益气养阴、固表利咽法治疗气阴两虚型 IgA 肾病临床研究

目的:观察益气养阴、固表利咽法治疗气阴两虚型IgA肾病的临床疗效。方法:将IgA肾病60例随机分为试验组与对照组,每组30例;2组患者均予以西医常规治疗,试验组在此基础上加用益气养阴、固表利咽为主的中药治疗;疗程均为6月,记录所有受试者治疗前、治疗后2月、4月、6月时中医证候积分、感冒次数及安全性指标,并评价总体临床疗效。结果:总有效率试验组为86.7%,对照组为66.7%,2组比较,差异有统计学意义(P 0.05)。治疗后,2组在半年内的治疗后感冒次数均比治疗前减少(P 0.05),且试验组感冒次数明显少于对照组(P 0.05)。治疗后,2组腰膝酸软、神疲乏力、面色少华、咽干、发热恶寒等中医证候积分均较治疗前明显下降(P 0.05),且试验组上述各项积分下降较对照组更显著(P 0.05)。治疗后2月、4月、6月,2组中医证候总积分均较治疗前明显降低(P 0.05),且试验组总积分下降较对照组同时间段更显著(P 0.05)。2组患者治疗前后肝功能、血常规、大便常规、心电图均无明显变化。结论:益气养阴、固表利咽法可以明显改善IgA肾病患者的相关临床症状及体征,减少患者的感冒次数,值得临床推广应用。     

急性氟乙酰胺中毒8例误诊分析

急性中毒是急诊临床工作中最常见的急症之一 ,抢救工作分秒必争 ,及时救治可迅速改善预后。我院自 1996年 5月～2 0 0 0年 5月共收治急性氟乙酰胺中毒 2 4 3例 ,其中 8例误诊 ,误诊率 3 2 9% ,现分析如下。1　临床资料1 1　一般资料 :8例中男 5例 ,女 3例。年龄 4～ 14岁。全部经毒源调查及毒物鉴定确诊。发病至确诊时间最短 2 4小时 ,最长 72小时。1 2　中毒方式 :8例均单独发病。误食含氟乙酰胺毒饵 3例 ;玩曾装过氟乙酰胺的塑料瓶、塑料袋中毒 2例 ;服毒自杀 3例。1 3　临床表现 :2例仅表现头痛、头晕、恶心、呕吐 ,视物模糊 ,精神恍惚 …     

还春口服液质量标准的实验研究

采用薄层色谱法鉴定还春口服液中人参、三七、淫羊藿；用薄层－分光光度法测定淫羊藿含量，方法简便，数据可靠，结果重现性好。     

肠易激综合征患者的睡眠特征

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.     

以巨幼细胞性贫血为突出表现的消耗性疾病12例分析

本文对 1998～ 2 0 0 1年我院收治的 12例以巨幼细胞性贫血 (巨幼贫 )为突出表现的消耗性疾病作回顾性分析 ,现报道如下。1　临床资料1 1　一般资料 :12例患者均符合巨幼贫诊断标准[1] 。其中男 5例 ,女 7例 ,年龄16～ 75岁 ,平均 5 7岁 ,病情 2个月～1 5年。1 2　临床表现 :有头昏、乏力、食欲不振 12例 ,味觉异常、四肢麻木 4例 ,颜面苍白、消瘦伴牛肉舌 3例 ,巩膜黄染 1例 ,颜面、下肢浮肿 1例。1 3　实验室检查 :外周血Ｈｂ 36～ 76ｇ/Ｌ ,ＷＢＣ (2 4～ 8 7)× 10 9/Ｌ ,ＰＬＴ (6 0～ 2 34)× 10 9/Ｌ ;红细胞体积 (10 0～15 0 )ｆｌ…     

肠易激综合征患者的睡眠特征

Objective To investigate the sleep features in the patients with irritable bowel syndrome (IBS) and compare the sleep quality between those IBS patients who were with and without anxiety and depression.Methods Pittsburgh sleep quality index questionnaire (PSQI), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were measured in the 145 IBS patients and 59 regular physical examination volunteers.IBS patients were also divided into two subgroups-patients with or without anxiety and depression based on cutoff scores of SAS and SDS.Comparisons of sleep quality were made between subgroups, and between IBS patients and volunteer controls.Results Compared with the controls,the SAS raw score, SDS raw score and SAS positive incidence in IBS patients were shown statistically significant differences (P ＜ 0.05 ), while the SDS positive incidence had no statistically significant difference(P ＞ 0.05 ).PSQI total scores were significantly higher in the IBS patients without anxiety and depression (P ＜ 0.05), 3 domains (sleep quality, sleep disturbances and daytime function disorder) were also found statistically significant differences ( P ＜ 0.05 ), compared with the controls.The IBS patients with anxiety and depression were statistically significantly different from the controls ( P ＜ 0.05 ) in 6 domains (sleep quality, sleep latency, sleep efficiency, sleep disturbances, sleep time and daytime function disorder) and significantly higher PSQI total scores( P ＜ 0.05 ).Statistically significant differences (P ＜0.05) were also found in all 7 domains and with higher PSQI total scores in IBS patients with anxiety and depression, compared with IBS patients without anxiety and depression.Conclusions IBS patients were more likely to have sleep abnormality, mainly in sleep quality, sleep disturbances and daytime function disorder and PSQI total scores.The abnormalities of these factors were independent of emotional disorder.However, emotional disorder worsened the sleep disorder in IBS patients.     

三级垂直管理模式下医院-社区中心糖尿病健康管理体系构建体会

目的通过分析余杭区第五人民医院三级垂直管理模式下医院-社区卫生服务中心糖尿病健康管理体系的构建和实践应用效果,为慢性病管理提供新模式。方法回顾性分析三级垂直网络内医院-社区卫生服务中心糖尿病健康管理体系的构建背景、构建内容和构建方法。结果规范化管理1年后,社区糖尿病患者复诊率、双向转诊率及患者满意度上升明显;患者糖尿病相关知识、自我管理能力及空腹血糖满意率变化明显。结论三级垂直网络内医院-社区卫生服务中心糖尿病健康管理体系的构建符合国家新医改精神,余杭区第五人民医院区域内优质资源的垂直管理形成了社区卫生服务慢性病管理的新模式。     

以糖尿病俱乐部形式干预农村社区糖尿病健康管理的效果

目的观察以糖尿病俱乐部的形式干预农村社区糖尿病患者及高危人群的效果。方法将余杭区第五人民医院下属南苑街道10个社区筛选出2型糖尿病197例,糖尿病高危人群119例,分为观察组162例,对照组154例,进行干预前后的对比观察。结果干预前两组的血糖控制满意率、糖尿病知识合格率,干预前后两组的生活与行为方式合格率接近,差异均无统计学意义;干预后观察组的血糖控制满意率、糖尿病知识合格率明显高于对照组,差异有统计学意义。结论以俱乐部形式进行干预可提高糖尿病患者及高危人群了解糖尿病防治知识的主动性与积极性,营造和普及糖尿病教育的社会大环境,有利于糖尿病防治观念的改善。     

胰腺纤维钙化性糖尿病一例报告

胰腺纤维钙化性糖尿病(Fibrocalculous pancreatic diabetes, FCPD)属于特殊类型糖尿病的少见亚型,具有特殊的发病机制、临床特征,检索国内文献,目前报道病例不足百例,发病率极低,容易误诊误治。现报道我院收治的1例FCPD患者并复习相关文献。     

银杏达莫治疗急性脑梗死120例临床疗效观察

[目的]观察银杏达莫注射液治疗急性脑梗死的临床疗效。[方法]选择急性脑梗死患者120例,随机分为研究组和对照组各60例,在常规治疗基础上,研究组使用银杏达莫注射液,对照组使用丹参注射液,21d为1个疗程,观察血液流变学的变化,并进行神经功能缺损评分。[结果]总有效率研究组为93.4%,对照组为66.7%,两组差异有统计学意义(P0.05),两组比较,血液流变学指标和神经功能缺损评分差异均有显著性(P0.05),两组均无不良反应。[结论]银杏达莫治疗急性脑梗死,疗效较高,安全性良好。