两种新型非生物型人工肝治疗慢性乙型重型肝炎疗效观察

Objective To explore the clinical effects of two new treatment methods of non-biologic artificial liver [slower plasma exchange (PE) combined with continuous veno-venous hemofiltration (CWH), and coupled plasma exchange filtration adsorption (CPEFA)] in treatment of chronic severe hepatitis B patients. Methods 130 patients with chronic severe hepatitis B were divided into three groups. 44 patients were treated with a parallel circuit of being combined slower PE and CWH based on the conservation medical therapy (group A). 43 patients were treated with CPEFA based on the conservation medical therapy (group B). 43 patients received PE with conservative medical therapy (group C). The clinical symptoms, signs, liver function, blood sodium concentration, effective rates and survival rates in three groups were surveyed before and after treatment. Results The symptom and signs of the majority in the above different groups improved. In group A and B, hyponatremia of patients were improved, the effective rates (within 6 months after the treatment) were 70.45% and 72.09% respectiverly. There was no statistical difference between the two groups (χ2=0.10,P>0.05), the survival rates(6 months) were 45.45% and 46.51% respectively and there was no statistical difference (χ2 = 0.08, P > 0.05). In group C, patients' hyponatremia did not change, the effective rate (51.16%)was obviously lower than those in group A and B (χ2 = 7.55,9.31, P < 0.01) and the total survival rate(6 months) was 30.23% also lower than those in group A, B (χ2 = 4.80,6.10, P < 0.05). Conclusions Being combined slower PE and CWH with a parallel circuit and CPEFA are two new, safe and effective methods of non-biologic artificial liver treatment.     

吗啡联合间苯三酚治疗急性肾绞痛的疗效观察

目的 探讨吗啡联合间苯三酚在急性肾绞痛治疗中的疗效.方法 将120例急性肾绞痛患者按随机数字表法分为A、B、C三组,每组40例.A组给予0.9%氯化钠100 ml+间苯三酚80 mg静脉滴注及吗啡9 mg分3次静脉推注,B组给予0.9%氯化钠100 ml+间苯三酚80 mg静脉滴注,C组给予0.9%氯化钠100 ml静脉滴注及吗啡9 mg分3次静脉推注.分别于给药后10、20、40min观察镇痛效果及其不良反应.结果 给药后20 min和40 min时,A组总有效率[82.5%(33/40)、95.0%(38/40)]明显高于B组[62.5%(25/40)、80.0%(32/40)]和C组[60.0%(24/40)、77.5%(31/40)](P＜0.05),疼痛缓解率也明显高于B组和C组(P＜0.05).A组在给药后20 min和加min时的总有效率和疼痛缓解率比较差异无统计学意义(P＞0.05).A组除1例患者出现恶心呕吐外,无疼痛加重及严重呼吸抑制等不良反应.结论 吗啡分次注射联用间苯三酚静脉滴注治疗急性肾绞痛具有起效快、效果显著、安全等优点.

Abstract：

Objective To evaluate the efficacy of multiple injection of morphine combined with phloroglucinol in the treatment of renal colic. Methods One hundred and twenty patients with severe renal colic were equally divided into three groups by random digits table,with 40 cases each group. The group A was administrated with physiological saline 100 ml and phloroglucinol 80 mg intervenous drop infusion combined with morphine 9 mg intravenous injection fractionated into three times, and the group B was administrated with physiological saline 100 ml and phloroglucinol 80 mg intervenous drop infusion,and the group C was administrated with physiological saline 100 ml intervenous drop infusion and morphine 9 mg intravenous injection fractionated into three times. At 10,20 and 40 min after administration, the antalgic efficacy of three groups were analyzed as well as the side effect. Results At 20 min and 40 min both of the total efficacy rates in group A[82.5%(33/40),95.0%(38/40)] were higher than those in group B [62.5%(25/40),80.0%(32/40)] and group C [60.0%(24/40),77.5%(31/40)] (P＜ 0.05),and the colic-exclusion rate in group A was also higher than that in group B and group C (P ＜ 0.05). The difference of the efficacy rates in group A in these two time-points had no statistical significance (P ＞0.05). No increased pain occurred in group A except 1 case of vomiting. Conclusion Multiple injection of morphine combined with phloroglucinol is quick, effective and safe in the early treatment of renal colic.     

拉米夫定联合还原型谷胱甘肽预防乙型肝炎病毒携带者抗结核的肝损害研究

Objective To explore the preventive effect of liver damage treated by lamivadine joint reduced glutathione for the tuberculosis patients with HBV infection. Methods 90 cases of tuberculosis patients with HBV infection were randomly divided into three groups (A, B, C), each group contained 30 cases. Patients in group A were treated by lamivudine combined with reduced glutathione to protect the liver before anti-tuberculosis treatment. Group B were treated with reduced glutathione. Group C were treated with Yiganling tablets. Both the liver function and serum HBV DNA levels before anti-tuberculosis treatment and 1 month and 2 months after treatment were observed and recorded. Results The cases of liver damage in group A, B, C were 1, 12, 18 respectively, there were statistical differences between group A and group B, group C (χ2 = 11.882, 22.259, P < 0.01). The cases of discontinued treatment due to different causes in group A,B,C were 0,4,11 respectively, there were statistical differences between group A and group B,group C(χ2 = 4.286, P < 0.05; χ2 = 13.469, P < 0.01). The cases of discontinue treatment in the no antivirus group were much more than the antivirus group. There were also statistical differences in both liver damage and discontinued treatment between group B and group C(χ2 = 5.455,4.356, P < 0.05). There was no statistical difference of baseline HBV DNA level between group A and group B (P > 0.05), and also no statistical difference between group A and group C ( P > 0.05), but there were statistical differences in HBV DNA level between group A and group B, as well as group A and group C after 1-month and 2-month therapy( t = - 6.542, - 6.746 and t = - 9.358, - 10.085, P < 0.01). Conclusions Tuberculosis patients coinfected with HBV can use reduced glutathione to prevent liver damage while antitubercular therapy, and simultaneous application of lamivudine therapy can restrain HBV replication and improve the prognosis obviously.     

谷胱甘肽对2型糖尿病周围神经病变患者血清氧化应激指标及感觉神经传导速度的影响

目的 观察2型糖尿病周围神经病变患者血清氧化应激相关指标的变化,探讨抗氧化剂--谷胱甘肽(GSH)对2型糖尿病周围神经病变患者的神经保护作用.方法 检测54例2型糖尿病周围神经病变患者(研究组)与30例健康体检者(对照组)血清中丙二醛(MDA)含量与超氧化物歧化酶(SOD)活性;将54例2型糖尿病周围神经病变患者按随机数字表法分为GSH组和CON组,每组27例.GSH组予GSH 1.8 g/d,CON组予B族维生素治疗,均治疗14 d.分别检测两组治疗前后MDA含量、SOD活性、双侧胫后感觉神经传导速度(SCV).结果 研究组MDA含量(7.23 ±2.31) μmol/L和SOD活性(59.72±13.58) kU/L,对照组MDA含量(4.87 ±1.17)μmol/L和SOD活性(76.19 ± 7.55)kU/L,研究组MDA含量高于对照组,SOD活性低于对照组,两组比较差异有统计学意义(P＜0.01);GSH组和CON组治疗后MDA含量下降,SOD活性升高,治疗前后比较差异有统计学意义(P＜0.05),但两组治疗后比较差异无统计学意义(P＞0.05).CON组治疗后SCV虽有上升但与治疗前比较差异无统计学意义(P＞0.05),而GSH组治疗后SCV显著增加(P＜0.05),两组治疗后比较差异有统计学意义(P＜0.05).结论 2型糖尿病周围神经病变患者体内存在氧化应激反应,GSH抗氧化治疗可以改善受损神经,较传统的营养神经治疗有较好的神经保护作用.

Abstract：

Objective To observe the change of oxidalive stress indexes in the patients with diabetic perineuropathy (DPN), and investigate the protection role of glutathione (GSH) on neuroprotective effect. Methods The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) and sensory nerve conduction velocity (SCV) were detected in 54 cases with DPN (DPN group) and 30 cases of health examination (control group). Fifty-four cases with DPN were divided into GSH group (given basic treatment and GSH 1.8 g/d) and CON group(given basic treatment and B vitamin) with 27 cases each by random-digits table. After treatment of 2 weeks, the levels of SOD, MDA and SCV were compared. Results The levels of MDA in DPN group were significantly higher than those in control group, while the activity of SOD was significantly lower than that in control group [(7.23 ±2.31) μmol/L vs. (4.87 ± 1.17) μmol/L, (59.72 ± 13.58) kU/L vs. (76.19 ± 7.55 ) kU/L](P＜ 0.01). After treatment, the level of MDA was decreased and the activity of SOD was increased in GSH group and CON group (P ＜0.05),but there was no significant difference between the two groups(P＞ 0.05). After treatment, the level of SCV was significantly increased in GSH group,while there was no significant difference in CON group (P ＞0.05). Conclusions Oxidative stress exists in DPN patients. The antioxidant treatment with GSH can improve impaired nerve and has a better effect of nerve protection than classical nerve nutrition therapy.     

高频喷射通气对单肺通气患者氧化应激反应的影响

Objective To determine the effects of high-frequency jet ventilation (HFJV) on oxidative stress in patients during one-lung ventilation (OLV). Methods Forty-five patients undergoing elective radical esophageal cancer resection were divided into three groups with 15 cases each by random digits table: two lung ventilation group ( group A), OLV group (group B), HFJV- OLV group ( group C, working pressure 1 kg/cm2 and frequency 100 times/min). Venous blood samples were taken before induction (T0),at30min (T1),90min (T2),150min (T3) after OLV and the end of operation (T4) for measuring serum superoxide dismutase(SOD),malondialdehyde (MDA) and nitric oxide (NO). Results SOD was lower at T2-T4 in group B[(47 ± 10), (37 ±9), (41 ±7) kU/L] and group C[(58 ± 12), (51 ± 11), (49 ± 9) kU/L] than those in group A [(78 ±8), (75 ±7), (79 ±6) kU/L](P＜ 0.05),and MDA and NO were lower at T1-T4 in group B and group C than that in group A(P＜ 0.05). SOD was higher at T3 in group C than that in group B (P ＜ 0.05), MDA at T1-T4 and NO at T2-T4 were lower in group C than those in group B (P ＜ 0.05). Conclusion HFJV can effectively decrease oxidative stress in patients during OLV.     

斯奇康注射液辅助治疗肺结核的临床研究

目的 观察斯奇康注射液辅助治疗肺结核的临床疗效、对细胞免疫功能的影响及不良反应的发生情况,为肺结核的辅助治疗提供一种安全、有效且价格低廉的药物.方法 将60例肺结核患者按随机数字表法分为治疗组和对照组,每组30例,两组均予标准抗结核化疗方案,治疗组加斯奇康注射液,观察患者的症状、病灶影像学改变、血常规、肝肾功能及T淋巴细胞亚群变化.结果 治疗后两组症状均较治疗前明显改善(P＜0.05),但治疗组明显优于对照组(P＜0.05);治疗组的有效率及控制率分别为36.7%(11/30)、96.7%(29/30),显著高于对照组的23.3%(7/30)、86.7%(26/30)(P＜0.05);治疗后,两组CD3、CD4和IL-2均升高,CD8下降,治疗组改善优于对照组(P＜0.05);治疗组白细胞减少率[10.0%(3/30)]明显低于对照组[33.3%(10/30)](P＜0.05).两组对肝肾功能损害程度差异无统计学意义.结论 斯奇康注射液治疗肺结核患者,能有效改善肺结核的症状,提高病灶吸收好转率,提高机体细胞免疫力,减轻结核化疗所致的白细胞下降的发生率,对肝肾功能无明显影响,临床用药较安全.

Abstract：

Objective To evaluate the effectiveness, the influence on cellular immune function and the side-effect of bacillus of Calmette-Guerin polysaccharide nucleic acid(BCG-PSN)combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis. Methods A total of 60 pulmonary tuberculosis patients were divided into treatment group(30 patients)and control group(30 patients)by random digits table. All patients accepted the same standard antituberculous chemotherapy, meanwhile patients in treatment group were injected with BCG-PSN. Observed and compared the clinical symptom,the size of the focas nidus,the change of toxic response and immunity. Results The symptoms were significantly relieved in both groups after treatment(P＜0.05), but it was significantly better in treatment group(P＜0.05), the effective rate and control rate in treatment group[36.7%(11/30),96.7%(29/30)]were significantly higher than those in control group[23.3%(7/30), 86.7%(26/30)](P ＜ 0.05). After treatment,the levels of CD3,CD4 and IL-2 were higher, and the level of CD8 was lower, but the treatment group improved significantly better than control group(P ＜ 0.05). The rate of leukopenia was lower in treatment group than that in control group[10.0%(3/30)vs. 33.3%(10/30),P ＜0.05]. As to the safety,no other toxicities were observed in the treatment group. Conclusions BCG-PSN combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis contributes to relieve the symptom, reduce size of the nidus, decrease leukopenia incidence and enhance the cell immunity. It is safe.     

持续静脉泵入呋塞米与多巴胺联合参麦注射液治疗难治性心力衰竭患者利尿剂抵抗

目的 观察持续静脉泵入呋塞米与多巴胺联合参麦注射液治疗难治性心力衰竭患者利尿剂抵抗的疗效、可行性及安全性.方法 将56例产生利尿剂抵抗的难治性心力衰竭患者按随机数字表法分为对照组及治疗组,每组28例.对照组给予常规利尿剂及常规抗心力衰竭治疗;治疗组在常规抗心力衰竭治疗的基础上持续静脉泵入呋塞米与多巴胺联合参麦注射液,连用5～7 d.比较两组的临床疗效以及心功能指标等方面的变化.结果 治疗后治疗组显效10例,有效14例,无效4例,总有效率为85.7%(24/28);对照组显效3例,有效10例,无效15例,总有效率为46.4%(13/28),两组总有效率比较差异有统计学意义(P＜0.05).对照组治疗后左室舒张末期内径(LVEDD)、短轴缩短率(FS)、左室射血分数(LVEF)及心脏指数(CI)与治疗前比较无显著改善(P＞0.05),而治疗组治疗后上述指标均有显著改善(P＜0.05),并且两组治疗后上述指标比较差异也有统计学意义(P＜0.05).治疗组出现低钾、低钠血症2例,经积极补钾、补钠治疗后纠正,未见其他不良反应.结论 在常规抗心力衰竭治疗基础上,持续静脉泵入呋塞米与多巴胺联合参麦注射液治疗,对难治性心力衰竭利尿剂抵抗疗效显著,临床安全可行.

Abstract：

Objective To observe the efficacy,feasibility and safety of continous intravenous infusion of furosemide,dopamine combined with Shenmai on treatment of refractory heart failure. Methods Fifty-six patients with diuretic resistance and refractory heart failure were divided into control group(28 patients)and treatment group(28 patients)by random digits table. Conventional diuretics and other anti-heart failure treatment were used in two groups, meanwhile, continuous intravenous infusion of furosemide,dopamine and Shenmai were used in treatment group for 5-7 days. The clinical symptoms and signs, pulmonary edema in chest X-ray and the improvements of pulmonary congestion were observed before and after treatment. Results In treatment group, 10 patients were markedly effective, 14 patients were effective, and 4 patients were unfruitful. The total effective rate was 85.7%(24/28). In control group, 3 patients were markedly effective, 10 patients were effective, and 15 patients were unfruitful. The total effective rate was 46.4%(13/28). There was significant difference in total effective rate between two groups (P ＜ 0.05). The indexes of left ventricular end-diastolic dimension, fractional shortening, left ventricular ejection fraction and cardiac index were significantly improved in treatment group(P ＜ 0.05), but was not significantly improved in control group(P ＞ 0.05). After treatment,2 patients emerged hypokalemia and hyponatremia, after symptomatic treatment,they all recovered. Conclusion Conventional treatment combined with continuous intravenous infusion of furosemide,dopamine and Shenmai in patients with refractory heart failure is markedly effective, feasible and safe.     

高频喷射通气对单肺通气患者氧化应激反应的影响

目的 研究高频喷射通气(HFJV)对单肺通气患者氧化应激反应的影响.方法 择期行食管癌根治术患者45例,按随机数字表法分为双肺通气组(A组)、单肺通气组(B组)、单肺通气时非通气侧给予HFJV(驱动压力1 kg/cm2,频率100次/min)组(C组),每组15例.分别于开胸前(T0),单肺通气后(A组于开胸后)30 min(T1)、90 min(T2)、150 min(T3),手术结束时(T4)测定超氧化物歧化酶(SOD)活性及丙二醛(MDA)、一氧化氮(NO)浓度.结果 T2～T4时B、C组SOD活性[B组:(47±10)、(37±9)、(41±7)kU/L;C组:(58±12)、(51±11)、(49±9)kU/L]低于A组[(78±8)、(75±7)、(79±6)kU/L](P＜0.05),T1～T4时B、C组MDA、NO浓度高于A组(P＜0.05);T3时C组SOD活性明显高于B组(P＜0.05),T1～T4时C组MDA浓度及T2～T4时NO浓度低于B组(P＜0.05).结论 HFJV能在一定程度上抑制单肺通气患者的氧化应激反应.

Abstract：

Objective To determine the effects of high-frequency jet ventilation (HFJV) on oxidative stress in patients during one-lung ventilation (OLV). Methods Forty-five patients undergoing elective radical esophageal cancer resection were divided into three groups with 15 cases each by random digits table: two lung ventilation group ( group A), OLV group (group B), HFJV- OLV group ( group C, working pressure 1 kg/cm2 and frequency 100 times/min). Venous blood samples were taken before induction (T0),at30min (T1),90min (T2),150min (T3) after OLV and the end of operation (T4) for measuring serum superoxide dismutase(SOD),malondialdehyde (MDA) and nitric oxide (NO). Results SOD was lower at T2-T4 in group B[(47 ± 10), (37 ±9), (41 ±7) kU/L] and group C[(58 ± 12), (51 ± 11), (49 ± 9) kU/L] than those in group A [(78 ±8), (75 ±7), (79 ±6) kU/L](P＜ 0.05),and MDA and NO were lower at T1-T4 in group B and group C than that in group A(P＜ 0.05). SOD was higher at T3 in group C than that in group B (P ＜ 0.05), MDA at T1-T4 and NO at T2-T4 were lower in group C than those in group B (P ＜ 0.05). Conclusion HFJV can effectively decrease oxidative stress in patients during OLV.     

人胰岛素类似物与人胰岛素减低糖化血红蛋白水平的比较研究

目的 探讨人胰岛素类似物与人胰岛素减低糖化血红蛋白(HbA1c)水平的差异.方法 随机抽取120例2型糖尿病患者,按住院号奇偶数分为人胰岛素类似物组和人胰岛素组,每组60例,比较两组在患病结局、血糖控制、HbA1c之间的差异.结果 人胰岛素类似物组治疗良好率(83.3%,50/60)与人胰岛素组治疗良好率(86.7%,52/60)比较差异无统计学意义(P＞0.05).治疗前两组空腹血糖和餐后2 h血糖比较差异无统计学意义(P＞0.05),治疗2周后两组比较差异有统计学意义(P＜0.05);两组内治疗前与治疗2周后空腹血糖和餐后2h血糖比较差异均有统计学意义(P＜0.05).治疗前两组HbA1c比较差异无统计学意义(P＞0.05),治疗3个月后两组比较差异有统计学意义(P＜0.05);两组内治疗前与治疗3个月后HbA1c比较差异均有统计学意义(P＜0.05).结论 人胰岛素类似物与人胰岛素在控制糖尿病患者血糖和HbA1c方面效果均较好,但人胰岛素类似物优于人胰岛素.

Abstract：

Objective To compare the level of glycosylated hemoglobin (HbA1c) in patients with diabetes treated with actrapid monotard analog or actrapid monotard. Methods One hundred and twenty patients with type 2 diabetes were divided into actrapid monotard analog group and actrapid monotard group with 60 cases in each by admission number. Fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPBG), HbA1c were obtained and analyzed. Results The overall cure rate were similar between actrapid monotard analog group and actrapid monotard group (83.3%, 50/60 vs. 86.7%, 52/60, P ＞ 0.05 ). There was no significant difference in FBG, 2hPBG before treatment between two groups (P ＞ 0.05),but there was significant difference at 2 weeks after treatment between two groups (P ＜ 0.05 ) . There was no significant difference in HbA1c before treatment between two groups (P＞ 0.05 ) ,but there was significant difference at 3 months after treatment between two groups (P ＜ 0.05 ). FBG, 2hPBG, HbA1c after treatment were improved compared with before treatment in two groups (P ＜ 0.05 ). Conclusion Actrapid monotard analog provides better blood glucose control compare with actrapid monotard while providing the convenience of injecting immediately before meals.     

The curative effect of recombinant human interferon α-2b gel on flooding prevention in loop electrosurgical excision procedure

Objective To evaluate the efficacy of recombinant human interferon α-2b gel on flooding prevention in loop electrosurgical excision procedure (LEEP) during and after the operation. Method The 152 patients with cervical disease were randomly divided into three groups: group A (recombinant human interferon α-2b gel treatment group), group B (hypophysin treatment group)and group C(control group). Results The amount of intraoperative bleeding and the amount of post-operative bleeding of the group A was (2.57±1.19) ml and (2.24±1.75) ml, the group B was (3.00±1.49) ml and (45.86± 26.14) hal, the group C was (45.62±39.57) ml and (56.90±41.90) ml, respectively. There was no difference between group A and group B in the amount of intraoperative bleeding (P>0.05), but significantly less than group C (P<0.01). There was no difference between group B and group C in the amount of post-operative bleeding (P>0.05), but significantly much more than group A (P<0.01). Conclusion Recombinant human interferon α-2b gel is effective on reducing intraoperative and post-operative bleeding in LEEP.     

α-硫辛酸联合甲钻胺治疗糖尿病外周神经病变的效果观察

目的评价应用α-硫辛酸联合甲钴胺治疗糖尿病外周神经病变的临床效果。方法选取糖尿病外周神经病变患者90例,按随机数字表法分为两组,每组45例,观察组给予α-硫辛酸联合甲钴胺治疗,对照组给予α-硫辛酸治疗,经过3周的药物治疗后观察患者的临床表现与肌电图情况,并进行分析比较。结果观察组的总有效率显著高于对照组[93．3％（42／45）比55．6％（25／45）],差异有统计学意义（P〈0．05）;观察组患者的腓总神经感觉传导速度治疗后显著高于对照组[（49．5±3．2）m／s比（40．2±2．9）m／s],差异有统计学意义（P〈0．05）;正中神经感觉传导速度,正中神经和腓总神经运动传导速度比较差异无统计学意义（P〉0．05）。在药物治疗期间和治疗后,患者均未出现不良反应。结论利用α-硫辛酸联合甲钻胺治疗糖尿病外周神经病变患者,可有效改善患者的临床症状,具有较好的临床效果。     

盐酸羟考酮控释片联合加巴喷丁治疗糖尿病性神经痛的临床应用

目的 探讨盐酸羟考酮控释片联合加巴喷丁治疗糖尿病性神经痛的疗效和安全性.方法 将80例糖尿病性神经痛患者按照随机数字表法分成两组,每组40例,A组单纯使用盐酸羟考酮控释片治疗,B组联合使用加巴喷丁,观察比较两组疼痛缓解程度、用药量、生活质量及不良反应情况.结果 两组疼痛均明显缓解,B组治疗后21～28 d的疼痛缓解率明显优于A组[95.0%(38/40)比62.5%(25/40)],差异有统计学意义(P＜0.05);B组和A组治疗后28 d的疼痛程度分别为1.2±0.3和2.8±0.5,差异有统计学意义(P＜0.01);B组治疗后28 d,盐酸羟考酮控释片使用剂量低于A组[(32.2±4.3)mg比(40.3±5.5)mg],差异有统计学意义(P＜0.05);B组患者的生活质量评分优于A组,差异有统计学意义(P＜0.05或＜0.01);B组治疗后7、14 d头晕发生率高于A组[35.0%(14/40)比15.0%(6/40)和30.0%(12/40)比10.0%(4/40)],差异有统计学意义(P＜0.05).结论 盐酸羟考酮控释片联合加巴喷丁治疗中重度糖尿病性神经痛疗效确切,安全可行.     

利多卡因及穴位电刺激与曲马多在治疗糖尿病神经痛中的疗效比较

目的评估利多卡因和穴位电刺激对糖尿病性神经性疼痛的疗效,探索其临床应用前景。方法 200例糖尿病患者根据所使用治疗方法随机分为4组:对照组(曲马多200mg/天)、利多卡因组(6mg/kg)、穴位电刺激组和利多卡因与穴位电刺激复合治疗组。观察糖尿病神经病变性疼痛的疗效,包括疼痛评分、神经传导功能及副作用等,综合评价上述治疗方法的疗效。结果利多卡因和穴位电刺激都能明显的缓解糖尿病性神经性疼痛(P<0.05),与曲马多相比无明显差异(P>0.05),并且副作用少。利多卡因可同时改善此类患者神经传导功能。结论利多卡因和穴位电刺激是临床上治疗糖尿病性神经痛的一种安全有效的方法之一。     

丹参川芎嗪注射液联合甲钴胺治疗2型糖尿病周围神经病变的临床分析

目的 观察丹参川芎嗪注射液联合甲钴胺治疗2型糖尿病周围神经病变的临床疗效.方法 112例2型糖尿病周围神经病变患者按随机数字表法分为两组,对照组56例采用甲钴胺治疗,观察组56例在对照组基础上加用丹参川芎嗪注射液治疗,比较两组的临床疗效及腓总神经、胫神经运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)的变化.结果 观察组总有效率为87.5％(49/56),明显高于对照组的57.1％(32/56),差异有统计学意义(P＜0.05).观察组治疗后腓总神经、胫神经MNCV和SNCV分别为(47.89±6.93)、(49.12±5.54) m/s和(43.69±4.97)、(42.35±5.14) m/s,与治疗前比较明显升高(P＜0.05),而对照组分别为(41.15±4.36)、( 39.89±3.67) m/s和(37.57±3.08)、(36.56±2.81) m/s,与治疗前比较差异无统计学意义(P＞0.05).并且,观察组治疗后腓总神经、胫神经MNCV和SNCV均明显高于对照组,差异有统计学意义(P＜0.05).结论 丹参川芎嗪注射液联合甲钴胺治疗2型糖尿病周围神经病变,能够明显提高临床疗效,改善患者的神经功能状态,值得临床推广应用.     

前列地尔联合硫辛酸治疗糖尿病周围神经病变疗效观察

目的：分析糖尿病周围神经病变患者采用硫辛酸与前列地尔联合进行治疗的临床效果。方法：按照随机数字表法抽取本院2010—2012年收治的100例糖尿病周围神经病变患者,分成观察组与对照组,每组50例。对照组在常规治疗基础上采用前列地尔治疗,观察组在常规治疗上采用硫辛酸联合前列地尔进行治疗。比较两组的治疗结果。结果：观察组患者总有效为86％,对照组患者总有效率为60％,两组比较差异有统计学意义（P〈0．05）;治疗后观察组患者感觉神经传导速度（SNCV）、运动神经传导速度（MNCV）等改善情况较为明显,与对照组比较差异均有统计学意义（P〈0．05）。结论：糖尿病周围神经病变患者采用硫辛酸与前列地尔联合进行临床治疗,临床效果确切,值得推广。     

血栓通联用甲钴胺治疗2型糖尿病周围神经病变的临床观察

目的观察联合应用血栓通和甲钴胺治疗2型糖尿病周围神经病变的临床疗效。方法将96例2型糖尿病周围神经病变患者随机分为观察组（48例）和对照组（48例）。血糖达标后对照组给予甲钴胺静滴;观察组给予血栓通联合甲钴胺静滴,疗程均为4周。两组治疗前后的神经传导速度、临床症状改善情况比较。结果观察组的总有效率显著高于对照组（87．5％vs68．8％,P〈0．05）;治疗后两组的神经传导速度均有显著改善,观察组的改善效果优于对照组（P〈0．05）;治疗过程中不良反应较少。结论血栓通联合甲钴胺治疗糖尿病周围神经病变疗效显著,不良反应少,有临床推广意义。     

前列地尔联合甲钴胺治疗糖尿病周围神经病变的疗效观察

目的观察前列地尔联合甲钴胺治疗糖尿病周围神经病变（DPN）的疗效。方法将100例DPN患者随机分成2组,各50例,对照组采用甲钴胺肌内注射,治疗组在对照组用药基础上加用前列地尔静脉滴注,2周后对比2组疗效。结果治疗组改善DPN患者临床症状的总有效率为90%,对照组为64%,差异有统计学意义（P〈0.01）;周围神经传导速度均有明显改善,但治疗组优于对照组（P〈0.05）。结论前列地尔联合甲钴胺治疗DPN可明显提高治疗效果。     

不同剂量甘露醇对高血压性脑出血患者脑血流动力学的影响研究

目的 观察不同剂量甘露醇对高血压性脑出血(HIH)患者脑血流动力学的影响.方法 将60例HIH患者按照随机数字表法分为三组,每组20例.在脑出血常规治疗的同时A组给予20%甘露醇250ml,3～4次/d,连续使用14～21 d;B组给予20%甘露醇125ml,根据病情决定每天给予次数和治疗时间;C组不使用甘露醇.采用经颅多普勒超声仪检测出血侧大脑中动脉M1段的平均血流速度(Vm)和搏动指数(PI),并监测所有患者的肾功能变化.结果 三组治疗后1 d的Vm比较差异无统计学意义(P＞0.05),而治疗后10 d、3周A组和B组Vm分别为(45.01±5.13)、(59.41±7.24)cm/s和(44.61±5.04)、(58.94±7.12)cm/s,均显著高于C组的(42.42±4.26)、(55.06±7.16)cm/s(P＜0.05),但A组和B组比较差异无统计学意义(P＞0.05).PI随治疗时间的延长而逐渐恢复,但治疗后1 d、10d及3周三组PI比较差异均无统计学意义(P＞0.05).治疗后3周,A组肾功能异常率[35.0%(7/20)]显著高于B组[20.0%(4/20)]和C组[15.0%(3/20)](P＜0.05).结论 应用小剂量甘露醇治疗HIH,不仅可以增加脑血流速度,改善脑血流灌注,减轻脑缺血性损伤,而且肾功能损伤小,安全性较高.     

单唾液酸四己糖神经节苷脂联合甲钴胺治疗DPN的临床观察

目的观察单唾液酸神经节苷脂联合甲钴胺治疗2型糖尿病周围神经病变（DPN）的临床疗效。方法选择我院自2012年3月一2012年10月收治的60例糖尿病周围神经病变患者,随机分为试验组、对照组各30例。试验组在给予甲钻铵的基础上,加用单唾液酸神经节苷脂;对照组只给予甲钴铵。共4周。观察临床疗效和神经传导速度,包括感觉神经传导速度（SCV）和运动神经传导速度（MCV）。结果试验组临床疗效（90．0％）明显优于对照组（65．0％）（P〈0．01）;治疗后两组的神经传导速度都较治疗前显著增加（P〈0．05）,而且,与对照组相比,试验组的神经传导速度较治疗前增加更显著（尸〈0．05）。结论单唾液酸神经节苷脂联合甲钴胺治疗2型糖尿病周围神经病变可有效改善患者的神经传导速度,临床疗效满意。     

高压氧治疗不同介入时机和疗程对脑外伤认知功能障碍的影响

目的 探讨高压氧治疗不同介入时机和疗程对脑外伤认知功能障碍患者认知功能的影响.方法 将90例脑外伤认知功能障碍患者按伤后高压氧治疗介入时机不同分为A组、B组和C组,每组30例;分别于伤后7～14d,15～28 d,＞28 d开始高压氧治疗,每天治疗1次,12次为1个疗程,各组在高压氧治疗前和治疗1,2,3个疗程后采用美国RLA认知功能水平分级标准评定表,评定各组患者的认知功能.结果 三组治疗1个疗程后与治疗前RLA分级比较差异无统计学意义（P＞0.05）;三组治疗2,3个疗程后与治疗1个疗程后RLA分级比较差异有统计学意义（P＜0.05）,三组治疗3个疗程后与治疗2个疗程后RLA分级比较差异有统计学意义（P＜0.05）.三组治疗1个疗程后总有效率比较差异无统计学意义（P＞0.05）.A组和B组治疗2,3个疗程后总有效率明显高于C组[73.33％（22/30）和66.67％（20/30）比46.67％（14/30）,93.33％（28/30）和86.67％（26/30）比60.00％（18/30）],差异有统计学意义（P＜0.05）,A组高于B组,但差异无统计学意义（P＞0.05）.结论 高压氧综合治疗能更有效地改善脑外伤认知功能障碍患者的认知功能,在伤后越早开始高压氧治疗效果越好,并且疗程越长疗效越佳.