中药熏洗(浴)疗法临床外用技术规范(草案)

熏洗(浴)疗法临床应用广泛,但方法各异。基于对熏洗(浴)疗法已有临床应用的数据挖掘与分析,结合临床应用实际和相关现代研究,经相关领域专家多次论证,形成中药熏洗(浴)疗法临床应用技术规范(草案)。该规范(草案)包括适应症、禁忌症、用药前评估、用药前准备、药液制备、熏洗温度、熏洗时间、熏洗频率、熏洗疗程、操作方法、用药后处理及评估、注意事项、常见不良反应及应对措施等,以期规范中药熏洗(浴)疗法的临床应用,提高临床疗效,减少不良反应。     

中药熏蒸联合针灸推拿治疗中风的临床效果

目的：观察中药熏蒸联合推拿和针灸治疗中风的临床疗效。方法：选取2018年11月至2020年7月南通大学第二附属医院收治的中风患者100例作为研究对象，按照入院顺序进行编号，按编号单双数不同分为对照组和观察组，每组50例。对照组给予推拿+针灸治疗，观察组则在对照组基础上给予中药熏蒸治疗。比较2组患者临床疗效、红细胞压积（HCT）、纤维蛋白原（FBG）、血浆黏度（CP）、免疫学（lgA，lgG，lgM）、神经缺损（NDF）、运动功能（FMA）、临床痉挛指数（CSI）及不良反应。结果：治疗后，观察组临床有效率为96.00%，对照组为84.00%，差异有统计学意义（P<0.05）；2组FBG、CP、HCT、IgA、IgM、IgG水平均显著降低，且观察组显著低于对照组（P<0.05）；2组NDF、CSI评分均明显降低，且观察组明显低于对照组（P<0.05）；2组FMA评分上升，且观察组显著高于对照组（P<0.05）；对照组与观察组的不良反应发生率分别为10.00%和12.00%，差异无统计学意义（P>0.05）。结论：改良中药熏蒸法联合推拿、针灸可改善中风患者血循环状态和免疫调节，促进神经及运动功能恢复，疗效确切。     

Bilateral acute iris transillumination following a fumigation therapy: a village-based traditional method for the treatment of ophthalmomyiasis

Bilateral acute iris transillumination (BAIT) is a relatively new clinical entity characterized by bilateral acute loss of iris pigment epithelium, iris transillumination, pigment dispersion in the anterior chamber and atonic pupilla. We report herein a 50-year-old female who presented with bilateral ocular pain, severe photophobia and red eyes. One month ago, a fly hit her eye, and she instantly complained of a discomfort and sensation of a foreign body in both eyes. She used a fumigation therapy, a traditional method for the treatment of ophthalmomyiasis. During follow-up examinations, intraocular pressures increased over 40?mmHg bilaterally despite maximal medical therapy, which necessitated trabeculectomy surgery with mitomycin. This is a typical BAIT case with no antecedent fluoroquinolone use or viral disease, but a fumigation therapy. There might be a possible relationship between BAIT and traditional fumigation therapy or this association might be coincidental, both of which need further evaluation.     

基于中医传承辅助平台分析痔术后熏洗中药复方的用药规律＊

目的 借助中医传承辅助平台，对中医药防治痔术后并发症的方剂组方规律进行研究，为临床防治痔术后并发症提供用药参考。方法 收集中国学术期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、维普、万方数据库中使用中医药方剂防治痔术后并发症的文献，将组方录入到中医传承辅助平台，并进行中药频次统计、关联规则分析、聚类分析等组方规律研究，提取新方组合。结果 筛选出防治痔术后并发症的方剂161首，使用中药123味，分析得出使用高频次的药物有苦参、黄柏、五倍子、芒硝、大黄、蒲公英、冰片、金银花、马齿苋、红花等；高频药物组合包含黄柏-苦参、苦参-五倍子、芒硝-苦参等；通过聚类分析得到3个新方，功效各有侧重。结论 防治痔术后并发症的熏洗处方用药主要以清热燥湿、解毒化瘀、消肿止痛为主，为临床用药和新药开发提供依据。     

紫癜1号中药熏洗治疗小儿过敏性紫癜临床观察

目的观察紫癜1号中药熏洗治疗小儿过敏性紫癜的临床效果。方法选取收治的过敏性紫癜患者80例,按照研究方法的不同分为观察组和对照组,对照组患者40例,给予喜炎平注射液、维生素C注射液、葡萄糖酸钙注射液等进行治疗;观察组患者在对照组基础上采用紫癜1号中药熏洗进行治疗,比较2组患者的临床治疗效果、皮肤紫癜消退时间及关节肿痛缓解状况等相关指标。结果对照组患者的治疗有效率为75.0%,观察组患者的治疗有效率为97.5%,观察组治疗有效率显著高于对照组;观察组患儿皮肤紫癜消退时间为(4.10±1.02)d,少于对照组(7.69±1.79)d;观察组患者经治疗后关节肿痛情况完全缓解达到50.0%,缓解达到35.0%,明显优于对照组。结论紫癜1号中药熏洗治疗小儿过敏性紫癜,治疗效果明显,有效缩短患者紫癜消退时间及缓解关节痛的程度。     

不同剂量硫磺熏蒸对党参化学成分的影响

目的 研究不同剂量硫磺熏蒸对党参化学成分的影响及硫熏党参贮藏不同时间化学成分的变化,为党参饮片的科学炮制及质量评价提供参考。方法 不同剂量硫磺熏蒸党参并贮藏期12个月,采用UV及HPLC方法测定党参多糖、5-羟甲基糠醛、党参炔苷等化学成分的变化。结果 硫磺熏蒸对党参多糖的影响较小,最高剂量（2.0%）硫熏,放置12个月,多糖含量降低5.83%;对5-羟甲基糠醛、党参炔苷的影响大,最高剂量（2.0%）硫熏,放置12个月,5-羟甲基糠醛含量增加83.27%,党参炔苷含量降低54.09%。结论 硫熏对党参化学成分有显著影响。应严格控制药材加工处理及炮制过程中硫磺的使用,确保中药材及饮片的质量。     

中药熏洗配合手术治疗胫骨Pilon骨折60例

目的:观察中药熏洗联合锁定加压接骨板(Locking Compression Plate,LCP)内固定治疗胫骨Pilon骨折的临床疗效。方法:选取2015年1月—2016年6月在本院住院治疗的胫骨Pilon骨折患者120例,随机分为对照组和观察组各60例。对照组60例给予锁定加压接骨板(Locking Compression Plate,LCP)内固定治疗。观察组在对照组治疗的基础上加用中药熏洗治疗,早期以消肿为主,中期下地活动后踝关节疼痛者以止痛为主,方选海桐皮汤加减,日1次。连续治疗4~6周,观察两组患者临床疗效及相关指标的变化。结果:观察组疗效明显优于对照组(P0.05)。治疗后1月、3月、6月观察组踝关节功能均优于同期对照组(P0.01)。观察组骨折愈合明显快于对照组,有统计学差异(P0.01);观察组手术切口均I期愈合,未发生并发症,对照组2例患者发生切口感染,5例切口延迟愈合。观察组和对照组切口愈合情况比较有统计学差异(P0.05)。结论:将中药熏洗联合锁定加压接骨板内固定用于Pilon骨折的治疗,可以提高临床疗效,改善患者踝关节功能,促进骨折和切口愈合,降低并发症发生率。     

芍红汤与马应龙麝香痔疮膏治疗血栓外痔82例

目的探讨芍红汤与马应龙麝香痔疮膏治疗血栓外痔的临床治疗效果。方法选择2012年4月—2014年9月期间我院收治的血栓外痔患者164例,根据治疗方法不同分为观察组和对照组。对照组82例,给予口服去痛片和外敷马应龙麝香痔疮膏治疗,观察组82例给予芍红汤熏洗坐浴后外敷马应龙麝香痔疮膏治疗。两组均连续治疗3d、6d后进行疗效对比。结果治疗3d、6d后,观察组治疗总有效率均高于同期对照组,差异显著(P0.05)。结论芍红汤与马应龙麝香痔疮膏联合治疗血栓外痔临床疗效显著,值得推广。     

Combined effect of zinc ions and cationic antibacterial agents on intraoral volatile sulphur compounds (VSC)

OBJECTIVE: Volatile sulphur compounds (VSC) are major components of oral malodour. As both zinc ions and cationic antibacterial agents inhibit the formation of oral VSC, this study aimed to determine whether these agents combined have synergistic anti-VSC actions. METHODS: Baseline oral VSC measurements of mouth air from 10 volunteers following cysteine rinsing (6mM, pH 7.2) were obtained using gas chromatography (GC). Subjects rinsed for 1 min with 10ml of the test solutions, 0.3% zinc acetate (Zn), 0.025% chlorhexidine (CHX), 0.025% cetyl pyridinium (CPC), and the combinations Zn+CHX and Zn+CPC. Cysteine rinses were repeated at 1h, 2h and 3h and VSC measurements recorded. Three subjects rinsed with the Zn+CHX combination and fasted for 9h, undergoing cysteine rinses and VSC measurements at 3h intervals. 10 microl of the test solutions were also added to 1ml aliquots of human whole saliva (n=8). Following incubation at 37 degrees C for 24h VSC levels in the saliva headspace were measured by GC. Inhibition of VSC formation and the fractional inhibitory index indicating synergy were calculated. RESULTS: Zn+CHX mouthrinse had a synergistic anti-VSC effect, and was effective for at least 9h. Zn+CPC mouthrinse was less effective. Both combinations showed a synergistic inhibiting effect in-vitro. CONCLUSIONS: Synergy between Zn and the antibacterial agents confirms different mechanisms of operation.     

Insoluble zinc, cupric and tin pyrophosphates inhibit the formation of volatile sulphur compounds

Oral malodour is mainly a result of the production of volatile sulphur compounds (VSC). The present study was concerned with investigating the anti-VSC effect of insoluble pyrophosphates (PP) of zinc, copper(II) and tin(II). The hypothesis to be tested was that the sulphide anions produced when VSC are solubilized in water have a higher affinity for the respective metal ions than the PP anion. The anti-VSC effects of insoluble PP were compared with the corresponding soluble metal salts using three in vitro methods: saliva putrefaction; dialysis of a suspension of PP and saliva against water; and analysis of water containing hydrogen sulphide and methyl mercaptan gases, and gases in the headspace. The levels of VSC were analysed by gas chromatography in the first and third methods, and released metal ions were analysed by atomic absorption spectroscopy in the second. The results showed that: the insoluble metal PP inhibited VSC formation in saliva by 99-100%; under dialysis, only minute amounts of metal ions are released from the combination of PP and saliva; and the PP lost their metal cations in water containing dissolved gases and inhibited VSC formation. Hence, the results support the experimental hypothesis. Sulphide ions are obviously very strong ligands for these metal ions.