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71.
72.
目的：观察益元和络汤治疗糖尿病性周围神经病变的疗效。方法：127例随机分为治疗组（67例）和对照组（60例）。治疗组给予益元和络汤配合西药基础治疗;对照组在西药基础治疗的同时口服弥可保。60d为1疗程。观察两组治疗前临床症状、血糖、血脂、优势侧腓总神经传导速度（NCV）及神经病变计分的变化,对比观察其疗效。结果：治疗组有效率97%,对照组有效率80%,有显著差异（P〈0.01）,两组患者治疗后血糖、血脂、NVC及MDNS比较均有显著差异。（P〈0.05）或（P〈0.01）。结论：益元和络汤配合西药基础治疗对糖尿病性周围神经病变有显著疗效。 相似文献
73.
Sabrina Ben Ahmed Adrien Louvancourt Guillaume Daniel Pierre Combe Ambroise Duprey Jean-Noël Albertini Jean-Pierre Favre Eugenio Rosset 《Journal of vascular surgery》2018,67(2):468-477
Objective
The objective of this study was to evaluate the early and long-term outcome of cryopreserved arterial allografts (CAAs) used for in situ reconstruction of abdominal aortic native or secondary graft infection and to identify predictors of mortality.Methods
We retrospectively included 71 patients (mean age, 65.2 years [range, 41-84 years]; men, 91.5%) treated for abdominal aortic native or secondary graft infection (65 prosthetic graft infections; 16 of them had secondary aortoenteric fistula, 2 venous graft infections, and 4 mycotic aneurysms) by in situ reconstruction with CAA in the university hospitals of Clermont-Ferrand and Saint-Etienne from 2000 to 2016. The cryopreservation protocol was identical in both centers (?140°C). Early (<30 days) and late (>30 days) mortality and morbidity, reinfection, and CAA patency were assessed. Computed tomography was performed in all survivors. Survival was analyzed with the Kaplan-Meier method. Univariate analyses were performed with the log-rank test and multivariate analysis with the Cox regression model.Results
Mean follow-up was 45 months (0-196 months). Early postoperative mortality rate was 16.9% (11/71). Early postoperative CAA-related mortality rate was 2.8% (2/71); both patients died of proximal anastomotic rupture on postoperative days 4 and 15. Early CAA-related reintervention rate was 5.6% (4/71); all had an anastomotic rupture, and two were lethal. Early postoperative reintervention rate was 15.5% (11/71). Intraoperative bacteriologic samples were positive in 56.3%, and 31% had a sole microorganism. Escherichia coli was more frequently identified in the secondary aortoenteric fistula and Staphylococcus epidermidis in the infected prosthesis. Late CAA-related mortality rate was 2.8%: septic shock at 2 months in one patient and proximal anastomosis rupture at 1 year in one patient. Survival at 1 year, 3 years, and 5 years was 75%, 64%, and 54%, respectively. Multivariate analysis identified type 1 diabetes (hazard ratio, 2.49; 95% confidence interval, 1.05-5.88; P = .04) and American Society of Anesthesiologists class 4 (hazard ratio, 2.65; 95% confidence interval, 1.07-6.53; P = .035) as predictors of mortality after in situ CAA reconstruction. Reinfection rate was 4% (3/71). Late CAA-related reintervention rate was 12.7% (9/71): proximal anastomotic rupture in one, CAA branch stenosis/thrombosis in five, ureteral-CAA branch fistula in one, and distal anastomosis false aneurysm in two. Primary patency at 1 year, 3 years, and 5 years was 100%, 93%, and 93%, respectively. Assisted primary patency at 1 year, 3 years, and 5 years was 100%, 96%, and 96%, respectively. No aneurysm or dilation was observed.Conclusions
The prognosis of native or secondary aortic graft infections is poor. Aortic in situ reconstruction with CAA offers acceptable early and late results. Patients with type 1 diabetes and American Society of Anesthesiologists class 4 are at higher risk of mortality. 相似文献74.
〔摘 要〕 袁尚锋主任医师是全国第六批老中医药专家师承指导老师、湖湘张氏正骨株洲流派传承代表,其在治疗成人
股骨头缺血性坏死方面有较深的造诣。笔者梳理了袁尚锋主任医师对成人股骨头缺血性坏死的病因病机、治则治法等方面
的理解及认识,并通过分析典型病案总结了其从肾虚血瘀证论治成人股骨头缺血性坏死的临床经验。 相似文献
75.
目的:基于明清医家文献,明确不孕不育症中医常用中药及其四气、五味和归经,为临床实践提供经验。方法:用关键词对中国基本古籍库进行检索,根据纳入和排除标准筛选合格文献。建立明清种子方数据库并对原始文献进行规范化处理,整理和分析明清种子方治疗类别、剂型、药物组成、四气、五味和归经,应用软件进行统计分析,得到明清治疗不孕不育症的用药规律。结果:本研究共纳入明清种子方剂235首,明清治疗不孕不育症文献中,1)常见剂型为丸剂;2)治疗类别主要为不孕;3)出现频率最高的方剂为五子衍宗丸;4)使用的药物主要是补虚药,其次为清热药和活血化瘀药;5)使用药物的四气主要为温,五味主要为甘,归经主要为肾、脾、肝;6)常用药对为白芍、当归;药物组合为白芍、当归、川芎、熟地黄。结论:明清医家治疗不孕不育以丸药为主,治方思路针对肾、脾、肝以甘温补虚为主流,同时也兼以清热药和活血化瘀药。此研究为现代临床治疗不孕不育提供了参考。 相似文献
76.
77.
I-Hui Chen Tzu-Pei Yeh Yueh-Chen Yeh Mei-Ju Chi Mei-Wen Chen Kuei-Ru Chou Yin-Yi Lien Chih-Fen Yuan 《Journal of the American Medical Directors Association》2019,20(7):822-829
ObjectiveTo compare the efficacy of acupressure with sham acupressure in older-adult nursing home residents presenting with poor sleep quality and psychological distress.DesignProspective, randomized, double-blind, sham-controlled trial.Setting and participantsSixty-two nursing home residents with poor sleep quality and psychological distress participated in this study. Participants were randomly assigned to an experimental group (n = 31) receiving acupressure at true acupoints (Baihui, Juque, Neiguan, Tianzhu, and Yongchung) or control group (n = 31) receiving acupressure at sham points. All participants received 20 minutes of acupressure before sleeping 3 times a week for 8 weeks. All participants were blinded to group allocation.MeasuresSleep quality and psychological distress were measured using the Pittsburgh Sleep Quality Index and the Kessler Psychological Distress scale, respectively. Both groups' outcomes were assessed by assessors blinded to group allocation at the baseline, the end of the intervention, and 1 month after the intervention.ResultsThe experimental group demonstrated significantly more improvement in sleep quality than did the control group at the end of the intervention (10.5 vs 13.3) and 1 month after the intervention (8.3 vs 14.2; both P ≤ .001). Moreover, the experimental group had lower psychological distress levels than did the control group at 1 month after the intervention (14.6 vs 17.9, P = .05). Furthermore, significant differences in mean sleep quality (F = 60.8, P < .001) and psychological distress (F = 24.6, P < .001) were observed in the experimental group between the measurements at baseline and after the intervention.ConclusionsAcupressure at true acupoints improves sleep quality, reduces psychological distress, and provides more clinically beneficial effects compared with that at sham points. Future studies should examine whether these effects are maintained in the long term. 相似文献
78.
目的：观察急性胰腺炎早期中西医结合治疗方案的临床疗效。方法：64例急性胰腺炎患者被随机平分为两组,对照组32例采用单纯西医治疗;治疗组32例在对照组西医治疗基础上加用中药清胰汤治疗。结果：治疗组的总有效率为93.8%,对照组总有效率为71.9%,治疗组的总有效率明显好于对照组（P〈0.05）。对照组肠功能恢复时间为（5.7±1.5）d,腹水吸收时间为（9.5±2.4）d,住院时间为（27.9±10.5）d;治疗组肠功能恢复为（2.6±0.9）d,腹水吸收为（6.5±2.7）d,住院时间为（20.5±9.5）d。结论：中西医结合治疗急性胰腺炎有较好的临床疗效,能明显改善患者的临床症状,缩短住院时间,值得临床推广。 相似文献
79.
顾明昌主任曾师承黄文东先生和胡建华教授,尽得心传。先生从事内科临床、教学、科研工作30余年,博采众长,学验俱丰,擅长中西医结合治疗内科疑难病。笔者有幸随先生于门诊、病房学习数载,今载录先生治疗功能性发热之验案,与同道分享。 相似文献
80.
以痹病辨证入手,探索宋金元医家在临床辨证上重视内因、脏腑辨证,强调内生病邪等诸多特色,反映当时辨病与辨证论治相结合的状况,总结宋金元时期辨证学说的发展概况。 相似文献