直肠粘膜保护剂治疗痔急性发作的临床研究

目的研究含直肠粘膜保护剂的肛门栓剂治疗痔急性发作的有效性及安全性。方法对123例患者采用随机、双盲对照的方法进行研究。研究组使用含直肠粘膜保护剂的肛门栓剂，对照组使用无粘膜保护成分的栓剂。结果（1）开盲后研究组60例，对照组63例。2组均未出现全身不良反应。（2）在治疗48h后，研究组疼痛、出血及瘙痒的减轻程度已明显优于对照组(P＜0.05)。（3）治疗7d后，研究组的疼痛、出血、水肿、糜烂和瘙痒的减轻程度也优于对照组(P＜0.05）。结论含直肠粘膜保护剂的肛门栓剂对痔发作有明显的疗效，未见到明显副作用。     

地奥司明片治疗急性发作痔92例临床分析

为观察地奥司明片对痔急性发作症状的I临床疗效,将146例痔患者分为两组,治疗组92例给予地奥司明片治疗,对照组54例给予痔速宁片治疗,对照观察两组药物对疼痛、便血、水肿、黏膜改变的时效和疗效。结果显示,治疗组对疼痛、便血的平均起效时间分别为（15．0±1．21）h和（25．0±2．33）h,症状消除时间分别为（3．7±1．2）d和（4．4±1．5）d,对照组疼痛、便血的平均起效时间分别为（22．0±0．84）h和（36．0±1.57）h,症状消除时间分别为（5．1±1．2）d和（5．6±1．2）d,治疗组优于对照组（P〈0．05）。7d后便血、黏膜改变的分值下降,治疗组优于对照组（P〈0．05）,治疗组和对照组显效率分别为69．6％和48．1％（P〈0．05）。结果表明,地奥司明片治疗痔急性发作起效快,疗效显著。     

柏红痔消外洗方在痔急性发作中的应用

为观察柏红痔消外洗方在痔急性发作患者中的应用疗效,将80例痔急性发作者随机分为观察组和对照组,各40例,观察组应用柏红痔消外洗方熏洗,对照组应用1：5000高锰酸钾溶液熏洗,每天2次,7d为一疗程,治疗2个疗程。结果显示,治疗后两组患者便血、疼痛、痔核脱垂症状评分均显著降低,其中观察组降低更明显,P〈0．05;而且观察组总有效率（92．5％,37／40）明显高于对照组（72．5％,29／40）,P〈0.01。结果表明,柏红痔消外洗方熏洗可有效缓解痔急性发作时的便血、疼痛、痔脱垂症状,效果显著。     

地奥司明片口服治疗痔急性发作的临床观察

为观察地奥司明片口服对痔急性发作症状的临床疗效,将120例痔急性发作患者随机分为两组,治疗组60例给予口服地奥司明片治疗,对照组60例给予口服痔宁片治疗,对照观察两组肛门疼痛、肛门水肿、便血、痔黏膜改变的时效和疗效。结果显示,治疗组肛门疼痛、便血的平均起效时间、平均消除时间均优于对照组（P〈0．05）。7d后两组均能显著改变临床症状及降低症状积分,但治疗组临床症状的改善及积分变化优于对照组（P〈0．05）,治疗组总有效率优于对照组（P〈0．05）。结果表明,地奥司明片口服治疗痔急性发作起效快,疗效显著。     

PPH术工期治疗急性嵌顿痔的临床研究

目的探讨吻合器痔上黏膜环切钉合术（PPH）I期治疗急性嵌顿性痔的临床疗效。方法40例已行手术治疗急性嵌顿痔患者根据术式分为PPH组（20例）和MMH组（20例）,对两组患者手术时间、术后VAS评分、术后出血、肛缘水肿、住院时间及住院费用进行比较分析。结果手术后两组患者预后良好,无严重并发症,PPH组住院费用多于MMH组（P〈0．01）,但在手术时间、术后疼痛的VAS评分、术后并发症（肛缘水肿）发生率及住院时间方面PPH组优于MMH组（P〈0．01）。结论PPH治疗急性嵌顿痔安全有效,且近期疗效优于MMH。     

微粒化纯化的黄酮成分治疗痔急性发作的多中心自身对照临床研究

目的　前瞻性评估微粒化纯化的黄酮成分 (爱脉朗 )治疗痔疮急性发作的疗效和安全性。方法　采用自身前后对照研究方法。按照预先设定的入组标准从全国 2 9家医院收治 110 3例痔疮急性发作的患者。按照预先设定的评分标准 ,分别在患者就诊时 (0天 ) ,门诊随诊第 4天 ,第 7天对入选患者的痔疮疼痛、便血、肛门脱垂、肛门瘙痒、肛门水肿 ,肛周糜烂等临床症状和体征进行打分 ,同时由医生和患者分别对患者的总体疗效进行打分。对各次随访患者分数变化的情况进行统计 ,评价爱脉朗对痔疮急性发作症状的疗效。结果　肛门疼痛、便血、肛门脱垂、肛门水肿、肛门瘙痒等症状体征评分均明显改善。结论　微粒化纯化的黄酮成分能有效缓解痔疮急性发作的症状。     

痔消颗粒洗剂治疗痔病的临床研究

为观察痔消颗粒洗剂治疗痔病的疗效，临床应用痔消颗粒洗剂治疗痔病320例，并与却毒汤治疗的160例进行对比观察。结果表明，该洗剂治疗痔病总有效率99．4％，总显效率84．4％，明显优于对照组（P〈0．01）。对便血、疼痛、肿胀、促进创面愈合疗效明显。     

金玄痔科熏洗散联合地奥司明片在痔急性发作时的应用

2012年10月至2013年9月,笔者采用金玄痔科熏洗散外洗联合地奥司明片口服治疗痔急性发作时疼痛、水肿、出血症状患者105例,取得满意效果,现报告如下。 临床资料：本组男65例,女40例;年龄13～75岁;病程1～8d。混合痔嵌顿82例,血栓性外痔23例。     

痔的外科治疗:比较超声刀痔切除术与闭式痔切除术的前瞻随机研究

痔切除术是对有症状的内痔和外痔确定性的治疗方式 ,超声刀作为一种新型手术工具 ,具有减少对组织的热损伤、创面愈合良好、易于切开组织等诸多优点。本研究目的是评价超声刀痔切除术在替代闭式痔切除术中的作用。　　方法 :30例 或 期痔患者前瞻性地随机分为两组 ,分别用电刀和超声刀行痔切除术。电刀组 1 6例 ,女 7例 ,平均年龄 ( 4 7.4± 4.8)岁 ,男 9例 ,平均年龄 ( 5 8.7± 3.6)岁。超声刀组 1 4例 ,女 8例 ,平均年龄 ( 4 8.5± 4.1 )岁 ,男 6例 ,平均年龄 ( 4 8.0± 5 .0 )岁。 1 1例患者切除 2个痔核 ,电刀组 9例 ,超声刀组 2例。 …     

Prophylactic antibiotics in appendicectomy: a prospective double blind randomized study

Our double blind prospective randomized trial comparing intravenous cefoxitin with rectal metronidazole in appendicectomy reveals both groups to be similar regarding basic data, with no significant difference in the results between the two drugs. Nearly all the wound infections occurred after the patient went home. Most were minor infections and the overall infection rate was 6%. The intravenous route was the more certain but the more expensive. Bacteriology suggests that the same flora were present in the appendiceal wall of normal and acute non-perforated appendices. This would suggest bacteriologically that the same risks exist with non-inflamed appendicectomy as occurs with inflamed non-perforated appendices. These findings support the use of short course prophylaxis in appendicectomy.     

Combined conventional/antioxidant ＂Astaxanthin＂ treatment for male infertility： a double blind, randomized trial

Aim： To evaluate the treatment of male infertility with a strong natural antioxidant, in addition to conventional treatment. Methods： Using a double blind, randomized trial design, 30 men with infertility of ≥12 months and female partners with no demonstrable cause of infertility received conventional treatment according to the guidelines of the World Health Organization （WHO）, and either a strong antioxidant Astaxanthin 16 rag/day （AstaCarox, AstaReal AB, Gustavsberg, Sweden） or placebo for 3 months. The effects of treatment on semen parameters, reactive oxygen species （ROS）, zona-free hamster oocyte test, serum hormones including testosterone, luteinizing hormone （LH）, follicle stimulating hormone （FSH） and Inhibin B, and spontaneous or intrauterine insemination （IUI）-induced pregnancies were evaluated. Results： ROS and Inhibin B decreased significantly and sperm linear velocity increased in the Astaxanthin group （n = 11）, but not in the placebo group （n = 19）. The results of the zona-free hamster oocyte test tended to improve in the Astaxanthin group in contrast with the placebo group, though not reaching statistical significance. The total and per cycle pregnancy rates among the placebo cases （10.5 % and 3.6 %） were lower compared with 54.5 % and 23. 1% respectively in the Astaxanthin group （P=0.028; P=0.036）. Conclusion： Although the present study suggests a positive effect of Astaxanthin on sperm parameters and fertility, the results need to be confirmed in a larger trial before recommending Astaxanthin for the complementary treatment of infertile men. （Asian J Androl 2005 Sep; 7： 257-262）     

Intraoperative bupivacaine during outpatient hernia repair in children: a randomized double blind trial

Postoperative pain is a major problem following surgery in the ambulatory child. A study was undertaken to test the effect of intraoperative bupivacaine on postoperative pain in children undergoing outpatient hernia repair. Ninety-nine children aged 1 to 7 years underwent outpatient inguinal herniorrhaphy under general anesthesia. Each was randomly assigned to receive bupivacaine (group 1) or saline (group 2), infiltrating the ilioinguinal and iliohypogastric nerves. Drug administration and patient evaluation were double-blinded. The groups were similar with respect to age, sex, side of procedure, and length of operation. In the immediate postoperative period, 17 group 1 patients required analgesics compared with 39 in group 2 (P less than .01); total codeine dosage was lower in group 1 (4.0 +/- 7.1 mg v 11.8 +/- 10.5 mg, P less than .05). Activity level 45 minutes after surgery (using a standardized scale) was greater in group 1 (P less than .05). Acetaminophen requirements at home were lower in group 1 on the day of surgery (3.1 +/- 4.3 mL v 5.7 +/- 7.4 mL, P less than .05) and over the following 48 hours (1.5 +/- 3.4 mL v 4.9 +/- 10.7 mL, P less than .05). Activity level at home on the day of surgery did not differ significantly between groups, but activity level over the following 48 hours was higher in group 1 (P less than .05). The two groups were similar with respect to all other parameters. We conclude that intraoperative bupivacaine decreases post-operative pain and analgesic use, and promotes early ambulation in children undergoing hernia repair.     

Intracorporeal pneumatic shock application for the treatment of chronic plantar fasciitis: a randomized, double blind prospective clinical trial

Objective  

Plantar fasciitis (PF) is a common clinical condition that usually resolves with non-operative treatments. Extracorporeal shock wave therapy (ESWT) has been used in the treatment of chronic PF not responding to other conservative measures; however, ESWT devices are expensive and available for daily practice in only few centers (In developing countries). A pneumatic lithotripter is a cheap and readily available device which uses pneumatic shock application for the intracorporeal lithotripsy. The aim of this study was to investigate the clinical efficacy of intracorporeal pneumatic shock therapy (IPST) application for the treatment of chronic PF using a cheap and readily available pneumatic lithotripter.     

Ondansetron versus diclofenac sodium in the treatment of acute ureteral colic: A double blind controlled trial

The aim of this study is to compare the effectiveness of the 5-HT₃ antagonist, ondansetron and a non-steroidal anti-inflammatory agent, diclofenac sodium, as a pain reliever in the treatment of acute ureteral colic. Sixty four patients with severe or moderate pain who were clinically diagnosed as having ureteral colic associated with microscopic or gross hematuria were included in the study. Thirty three patients were administered ondansetron and 31 patients were administered diclofenac sodium. Exclusion critera were known kidney or liver disease causing dysfunction, known hypersensitivity to ondansetron or diclofenac sodium, pregnancy, lactation, duodenal ulcer or bleeding. After pain assessment with a verbal scale and a visual analog scale (VAS), we randomized patients and administered 8 mg ondansetron intravenously to 33 patients and 75 mg diclofenac sodium intramuscularly to 31 patients and pain scores were recorded every 15 minutes. If significant pain relief was not achieved within 60 minutes, IV meperidine was given as rescue pain medication. Ondansetron was effective as a primary pain reliever in 14 (42.4%) patients, whereas 19 patients required additional medication. Diclofenac sodium was effective as a primary pain reliever in 24 (77.4%) patients, whereas 7 patients required additional medication. Ondansetron was not superior to diclofenac sodium in relieving pain in patients with acute ureteral colic.     

Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial.

BACKGROUND: Nonsteroidal anti-inflammatory drugs and opioids are routinely used after cardiac surgery in order to mitigate postoperative pain; however, these drugs are burdened by side effects. Tramadol and paracetamol are believed to be lacking in such side effects. The aim of this study was to examine the efficacy of intravenous paracetamol as an adjunctive analgesic to a tramadol-based background analgesia after cardiac surgery. METHODS: A total of 113 patients participated in this single center, placebo-controlled, double-blind, randomized trial. Fifty-six patients were randomized to receive paracetamol and 57 to placebo. Intravenous study drug (1 g) was administered 15 min before the end of surgery and every 6h for 72 h. Standard analgesia (tramadol) and anti-emetic prophylactic regimen (ondansetron) were available to both patient groups. Postoperative pain was evaluated by visual analog scale, and it was measured at rest and during a deep breath. A rescue dose of 2-5 mg of intravenous morphine was administered whenever the VAS score was greater than 3. RESULTS: Baseline characteristics were equivalent between the two groups. At 12, 18, 24 h after the end of operation, patients who received paracetamol had significantly less pain at rest (p=0.0041, 0.0039, 0.0044, respectively); after this time the two groups did not differ. During a deep breath the difference was significant only at 12 h (p=0.0040). Paracetamol group required less cumulative morphine than placebo group (48 mg vs 97 mg) even if the difference did not reach statistical significance (p=0.274). CONCLUSIONS: In patients undergoing cardiac surgery, intravenous paracetamol in combination with tramadol provides effective pain control.     

爱普列特治疗良性前列腺增生的有效性及安全性

目的 评价爱普列特治疗BPH的有效性和安全性.方法 采用随机、双盲、双模拟及安慰剂对照的多中心临床试验方法.分3组:爱普列特组10例,平均年龄(72±10)岁;非那雄胺(商品名:保列治)组13例.平均年龄(70±10)岁;安慰剂组16例,平均年龄(70±7)岁.3组患者接受治疗时间均为6个月.每月随访1次,随访评估内容包括IPSS、困扰评分、前列腺体积、尿流率、残余尿量、PSA及国际勃起功能评分问卷(IIEF-5)等,治疗前所有评估指标3组间比较差异均无统计学意义(P值均＞0.05).采用SAS 9.0统计学软件,双侧检验,计量数据组间比较采用t检验,计数数据组间比较采用χ~2检验,a=0.05.结果 爱普列特组IPSS评分F降50.0%±10.3%,与保列治组(37.0%±11.2%)比较差异无统计学意义(P=0.94),但均高于安慰剂组(22.0%±7.6%,P＜0.05);爱普列特组前列腺体积缩小40.0%±12.1%,明显高于保列治组(19.1%±7.3%,P=0.041)及安慰剂组(4.3%±3.2%,P=0.004),保列治组前列腺体积缩小百分比与安慰剂组比较差异无统计学意义(P=0.348).爱普列特组患者Q_(max)改善70.2%±13.9%,与保列治组(50.0%±9.7%)比较差异无统计学意义(P=0.630),但均显著高于安慰剂组(0.5%±0.8%,P＜0.05).其他几项评估指标3组间比较差异无统计学意义.结论 爱普列特能安全有效地治疗BPH,与保列治比较,缩小前列腺体积的疗效更快且更显著.     

Effectiveness of naproxen in laparoscopic sterilization: a double blind randomized placebo controlled study

Effectiveness of naproxen suppositories on ambulation was studied following laparoscopic sterilization. In a double-blinded randomized placebo study, 20 patients received 500 mg naproxen suppositories and 20 patients placebo suppositories. Postoperatively 10 naproxen patients and 11 placebo patients reported high pain scores, indicating severe pain and requiring opiates. Times to reach street fitness were equally prolonged in both groups. Most patients in both groups required 3 days to resume normal duties and post-discharge weakness was a common complaint. Our conclusion was that premedication with naproxen 500 mg suppositories in day-case laparoscopic sterilization therapeutically behaves like other commonly used non-steroidal anti-inflammatory drugs (NSAIDs) and does not substantially contribute to ambulation.