胰激肽原酶联合坎地沙坦酯治疗早期糖尿病肾病的临床研究

目的 探讨胰激肽原酶联合坎地沙坦酯片治疗早期糖尿病肾病的临床疗效.方法 选取92例早期糖尿病肾病患者,将其按照给药方案的不同均分为观察组和对照组(n=46),观察组采取胰激肽原酶针联合坎地沙坦酯片治疗,对照组患者单独采取坎地沙坦酯片治疗,对比2组患者的尿素氮、血肌酐和尿微量白蛋白排泄率.结果 治疗后,对照组尿素氮、血肌酐和尿微量白蛋白排泄率分别为(5.13±3.61)μmol/L、(69.64±15.62)μmol/L和(143.72±19.95)μg/24h,观察组尿素氮、血肌酐和尿微量白蛋白排泄率分别为(4.37±1.15)μ mol/L、(49.68±11.93) μmol/L和(81.78±10.04) μg/24 h,2组比较差异有统计学意义(P＜0.05).结论 胰激肽原酶联合坎地沙坦酯片治疗早期糖尿病肾病的临床疗效显著,有利于改善患者肾功能,值得在临床上推广.     

Th17细胞与糖尿病肾病的相关性研究

目的探讨Th17细胞与糖尿病肾病的相关性。方法选择2013年3~6月湖北省中山医院收治的96例2型糖尿病患者作为研究对象,根据患者尿白蛋白排泄率(UAER)不同分为两组:正常蛋白尿组(UAER<20μg/min)52例,糖尿病肾病组(UAER≥20μg/min)44例;同期选择健康体检者50例作为对照组。采用流式细胞仪检测各组受试者Th17细胞的比例。分析Th17细胞与患者糖化血红蛋白、UAER等指标的相关性。结果糖尿病肾病组UAER、尿素氮、血肌酐、Th17/CD4+T细胞显著高于正常蛋白尿组和对照组[(221.1±43.27)μg/min比(14.2±2.6)μg/min、(7.1±1.9)μg/min;(7.6±3.4)mmol/L比(5.0±1.0)mmol/L、(4.3±1.0)mmol/L;(74±32)μmol/L比(60±11)μmol/L、(62±18)μmol/L;(2.79±1.07)%比(0.37±0.21)%、(1.83±0.96)%],糖化血红蛋白(Hb A1c)、空腹血糖(FBG)显著高于对照组[(9.2±2.6)%比(4.4±1.1)%;(11.6±2.2)mmol/L比(5.1±0.5)mmol/L],正常蛋白尿组UAER、Hb A1c、FBG、Th17/CD4+T细胞[(14.2±2.6)μg/min,(8.9±1.9)%,(10.5±1.7)mmol/L,(1.83±0.96)%]显著高于对照组,差异有统计学意义(P<0.05)。正常蛋白尿组与糖尿病肾病组Hb A1c、FBG比较差异无统计学意义(P>0.05)。Th17细胞与UAER呈正相关(r=0.802,P<0.01)。UAER[OR=2.764,95%CI 1.199~6.372]和Th17/CD+4T[OR=3.524,95%CI 1.984~6.259]是影响糖尿病肾病患者的危险因素。结论Th17细胞在预测诊断糖尿病肾病方面具有一定的临床价值,能否作为临床诊断指标有待于大量样本深入展开研究。     

糖尿病肾病患者晚期氧化蛋白产物与SOD、TNF-α的关系

目的 研究糖尿病肾病患者血清蛋白氧化损伤指标晚期氧化蛋白产物(AOPP)的改变及其与超氧化物歧化酶(SOD)、肿瘤坏死因子α(TNF-α)的关系,探讨蛋白氧化损伤与糖尿病肾病氧化应激状态和炎症因子的关系.方法 糖尿病患者85例,根据尿微量白蛋白排泄率和肌酐水平分为无肾病(DM)组、早期肾病(DN3)组、临床肾病(DN4)组、终末期肾病(DN5)组.用Witko-Sarsat介绍的方法改进后分别测定各组的血清AOPP,黄嘌呤氧化酶法测定SOD,ELISA方法测定血清TNF-α.结果 DN5组患者的血清AOPP(117.8±64.8)μmol/L和DN4组的血清AOPP(80.0±23.0)μmol/L显著高于DM组(58.2±17.7)μmol/L(P＜0.01);DN3组血清AOPP(72.7±17.2)μmol/L与DM组比较无统计学意义.血清AOPP与SOD显著负相关(r=-0.217,P＜0.05),与TNF-α无明显相关性(r=-0.064,P＜0.01).结论 临床糖尿病肾病患者的血清蛋白氧化较无糖尿病肾病患者增强,并且与糖尿病肾病氧化应激状态有关,但与炎症因子TNF-α无明显关系.     

前列地尔联合洛汀新治疗糖尿病肾病的疗效观察

目的：探讨前列地尔联合洛汀新治疗早期糖尿病肾病的临床疗效。方法将该院收治的90例糖尿病早期肾病患者,随机分为观察组和对照组,每组各45例。两组均给予洛汀新10 mg,口服,1次/d;观察组再给予前列地尔注射液10μl加入0.9%氯化钠100 mL,静脉点滴。两组在控制血压、血糖、血脂等治疗方面相同,治疗14 d后,比较两组的血肌酐、空腹血糖、24 h尿蛋白、8 h尿白蛋白排泄率。结果治疗2周后,2组患者的尿蛋白、白蛋白、血肌酐均明显好转;其中,观察组血肌酐（113.97±14.53）μmol/L,尿蛋白（0.23±0.02）g/24 h,尿蛋白排泄率（72±31）μg/min;对照组治疗后的各数据为（127.2±10.11）μmol/L,（0.32±0.07）g/24 h,（136±36）μg/min;观察组和对照组相比,观察组的尿蛋白及白蛋白排泄率改善明显(P<0.05)。结论短期使用前列前列地尔联合洛汀新治疗老年糖尿病早期肾病疗效显著,可延缓糖尿病肾病的发生发展。     

血清胱抑素C和同型半胱氨酸在2型糖尿病肾病患者中的水平改变意义

目的：分析血清胱抑素C和同型半胱氨酸在2型糖尿病肾病患者中的水平改变意义。方法选择400例糖尿病肾病患者设定为观察组,400例单纯糖尿病患者设定为对照组,400例体检的健康人设定为健康组,比较3组的血清胱抑素C、同型半胱氨酸等水平。结果观察组胱抑素C （1.86±0.65）mg/L,同型半胱氨酸（15.01±3.19）μmol/L,血肌酐（77.52±12.58）μmol/L,血尿素氮（6.16±2.50）mol/L;对照组胱抑素C（0.98±0.26） mg/L,同型半胱氨酸（11.30±2.65）μmol/L,血肌酐（73.12±18.01）μmol/L,血尿素氮（6.09±1.81）mol/L;健康组胱抑素C（0.76±0.11）mg/L,同型半胱氨酸（8.89±1.29）μmol/L,血肌酐（72.98±14.25）μmol/L,血尿素氮（5.95±1.00）mol/L;观察组血清胱抑素C和同型半胱氨酸高于健康组,对照组血清胱抑素C和同型半胱氨酸高于健康组,差异有统计学意义（P＜0.05）;3组血清肌酐与血尿素氮差异无统计学意义。结论糖尿病肾病患者在发病早期就会表现出胱抑素C与半胱氨酸升高的现象,掌握患者病情变化,利于及早诊断治疗,可以有效改善患者临床治疗效果,值得临床推广应用。     

血浆同型半胱氨酸水平与糖尿病肾病分期的相关性分析

目的探讨血浆同型半胱氨酸(tHcy)水平与糖尿病肾病(Diabetic nephropathy,DN)发生以及临床分期的相关性。方法检测51例健康人(control,CON组)和76例2型糖尿病患者(按照24h尿白蛋白排泄率分组为无糖尿病并发症组和早期糖尿病肾病组和临床糖尿病肾病组)的血浆同型半胱氨酸,比较各组间血浆同型半胱氨酸水平。结果糖尿病患者组的血浆tHcy水平为(11.85±7.79)μmol/L高于CON组(7.59±1.23)μmol/L,(P<0.01);无糖尿病并发症组血浆tHcy水平为(8.66±2.66)μmol/L;早期糖尿病肾病组血浆tHcy水平为(13.48±3.36)μmol/L;临床糖尿病肾病组组血浆tHcy水平为(25.50±12.41)μmol/L。各组间tHcy水平均有差异极为显著性(P<0.01)。结论糖尿病患者血浆tHcy水平高于CON组,而且随着病程的发展,血浆tHcy水平呈上升趋势,血浆tHcy水平可以作为监测DN发生、发展的一个指标。     

水化治疗对糖尿病肾病患者对比剂肾病的预防作用

目的观察水化治疗对使用非离子等渗对比剂的糖尿病肾病患者对比剂肾病的预防作用。方法 2007年1月至2010年12月本科收治的糖尿病肾病患者80例,其中男性30例,女性50例,年龄(64.4±9.3)岁,分为2组:①水化治疗组(n=39),在使用非离子等渗对比剂(碘克沙醇320 mg/ml)进行多检测器行列螺旋式计算机体层摄影(multidetec-tor-row helical computerized tomography,MDCT)检查前后12 h内予0.9%盐水以1 ml/(kg.h)的速度滴注进行水化,静脉补液量根据患者的体质量及患者心功能进行调整,要求患者24 h尿量达到2 L以上以达到充分水化。②常规治疗组(n=41),按患者正常治疗流程,不额外增加患者的饮水量及静脉液体输入量。记录和分析2组患者在检查前后48、72、168 h的血清肌酐浓度(SCr)变化情况。结果水化治疗组的血肌酐基础值为(160.9±62.7)μmol/L,给予非离子对比剂后48、72、168 h的血肌酐值分别为(145.8±78.7)、(143.1±47.6)、(153.8±59.8)μmol/L。水化治疗组的4次血肌酐值差异无统计学意义(P>0.05)。常规治疗组的血肌酐基础值为(180.3±91.4)μmol/L,给予非离子对比剂后48、72、168 h的血肌酐值分别为(185.5±71.3)、(188.7±104.3)、(188.3±90.6)μmol/L,常规治疗组给予对比剂前后的4次血肌酐值差异也无统计学意义(P>0.05)。但水化治疗组对比剂肾病发生率低于常规治疗组(P<0.05)。结论水化治疗可减少对比剂肾病的发生。     

三维一体延续性护理在糖尿病肾病维持性血液透析患者中的应用

目的探讨三维一体延续性护理在糖尿病肾病维持性血液透析患者中的应用效果。方法选取2018年1月至2019年10月在海丰县彭湃纪念医院肾内科进行维持性血液透析住院治疗的40例糖尿病肾病患者作为研究对象,按照随机数表法将患者分为观察组和对照组各20例。住院期间两组患者给予相同护理方案,出院后,对照组给予常规护理,观察组给予三维一体延续性护理,时间为3个月。护理3个月后,比较两组患者的血糖控制情况和血肌酐、血钾水平、护理满意度及并发症发生情况,并比较两组患者护理前及护理3个月后的生活质量(采用SF-36生活质量量表评价)。结果护理后,观察组和对照组患者的空腹血糖[(6.41±0.23) mmol/L vs (7.35±0.42)mmol/L]、餐后2 h血糖[(7.75±0.53) mmol/L vs (10.11±0.84) mmol/L]、糖化血红蛋白[(6.32±0.21%) vs (7.67±0.35%)]、血肌酐[(274.75±19.24)μmol/L vs (385.7±27.17)μmol/L]及血钾[(4.42±0.42) mmol/L vs (5.47±0.65) mmol...     

缬沙坦联合黄芪注射液治疗早期糖尿病肾病的效果观察

目的探讨缬沙坦联合黄芪注射液应用在糖尿病肾病患者中的临床治疗效果及应用价值。方法将该院治疗的早期糖尿病肾病患者144例采取随机数字表法分为观察组和对照组,对照组给予缬沙坦治疗,观察组联合黄芪注射液治疗,记录两组治疗情况。结果观察组治疗后24 h尿蛋白定量(95.27±8.79)mg/d,尿β2微球蛋白(0.04±0.01)mg/L,尿素氮(5.68±0.38)mmol/L,肌酐(86.03±4.61)μmol/L;对照组治疗后24 h尿蛋白定量(143.76±14.33)mg/d,尿β2微球蛋白(0.11±0.09)mg/L,尿素氮(6.26±1.01)mmol/L,肌酐(92.89±10.24)μmol/L,组间对比差异有统计学意义(t=24.4750、6.5593、4.5606、5.1834,P0.05)。结论缬沙坦联合黄芪注射液应用在糖尿病肾病患者中可以缓解肾小球高滤过与高内压,减少尿蛋白漏出,缓解早期糖尿病肾病进展,值得在临床上推广使用。     

肥胖对糖尿病肾病患者体内氧化应激系统的影响及相关因素分析

目的 探讨肥胖对糖尿病肾病慢性肾功能不全（CKD 2 ～4期）患者体内氧化应激系统及相关因素的影响.方法 选择同济大学附属东方医院肾内科糖尿病肾病CKD 2 ～4期的患者76例及健康对照组61例,分别按BMI分为正常组、超重组和肥胖组,比较各组生化及各氧化应激指标.结果 糖尿病肾病患者血清前列腺素F2α（PGF20α）及晚期氧化蛋白产物（AOPP）水平分别为（656±38） μg/L及（74±14） μmol/L,较健康对照（214 ±115） μg/L及（39±6）μmol/L明显升高（P＜0.05）,维生素E水平（14.9±2.6）mg/L较健康对照（25.±4.0）mg/L下降（P＜0.05）.糖尿病肾病PGF2α水平各组分别为（632±31） μg/L、（656±33） μg/L、（679 ±36） μg/L;AOPP各组水平分别为（64±8）μmol/L、（75±10） μmol/L、（83±16） μmol/L;超重组均较体重正常组明显升高,肥胖组较超重组明显升高（P＜0.05）.糖尿病肾病维生素E水平各组分别为（16.2±1.4） mg/L、（14.8±3.6） mg/L及（13.8±1.6）mg/L,各组比较有下降趋势（P＞0.05）.通过多元逐步线性回归分析显示BMI、TC、TG、吸烟史影响患者体内氧化应激系统.结论 糖尿病肾病患者体内存在氧化应激状态.肥胖影响糖尿病肾病患者氧化应激系统的水平.与肥胖相关的脂质紊乱同样影响糖尿病患者氧化应激水平.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.