中药联合针灸治疗小儿夏季腹泻55例

目的:探讨中药联合针灸治疗小儿夏季腹泻的临床疗效.方法:将解放街道社区卫生服务中心门诊收治的夏季腹泻患儿105例随机分为观察组55例及对照组50例,观察组应用中医的治疗原则联合中药和针灸进行辨证施治;对照组予以西医治疗.两组均在治疗7d后予以疗效评价.结果:观察组治愈50例,有效4例,无效1例,总有效率为98.2％;对照治愈38例,有效6例,无效6例,总有效率为88％.两组总有效率比较,差异具有统计学意义(P＜0.05).结论:中药联合针灸治疗小儿夏季腹泻疗效肯定,副作用小,相比西医治疗具有明显优势.     

Sensory fibers containing vanilloid receptor-1 (VR-1) mediate spinal cord stimulation-induced vasodilation

BACKGROUND AND AIMS: Spinal cord stimulation (SCS) is used to improve peripheral blood flow in selected populations of patients with ischemia of the extremities. Previous studies show that antidromic activation of sensory fibers is an important mechanism that contributes to SCS-induced vasodilation. However, the characteristics of sensory fibers involved in vasodilation are not fully known. This study investigated the contribution of vanilloid receptor type 1 (VR-1) containing fibers to SCS-induced vasodilation. METHODS: A unipolar ball electrode was placed on the left dorsal column at the lumbar 2-3 spinal cord segments (L2-L3) in sodium pentobarbital anesthetized, paralyzed and ventilated rats. Cutaneous blood flows from both ipsilateral (left) and contralateral (right) hind foot pads were recorded with laser Doppler flow perfusion monitors. SCS (50 Hz; 0.2 ms) was applied through the ball electrode at 30%, 60%, 90% and 300% of motor threshold (MT). Resiniferatoxin (RTX), an ultra potent analog of capsaicin and VR-1 receptor agonist, was used to suppress the activities of VR-1 containing sensory fibers. RESULTS: SCS at 30%, 60%, 90% and also at 300% of MT significantly increased cutaneous blood flow in the ipsilateral foot pad compared to that in the contralateral side. RTX (2 microg/kg, i.v.) significantly attenuated SCS-induced vasodilation of the ipsilateral side (P<0.05, n=7) compared with responses prior to RTX administration. A pledget of cotton soaked with RTX (2 microg/ml) placed on L2-L3 spinal cord significantly decreased SCS-induced vasodilation of the ipsilateral side at 30%, 60%, 90% and 300% of MT (P<0.05, n=7) compared with responses prior to RTX administration. Additionally, topical application of a pledget of cotton soaked with RTX (2 microg/ml) on the sciatic nerve at the middle level of the thigh or on the tibial nerve at the lower level of the lower hindlimb also decreased SCS-induced vasodilation (n=5). CONCLUSION: SCS-induced vasodilation is predominantly mediated via VR-1 containing sensory fibers.     

消喘膏贴敷改善稳定期慢性阻塞性肺病生存质量的研究——临床试验和社区验证

目的:验证冬病夏治消喘膏穴位贴敷疗法对慢性阻塞性肺病(COPD)稳定期生存质量的干预效果和社区推广疗效。方法:临床研究采用多中心、随机、安慰剂对照、双盲(RCT)设计,142例纳入患者随机分为2组,分别给予消喘膏和安慰剂贴敷治疗,连续贴敷2年。社区验证组入组60例COPD患者进行治疗前后疗效对照。观察SGRQ量表、BODE指数、年均感冒和急性加重次数、急诊和住院次数等指标。结果:RCT试验,消喘膏贴治2年后,SGRQ量表活动、影响及总分评分均较对照组下降;疗后2年BODE指数下降值大于对照组;疗后2年患者感冒和急性加重次数、急诊次数和住院次数较对照组减少。社区验证取得相似结果。结论 :消喘膏贴敷疗法在提高COPD稳定期患者的生存质量、减少患者急性加重方面有较好疗效,社区推广应用疗效稳定。     

冬夏季节变化对健康人外周血免疫淋巴细胞的影响

目的从天人相应理论入手探讨冬夏季节对人体细胞免疫功能的影响。方法对20例大学生志愿者分别在立夏(SB)、夏至(SS)、立冬(WB)、冬至(WS)实验日采用不同方法检测免疫物质水平,每次所测分为立夏组、夏至组、立冬组、冬至组。应用流式细胞术对健康人血清中淋巴细胞免疫标志CD3+、CD4+、CD8+、CD56+进行分析。结果立夏组、夏至组健康人外周血T淋巴细胞CD3+、CD4+、CD4+/CD8+均不同程度显著高于立冬组、冬至组。冬夏季节各组对T淋巴细胞CD8+和NK细胞CD56+无明显影响。结论冬夏季节对机体细胞免疫功能具有一定的调节作用,免疫功能存在夏季强冬季弱的变化趋势,与中医天人相应和肺卫防御理论的认识是一致的。     

高士宗论暑之我见

目的：探讨高士宗对暑的论述。方法：通过对《黄帝内经》及高士宗的《医学真传》等古文献研究，探讨暑的生理和病理机制，症状特点和治疗经验。结果与结论：暑为夏季火热之邪，因此治疗多见热思凉，但究其阴阳寒暑与人身气血关系，用温热药治疗效果明显。     

夏秋灸治哮喘疗效与NO及肺功能关系的临床研究

目的:比较夏秋季节灸贴治疗哮喘的疗效,探讨季节变化与支气管哮喘疗效关系的可能机制。方法:64例支气管哮喘缓解期肺气亏虚证患者按1∶1比例随机分为:夏季组32例,于传统“三伏日”初、中、末伏当日集中治疗;秋季组32例,于“秋分前10日、秋分当日及秋分后10日”3日集中治疗。两组均于首次治疗前15日及末次治疗后15日进行NO和肺功能指标检测。结果:夏季组与秋季组经灸贴治疗后临床总有效率分别为84.38%、71.88%,NO值有所下降,肺功能指标显著改善(P<0.05,0.01)。两组比较,夏季组优于秋季组(P<0.05,0.01)。结论:夏秋灸治疗哮喘的疗效差异与异常升高的NO的降低程度有关,NO的差异可能是灸治起效的关键。     

冬病夏治法治疗慢性支气管炎96例

[目的]探讨冬病夏治法治疗慢性支气管炎临床疗效。[方法]采用夏季三伏天穴位敷贴96例。[结果]痊愈35例,有效53例,无效8例,总有效率91·7%。[结论]冬病夏治法治疗慢性支气管炎有较好疗效。     

浙江省某县木材装饰贴面加工企业夏季作业环境调查

[目的]了解木材装饰贴面加工企业的夏季作业环境。[方法]选取3家木材装饰贴面加工厂为调查对象, 在夏季晴朗天气分别测定其不同车间环境中的气象条件、噪声、照度、甲醛和木尘,连续3天。[结果]不同车间气温 (32．3±2．1)-(40．0±0．0)℃,气湿(52±0)％-(73±2)％,风速(0．14±0．06)-(1．68±0．46)m/s;热压车间热辐射(0．143 ±0．008)-(0．159±0．023)kW/m2;噪声72-99 dB,作业面照度(131±23)-(330±314)Ix;布胶、贴面及热压车间甲醛浓度(0．41±0．23)-(0．45±0．21)mg/m3;砂光、修补车间木尘浓度(2．54±1．19)-(3．10±2．06)mg／m3。[结论]该县装饰贴面加工企业夏季作业环境车间气温、噪声状况有待改善。     

补肺助阳汤治疗老年慢性支气管炎131例观察

目的：观察用补肺助阳汤夏季治疗老年慢性支气管炎的疗效。方法：选老年慢性支气管炎患者131例，在夏季三伏天予自拟补肺助阳汤，治疗1个月。结果：显效18例，好转34例，有效12例，无效4例，总有效率为96．95％(95％CI=91．67％～99．06％)。结论：补肺助阳汤夏季治疗老年慢性支气管炎，疗效较满意。