中药配合综合干预对高血压病的防治效果研究

目的：观察中药配合综合干预对高血压病的防治作用。方法：回顾分析2013年10~12月于我院就诊的病历资料完整的高血压病患者120例,依据入院先后分为观察组与对照组,观察组患者在常规治疗的基础上加用菊明颗粒配合综合干预治疗,对照组只采用常规治疗;两组患者均治疗8周,并每3个月随访1次,共随访1年,评价菊明颗粒配合综合干预对高血压病的防治作用及对患者生活的影响。结果：两组患者干预治疗后收缩压（SBP）、舒张压（DBP）均较干预治疗前显著下降,干预治疗前后比较差异有统计学意义（P〈0.05）;观察组干预治疗后SBP、DBP下降较对照组更为显著,组间比较差异有统计学意义（P〈0.05）;观察组患者治疗总有效率显著高于对照组（P〈0.05）;两组患者治疗后中医证候积分均较治疗前显著下降（P〈0.05）,观察组干预治疗后中医证候积分下降较对照组更为显著（P〈0.05）;观察组患者生理职能（role-physieal,Rp）、情感职能（role-Emotional,RE）、躯体疼痛（bodily Paln,Bp）与治疗前比较显著提高（P〈0.05）;对照组患者干预后RE较治疗前显著提高（P〈0.05）;两组患者治疗后各维度均无统计学差异（P〉0.05）。结论：中药配合综合干预可有效控制患者血压,改善患者中医证候积分及生活质量,效果显著。     

扫散法合点揉法治疗阴虚阳亢型原发性高血压伴失眠疗效分析

目的 :探讨扫散法结合穴位点揉法对阴虚阳亢型原发性高血压伴失眠的疗效。方法 :符合纳入标准的患者70例,按数字随机抽取法分为对照组和治疗组各35例。对照组常规服用降压药物治疗,治疗组在常规治疗基础上增加头部胆经扫散法结合穴位点揉法,比较两组治疗后血压、生活质量、睡眠质量和中医证候的改变。结果:两组治疗后收缩压、舒张压、健康生活调查简表(SF-36)、匹兹堡睡眠质量指数(PSQI)、中医证候积分较治疗前均改善,差异有统计学意义(P0.05);治疗组收缩压、舒张压、SF-36、PSQI、中医证候积分改善程度较对照组明显,差异有统计学意义(P0.05)。血压疗效对照组显效14例,有效21例,治疗组显效25例,有效10例;中医证候疗效对照组显效13例,有效20例,无效2例,治疗组显效24例,有效11例,两组疗效比较,治疗组优于对照组(P0.05)。结论:扫散法和点揉法可有效治疗阴虚阳亢型高血压伴失眠患者,显著改善其中医证候、睡眠质量和生活质量,能较好地控制血压。     

中医体质辨识结合饮食调护对高血压患者中医证候及血压控制的影响

目的 探讨中医体质辨识结合饮食调护在高血压患者中的应用效果。方法 选取2019年12月—2021年12月就诊于山东大学齐鲁医院的86例高血压患者,按随机数字表法分为2组,各43例。对照组给予常规干预,观察组采用中医体质辨识结合饮食调护,持续干预6个月,对比2组中医证候积分、血压水平及生活质量。结果 干预前2组中医证候积分、血压水平、生活质量比较,无统计学差异（P>0.05）;干预后观察组中医证候积分、收缩压、舒张压低于对照组,生活质量综合评定问卷（GQOLI-74）中的心理维度评分、躯体维度评分、社会功能评分、物质生活评分均高于对照组,有统计学差异（P<0.05）。结论 中医体质辨识结合饮食调护能够显著降低高血压患者血压水平,改善中医证候及生活质量。     

天麻钩藤饮配合降压西药治疗高血压病的临床对照研究

[目的]观察天麻钩藤饮配合降压西药治疗高血压病的临床疗效及对生活质量的影响。[方法]将324例高血压病患者随机分成三组,中西药组108例予降压西药加天麻钩藤饮治疗,中药组108例予单纯天麻钩藤饮治疗,西药组108例予单纯降压西药治疗。4周后评价各组降压疗效、中医证候积分、生活质量评分。[结果]三组治疗后血压均有所下降,中西药组与西药组降压疗效均优于中药组(P0.05),但在改善患者的证候积分及证候疗效方面,中西药组与中药组均优于西药组(P0.01或P0.05);各组治疗后生活质量均较治疗前改善(P0.01),尤其在体力精力、躯体不适、情感控制方面中西药组改善较西药组、中药组明显(P0.05)。[结论]天麻钩藤饮配合降压西药治疗高血压病可增强降压效果,并能减少西药毒副作用、改善患者症状和提高生活质量。     

天麻钩藤饮联合穴位贴敷治疗1级高血压及对生活质量影响

目的 :探讨天麻钩藤饮联合穴位贴敷治疗1级高血压及其对生活质量的影响。方法 :选取2016年11月—2018年4月我院收治的1级高血压患者240例,采用随机数字表法分为对照组和治疗组,各120例。其中对照组予以宣传教育、限盐饮食及运动处方进行治疗;治疗组在对照组的基础上予以天麻钩藤饮联合穴位贴敷的治疗方案,两组患者均治疗2周。比较两组患者临床疗效、治疗前后不同时段血压改善情况、中医证候积分及生活质量。结果 :治疗组患者临床总有效率为96.67%,对照组患者临床总有效率为68.33%,差异具有统计学意义(P0.05);与对照组相比,治疗组患者治疗后1周、2周的收缩压及舒张压改善更显著(P0.05);经治疗,与对照组相比,治疗组患者中医证候积分改善更显著(P0.05);治疗后,治疗组患者生活质量较对照组患者改善明显,差异具有统计学意义(P0.05)。结论 :天麻钩藤饮联合穴位贴敷治疗1级高血压取得较好的临床疗效,起到平肝熄风、清热活血、补益肝肾之功效,同时还可提高患者生活质量,促进恢复速度,值得临床推广应用。     

太冲穴穴位埋线配合降压药治疗高血压病的疗效观察及护理

目的：太冲穴穴位埋线配合降压药治疗高血压病的疗效。方法：随机将124例患者分为观察及对照组各一半。对照组口服苯磺酸氨氯地平片;观察组在降压药治疗基础上,在太冲穴等穴位同时进行埋线,比较2组治疗前后动态血压情况、中医证候积分及疗效。结果：观察组与对照组均能有效降低24h平均收缩压、24h平均舒张压。2组证候疗效经Ridit分析,治疗组总有效率高于对照组。结论：太冲穴穴位埋线配合降压药治疗高血压病虽然效果与西医一致,但对各项临床不适症状能减轻或去除,并适时提供中医护理,从而提高患者的生活质量。     

“上下同治”法治疗肝火上炎型眩晕(高血压病)的临床研究

目的探讨耳穴贴压联合穴位贴敷治疗肝火上炎型眩晕(高血压病)的疗效和安全性,为其防治高血压病提供更多的科学依据,以便对中医适宜技术进行更好地推广。方法将高血压病患者120例随机分为试验组和对照组各60例,两组患者均给予缬沙坦胶囊,试验组在缬沙坦胶囊治疗基础上,给予耳穴贴压联合穴位贴敷治疗。治疗4周后观察两组患者临床症状、证候积分、血压水平及安全指标的变化情况。结果两组患者治疗后临床症状、证候积分、血压水平均较治疗前明显改善,差异有统计学意义(P0.05,P0.01),且试验组优于对照组(P0.01)。结论耳穴贴压联合穴位贴敷可有效改善高血压病患者临床症状、证候积分、血压水平,临床疗效确切,操作方便,安全无不良反应,可作为临床上高血压病的有效治疗方法,适合临床推广。     

加减二仙汤治疗阴虚阳亢型围绝经期高血压病的临床观察

目的:观察加减二仙汤治疗阴虚阳亢型围绝经期高血压病妇女的临床疗效。方法:将48例围绝经期高血压病患者随机分为治疗组(n=25)和对照组(n=23),对照组给予福辛普利钠片口服,治疗组在对照组基础上给予加减二仙汤口服,疗程为4周。观察并比较两组患者的中医证候积分及血压,检测患者的血管紧张素Ⅱ(AngⅡ)、雌二醇(E2)、卵泡刺激素(FSH)及黄体生成素(LH)的水平。结果:治疗后,治疗组患者的中医证候积分显著降低(P0.05),且两组患者治疗前后积分差值比较差异有统计学意义(P0.05);两组患者的收缩压与舒张压均显著下降(P0.05),且治疗组患者的收缩压较对照组降低更加明显(P0.05);治疗组患者的E2水平显著升高(P0.05),且两组患者的AngⅡ、E2、LH治疗前后差值比较差异均有统计学意义(P0.05)。结论:加减二仙汤治疗围绝经期高血压病具有协同降压作用,同时能够改善患者的雌激素水平及中医证候。     

疏风止嗽汤治疗慢性咳嗽的临床疗效

目的 探讨疏风止嗽汤治疗慢性咳嗽的临床疗效。 方法 选择2020年1—12月在乌兰察布市中医蒙医医院治疗的慢性咳嗽患者60例为研究对象,随机分为观察组与对照组,每组各30例。观察组采用疏风止嗽汤治疗,对照组采用孟鲁司特钠联合右美沙芬愈创甘油醚糖浆治疗。比较两组治疗前后中医证候积分、LCQ-MC评分,比较两组临床疗效、不良反应及复发率。 结果 治疗后两组中医证候积分均较治疗前显著下降,差异有统计学意义(P＜0.001);治疗后观察组中医证候积分显著低于对照组,差异有统计学意义(P＜0.001)。观察组总有效率为93.3%,对照组总有效率为83.3%,差异无统计学意义(P＞0.05);但观察组痊愈、显效率更高,秩和检验结果显示,差异有统计学意义(P＜0.05)。治疗后两组LCQ-MC评分均显著较治疗前升高,差异有统计学意义(P＜0.001);治疗后,观察组LCQ-MC评分显著高于对照组,差异有统计学意义(P＜0.001)。观察组不良反应总发生率低于对照组,差异有统计学意义(P＜0.05);观察组无复发情况,对照组有4例复发,差异有统计学意义(P＜0.05)。 结论 疏风止嗽汤治疗慢性咳嗽具有较好的临床疗效,并且不良发应少,复发率低,可显著改善患者的生活质量。     

高血压的社区护理干预效果分析

目的 探讨社区干预以提高高血压患者的治疗依从性.方法 高血压患者200例随机分为干预组100例、对照组100例.观察两组高血压患者护理干预前后血压和治疗依从性的变化.结果 干预组的治疗依从性优于对照组(P＜0.05);干预组24h、白天和夜间血压、血压负荷均低于对照组(P＜0.05).结论 社区护理干预对于控制高血压、提高高血压患者的生活质量是有效的.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.