关节超声检查在类风湿关节炎诊疗中的意义

类风湿关节炎(RA)的病理学改变主要为滑膜炎、软骨侵蚀及软骨下骨侵蚀,其中滑膜炎是其早期常见的首发表现,而选择适宜的方法对RA进行早期诊断,则对其治疗及预后至关重要.近年来,关节超声在RA的早期诊断、病情判断、疗效监测及评估预后等方面均展现出独特的价值和广阔的应用前景.本文就关节超声检查对RA诊治的指导意义进行综述.     

蒸发光散射检测-高效液相色谱法测定龙生蛭胶囊中黄芪甲苷的含量

目的建立高效液相-蒸发光散射检测法测定龙生蛭胶囊中黄芪甲苷的含量。方法色谱柱为Diamonsil C18(250mm×4.6 mm,5μm)。流动相为乙腈-水(33∶67),流速1.0 ml/min。ELSD参数:漂移管温度105℃,气体流量2.8 ml/min。结果黄芪甲苷在2.45~10.64μg的线性关系良好(r=0.999 2,n=5)。结论方法简便准确,重现性好,灵敏度高。     

HPLC测定中风回春胶囊中阿魏酸的含量

目的建立高效液相色谱法(HPLC)测定中风回春胶囊中阿魏酸的含量。方法色谱柱为Krom a-sil C18柱(4.6 mm×200 mm,5μm),流动相为乙腈-0.1%磷酸溶液(20∶80),流速为1 mL/m in,检测波长为325 nm。结果阿魏酸在0.05~0.25μg范围内线性良好,回归方程:Y=26 113X-8 154.8,r=0.999 6,平均回收率为97.98%,RSD为0.74%。结论本方法简便,准确,重现性,可有效地控制该制剂的质量。     

疏肝解郁颗粒治疗轻中度抑郁症多中心随机双盲安慰剂对照临床观察

目的评价疏肝解郁颗粒在治疗轻中度抑郁症方面的临床疗效与安全性。方法采用随机双盲、安慰剂对照、多中心临床试验。选择符合轻中度抑郁症受试者480例,按照3∶1的比例分为试验组360例,安慰剂对照组120例。试验组服用疏肝解郁颗粒,安慰剂对照组服用疏肝解郁颗粒模拟剂,疗程均为6周。在治疗前后进行17项汉密尔顿抑郁量表(HAMD-17)评分、汉密尔顿焦虑量表(HAMA)评分及中医证候评分,治疗后对临床疗效、中医证候疗效和临床总体印象量表(CGI-GI)的疗效进行疗效总评。安全性评估包括:评估不良事件、实验室检查和心电图检查等。结果本试验共入组病例数456例(试验组342例,对照组114例)。治疗结束后,2组HAMD及HAMA评分均降低,其中试验组的HAMD下降(8. 56±3. 29)分,对照组降低(6. 21±3. 61)分;试验组总有效率为53. 39%,对照组总有效率为27. 19%,组间差异均有统计学意义(P 0. 05)。试验组中医证候疗效总有效率为83. 18%,对照组总有效率为45. 61%。2组在各访视点CGI严重程度评分差异皆有统计学意义(P 0. 05)。发生不良事件9例,试验组6例、对照组3例,2组比较差异无统计学意义(P=0. 6977)。结论疏肝解郁颗粒治疗轻中度抑郁症疗效可靠,能有效的缓解临床症状,不良反应小,安全性好。     

小儿推拿疗法对脑瘫患儿反复呼吸道感染预防效果的观察

目的:观察小儿推拿疗法对脑瘫患儿反复呼吸道感染的预防效果.方法:将符合标准的62例患者随机数字表法分为观察组(32例)和对照组(30例).观察组给予常规康复治疗和小儿推拿治疗,对照组常规康复治疗和口服泛福舒治疗,观察1年评定预防效果,对比2组治疗前后的T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)水平和血清免疫球蛋白(IgG、IgA、IgM).结果:2组呼吸道感染的发生均可减少,2组T细胞亚群及血清免疫球蛋白比较差异无显著性意义(P＞0.05).结论:小儿推拿组与泛福舒组疗效相当,小儿推拿疗法可减少脑瘫患儿呼吸道感染的发生.     

揿针治疗老年膝关节骨性关节炎疗效观察：随机对照试验

ObjectiveTo observe the effects of the thumb-tack needling therapy on knee joint pain and joint function in the elderly patients with knee osteoarthritis (KOA) and compared with medication.MethodsA total of 60 patients were randomized into a thumb-tack needling group and a medication group, 30 cases in each one. In the thumb-tack needling group, the therapy with the thumb-tack needle retaining and waiting for qi was adopted. The acupoints were Hèdĭng (EX-LE2鹤顶), Nèixīyăn (内膝眼EX-LE4), Dúbí (犊鼻ST35), Xuèhăi (血海SP10), Liángqiū (梁丘ST34) and Ashi points on the affected side. The needles were retained for 24 h. This therapy was given once every two days, 3 times a week. The treatment for 2 weeks was as one course and consecutive 2 courses of treatment were required. In the medication group, diclofenac sodium sustained release tablets were taken orally, 75 mg each time, once daily, consecutively for 4 weeks. Successively, the score of visual analogue scale (VAS) at the affected knee before treatment, after treatment and 3 months after treatment as well as Lequesne indicator before and after treatment were evaluated. The clinical therapeutic effect was observed in the patients of the two groups after treatment.Results(1) After treatment, VAS scores were reduced as compared with those before treatment in the patients of the two groups (both P < 0.05). After treatment, VAS score in the thumb-tack needling group was lower than that in the medication group (P < 0.05). (2) After treatment, the scores of all the items of Lequesne indices reduced as compared with those before treatment in the patients of the both groups, indicating significance differences (all P < 0.05). After treatment, compared with the medication group, the score of pain, morning stiffness and walking ability as well as the total score were all lower in the thumb-tack needling group, indicating significant differences (all P < 0.05). (3) The curative and remarkably effective rate and the total effective rate were 66.7% and 93.3% in the thumb-tack needling group, higher than 56.7% and 86.7% in the medication group respectively (both P < 0.05).ConclusionThe thumb-tack needling therapy effectively relieves knee joint pain and improves joint function in the patients and the therapeutic effect is better than medication group. Hence, this therapy deserves to be promoted in clinical practice.     

重庆市某贫困县农村学龄前留守儿童营养状况及影响因素分析

目的了解重庆市某县农村学龄前留守儿童的营养状况及其影响因素。方法按分层整群随机抽样的原则,抽取该县402名0~6岁学龄前留守儿童,进行问卷调查、体格检查及血红蛋白检测。结果该县农村学龄前留守儿童年龄别身高(HAZ)、年龄别体重(WAZ)、身高别体重(WHZ)分别为-1.75±1.64、1.07±1.53和-0.35±1.00;生长发育迟缓率为20.15%、低体重或消瘦率为6.22%、超重或肥胖率9.95%、贫血率为23.88%。多因素分析显示:生长发育迟缓的影响因素是父亲文化程度、父亲打工时间、三餐能否保证、贫血及与看护人的关系;超重或肥胖的影响因素是生活情况、出生后6个月内喂养方式、三餐能否保证;低体重或消瘦的影响因素为母亲打工时间。结论该县农村学龄前留守儿童生长发育迟缓问题相对突出,减少父母外出打工时间、儿童不良饮食行为可改善营养状况。     

中风回春丸辅助治疗缺血性脑卒中的临床观察

目的:观察中风回春丸辅助治疗对缺血性脑卒中患者血液流变学状态及神经功能的保护作用。方法:将126例缺血性脑卒中患者随机分为对照组和观察组各63例。对照组予以常规对症支持治疗,观察组在常规治疗的基础上加用中风回春丸。观察两组疗效、治疗前后血液流变学指标检测结果和神经功能评分变化情况。结果:观察组治疗总有效率(90.48%)高于对照组(76.19%)(P0.05);治疗30 d后,两组WBV、ESR、FIB、HCT水平及NIHSS评分均较治疗前降低,且观察组低于对照组(P0.05);ESS评分则较治疗前升高,且观察组高于对照组(P0.05)。结论:中风回春丸对缺血性脑卒中有较好的辅助治疗作用,能有效降低患者的血液黏度,改善其神经功能。     

羟氯喹对类风湿关节炎合并2型糖尿病患者血糖和血脂的效果观察

目的分析在类风湿关节炎合并2型糖尿病患者中运用羟氯喹治疗的临床效果。方法该文参考抽签法将该院选自2018年5月-2019年5月期间诊治的70例类风湿关节炎合并2型糖尿病患者进行分组,参照组(n=35)使用常规治疗,试验组(n=35)使用羟氯喹治疗,比对试验组与参照组临床治疗差异。结果治疗后试验组类风湿关节炎合并2型糖尿病患者LDL-C、TC、TG、DAS28评分、HbA1c、2 h PG、FPG、临床治疗有效率与参照组数据比较,差异有统计学意义(P<0.05),数据指标之间表明统计学验证价值。结论将羟氯喹治疗用于类风湿关节炎合并2型糖尿病患者中可改善血糖和血脂水平。     

中西医结合治疗糖尿病合并急性脑卒中临床价值分析

目的:探讨中西医结合治疗糖尿病合并急性脑卒中患者的临床效果和价值。方法:从我院近年来收治的糖尿病合并急性脑卒中患者中抽取50例纳入本次研究,随机分为比较组和研究组各25例,分别给予西药和中西医结合治疗,比较两组患者的治疗效果、血糖指标和血液流动指标。结果:研究组的临床总有效率明显高于比较组,P0.05;研究组的血糖和血液流动指标明显低于比较组,P0.05。结论:中西医结合治疗糖尿病合并急性脑卒中具有显著疗效,值得临床推应用。