扶正化瘀片治疗肝炎后肝硬化的研究

Objective: To investigate the efficacy and safety of the Fuzheng Huayu Tablet (扶正化瘀片, FZHYT), which is used to reinforce qi and resolve stasis in patients with posthepatitic cirrhosis (PHC). Methods: A multicenter, randomized, controlled clinical trial was conducted in 180 patients with PHC. The patients were randomly assigned using random numbers to a treatment group treated with FZHYT and a placebo group; the treatment course was 6 months for both groups. Overall response, adverse events (AEs), and the 2-year survival rate were assessed after treatment. Evaluations were made on changes in liver function, liver fibrosis, coagulation, hemodynamics, degrees of esophagogastric varices, ascites, quality of life (QOL), and scores of main symptoms. Results: The overall response was significantly higher in the treatment group than the placebo group (86.7% vs. 62.2%, P<0.01). Patients in both groups had signi?cant improvements in liver function [total bilirubin (TBIL), albumin (ALB)], liver fibrosis [hyaluronic acid (HA), type Ⅳ collagen (CⅣ)], coagulation [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and thrombin time (TT)], hemodynamics portal venous flow (PVF), and splenic vein flow (SVF) after treatment. Between-group comparisons showed that compared with the placebo group patients in the treatment group achieved significantly greater improvements in TBIL, ALB, HA, C Ⅳ, PT, APTT, PVF, SVF, time to ascites resolution, 2-year survival, QOL, and symptom scores (P<0.05 or P<0.01). There were no significant AEs during the treatment. Conclusions: FZHYT is effective and safe for the treatment of hepatic cirrhosis as it is associated with improved liver function, liver ?brosis, coagulation, portal hypertension state, QOL, 2-year survival rate, and fewer AEs.     

Xinfeng Capsule(新风胶囊)for the Treatment of Rheumatoid Arthritis Patients with Decreased Pulmonary Function—A Randomized Controlled Clinical Trial

Objective:To determine the effectiveness and safety of Xinfeng Capsules(新风胶囊,XFC) for the treatment of rheumatoid arthritis(RA) patients with decreased pulmonary function.Methods:This was a randomized controlled clinical trial of 80 RA patients.Participants were assigned to the trial group(40 cases) and the control group(40 cases) by block randomization.The trial group was treated with XFC,three pills each time three times daily for 2 months.The control group was treated with tripterygium glycoside(TPT),two pills each time three times daily for 2 months.Both groups were followed up after 2 months.The clinical effects,changes in joint and pulmonary function,and quality of life before and after treatment were observed;safety indices were also evaluated.Results:Pain,swelling,tenderness,and duration of morning stiffness of joints were obviously decreased after treatment in both the trial and the control groups compared with baseline(P0.01).Compared with before treatment,hand grip strength increased significantly after treatment in the trial group(P=0.0000);pulmonary function parameters such as forced expiratory volume in the first second of expiration/forced vital capacity(FEV_1/FVC),50%of the expiratory flow of forced vital capacity(FEF_(50)),carbon monoxide diffusing capacity(DLco) were increased(P0.01 or P0.05);measures of quality of life such as role-physical,body pain,vitality and mental health were also improved after treatment in the trial group(all P0.05).Joint swelling in the trial group decreased compared with the control group(P=0.0043),while hand grip strength was increased after treatment(P=0.0000).The increase in FEF_(50),DLco,and the dimensions of quality of life such as vitality and mental health were all significantly greater in the trial group than the control group(P0.05 or P0.01).Conclusions:XFC not only relieved joint pain in RA patients,but also significantly improved the ventilation and diffusion function of the lungs.Therefore,XFC could improve the whole body function and enhance the quality of life of RA patients.     

Clinical Study on Treatment of Senile Vascular Dementia by Acupuncture

63 patients with senile vascular dementia were randomly divided into the treatment group (treated byacupuncture) and the control group (treated with piracetam).The authors observed the changes in thescore of Hasegawa's dementia scale (HDS),P_(300),rheoencephalogram,topographic EEG,superoxidedismutase (SOD) activity in erythrocytes,and lipid peroxide (LPO) level in plasma before and aftertreatment.The statistical data showed that the total effective rate in the treatment group (80.6%) wassignificantly higher than that in the control group (25%),and the differences in the observed indexesbefore and after treatment were significant (P<0.05 or P<0.01) in the treatment group but not in thecontrol group (P>0.05),indicating that the acupuncture treatment was superior in immediatetherapeutic effect on senile vascular dementia to drug treatment.     

Clinical study on treatment of liver fibrosis of chronic hepatitis B patients with Ginkgo leaf

Objective: To study the anti-liver fibrosis effect of Ginkgo leaf in patients with chronic hepatitis B.Methods: Eighty-six patients with chronic hepatitis B were randomly divided into two groups with similar general condition. The 42 patients in the treated group were treated with Ginkgo leaf tablet (GLT), and the 44 patients in the control group were treated with Yiganling tablet (益肝灵片). The treatment was conducted for 3 successive months in both groups. Changes in the histo-pathology of liver, serum levels of platelet activating factor (PAF), hyaluronic acid (HA), collagen type Ⅳ (C-Ⅳ), laminin (LN) and pro-collagen peptide type Ⅲ (PCⅢ)were observed before and after treatment. Results: The markedly effective rate and the total effective rate in the treated group were 45.1% and 76.2% respectively, while in the control group the corresponding rates were 18.2% and 43.2%. Comparison between the two groups showed significant difference (P<0.01). Serum levels of PAF, HA, C-Ⅳ, LN and PCⅢ were lowered significantly in the treated group after treatment. Compared with the corresponding parameters in the control group after treatment, the differences were all significant (P<0.01 or P<0.05). The pathological examination of liver showed improvement in both groups, the inflammation grade lowered in 10 patients (55.6%) of the treated group and in 5 patients (35.7%) of the control group, insignificant difference was shown between them. But in comparing the fibrosis staging lowering patients between the two groups, 12 patients (66.7%) vs 3 patients (21.4%), the difference was significant (P<0.05). Moreover, there were 4 patients in the control group with their fibrosis aggravated, while in the treated group, none was aggravated (P<0.05).Conclusion: Ginkgo leaf tablet has some liver protective and anti-liver fibrosis benefits.     

Seventy-two Cases of Antidiabetic-Induced Hepatopathy Treated by Huatan Yigan Decoction

In order to observe the therapeutic effects of Huatan Yigan Decoction (化痰益肝汤 Decoction for resolvingphlegm and replenishing the liver) on antidiabetic-induced hepatopathy,129 cases were divided into twogroups,72 cases in the treatment group were administrated with Huatan Yigan Decoction and 57 cases inthe control group with the liver-protecting drugs.Their liver function,plasma prothrombin time (PT),bloodurea nitrogen and symptoms of the patients before and after treatment were observed during the threetherapeutic courses.Results:The total effective rate and cured rate of the treatment group manifested anobvious difference in comparison with those of the control group (P<0.05 or P<0.01).Even though the liverfunction,blood urea nitrogen (BUN) and symptoms in both groups were improved markedly,theseindicators in the treatment group were improved more markedly than those in control group (P<0.01).Noadverse effect was found during the treatment.Conclusion:Huatan Yigan Decoction shows a repair actionon hepatic injury.     

Effect of modified Wuzi Yanzong Granule (加味五子衍宗颗粒) on patients with mild cognitive impairment from oxidative damage aspect

Objective:To observe the effects of modified Wuzi Yanzong Granule(加味五子衍宗颗粒,WYG)on memory function and the activity of serum superoxide dismutase(SOD), malondialdehyde(MDA)levels,leukocyte mitochondrial DNA(mtDNA)deletion rate andβ-amyloid protein_(1-28)(Aβ_(1-28))in patients with mild cognitive impairment(MCI).Methods:Thirty-six patients with MCI were selected based on the internationally recognized Petersen's criteria,and equally and randomly assigned to two groups.The treated group was treated with WYG and the control group was treated with placebo for 3 months.In addition,20 healthy subjects were included in the study as the normal control group.Changes of memory function,SOD activity,MDA content,leukocyte mtDNA deletion rate and Aβ_(1-28)content were observed before and after treatment.Results: Compared with the normal control group,the memory quotient and SOD activity in patients with MCI decreased significantly(P<0.01),while MDA,Aβ_(1-28)levels and the leukocyte mtDNA deletion rate increased significantly(P<0.01).After treatment,levels of memory quotient and serum SOD activity increased while the serum MDA level,leukocyte mtDNA deletion rate and Aβ_(1-28)level decreased in the treated group compared with those before treatment(P<0.01,P<0.05).Meanwhile,leukocyte mtDNA deletion rate and Aβ_(1-28)content in the treated group were all lower than those in the control group(P<0.05).Conclusion:WYG could improve memory function in patients with MCI and the therapeutic mechanism is possibly related to the increased activity of anti-oxidase,the improved free radical metabolism and the alleviation of leukocyte mtDNA oxidation damage.WYG shows clinical significance in delaying the progression of MCI.     

Tiaobu Xinshen Recipe (调补心肾方) Improved Mild Cognitive Impairment of Alzheimer's Disease Patients with Xin (Heart) and Shen (Kidney) Deficiency

Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer's disease(MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin(Heart) and Shen(Kidney) deficiency were assigned to the experimental group(47 cases, treated with TXR) and the control group(41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA)], and Chinese medicine(CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and Mo CA scores of the two groups were increased after treatment compared with those before treatment(P0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups(P0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group(P0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment(P0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency.     

Effect of Tiaozhi Yanggan Decoction (调脂养肝汤) in treating patients with non-alcoholic fatty liver

Objective:To observe the clinical efficacy and safety of Tiaozhi Yanggan Decoction (调脂养肝汤,TZYGD)in treating non-alcoholic fatty liver.Methods:One hundred and thirty-eight patients were enrolled and randomized into two groups according to the random number table in a ratio of 3:1,with 8 cases eventually dropping out.The symptoms,signs,liver function markers, blood lipids,iconographic indices and clinical comprehensive efficacy after a 12-week treatment course were assessed in 101 patients treated with TZYGD in the treated group and 29 patients treated with Thiola in the control group.Results:The total effective rate in the treated group and the control group was 81.19% and 68.97%,respectively,showing a significant difference between the two groups with the former being significantly higher than the latter(P<0.05).Moreover,the improvements in the symptoms,signs,liver function,blood lipids and iconographic indices in the treated group were favorable with no serious adverse reactions.Conclusion:TZYGD is effective and highly safe in treating non-alcoholic fatty liver.     

Effect of TCM Combined with Chemotherapy on Immune Function and Quality of Life of Patients with Non-small Cell Lung Cancer inStage Ⅲ-Ⅳ

Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in stage Ⅲ-Ⅳ. Methods: One hundred cases with stage Ⅲ-Ⅳ NSCLC were randomly divided into two groups. The treated group (n=50) received CT combined with TCM, and the control group received CT alone. The percentage of T lymphocyte subset in peripheral blood and the change of natural killer (NK) cell count were observed after treatment. The QOL and tolerance of CT were also compared between the two groups after treatment. Results: In the treated group, CD3 cell count, CD4 cell count, CD4/ CDg ratio and NK cell activity were higher than those in control group, while CD8 cell count in the treated group was lower than that in the control group (P<0.05), and QOL and tolerance of CT in the treated group were also better (P<0.05). Conclusion: TCM combined with CT could raise the patients' ability in to     

Effects of Erigeron Injection on Vascular Endothelium in Patients after Intracoronary Stenting

Objective: To observe the levels of serum C-reactive protein (CRP), endothelin-1 (ET-1), nitric oxide (NO), and superoxide dismutase (SOD) in patients after intracoronary stenting (ICS), and the effects of Erigeron Injection (El) on them. Methods:Seventy-two patients, who received ICS and had symptoms of chest stuffiness, palpitation and chest pain, were randomly divided into two groups, with 36 patients in the control group treated with Plavix alone for anti-platelet aggregation, and the other 36 patients in the treated group treated with Plavix and El in combination. CRP, ET-1, NO and SOD were determined and compared before and 1, 2 and 3 weeks after treatment. Results: As compared with those in the control group, improvement of symptoms in the treated group was significantly better, with the levels of CRP and ET-1 lower and levels of SOD and NO higher or approaching to normal ranges and significant difference was shown between the two groups (P<0.01). Conclusion: El could alleviate uncomfortable feelings such as chest stuffiness in patients after ICS, and improve the function of vascular endothelium.     

Clinical Observation on Treatment of Ischemic Apoplexy by Electroacupuncture plus Acupoint-Injection

Objective: To observe the therapeutic effects of electroacupuncture plus acupoint-injection for ischemic apoplexy. Method: 78 cases of ischemic apoplexy were randomly divided into a treatment group of 39 cases treated by electroacupuncture plus acupoint-injection and a control group of 39 cases treated by electroacupuncture alone. Results: The neural functional defect score (NFDS) decreased while the functional independence mark (FIM) increased with obvious significant differences before and after treatment in both of the two groups. And there were very remarkable differences between the two groups in the changes of both NFDS and FIM after treatment (P<0.01), showing better results in the treatment group than that of the control group. Conclusion: Electroacupuncture plus acupoint-injection can promote the recovery of the neural function for the ischemic apoplexy patients and markedly enhance their daily living ability, with better effects than that in patients treated by electroacupuncture alone.     

Clinical observation on treatment of hyperplasia of mammary gland by Lirukang Granule (利乳康颗粒)

Objective:To explore the effi cacy and mechanism of Lirukang Granule(利乳康颗粒,LRKG) in treating hyperplasia of mammary gland(HMG).Methods:One hundred patients with HMG were randomly assigned to two groups,50 in each group.The patients in the treated group were orally administered with LRKG thrice a day,one package each time,and those in the control group were given orally Rukuaixiao Tablet(乳块消,RKX) thrice a day,4 tablets each time.The therapeutic course for both groups was 4 months.The clinical eff icacy,pain alleviating rate,as well as changes of local sign and symptom scores were observed before and after treatment.The changes of serum estradiol(E2),progesterone(P),testosterone(T),follicle stimulating hormone(FSH),luteinizing hormone(LH) and prolactin(PRL) in some randomly selected patients(24 patients in the treated group and 24 in the control group) before and after treatment were measured with radioimmunoassay.Results:The total clinical effi cacy in the treated group was superior to that in the control group,signifi cant difference was shown between the two groups(P<0.01).The cure-effective rate and total effective rate in the treated group were 70.0%and 88.0% respectively,signif icantly higher than those in the control group(38.0% and 64.0%) respectively(P<0.01),and the pain alleviating rate in the treated group was also significantly higher in the former than that in the latter(88.0% vs 64.0%,P<0.05).Moreover,the treated group showed obvious superiority in improving the patients' symptom and sign scores(P<0.01),and abnormalities of gonadal hormone as compared with the respective items in the control group(P<0.01).Conclusion:LRKG has good effi cacy in the treatment of HMG,and its mechanism may be related to the regulation on endocrine and immune function.     

Clinical Observation in 45 Cases of Hemorrhagic Apoplexy of the Acute Stage Treated by Promoting Blood Circulation and Removing Blood Stasis

To explore the therapeutic effects of the method of promoting blood circulation and removing blood stasison hemorrhagic apoplexy of acute stage,45 cases were treated by the method and observed for theirconscious state and motor function,which were compared with 40 cases treated with regular western drugs.The results showed that the effective rate in the treated group was 82.2% and that in control group 60% witha significant difference(P<0.05) between the two groups.In the treated group,the scores of the consciousstate and the motor function after treatment were elevated dramatically(P<0.01),indicating a much bettereffect in the treated group than in the control group.     

Effect of Anluohuaxian Tablet Combined with y-IFN on Schistosomal Liver Fibrosis

The therapeutic effects of anluohuaxian tablet combined with γ-IFN on schistosomal liver fibrosis and its mechanism were studied in a murine model and clinical cases of schistosomal liver fibrosis.Fifty Kunming mice were randomly divided into 5 groups:normal control group,infection control group,anluohuaxian tablet-treated group,γ-IFN-treated group and combined treatment (anluohuaian tablet+γ-IFN) group.Pathologic changes in liver,including hepatic pigmentation and the size of schistosomal egg granuloma,were observed by HE staining after treatment for 8 weeks.The expression of the type Ⅰ and Ⅲ collagen,and TIMP-1 was detected by immunohistochemistry.TGF-β1 mRNA expression was examined by real-time fluorescent quantitative PCR.Sixty patients with schistosomal liver fibrosis were divided into treatment group and control group.The patients in treatment group were treated with anluohuaxian tablet in combination with γ-IFN for 6 months.Be-fore and after treatment,the changes of symptoms and signs,liver function,serum liver fibrosis in-dexes and imaging indexes were observed.The results showed that as compared with infection con-trol group,all forms of treatments relieved the hepatic pathological injury with apparently diminished size of schistosomal egg nodules and decreased percentage of pigmentation (P<0.05).Furthermore,the expression of collagen Ⅰ and Ⅲ,TIMP-Ⅰ,and TGF-β1 mRNA in combined treatment group was significantly decreased as compared with anluohuaxian tablet-treated and γ-IFN-treated groups (P<0.05).In the clinical observation,the serum liver fibrosis indexes,the portal vein width as well as the spleen thickness was significantly reduced in treatment group as compared with control group (P<0.05).It was concluded that the combined use of anluohuaxian tablet with γ-IFN in schistosomal liver fibrosis could protect liver function,alleviate liver fibrosis,and could be used as a choice in treating patients with schiatosomal liver fibrosis.     

Effect of Anluohuaxian Tablet Combined with γ-IFN on Schistosomal Liver Fibrosis

The therapeutic effects of anluohuaxian tablet combined with γ-IFN on schistosomal liver fibrosis and its mechanism were studied in a murine model and clinical cases of schistosomal liver fibrosis, Fifty Kunming mice were randomly divided into 5 groups： normal control group, infection control group, anluohuaxian tablet-treated group, γ-IFN-treated group and combined treatment （anluohuaian tablet＋γ-IFN） group. Pathologic changes in liver, including hepatic pigmentation and the size of schistosomal egg granuloma, were observed by HE staining after treatment for 8 weeks. The expression of the type Ⅰ and Ⅲ collagen, and TIMP-1 was detected by immunohistochemistry. TGF-β1 mRNA expression was examined by real-time fluorescent quantitative PCR. Sixty patients with schistosomal liver fibrosis were divided into treatment group and control group. The patients in treatment group were treated with anluohuaxian tablet in combination with γ-IFN for 6 months. Before and after treatment, the changes of symptoms and signs, liver function, serum liver fibrosis indexes and imaging indexes were observed. The results showed that as compared with infection control group, all forms of treatments relieved the hepatic pathological injury with apparently diminished size of schistosomal egg nodules and decreased percentage of pigmentation （P〈0.05）. Furthermore, the expression of collagen Ⅰ and Ⅲ, TIMP-1, and TGF-β1 mRNA in combined treatment group was significantly decreased as compared with anluohuaxian tablet-treated and γ-IFN-treated groups （P〈0.05）. In the clinical observation, the serum liver fibrosis indexes, the portal vein width as well as the spleen thickness was significantly reduced in treatment group as compared with control group （P〈0.05）. It was concluded that the combined use of anluohuaxian tablet with γ-IFN in schistosomal liver fibrosis could protect liver function, alleviate liver fibrosis, and could be used as a choice in treating patients with schiatosomal liver fibrosis.     

Clinical Study on Therapeutic Effect of Acupuncture on Behcet''''s Disease

Forty-six cases of Behcet's disease were randomly divided into two groups. The 26 cases in the treatmentgroup were treated by acupuncture and the 20 cases in the control group with the drugs. The level ofL-chain () of IgM and the level of the trace element Zn were determined before and after treatment inthe treatment group. The results showed that the recurrence rate in the treatment group was significantlylower than that in the control group (P<0.01), and the differences in the level of L-chain () of IgM andlevel of Zn in the treatment group before and after treatment were very significant (P<0.01). These twoindexes tended to become normal after treatment.     

Clinical Observation of the Effect of Xuesaitong Soft Capsule (血塞通软胶囊)on Post-hepatitis Fibrosis

Objective:To study the effect of Xuesaitong soft capsule (血塞软胶囊, XST) on liver fibrosis criteria in patients with post-hepatitis fibrosis. Methods: Sixty-four patients with such fibrosis were randomly divided into the treated group and control group. They were treated with XST and Dahuang Zheter treatment. Results: The levels of serum procollagen Ⅲ, hyaluronic acid, collagen Ⅳ, laminin in the two groups were significantly lower (P＜0.01) than those before treatment. The differences between the two groups were insignificant (P＞0.05). Conclusion: XST could recover liver dysfunction and had anti-liver fibrosis function.     

A Clinical Study on Haunglian Fire-Purging Mixture In Treatment of 46 Cases of Primary Hypertension

In order to observe the therapeutic effects of Huanglian Fire-Purging Mixture (黄连清降合剂) on primary hypertension, 46 cases of primary hypertension in the treatment group were treated with Huanglian Fire-Purging Mixture to clear away heat from the liver, relieve mental stress, purge fire and remove toxin;and the other 26 cases of primary hypertension in the control group were treated with Niuhuang Bolus for Lowering Blood Pressure (牛黄降压丸). The effect in the treatment group was obviously superior to that in the control group (P＜0.05). The Huanglian Fire-Purging Mixture shows noticeable effects 3-6 hours after medication. The mixture can improve the clinical symptoms, the left ventricular diastolic function and myocardial ischemia, correct dyslipoproteinemia and dysglycemia, and reduce blood viscosity. And it is safe and with no obvious adverse reactions.     

Clinical Study on Treatment of Primary Hepatocellular Carcinoma by Shenqi Mixture(参芪合剂)Combined with Microwave Coagulation

Objective: To observe the short-term efficacy and safety of Shenqi mixture (参芪合剂,SQM) combined with microwave coagulation in treating primary hepatocellular carcinoma (HCC). Methods:Seventy-two patients with primary HCC of stage Ⅱ - Ⅲ, Karnofsky scoring ≥50 scores and predicted survival period ≥3 months were selected and randomly assigned into two groups, the treated group and the control group, 36 in each. Microwave therapy was applied to both groups by double leads, 60 W, 800 sec once a week for two weeks. To the treated group, SQM was given additionally through oral intake of 20 ml, three times a day for 1 month. The changes in tumor size, main symptoms, serum level of alpha-fetoprotein (AFP), immune function and adverse reaction were observed after treatment and the immune parameters of the patients were compared with 30 healthy persons in the normal control group. Results: (1) In the SQM treated group, after treatment 3 patients got completely remitted (CR), 24 partial remitted (PR), 4 unchanged (NC) and 5 progressively deteriorated (PD), the effective rate being 75.00%; while in the control group, 1 got CR, 19 PR, 9 NC and 7 PD, the effective rate being 55.56%. Comparison of the effective rate between the two groups showed significant difference ( P＜0.05). (2) AFP level decreased after treatment in both groups, but the decrement in the treated group was significantly higher than that in the control group (P＜0.01). (3) After treatment, in the treated group, CD3 , CD4 , CD4 /CD8 and NK activity were improved, Karnofsky scores increased and liver function bettered, with these improvements significantly superior to those in the control group (P＜0.01). (4) The improvement in symptoms such as hepatic region pain, fever, weakness, poor appetite and jaundice in the treated group after treatment was also superior to that in the control group ( P＜0.01). (5) The 12-month, 18-month and 24-month survival rates were higher and the recurrence rate was lower in the treated group than those in the control group, showing significant difference (P＜0.05). Conclusion: Combined therapy with SQM and microwave coagulation could not only kill the tumor and residue tumor cells to prevent recurrence, but also enhance the cellular immunity of organism. It is one of the effective therapies for patients with middle-advanced hepatocarcinoma, who have lost the chance of surgical operation. it could improve clinical symptoms, elevate the quality of life, prolong the survival period of patients, but shows no evident adverse reaction.     

Effect of Combined Low-frequency Repetitive Transcranial Magnetic Stimulation and Virtual Reality Training on Upper Limb Function in Subacute Stroke:a Double-blind Randomized Controlled Trail

The effect of combined low-frequency repetitive transcranial magnetic stimulation(LF r TMS) and virtual reality(VR) training in patients after stroke was assessed. In a double-blind randomized controlled trial, 112 patients with hemiplegia after stroke were randomly divided into two groups: experimental and control. In experimental group, the patients received LF r TMS and VR training treatment, and those in control group received sham r TMS and VR training treatment. Participants in both groups received therapy of 6 days per week for 4 weeks. The primary endpoint including the upper limb motor function test of Fugl-meyer assessment(U-FMA) and wolf motor function test(WMFT), and the secondary endpoint including modified Barthel index(MBI) and 36-item Short Form Health Survey Questionnaire(SF-36) were assessed before and 4 weeks after treatment. Totally, 108 subjects completed the study(55 in experimental group and 53 in control group respectively). After 4-week treatment, the U-FMA scores [mean difference of 13.2, 95% confidence interval(CI) 3.6 to 22.7, P<0.01], WMFT scores(mean difference of 2.9, 95% CI 2.7 to 12.3, P<0.01), and MBI scores(mean difference 16.1, 95% CI 3.8 to 9.4, P<0.05) were significantly increased in the experimental group as compared with the control group. The results suggested the combined use of LF r TMS with VR training could effectively improve the upper limb function, the living activity, and the quality of life in patients with hemiplegia following subacute stroke, which may provide a better rehabilitation treatment for subacute stroke.