循证医学与经验医学的区别

从4个方面论述了循证医学与经验医学的区别，主要是评价结果的指标不同，循证医学更重视以满意的终点指标为主要评价指标：其次是证据的来源不同，循证医学倡导的是慎重、准确而明智地应用目前所能获得的最佳证据，即RCT结果；此外，对研究方法的要求不同，循证医学强调的是采用RCT方法，对大样本病例进行系统观察和评价；最后是对样本量的要求不同，循证医学要求证据的获得是基于大样本、多中心、大规模的临床试验。循证医学从根本上克服经验医学模式下的无序医疗，向着有序医疗的目标迈进。     

晚期肝癌中西医综合个体化治疗研究

目的探索中西医综合个体化治疗晚期肝癌的临床疗效.方法根据每位病人的具体情况,用介入治疗、抗癌中药等"攻邪",用中医药辨证施治汤剂、药膳等"扶正".结果完全缓解(CR)、部分缓解(PR)、稳定(SD)和恶化(DP)分别为7.50%、35.00%、40.00%和17.50%,生存时间为20.83±16.42个月,1、3、5年生存率分别为63.75%、31.82%和22.22%.结论中西医综合个体化治疗晚期肝癌可取得较好的临床效果,显著延长病人的生命.     

Current research and development of integrated traditional Chinese and Western Medicine in gastroenterology

Traditional Chinese medicine (TCM) is one of China’s scientific treasures. We are very fortunate to apply modern scientific knowledge and methodology towards reorganizing our inherited TCM and to then promote the integration of TCM and Western medicine (TCM-WM). Over the 45 years, many remarkable achievements have been made in this regard and we are looking forward to the next achievements in the coming century; however, many challenges remain to the establishment of TCM-WM as a trusted and oft used approach for improving human health.     

氟宁抗氟作用机制的初步研究

目的　探讨氟宁抗氟的作用机制。方法　采用随机分组，A组为氟宁组，B组为试验对照组，C组为空白对照组，观察各组动物血、尿、粪、器官组织的含氟量及血清酶活性变化。结果　A组骨、牙齿中含氟量显著低于B组（P<0.05），血和尿含氟量显著高于B组（P<0.05），碱性磷酸酶（AKP）及肌酸磷酸激酶（CPK）活性显著低于B组（P<0.05）。结论　氟宁可促进氟的排泄，减少氟在组织中的沉积，具有明显的抗氟作用     

病态窦房结综合征的临床研究概况

探讨导致病态窦房结综合征的作用机制,并且就中西医对病态窦房结综合征的病因、发病机制、治疗方法、用药、药理等临床研究进展进行综述.     

经导管栓塞化疗中晚期肝癌

目的研究中晚期肝癌非手术治疗的最佳方案。方法135例随机分成Ａ、Ｂ、Ｃ３组。Ａ组肝动脉内灌注化疗药物，Ｂ组药物灌注加碘油乳剂及明胶海绵栓塞，Ｃ组碘油乳剂及明胶海绵栓塞。结果３组平均生存期为5.7月，10.6月和8.7月；0.5、１、２、３年生存率Ａ组51.6％、12.9％，无     

中西医结合治疗青春期甲亢31例临床观察

目的　观察中成药“抑亢丸”辅助治疗青春期弥漫性甲状腺肿伴甲亢 (Graves病 )疗效。方法　对已接受西医系统抗甲亢治疗 3 0个月以上的 5 6位青春期Graves病患者随机分为观察组 (2 5例 )和治疗组 (3 1例 ) ,分别予以原抗甲亢药物 (ATD)方案治疗和在此基础上加用“抑亢丸”治疗 3个月 ,通过甲状腺功能 (FT3 、FT4)和甲状腺免疫标志物 (TPOAb、TMA、TGA)变化比较两组治疗效果。结果　 3个月后治疗组TPOAb、TGA、TMA较观察组显著下降 (P <0 .0 1,P <0 .0 5 ,P <0 .0 5 ) ,提示免疫功能改善。治疗组FT3 、FT4下降明显 (P <0 .0 1,P <0 .0 5 ) ,与免疫功能改善相平行 ,提示甲状腺功能明显恢复。结论　中药“抑亢丸”联合西医抗甲亢系统治疗青春期甲亢可改善甲状腺自身免疫功能 ,从而促进甲状腺功能恢复正常     

The Archetypes of Medicine: A Job Description for the 21st Century

Medicine is facing an identity crisis, one that might find resolution by revisiting a past rich in multifaceted individuals who transcended the strict definition of ‘doctor’, excelled in other fields of human endeavor, and showed us different ways of being physicians. This paper reviews 12 archetypes that have been part of the profession since its inception, but that, as of late, might have been forgotten. Our goal is to elicit discussion and introspection, with the premise that being a physician ought to be something larger than being a mere technician. If our premise is accepted, then the next step would be to identify those personal traits that made those archetypes possible, so that we can start both recruiting for them and then nurturing them during training.     

Acute effects of the calcium antagonist, nifedipine, on blood pressure, pulse rate, and the renin-angiotensin-aldosterone system in patients with essential hypertension

Ten milligrams nifedipine was administered orally to young and old persons with or without hypertension, and the acute effects of nifedipine on the renin-angiotensin-aldosterone system were studied one half to 3 hours later. Nifedipine reduced blood pressure and increased pulse rate in young and old persons with or without hypertension. Simultaneously, nifedipine produced a significant increase of plasma renin activity in young persons with or without hypertension but failed to do so in old persons with or without hypertension. As a result, angiotensin I and II increased significantly in young persons but not in old persons. Hydralazine elevated aldosterone concentration by stimulating the renin-angiotensin system but nifedipine failed to do so despite its effect on the renin-angiotensin system in young individuals. Since calcium is required to secrete aldosterone, it is suggested that nifedipine blocked aldosterone secretion by the agent's calcium antagonizing action.     

女性心血管疾病药物治疗的特点

随着心血管疾病在女性中发病率的逐年升高,女性心血管疾病的药物治疗引起了广泛关注.由于女性心血管疾病的临床特点和病理生理机制具有一定特异性,药物代谢动力学也不同于男性,更好地理解这种性别差异,对临床上选择用药和药物剂量有重要指导意义.本文结合近年来临床试验的结果,对心血管疾病常用药物在女性患者中的治疗作用和不良反应以及造成性别差异的原因等方面进行论述.     

中药治疗功能性消化不良的概况

功能性消化不良(functional dyspepsia,FD)是一种常见的功能性胃肠疾病,临床症状有上腹痛、上腹胀、早饱、嗳气、食欲不振、恶心、呕吐等,但其临床表现不能用器质性、系统性或代谢性疾病等来解释,罗马Ⅳ标准[1]按其临床表现分为餐后不适综合征和上腹痛综合征2大类。西方国家流行病学调查发现,有20%~40%的普通人有FD症状,国内也同样有20%~45%的人出现FD症状,消化科门诊中FD患者占总量的20%~40%[2]。     

Life guidelines of the Sasang constitutional medicine in the management of 'Mibyou' in Korea

'Mibyou' is taken as a presymptomatic clinical stage between the healthy and ill status. In Korea, Sasang Constitutional Medicine (SCM) provides life guidelines for each of the constitutional types, and these guidelines have been adopted in the management of 'Mibyou.' The SCM claims that human constitutions are classified into four constitutional types and those are Tae-yang, Tae-eum, So-yang, and So-eum type. Tae-yang type is recommended to be diligent, calm down, and be gentle. Fresh and plain foods such as marine products and vegetables are desirable for this type. Tae-eum type is recommended to try to be outgoing. Foods with animal and bean protein are recommended for Tae-eum type. So-yang type is recommended to be patient. Fresh and cold foods such as vegetables and marine products are good for this type. So-eum type is recommended to be positive and active. The suitable foods for So-eum type are warm 'Qi' foods or foods which are easy to digest. In conclusion, there is a recent trend to manage 'Mibyou' by controlling the individual's behaviors, exercise, and diet according to the life guidelines suggested by the SCM in Korea. This has proven highly effective in preventing the diseases each constitution type can easily suffer.     

2014年心血管病药物治疗学领域要点回顾

<正>2014年度,心血管疾病药物治疗学领域取得了一系列新进展。一些指南性文件的更新与发布将会进一步促进心血管疾病的规范化防治,多项具有里程碑意义的临床试验揭晓也为我们提供了大量重要信息。本年度有以下内容值得重点关注:1中国心力衰竭防治指南更新其更新要点主要包括:(1)醛固酮拮抗剂适用人群扩大至所有有症状(NYHAⅡ^Ⅳ级)的心力衰竭患者;(2)单纯减慢心率的药物伊伐布雷定得     

Effectiveness of CAM therapy: understanding the evidence

By definition, complementary and alternative medicine (CAM) attempts to diagnose and treat illnesses in unconventional ways. CAM has been classified as: (1) alternative medical systems (eg, traditional Chinese medicine [including acupuncture], naturopathic medicine, ayurvedic medicine, and homeopathy); (2) biologic-based therapies (eg, herbal, special dietary, and individual biologic treatments); (3) energy therapies (eg, Reiki, therapeutic touch, magnet therapy, Qi Gong, and intercessory prayer); (4) manipulative and body-based systems (eg, chiropractic, osteopathy, and massage); and (5) mind-body interventions (eg, meditation, biofeedback, hypnotherapy, and the relaxation response). This review focuses on how to assess the effectiveness of CAM therapies for chronic musculoskeletal pains, emphasizing the role of specific and nonspecific analgesic mechanisms, including placebo.