穴位贴敷防治支气管哮喘不同皮肤反应对免疫球蛋白及嗜酸粒细胞的影响

目的:研究穴位贴敷防治支气管哮喘所出现的不同程度皮肤反应对血清免疫球蛋白(Ig E、Ig A、Ig M、Ig G)和嗜酸粒细胞(EOS)的影响。方法:对支气管哮喘患者于三伏天穴位贴敷,每伏贴敷一次,共3次。根据穴位贴敷后皮肤反应评分情况分为A、B、C、D 4组,A组43例,B组42例,C组39例,D组40例。检测治疗前、后各组患者血清Ig E、Ig A、Ig M、Ig G水平和血EOS计数。结果:除A组外,B、C、D 3组治疗前后各种血清免疫球蛋白及血EOS均有显著性差异(P<0.05或P<0.01)。治疗后与A组比较,B组各种血清免疫球蛋白及血EOS均无显著差异(P>0.05),C组除血EOS有显著差异外(P<0.05),各种免疫球蛋白均无显著差异(P>0.05),D组血清除Ig M及血EOS有显著差异外(P<0.05),Ig E、Ig A、Ig G均无显著差异(P>0.05)。结论:冬病夏治穴位贴敷有皮肤反应比无皮肤反应更能有效调节支气管哮喘患者的免疫功能。而出现皮肤反应后,随皮肤反应增强其对免疫功能的调节仅有轻度影响。因此适度皮肤反应即可有效调节免疫功能。     

气象节律视角下探析“脾主长夏”的涵义

“脾主长夏”是《黄帝内经》中脾与岁时关系的一种概念,历年来各医家均对其中长夏季的起止时间说法不一,后人对此概念阐释甚少,不利后学。运气理论中的气象节律蕴含着丰富的季节特征,其中的土季与长夏季,气候特点十分接近,运用其发病规律对长夏季病邪特点及具体时间段进行分析,认为长夏季可由 1 个主体时间段和 2 个缓冲时间段组成。主体时间段由夏至开始,到处暑结束,整体上以湿邪为主,其中前一阶段为夏至到大暑时段,暑邪流行,后一阶段为大暑到处暑时段,风湿邪气流行;处于主体时间段前后的 2 个缓冲时间段（芒种到夏至、处暑到白露）均蕴含湿气,并对于长夏季主体起到承前启后的作用。     

穴位贴敷治疗支气管哮喘述要

[目的]从支气管哮喘中西医浅见认识及穴位贴敷治疗的认识,讨论穴位贴敷疗法对支气管哮喘的疗效。[方法]运用三伏天中药穴位贴敷疗法。取穴:肺俞、心俞、膈俞(均为双侧),观察门诊支气管哮喘患者30例。[结果]30例中痊愈12例,占40%;有效14例,占46.67%;无效4例,占13.33%,总有效率为86.67%。[结论]穴位贴敷疗法对支气管哮喘具有显著疗效。值得临床推广应用。     

冬病夏治“天灸疗法”治疗小儿肺系疾病理论探析

对冬病夏治、天灸疗法在应用于小儿肺系疾病中的中医理论及机制、现代研究进行了探析,肯定了冬病夏治、天灸疗法在防治呼吸道疾病方面的重要作用。     

银花清暑合剂治疗小儿夏季感冒暑湿袭表证临床观察

目的:评价银花清暑合剂治疗小儿夏季感冒暑湿袭表证的安全性及有效性。方法:选取小儿夏季感冒暑湿袭表证门诊患儿180例,随机分为治疗组(90例)和对照组(90例),治疗组予银花清暑合剂口服,对照组予香菊感冒颗粒口服,1个疗程后统计分析观察结果。结果:治疗组和对照组经治疗后痊愈率分别为69.9%、51.1%;总有效率分别为96.7%、81.1%;两组疗效比较差异有显著统计学意义(P<0.01),治疗组疗效优于对照组。在用药过程中,两药均未发现明显不良反应。结论:银花清暑合剂是治疗小儿夏季感冒暑湿袭表证安全有效的药物。     

冬病夏治治疗哮喘缓解期420例临床观察

目的:观察采用中药穴位贴敷治疗哮喘缓解期的疗效。方法:选取2009年我院住院部患儿420例,在三伏天进行中药穴位贴敷。结果:临床治愈63例(15%),有效300例(71%),无效57例(14%),总有效率86%。通过临床观察,贴敷局部引起水泡的患儿,疗效好。结论:运用冬病夏治是治疗和预防哮喘缓解期有效的治疗方法。     

心脏移植的发展现状和新挑战

心脏移植是终末期心力衰竭患者的首选治疗。供者不足一直以来都是限制心脏移植数量增长的主要问题,随着新技术的不断更新和引入,供者池被不断扩大,比如使用年龄较大的供者、丙型肝炎病毒感染的供者、毒品过量致死的供者或心脏死亡器官捐献（DCD）供者的心脏等。与此同时,高龄、多器官功能不全、机械循环支持及人类白细胞抗原抗体致敏受者的比例近几年明显增加。供者数量的不足、受者状况的复杂化、免疫抑制治疗的个体化管理和远期移植物血管病的防治等都是心脏移植领域面临的挑战。本文通过概述现今全球在扩大供者库、提高受者质量、加强排斥反应的诊治和心脏移植物血管病变的预防等方面的新进展,以期有助于改善在等待或已经接受心脏移植的终末期心力衰竭患者的生存时间和生活质量。     

Effect of summer acupoint application treatment (SAAT) on gut microbiota in healthy Asian adults: A randomized controlled trial

Acupoint application has served as an important complementary and adjunctive therapy in China. The purpose of this study is to explore the impact of summer acupoint application treatment (SAAT) on the abundance and biological structure of gut microbiota in healthy Asian adults. Based on the CONSORT guidelines, 72 healthy adults were included in this study, randomly divided into 2 groups, receiving either traditional (acupoint application within known relevant meridians, Group A) or sham (treated with placebo prepared by mixing the equal amount of starch and water, Group B) SAAT. SAAT stickers include extracts from Rhizoma Corydalis, Sinapis alba, Euphorbia kansui, Asari Herba, and the treatment group received 3 sessions of SAAT for 24 months, administered to BL13 (Feishu), BL17 (Geshu), BL20 (Pishu), and BL23 (Shenshu) acupoints. Fecal microbial analyses via ribosomal ribonucleic acid (rRNA) sequencing were performed on donor stool samples before and after 2 years of SAAT or placebo treatment to analyze the abundances, diversity, and structure of gut microbiota. No significant baseline differences were present between groups. At the phylum level, the baseline relative abundance of Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, and Fusobacteria was identified in fecal samples collected from each group. After treatment, the relative abundance of Firmicutes was significantly increased in both groups (P < .05). Notably, a significant decrease in the relative abundance of Fusobacteria was observed in the SAAT treatment group (P < .001), while the abundance of Bacteroidetes was decreased significantly in the placebo group (P < .05). At the genus level, the relative abundance of Faecalibacterium and Subdoligranulum species in the 2 groups were all significantly increased (P < .05). In addition, a significant reduction in the relative abundance of Blautia, Bacteroides, and Dorea in Group A (P < .05) and Eubacterium hallii group and Anaerostipes (P < .05) in Group B was observed after treatment. Our findings indicated SAAT substantially influenced the bacterial community structure in the gut microbiota of healthy Asian adults, which might serve as potential therapeutic targets for related diseases, and provided a foundation for future studies aimed at elucidating the microbial mechanisms underlying SAAT for the treatment of various conditions such as obesity, insulin resistance, irritable bowel syndrome.     

伏九贴敷治疗儿童反复咳喘100例临床观察

目的：观察“伏九贴敷”治疗儿童反复咳喘的临床疗效。方法：采用随机对照的方法，将200例反复咳喘患几分成观察组（贴敷组）和对照组（非贴敷组）各100例。观察组给予伏九贴敷治疗，2年为1个疗程。结果：“伏九贴敷”在平喘及消除肺部哮鸣音等方面，显效84例，有效13例，无效3例，总有效率97％，两组有显著性意义。结论：“伏九贴敷”用于治疗咳喘疗效确切，值得临床进一步推广。     

Allergy Considerations in Implanted Neuromodulation Devices

ObjectivesAllergic reactions are rare and poorly understood complications of neuromodulation device implantation. There are currently no guidelines for management of allergic reactions to these devices and their components. Here we review the published cases of allergic reactions to implanted neuromodulatory devices and leverage the experiences of other specialties that deal with similar complications to formulate recommendations for prevention and management.Materials and MethodsA review and assessment of the literature.ResultsAllergic reactions to a number of implantable devices have been observed and published. In dentistry and orthopedics, metals such as nickel are the most frequent cause of allergic reactions. In interventional cardiology, where devices closely resemble neuromodulatory devices, titanium, silicone, and polyurethanes are the most common causes of allergic reactions. In neurosurgery, allergic reactions to implantable neuromodulatory devices are rare, and we summarize 13 cases published to date. Such allergic reactions generally present as local dermatitis, erythema, and pruritus, which can be difficult to distinguish from surgical site infection. In one published case, symptoms resolved with corticosteroid treatment, but all other cases required explantation. The successful reimplantation with a modified device was reported in some cases.ConclusionsPatients should be screened for a personal history of contact allergy before implantation procedures. A multidisciplinary approach to suspected cases of postoperative allergic reactions involving collaboration between neurosurgeons and other implanting physicians, dermatologists or allergists, and device manufacturers is recommended. In cases where an allergic reaction is suspected, an infectious etiology should be ruled out first. Clinical suspicion can then be supported with the use of patch testing, interpreted by an experienced dermatologist or allergist. If patch testing supports an allergic etiology, the implanting physician and the device manufacturer can work together to modify the device for safe reimplantation.