therapeutic goals which aim for uninterrupted inflammatory disease control rather than periodic symptom control may increase the occurrence of growth failure in children treated with IC. In this article, current information about the mechanisms of growth suppression by glucocorticoids and the effects of IC on growth is reviewed, and recommendations for designing studies to investigate the effects of drugs on growth are presented.     

福莫特罗治疗哮喘急性发作临床分析

目的 了解富马酸福莫特罗在儿童中、重度哮喘息性发作中的作用。方法 以盐酸丙卡特罗为对照，观察5～10岁哮喘患儿服药起效时间、持续时间、有效性和安全性。结果 57例中、重度哮喘息性发作儿童口服富马酸福莫特罗后2h症状体征的改善情况、呼吸峰流速值改善情况、1周后夜间睡眠改善情况优于对照组，两组差异有意义，12h症状体征的改善、呼吸峰流速值改善情况、总体疗效与对照组之间无显著差异．未发现明显不良反应。结论 富马酸福莫特罗和盐酸丙卡特罗在疗效及副作用方面一致，其起效时间明显快于盐酸丙卡特罗．对夜间睡眠改善情况明显优于盐酸丙卡特罗，对儿童中重度哮喘急性发作具有较好的疗效。     

Assessing the Quality of Life of Adults with Chronic Respiratory Diseases in Routine Primary Care: Construction and First Validation of the 10-Item Respiratory Illness Questionnaire-Monitoring 10 (RIQ-MON10)

BACKGROUND: As doctors' judgements about the burden of a disease often differ from patients' own assessments a manageable method to incorporate the latter into routine care might support patient-centered decision-making. For this purpose we shortened the 55-Item Quality of Life for Respiratory Illness Questionnaire (QoL-RIQ). METHODS: Secondary analyses of the data of 3 controlled studies (n = 328, 502 and 555). PROCEDURES: inter-item correlations, scale distributions, Cronbach's alpha and factor analysis. Dyspnoea, forced expiratory volume in 1 s (FEV1), COOP/WONCA charts, the Medical Research Council-ECCS symptoms questionnaire and the MOS-SF 36 served as criteria to test validity and responsiveness. RESULTS: Item-reduction resulted in a 10-item short form (alpha's 0.87-0.90), consisting of 2 5-item factors: (1) physical and emotional complaints and (2) physical and social limitations. The correlations of the short form with dyspnoea (r from 0.57 to 0.60), the generic health status instruments (r from 0.39 to 0.59) and lung function (r from 0.10 to 0.15) fulfilled the criteria. FURTHER RESULTS: a clinical relevant score difference (> 0.5) between upper and lower quartiles of the convergent instruments, an intraclass correlation between repeated scores in a stable group of 0.82 and a standardised response mean of 0.86 in an improved group of patients. CONCLUSIONS: The short form (RIQ-MON10) maintained the psychometric properties of the original instrument and is promising for assessing quality of life (QoL) during routine primary care visits.