Study on graded therapy of hemophilic arthritis by integrative traditional Chinese and Western medicine

Objective:To study the effect and safety of graded therapy featuring integrative traditional Chinese and Western medicine for the treatment of hemophilic arthritis.Methods:Forty patients with hemophilic arthritis were hospitalized randomly,with their blood coagulation factor activity determined by one-stage method and their arthritis classified into 4 stages.The treatment was applied according to the stage of arthritis and finding of intra-articular cavity puncture.For stageⅠ,based on the principle of RICE(rest,ice,compression and elevation),1.8g of Xuefuda(血府达)was medicated orally once per day,intravenous dripping of 250mL of hemostasis mixture twice a day and 1.2g of clindamycin per day were also given for hemostasis and anti-inflammation.For stageⅡ-Ⅲ,Kangyanling(抗炎灵)was additionally administered via intra-articular cavity injection twice a week,2mL every time,for 5-6 times in total.For stageⅣ,the drug for intra-articular cavity injection was replaced with 25mg of sodium hyaluronate and the frequency of injection reduced to every two weeks,for 5-6 times in total.Coagulation factorsⅢandⅣas well as blood plasma were not given in the whole treatment course.Short-term therapeutic effects and adverse reaction in patients were evaluated,and the long-term effects were followed-up after patients left the hospital with 6-month consolidation therapy by Xuefuda.Results:After a 3-week treatment,33 patients (82.5%)were completely remitted;5(12.5%)were partially remitted and 2(5.0%)un-remitted,setting the short-term effective rate at 95.0%(38 cases).The 6-month follow-up showed that except for a relapse in 2 and 4 patients of stageⅢandⅣrespectively,long-term remission displayed in all the other 34 patients,with the remission sustaining rate being 85.0%.No complication such as an infection,bleeding or aggravating pain occurred in the 215 times intra-articular puncturing conducted in the 40 patients.Normal figures were shown in liver and kidney function,electrolytes,ECG,blood glucose and routine test of blood and urine throughout the course.Conclusion:The graded treatment of integrative medicine for hemophilia with non-blood preparation has a favorable effect and is safe or without any adverse reaction,which opens a high efficacy and new safe path and thinking for the treatment of and deformity prevention in the hemophilic patients.     

500例血友病的病因学分类研究

目的 探讨血友病的病因学分类方法.方法 随机选取2005年2月至2010年5月陕西医大血液病研究院接诊的500例血友病患者为研究对象.对其采用一期法检测凝血因子活性,Bethesda法检测FⅧ、FIX抗体,活化部分凝血活酶时间(APTT),正常人血浆混合APTT纠正试验,鉴别凝血因子缺乏、同种抗体与自身获得性血友病.按...     

中西药联用防治500例血友病出血的临床研究

目的 研究中药止血煎剂联合西药止血合剂防治血友病出血的效果及其安全性。     

文身致泛发性寻常疣一例

患者男,24岁。因背部多发性角化性丘疹2个月,渐增大、增多,而于2010年7月10日来我科就诊。患者4个月前在当地某美容院进行文身后背部出现较多散在的针头大小丘疹,无自觉症状,未予治疗,随后丘疹渐增大、数目增多。体格检查：一般情况好,各系统检查无异常。皮肤科检查：背部可见似鳞片状青灰色文身图案,及较多灰黄色、污褐色圆形、多角形丘疹,粟粒至豌豆大小,表面粗糙,角化明显,部分皮疹融合。所有角化性丘疹均位于青灰色文身图案之上。实验室检查：血尿常规、肝肾功能、血糖均正常,心电图正常,腹部B超检查均未见异常。皮损组织病理检查：角化过度,棘层肥厚,乳头瘤样增生,棘层上部可见较多空泡化细胞,真皮浅层少许淋巴样细胞浸润。     

椎基底动脉供血不足和脑干梗死患者的瞬目反射检测

目的：探讨瞬目反射(BR)对椎基底动脉供血不足(VBI)及脑干梗死的临床应用价值。方法：用表面电极刺激三叉神经眶上支，在双侧眼轮匝肌进行记录。对BR异常者治疗1、3、6个月后复查。结果：VBI组80例治疗前BR异常者58例(72．5％)，治疗一个月后复查BR恢复正常者39例，BR正常或治疗后恢复正常者近期都能获得基本痊愈，而BR持续异常者则预后较差。脑干梗死组26例，：BR全部异常且异常程度重于VBI组。结论：在对VBI及脑干梗死诊断、疗效观察及预后评价中，BR是一项极为客观有用的指标。     

281名性服务者梅毒感染情况分析

目的 了解2004年澄迈县娱乐场所的性服务小姐及吸毒人群梅毒与艾滋病感染情况，为防制提供科学依据。方法 采取连续抽样的方法，分别采集澄迈县2002年以来开展宣传干预的永发镇和未干预的金江镇的娱乐场所中提供性服务的高危人群血液标本281人(其中永发镇122人，金江镇159人)，分别采用双抗原夹心酶联免疫法(ELISA)，和甲苯胺红初筛试验(TRUST)进行初筛检测HIV和梅毒抗体，梅毒初筛阳性再以明胶凝聚试验(TPPA)确证后判定。结果 在永发镇，122人中有3例梅毒阳性，阳性率为2．45％；而未进行过干预的对照区金江镇159人中，有12例梅毒阳性，阳性率为7．54％。另外，同时对金江镇的吸毒36人进行HIV和梅毒感染测定，有4例梅毒感染阳性，阳性率为11．11％。结论 开展行为干预的永发镇性服务梅毒的感染率比较未开展行为干预的金江镇服务小姐低两倍，说明开展行为干预产生了明显效果。     

血友病并发低钙血症对凝血的影响及防治研究

目的研究血友病并发低钙血症对凝血的影响及其防治方法。方法 2007年2月至2010年7月,陕西医大血液病研究院对随机接诊的360例血友病患者于治疗前及补钙治疗3周后复查血清钙浓度,观察其疗效。并对正常人及血友病患者进行不同浓度氯化钙活化部分凝血活酶时间(APTT)试验,观察钙对凝血的影响。结果血友病低钙血症的发病率为77.56%(279/360例),血清钙浓度为(1.78±0.29)mmol/L。治疗3周后与治疗前相比,血钙浓度增加(0.73±0.03)mmol/L,比较差异有统计学意义(P<0.01)。不同浓度氯化钙对血友病及正常人APTT试验:正常人依次为(35.33±5.85)、(58.33±10.50)、(95±18.02)、(188.66±21.73)s,血友病患者依次为(83.66±9.50)、(145.33±24.01)、(166.33±11.59)、(264.33±30.36)s,比较差异有统计学意义(P<0.01)。结论血友病患者低钙血症并发率为77.56%,APTT延长与血清钙浓度降低相关,为防治血友病出血提供了科学依据和新思路。     

鼻硬结病一例

患者,男, 67岁, 1998年 7月来诊。 30余年前鼻部出现米粒至黄豆大结节,逐渐增多,增大,鼻尖肥大,鼻腔分泌物增多,有臭味。自以为患感冒,曾被诊断为酒渣鼻,一直未经正确诊治。近 2年来自觉呼吸受阻来本科门诊。 体检：各系统检查未发现异常。皮肤科情况：鼻部皮肤肥厚,密布黄豆大硬性结节,鼻尖肥大而长,形成鼻赘 (Hebra鼻 ),面颊、耳垂皮肤肥厚,并密集绿豆至黄豆大结节,毛孔扩大而凹陷,无毛细血管增生扩张 (图 1)。鼻粘膜潮红肥厚。耳后、颌下淋巴结肿大,质硬,光滑,移动好,无压痛。 实验室检查：血、尿常规及肝功能检验…     

Study on the efficacy and safety of Xueyou Mixture (血友合剂) in treating hemophilia

Objective:To observe the effect of Xueyou Mixture(血友合剂,XYM) on blood coagulation factors and its safety in treating hemophilia.Methods:To the randomly selected 65 inpatients of hemophilia,XYM was administered accompanied with intravenous dripping of liver cell growth factor 60-100 mg once a day to protect the liver,with no blood products like concentrated Ⅷ and FⅨ factors or blood plasma given.The treatment lasted for 3 weeks.The short-term eff icacy and adverse reactions were observed.The long-term efficacy in patients was observed in a follow-up study of 6-12 months after they were discharged from the hospital but continuously took XYM orally.Results:The short-term markedly effective rate in the patients was 95.38%(62/65).After they were treated for 3 weeks,the level of FⅧ factor activity increased in 56 patients of type A from(3.32±2.21) % to(4.18±2.23) %,and in 9 of type B from(4.92±1.81) % to(5.64±1.96) %.Compared with that before treatment,the difference was signif icant in both of them(P<0.01).No obvious adverse reaction was found in the treatment period.The follow-up study showed that in 22 patients of type A,the FⅧ factor activity ratio increased from(3.25±2.11) % to(6.31±2.16) %,(8.36±1.05) %,and(16.38±2.71) % in the 2nd,3rd and 6th month after discharge respectively,all showing significant difference to that before treatment(P<0.01);and in 4 patients of type B,it increased from(4.15±2.26) % to 7.8% and 11.6%(mean value) in the 2nd and 6th month respectively.Conclusion:XYM could raise the activity of factors Ⅷ and Ⅸ in patients with hemophilia,and the degree of the rise is related with the duration of the therapy,with no obvious adverse reaction,which strikes out a new path and new train of thinking for the treatment of the disease by non-blood preparation.