不同剂量颈复汤联合倍他司汀对老年颈性眩晕患者血浆ET-1及CGRP水平的影响

目的探讨不同剂量颈复汤联合倍他司汀对老年颈性眩晕患者血浆内皮素-1(ET-1)及降钙素基因相关肽(CGRP)水平的影响。方法选取2015年7月至2017年4月在广东省中医院珠海医院接受治疗的105例颈性眩晕患者,采用随机数字表法将患者分为倍他司汀组、颈复汤组、颈复汤低剂量组、中剂量组和高剂量组每组21例。分别给予倍他司汀、低剂量颈复汤、低剂量颈复汤联合倍他司汀、中剂量颈复汤联合倍他司汀、高剂量颈复汤联合倍他司汀进行治疗,均治疗1 w。比较各组治疗后1 d的总有效率,比较各组治疗前、治疗后1 d的血浆ET-1、CGRP水平、眩晕评分和头晕残障量表(DHI)评分及不良反应率。结果颈复汤高剂量组、中剂量组、低剂量组的总有效率两两比较差异均无统计学意义(P>0.05),高剂量组、中剂量组的总有效率均高于倍他司汀组以及颈复汤组,低剂量组的总有效率高于颈复汤组(P<0.05)。治疗后1 d,高剂量组的ET-1水平、DHI评分低于其他各组,CGRP水平、眩晕评分高于其他各组(P<0.05);中剂量组ET-1水平、DHI评分低于低剂量组、颈复汤组、倍他司汀组,CGRP水平、眩晕评分高于低剂量组、颈复汤组、倍他司汀组(P<0.05);低剂量组ET-1水平、DHI评分低于颈复汤组、倍他司汀组,CGRP水平、眩晕评分高于颈复汤组、倍他司汀组(P<0.05)。各组的不良反应率比较差异无统计学意义(P>0.05)。结论颈复汤联合倍他司汀治疗老年颈性眩晕患者的临床疗效较好,并且相对于低剂量和中剂量,高剂量的颈复汤联合倍他司汀能更好的改善患者血浆ET-1及CGRP水平,且无明显的不良反应。     

加味归脾汤治疗良性阵发性位置性眩晕的疗效观察

目的探讨加味归脾汤治疗良性阵发性位置性眩晕病人的临床疗效。方法将64例良性阵发性位置性眩晕病人随机分为治疗组与对照组,各32例。对照组给予盐酸倍他司汀氯化钠注射液、氟哌噻吨美利曲辛配合复位手法等对症治疗,治疗组在对照组基础上给予归脾汤加味口服。初诊时、连续治疗2周后分别采用中医证候积分、眩晕量表及汉密尔顿焦虑量表(HAMA)评估疗效。结果治疗后,两组HAMA评分均较治疗前降低,治疗组较对照组降低明显(P0.05);眩晕症状较治疗前明显改善,且治疗组较对照组改善明显(P0.05);治疗组中医证候评分较对照组下降明显(P0.05)。结论加味归脾汤结合西药治疗可有效改善良性阵发性位置性眩晕病人的眩晕程度及伴随症状,效果优于单独西药治疗。     

中西医结合治疗颈性眩晕内科方案的研究

目的探讨中西医结合治疗颈性眩晕内科方案,评估临床疗效。方法将170例确诊为颈性眩晕的患者随机分为中西医结合(颈复汤低、中、高剂量分别联合西药倍他司汀)组,中药颈复汤中剂量组,西药倍他司汀对照组,共计5组,每组34例,疗程1周。临床观察指标:DHI眩晕障碍评分量表,眩晕缓解天数量表,症状视觉模拟评分(VAS评分)。结果治疗后中西医结合三组DHI眩晕障碍评分量表、眩晕缓解天数量表、症状积分比较均较中药对照组有统计学意义(P<0.05);低、中、高剂量三组间比较有统计学意义(P<0.05);中、高剂量组DHI眩晕障碍评分量表与症状积分较西药对照组有统计学意义(P<0.05)。结论中西医结合治疗方案优于单纯中药组和单纯西药组;中、高剂量组疗效优于低剂量组。中西医结合治疗颈性眩晕更有优势,是有效、安全、科学、规范、便捷、经济的内科综合诊疗方案。     

倍他司汀联合尼莫地平治疗高血压眩晕的临床效果

目的 探究倍他司汀联合尼莫地平治疗高血压眩晕的应用效果。方法 选取2020年3月至2022年3月我院收治的高血压眩晕患者110例,按照随机数字表法分为对照组、观察组,各55例。对照组给予患者苯磺酸氨氯地平片、尼莫地平片治疗,观察组在此基础上加用倍他司汀治疗。对比两组患者临床疗效、血压水平、眩晕症状评分、血管内皮功能、椎动脉及基底动脉血流动力学指标。结果 两组一般资料比较（P>0.05）。观察组治疗总有效率高于对照组（P<0.05）。观察组治疗后血压水平、EEV评分均低于对照组（P<0.05）。治疗后观察组血管内皮功能优于对照组（P<0.05）。观察组治疗后椎动脉和基底动脉血流动力学指标均优于对照组（P<0.05）。结论 高血压眩晕患者采用倍他司汀和尼莫地平治疗,利于提高临床疗效,降低血压水平,改善椎动脉及基底动脉血流动力学指标,改善眩晕症状。     

化痰定眩方联合倍他司汀治疗老年眩晕的疗效及对脑血流速度的影响

目的 探讨老年眩晕患者应用化痰定眩方联合倍他司汀治疗的临床疗效及其对患者脑血流速度的影响。方法 老年眩晕患者124例采用随机数字表法分为观察组与对照组各62例。两组均接受常规治疗,对照组在常规治疗基础上应用倍他司汀治疗,观察组在对照组基础上联合应用化痰定眩方治疗,两组均治疗15 d。对比两组治疗后15 d临床疗效、治疗前后血液流变学变化及脑血流速度,并比较两组治疗过程中不良反应发生情况。结果 治疗后15 d,观察组总有效率显著高于对照组(P<0.05);治疗前,两组全血黏度(WBV)、血浆黏度(PV)、红细胞比容(HCT)、血小板聚集(PAG)指数、大脑前动脉(ACA)、大脑中动脉(MCA)及大脑后动脉(PCA)血流速度差异无统计学意义(P>0.05);治疗后15 d,观察组WBV、PV、HCT、PAG指数均显著小于对照组,ACA、MCA及PCA血流速度均显著大于对照组(P<0.05,P<0.001);两组不良反应发生率差异无统计学意义(P>0.05)。结论 化痰定眩方联合倍他司汀治疗可改善老年眩晕患者血液流变学指标,加快脑血流速度,临床疗效显著且不会增加...     

银丹心脑通胶囊联合盐酸倍他司汀口服液治疗椎基底动脉供血不足性眩晕疗效观察

目的观察银丹心脑通胶囊联合盐酸倍他司汀口服液对椎基底动脉供血不足眩晕的临床疗效。方法将68例诊断为椎基底动脉供血不足的眩晕患者,随机分成治疗组和对照组。治疗组口服银丹心脑通胶囊联合盐酸倍他司汀口服液;对照组口服盐酸倍他司汀口服液。两组均治疗14d后观察临床疗效及颈动脉血流变化情况。结果治疗组总有效率为91.67%,对照组总有效率为78.13%,差异有统计学意义(P<0.05)。两组治疗后颈动脉血流速均较治疗前改善。结论口服银丹心脑通胶囊联合盐酸倍他司汀口服液治疗椎基底动脉供血不足性眩晕疗效优于单用盐酸倍他司汀口服液,联合治疗方案是治疗椎基底动脉供血不足型眩晕的较为有效方法。     

中西医结合治疗眩晕的疗效分析

目的探讨并分析天麻钩藤饮及其加减联合甲磺酸倍他司汀治疗眩晕的疗效。方法选取2013年12月~2015年11月我院收治的眩晕病患者213例作为研究对象,将其随机分为试验组107例和对照组106例。对照组采取甲磺酸倍他司汀治疗方案,试验组采取联合天麻钩藤饮及其加减方案。比较两组患者的疗效。结果试验组总有效率为95.33%显著高于对照组的77.36%,差异有统计学意义(P0.05)。结论天麻钩藤饮及其加减联合甲磺酸倍他司汀治疗眩晕的疗效显著,值得应用。     

手法复位联合甘露醇、盐酸倍他司汀治疗良性阵发性位置性眩晕效果观察

目的观察手法复位联合甘露醇、盐酸倍他司汀治疗良性阵发性位置性眩晕(BPPV)的临床效果。方法将83例BPPV患者按照时间顺序分为观察组(后42例)和对照组(前41例),两组均进行手法复位,其中后半规管BPPV患者采用改良Epley法治疗,水平半规管BPPV患者采用Barbecue翻滚治疗。观察组同时静推甘露醇,静滴及口服盐酸倍他司汀。评价两组治疗后1周和3个月的临床疗效,随访记录两组治疗后半年的复发率和1、1.5、2 a的累计复发率。结果观察组治疗后1周和3个月的总有效率均高于对照组,P均<0.05。治疗后半年,观察组复发率为2.5%(1/40),对照组为15.2%(5/33),P>0.05。治疗后1、1.5、2 a,观察组累计复发率均低于对照组,P均<0.05。结论手法复位联合甘露醇、盐酸倍他司汀治疗BPPV效果较好,且能有效降低其复发率。     

昂丹司琼联合盐酸倍他司汀治疗眩晕症的疗效观察

目的观察昂丹司琼联合盐酸倍他司汀治疗眩晕症的疗效,探讨昂丹司琼治疗眩晕症的作用机制。方法选择我院神经内科眩晕症患者60例为研究对象,随机分为两组,治疗组(昂丹司琼联合盐酸倍他司汀组)30例,对照组(盐酸倍他司汀组)30例,治疗期间监测不良反应,观察患者治疗眩晕前后(包括眩晕程度、频度、持续时间),日常生活及工作等情况变化,计算出各观察指标的积分与总积分。结果治疗组总有效率为93.3%,优于对照组的60.0%,两组比较差异有统计学意义(P0.05)。结论昂丹司琼联合盐酸倍他司汀治疗眩晕症是安全的。     

G-Force眩晕综合诊疗系统加减半夏白术天麻汤治疗良性阵发性位置性眩晕的临床疗效

目的 观察G-Force眩晕综合诊疗系统配合加减半夏白术天麻汤治疗良性阵发性位置性眩晕(BPPV)的临床疗效。方法 选取符合诊断标准的BPPV患者80例，采用随机数表法随机分为治疗组和对照组各40例。对照组给予G-Force眩晕综合诊疗系统辅助下耳石复位法进行治疗，治疗组在对照组的基础上给予加减半夏白术天麻汤进行治疗，分别观察两组在治疗2 d、2 w、2个月的临床疗效，并测定治疗2个月的血脂指标，并记录两组治疗2 w、2个月的眩晕残障(DHI)量表评分，并在完成治疗后进行时长为3个月的随访，调查两组复发情况。结果 对比两组治疗后2 d的疗效，治疗组总有效率与对照组总有效率差异显著(P<0.05);治疗2 w后，治疗组总有效率与对照组总有效率差异显著(P<0.05);治疗后2个月，治疗组总有效率与对照组相比均具有显著差异(P<0.05)。治疗2个月后，与对照组相比，治疗组三酰甘油(TG)、总胆固醇(TC)、载脂蛋白(Apo)-A1水平显著下降(P<0.05),两组低密度脂蛋白(LDL)、高密度脂蛋白(HDL)无显著差异(P>0.05)。治疗2 w后，治疗组的...     

Treatment of patients with Eisenmenger's syndrome with Bosentan

We treated prospectively 14 patients with Eisenmenger's syndrome, with a mean age of 10 years, ranging from 3 to 18 years. Treatment continued for 12 months, and demonstrated a lasting symptomatic improvement, but no improvement in terms of mean saturation of oxygen over 24 hours. Exercise capacity, as judged by peak uptake of oxygen, worsened in the six patients able to perform a treadmill test. The symptomatic benefit from dual blockage of endothelin receptors in these patients may be due to mechanisms other than selective pulmonary vasodilatation alone.     

Satisfaction with ambulatory care of persons with AIDS

OBJECTIVE: To examine the relation of patient characteristics and site of care to the perception of ambulatory care quality by persons with AIDS (PWAs). DESIGN: Patient surveys and medical record review were used to determine PWAs’ perceptions of their ambulatory care, self-perceived health status, primary care relationships, sociodemographic characteristics, and severity of illness. SETTING: A public-hospital HIV clinic, an academic group practice, and a staff-model health maintenance organization (HMO) that together care for 20% of all Massachusetts PWAs. PATIENTS: All active patients as of February 12, 1990, and all new AIDS patients at each of the three sites during the subsequent 13 months. MEASUREMENTS AND MAIN BESULTS: The primary outcome measure was a six-item scale of patient-rated quality of care (PRQC), a newly developed measure that combined patients’ ratings of their physician care, nursing care, involvement in medical decisions, and overall quality of care. Multiple logistic regression was carried out with low PRQC (lowest quart He) as the dependent variable, to identify correlates of patient perceptions of poor quality. Patients who had a primary nurse were significantly less likely to have low PRQC scores (OR=0.50, 95% CI=0.26 to 0.97). Black patients and patients who used injection drugs were significantly more likely to rate their care in the lowest quartile (OR=2.22, 95% CI=1.04 to 4.78; and OR=2.43, 95% CI=1.13 to 5.23, respectively), as were those who had lower self-perceived health status, after controlling for confounders; no association was found by site or severity. CONCLUSIONS: These results show that primary nursing may be an important determinant of how PWAs rate the quality of their ambulatory care. Furthermore, PWAs who are black or who are injection drug users are less satisfied than are others with the quality of their ambulatory AIDS care. Presented in part at the annual meeting of the Society of General Internal Medicine, April 30, 1993, Arlington, Virginia. Supported by the Agency for Health Care Policy and Research, grant number HS06239.     

Experience with the treatment of patients with hypertrophic cardiomyopathy with obsidan and isoptin

Forty-five patients with hypertrophic cardiomyopathy were examined clinically and echocardiographically. The results of their treatment with obsidan and isoptin in relation to various types of central hemodynamic disorders are presented. The data have been obtained making it possible to treat patients differentially with regard to the form of the disease. The treatment of this category of patients requires the echocardiographic monitoring of the parameters of the central hemodynamics and myocardial contractility.     

分析老年糖尿病患者应用甘精胰岛素联合阿卡波糖治疗的效果

目的探讨甘精胰岛素联合阿卡波糖在老年糖尿病患者中的临床疗效。方法选取该院2018年7月—2019年7月收治的113例老年糖尿病患者作为研究对象,经随机数字表法,划分A组(n=56,阿卡波糖)和B组(n=57,甘精胰岛素+阿卡波糖),比较两组临床疗效、血糖指标。结果B组患者临床治疗总有效率显著高于A组;经治疗,B组患者空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)水平明显低于A组。两组之间比较差异有统计学意义(P<0.05)。结论在老年糖尿病患者中应用甘精胰岛素+阿卡波糖,临床疗效显著,使患者的空腹血糖、餐后2 h血糖、糖化血红蛋白等指标得到了明显改善,安全性强。     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.