大黄虫丸抗肿瘤作用研究进展

正经典名方大黄虫丸出自汉代张仲景的《金匮要略·血痹虚劳病脉证并治第六》:"五劳虚极羸瘦,腹满不能饮食,食伤、忧伤、饮伤、房室伤、饥伤、劳伤,经络营卫气伤,内有干血,肌肤甲错,两目黯黑。缓中补虚,大黄虫丸主之。"大黄虫丸由大黄、黄芩、甘草、桃仁、杏仁、芍药、干地黄、干漆、虻虫、水蛭、蛴螬、虫共十二味中药组成,组方精良,用药精妙,具有通经活络、祛瘀生新、缓中补虚之功效。恶性肿瘤病至晚期,     

金水六君煎加味联合沙美特罗替卡松粉吸入剂对慢性持续期老年哮喘患者血清VEGF,TGF-β1的影响

目的:探讨金水六君煎加味联合沙美特罗替卡松粉吸入剂治疗慢性持续期老年哮喘患者的临床疗效及对血清血管内皮生长因子(vascular endothelial growth factor,VEGF),转化生长因子-β_1(transforming growth factor-β_1,TGF-β_1)的影响。方法:选取符合纳入标准的老年哮喘患者100例,随机数字表法分为对照组和治疗组。每组各50例。两组均根据病情给予氧疗、化痰、抗感染等措施,并给予沙美特罗替卡松粉吸入剂50μg·(500μg)~(-1),1吸/次,2次/d。同时,对照组加用茶碱缓释胶囊0. 1 g,bid,治疗组加用金水六君煎加味治疗。两组疗程均为8周。观察两组患者的中医证候疗效,治疗前后、治疗后3,6个月两组患者的哮喘控制测试(asthma control test,ACT)得分,治疗前后两组患者的肺功能及血清VEGF,TGF-β1水平。评价两组治疗期间的用药安全性。结果:治疗组的总有效率高于对照组(P 0. 05)。与对照组比较,治疗后、治疗后3,6个月治疗组ACT得分均明显升高(P 0. 05)。治疗后与对照组比较,治疗组的呼气流量峰值(peak expiratory flow,PEF)变异率和血清VEGF,TGF-β1水平均明显降低(P 0. 05); 1 s用力呼气量占预计值百分比(percentage of forced expiratory volume in first second and its predicted value,FEV1%),第1秒末用力呼气量占用力肺活量百分比(percentage of forced expiratory volume in first second and forced vital capacity,FEV_1/FVC)均明显升高(P 0. 05)。治疗期间两组不良反应发生率比较,治疗组明显低于对照组(P 0. 05)。结论:与茶碱缓释胶囊联合沙美特罗替卡松粉吸入剂治疗比较,金水六君煎加味联合沙美特罗替卡松粉吸入剂治疗慢性持续期老年哮喘可更明显地提高患者的临床疗效,改善肺功能,其作用机制可能与调节血清VEGF及TGF-β_1水平有关。     

加味消风散治疗支气管哮喘风哮证的疗效观察及对炎症因子的影响

目的:观测加味消风散治疗慢性持续期支气管哮喘风哮证的临床疗效及对炎症因子的影响。方法:将120例符合纳入标准的慢性持续期哮喘患者随机分为对照组和治疗组,各60例。对照组60例,单用布地奈德福莫特罗粉吸入剂(160μg/4.5μg),2吸/次,bid。治疗组予加味消风散,日1剂,并联合布地奈德福莫特罗粉吸入剂(160μg/4.5μg)治疗。两组疗程均为1个月。观察两组患者临床疗效,治疗前后及治疗结束3个月后哮喘控制测试(asthma control test,ACT)评分表的得分情况以及治疗前后半年内哮喘平均急性发作次数,测定两组患者治疗前后第1秒用力呼气量占预计值百分比(percentage of forced expiratory volume in first second and its predicted value,FEV1%),PEF变异率(variety ratio of peak expiratory flow,PEF),外周血嗜酸性粒细胞(eosinophilic granulocyte,EOS)计数和血清白细胞介素-4(interleukin-4,IL-4),白细胞介素-6(interleukin-6,IL-6),白细胞介素-13 (interleukin-13,IL-13)水平。并对两组患者进行安全性评价。结果:治疗组总有效率高于对照组(P0.05);治疗后及治疗结束3个月后ACT评分比较,治疗组高于对照组(P0.05);治疗后治疗组FEV1%高于对照组(P0.05);治疗后治疗组急性发作次数,PEF变异率,外周血EOS计数和血清IL-4,IL-6,IL-13水平低于对照组(P0.05)。结论:加味消风散联合布地奈德福莫特罗粉吸入剂治疗支气管哮喘风哮证可有效缓解症状,提高临床疗效,改善肺功能,降低血清炎症因子水平,改善气道慢性炎症状态。     

罕见小肠囊腺瘤1例报道

SUMMARY In recent years, there have been more and more reports about cystadenoma. Cystadenoma can occur in many parts of the body, and cystadenoma in different parts may show different clinical symptoms, however, some patients with cystadenoma have no symptoms. The vast majority of cystadenomas are benign lesions, but a small number of cystadenomas can be malignant. For example, a small number of ovarian cystadenomas and pancreatic cystadenomas may be malignant. This study reported a patient with small intestinal cystadenoma diagnosed by pathology. The patient's physical examination revealed a lesion in the left upper abdomen. He had only abdominal distension and no other discomfort. His laboratory examination results were basically normal, i.e. blood routine, urine routine, stool routine, liver function, kidney function, myocardial enzyme, tumor marker, etc. The patient underwent sectional small intestine resection and the pathological sample was analyzed. The histological findings of the resected intestinal sample were consistent with cystadenoma. Computed tomography scan of the abdomen was performed 4 months after the surgery. No recurrence of the tumor was found. The patient recovered in good condition. By consulting the literature, I found very few reports of small intestinal cystadenoma before, it was very rare. This article described the clinical manifestation, diagnosis and differential diagnosis, treatment and prognosis of a case of small intestinal cystadenoma, it suggested that cystadenoma can occur in the small intestine, other than the ovary, pancreas, liver, lung, thyroid, prostate, seminal vesicle, skin, etc. The cystadenoma in small intestine is easy to be mistaken with other tumors, such as small intestine stromal tumor, small intestine adenocarcinoma, small intestine lipoma, small intestine hemangiomas, etc., and it is difficult to fully confirm through imaging examinations, such as computed tomography and magnetic resonance imaging. Laparotomy and histopathological examination are necessary before definitive diagnosis. This disease can be treated by small bowel resection at the affected region and good prognosis can be achieved.     

罕见小肠囊腺瘤1例报道

SUMMARY In recent years, there have been more and more reports about cystadenoma. Cystadenoma can occur in many parts of the body, and cystadenoma in different parts may show different clinical symptoms, however, some patients with cystadenoma have no symptoms. The vast majority of cystadenomas are benign lesions, but a small number of cystadenomas can be malignant. For example, a small number of ovarian cystadenomas and pancreatic cystadenomas may be malignant. This study reported a patient with small intestinal cystadenoma diagnosed by pathology. The patient's physical examination revealed a lesion in the left upper abdomen. He had only abdominal distension and no other discomfort. His laboratory examination results were basically normal, i.e. blood routine, urine routine, stool routine, liver function, kidney function, myocardial enzyme, tumor marker, etc. The patient underwent sectional small intestine resection and the pathological sample was analyzed. The histological findings of the resected intestinal sample were consistent with cystadenoma. Computed tomography scan of the abdomen was performed 4 months after the surgery. No recurrence of the tumor was found. The patient recovered in good condition. By consulting the literature, I found very few reports of small intestinal cystadenoma before, it was very rare. This article described the clinical manifestation, diagnosis and differential diagnosis, treatment and prognosis of a case of small intestinal cystadenoma, it suggested that cystadenoma can occur in the small intestine, other than the ovary, pancreas, liver, lung, thyroid, prostate, seminal vesicle, skin, etc. The cystadenoma in small intestine is easy to be mistaken with other tumors, such as small intestine stromal tumor, small intestine adenocarcinoma, small intestine lipoma, small intestine hemangiomas, etc., and it is difficult to fully confirm through imaging examinations, such as computed tomography and magnetic resonance imaging. Laparotomy and histopathological examination are necessary before definitive diagnosis. This disease can be treated by small bowel resection at the affected region and good prognosis can be achieved.     

宣肺化痰、活血利水方离子导入治疗胸腔积液的临床护理分析

目的探讨宣肺化痰、活血利水方离子导入治疗胸腔积液的临床护理效果。方法选取我院2013年4月—2015年4月128例胸腔积液患者进行回顾性分析,随机分为治疗组和对照组各64例。对照组采用常规西药治疗和护理,治疗组采用离子导入宣肺化痰、活血利水方并配以常规西药治疗和护理。比例2组患者心理健康状况[焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分]、满意度、并发症发生情况。结果护理后,2组患者的SAS和SDS评分明显优于护理前(P0.05),而且治疗组的SAS和SDS评分明显优于对照组(P0.05);治疗组的满意度(100%)明显高于对照组(78.1%)(χ~2=9.038,P0.05);治疗组的并发症发生率(7.8%)明显低于对照组(15.6%)(χ~2=7.938,P0.05)。结论采用宣肺化痰、活血利水方离子导入治疗胸腔积液并进行临床护理可以改善患者心理状况,满意度高,并发症少,具有重要临床意义。     

补肾祛风颗粒治疗难治性哮喘疗效观察

目的观察补肾祛风颗粒联合西医常规治疗难治性哮喘的临床效果。方法将100例符合纳入标准的难治性哮喘患者随机分为对照组和治疗组,每组50例。对照组给予沙美特罗替卡松粉吸入剂、醋酸泼尼松片、硫酸沙丁胺醇吸入气雾剂治疗,治疗组在对照组治疗基础上给予补肾祛风颗粒治疗,2组疗程均为3个月。观察2组患者治疗前后哮喘生活质量评估表(AQLQ~(Marks))得分、肺功能[第1秒末用力呼气量占用力肺活量百分比(FEV_1/FVC)、1秒用力呼气量占预计值百分比(FEV_1%)、呼气流量峰值(PEF)变异率]、外周血嗜酸性粒细胞(EOS)计数、血清皮质醇(Cor)、肿瘤坏死因子α(TNF-α)、白细胞介素-4(IL-4)和γ干扰素(IFN-γ)水平,统计2组患者治疗期间激素撤减剂量、哮喘急性发作次数及不良反应发生情况。结果治疗结束后,2组患者AQLQ~(Marks)得分、PEF变异率、外周血EOS计数、血清TNF-α及IL-4水平均显著降低(P均0.05),且治疗组均显著低于对照组(P均0.05);2组患者FEV_1/FVC、FEV_1%、血清Cor及IFN-γ水平均显著升高(P均0.05),且治疗组均显著高于对照组(P均0.05)。治疗期间治疗组患者激素撤减剂量显著高于对照组(P0.05),哮喘急性发作次数显著少于对照组(P0.05),不良反应发生率显著低于对照组(P0.05)。结论补肾祛风颗粒联合西医常规治疗与单纯西医常规治疗相比,可更显著改善难治性哮喘患者的生活质量及肺功能,减少激素的使用和急性哮喘的发作,提高Cor水平,调节气道炎症,同时降低不良反应发生率,值得临床推广应用。     

新入职护士死亡教育需求状况及影响因素分析

目的 了解新入职护士死亡教育需求状况并分析其影响因素,为医院管理者对新入职护士开展死亡教育培训提供参考.方法 以便利抽样法于2021年7～8月选取河北省11所医院的387名新入职护士,采用一般资料调查表、死亡教育需求量表、死亡态度描绘量表及死亡焦虑量表进行调查.结果 新入职护士死亡教育需求总分为171.76±40.83...     

固本通络方联合西药治疗缓解期儿童哮喘疗效及对免疫功能的影响

目的观察固本通络方联合西药治疗缓解期儿童哮喘的临床疗效及对免疫功能的影响。方法将符合纳入标准的90例缓解期哮喘患儿随机分为2组,对照组45例给予布地奈德粉吸入剂(200μg/次,2次/d)治疗,治疗组45例给予固本通络方联合布地奈德粉吸入剂(200μg/次,2次/d)治疗,2组疗程均为2个月。观察2组治疗后临床疗效和治疗前后、治疗结束3个月及6个月后儿童哮喘控制测试问卷(C-ACT)得分情况,记录2组治疗前及治疗结束后1年内哮喘平均发作次数,检测2组治疗前后肺功能指标及血清免疫球蛋白A(IgA)、IgG、IgM、IgE水平,并评价2组安全性。结果治疗组总有效率显著高于对照组(P0.05)。2组治疗结束后、治疗结束3个月及6个月后C-ACT评分均显著高于治疗前(P均0.05),且治疗组上述时间C-ACT评分均显著高于对照组(P均0.05)。2组治疗结束后1年内哮喘发作次数均显著低于治疗前(P均0.05),且治疗组显著低于对照组(P0.05)。2组治疗后PEF变异率及血清IgE水平均显著降低(P均0.05),FEV_1/FVC、FEV_1%及血清IgA、IgG、IgM水平均显著升高(P均0.05),且治疗组上述指标改善情况均显著优于对照组(P均0.05)。2组不良反应发生率比较差异无统计学意义(P0.05)。结论固本通络方联合西医常规治疗缓解期儿童哮喘效果更好,可更显著地改善患儿的临床症状及肺功能,提高患儿的免疫功能,并降低血清IgE水平。     

针刺足三里、太冲、合谷穴配合三阶梯止痛治疗胃癌痛临床观察

【目的】观察针刺足三里、太冲、合谷穴配合世界卫生组织(WHO)三阶梯止痛法治疗胃癌癌性疼痛(简称胃癌痛)的疗效及安全性,为临床上治疗胃癌痛提供一种安全有效的治疗方案。【方法】将60例中重度胃癌痛患者随机分为治疗组和对照组各30例。治疗组采用针刺足三里、太冲、合谷穴配合WHO三阶梯止痛法治疗,对照组仅釆用WHO三阶梯止痛法治疗,2组均以7 d为1个疗程。1个疗程后釆用癌痛数字分级法(NRS)、生活质量量表[QOL-BREF(WHO)]、抑郁自评量表(SDS)来评价2组患者疗效,并比较2组患者的不良反应发生率。【结果】(1)治疗后,治疗组的止痛显效率明显高于对照组,差异有统计学意义(P0.05)。(2)治疗后,2组患者的生活质量均较治疗前明显改善(P0.05),且治疗组的改善作用优于对照组,差异有统计学意义(P0.05)。(3)治疗后,2组患者的抑郁评分均较治疗前明显改善(P0.05);但治疗后2组比较,差异无统计学意义(P0.05)。(4)治疗组的药物不良反应发生率较对照组低,差异有统计学意义(P0.05)。【结论】针刺足三里、太冲、合谷穴配合三阶梯止痛法治疗胃癌痛的效果明显优于单用三阶梯止痛法。