儿泻暖脐膏治疗婴幼儿急性腹泻的临床研究

为了观察中药治疗婴幼儿急性腹泻的临床效果，应用儿泻暖脐膏敷脐配合西药常规疗法（简称治疗Ⅰ组）治疗婴幼儿急性腹泻，并与十香暖脐膏敷脐配合西药常规疗法（简称治疗Ⅱ组）及西药常规疗法（简称对照组）对照。结果治疗Ⅰ组102例，治愈61例（59．8％），显效24例（23．5％），有效11例（10．8％），无效6例（5．9％），显效率83．3％，总有效率94．1％；治疗Ⅱ组54例，治愈25例（46．3％），显效15例（27．8％），有效11例（20．4％），无效3例（5．6％），显效率74．1％，总有效率94．4％；对照组55例，治愈22例（40．0％），显效12例（21．8％），有效9例（16．4％），无效12例（21．8％），显效率61．8％，总有效率78．2％。治疗Ⅰ组的治愈率、显效率和总有效率均高于对照组（P＜0．05或P＜0．01）；治疗Ⅱ组总有效率显著高于对照组（P＜0．05）。提示儿泻暖脐膏敷脐配合西药常规疗法能提高临床疗效。     

冷积丸治疗五更泻69例

目的观察冷积丸对五更泻的临床治疗效果．方法69例病例均符合《中医病证诊断疗效标准》的泄泻之肾阳亏虚型诊断标准，应用冷积丸（主要由白芷30g，白术20g，白芍20g，桔梗15g，肉蔻10g，丁香15g，巴豆5g，硫黄5g等中药组成）进行治疗，其中男43例，女6例；年龄在20岁～57岁之间，平均40岁；病程1a～23a；均为我院消化科门诊患者．1mo为1个疗程，最短1个疗程，最长6个疗程，平均3．6个疗程．结果按《中医病证诊断疗效标准》的泄泻疗效评定标准，治愈16例，占23．2％；好转48例，占71％；未愈4例（均为30岁～35岁患者），占5．8％；有效率为94．2％．结论冷积丸对五更泻标本兼治，临床效果显著．     

儿泻暖脐膏治疗婴幼儿急性腹泻的临床研究

为了观察中药治疗婴幼儿急性腹泻的临床效果，应用儿泻暖脐膏敷脐配合西药常规疗法（简称治疗１组）治疗婴幼儿急性腹泻，并与十香暖脐膏敷脐配合西药常规疗法（简称治疗Ⅱ组）及西药常规疗法（简称对照组）对照。结果治疗Ｉ组１０２例，治愈６１例（５９．８％），显效２４例（２３．５％），有效１１例（１０．８％），无效６例（５．９％），显效率８３．３％，总有效率９４．１％；治疗Ⅱ组５４例，治愈２５例（４６．３％），显     

秋泻合剂治疗小儿秋季腹泻68例

[目的]观察秋泻合剂治疗小儿秋季腹泻（秋泻）的临床疗效，并探讨其作用机制。[方法]将136例秋泻患儿随机分2组，治疗组采用秋泻合剂治疗，对照组采用病毒唑治疗，观察用药3d后的临床疗效及治疗前后CD3、CD4、CD8变化。[结果]治疗组显效率为75．0％，对照组为51．5％（P〈0．05）；治疗组止吐、退热以及恢复食欲的时间明显短于对照组（P〈0．05）；轮状病毒3d转阴率治疗组为69．12％，对照组为45．59％（P〈0．05）；治疗组显著升高秋泻患儿CD3、CD4细胞百分率及CD4／CD8比值，两组比较差异有统计学意义（P〈0．05）。[结论]秋泻合剂治疗小儿秋泻，具有显著缩短病程、改善症状、词节免疫功能的作用。     

利胆通腑法治疗胆系疾病202例

目的 观察利胆通腑法治疗胆系疾病的疗效。方法 以利胆通腑法组方辩证加减为主治疗。结果 痊愈138例，占70％；显效32例，占15％；有效30例，占13％；无效3例，占1％；死亡2例，占1％；总有效率98％。结论 利胆通腑法为主治疗胆系疾病具有显著疗效。     

肠宁胶囊治疗肾阳虚型泄泻的实验研究及临床观察

本文对中药复方制剂肠宁胶囊治疗脾肾阳虚型泄泻进行了主要药效学、急性毒性、慢性毒性实验。实验结果表明：肠宁胶囊能对抗寒药大黄的致泻作用，减少泄泻的稀粪点数；能降低小肠推进率，减慢小肠对炭乳的排空速度，并具有显著的镇痛作用，还能增强小鼠的体质，具有显著的耐寒能力。该药无毒、无副作用。并采用双育法进行临床观察，结果表明：肠宁胶囊治疗脾肾阳虚型泄泻的总有效率为９２．３％。药理实验结果与临床疗效相符。     

生长抑素治疗肝硬化食管静脉曲张破裂大出血临床观察

本院应用生长抑素(瑞士Serono公司产品，商品名施他宁)治疗肝硬化食管静脉曲张破裂大出血24例，止血有效18例，占75％，出血未控制6例，占25％。止血起效时间6～18小时，出血停止8～48小时．未发现不良副反应。临床显示．施他宁具有高效、安全、方便的特点，是目前治疗肝硬化食管静脉曲张破裂大出血比较理想的药物。     

自拟清眩通脉饮合舒血宁治疗椎-基底动脉供血不足的疗效观察

目的 观察自拟清眩通脉饮合舒血宁治疗椎-基底动脉供血不足（VBI）的临床疗效。方法 将49例VBI病人随机分为清眩通脉饮合舒血宁为治疗组（30例）和舒血宁对照组（19倒）。治疗组口服清眩通脉饮，每日1剂，舒血宁注射液10mL加入5％葡萄糖液中静脉输注，每日1次；对照组仪予舒血宁注射液，用法同治疗组，两组疗程均为2周。结果 清眩通脉饮舍舒血宁对VBI的总有效率迭100％，高于舒血宁注射液的74％。结论 自拟清眩通脉饮合舒血宁注射液可提高VBI的临床疗效。     

奇经疗法治疗心绞痛60例临床观察

目的探讨奇经疗法对心绞痛的疗效。方法按随机的原则分为治疗组与对照组，治疗组按奇经疗法的要求进行点按弹拨、梅花磁针及增效垫贴敷治疗，对照组口服长效硝酸甘油片。结果治疗组60例，痊愈40例，占66．67％；有效12例，占20．00％；无效8例，占13．33％，总有效率86．67％。对照组15例，痊愈8例，占53．33％；有效3例，占20．00％；无效4例，占26．67％，总有效率73．33％。两组差异无显著性。结论奇经疗法对心绞痛有较好的治疗效果，可以减低心肌耗氧量，增加心肌血供。     

葛兰心宁软胶囊治疗冠心病心绞痛的有效性和安全性

目的：探讨葛兰心宁软胶囊治疗冠心病心绞痛的有效性和安全性。方法选取2013年1月—2014年1月我院收治的冠心病心绞痛患者124例，将其随机分为对照组和观察组，各62例。在常规治疗的基础上，对照组患者给予复方丹参注射液治疗，观察组患者给予葛兰心宁软胶囊治疗，比较两组患者心绞痛症状和心电图改善情况及不良反应发生情况。结果观察组患者心绞痛症状改善总有效率为91.9％，高于对照组的83.9％；心电图改善总有效率为95.2％，高于对照组的85.5％（ P＜0.05）；两组均未出现严重不良反应。结论葛兰心宁软胶囊治疗冠心病心绞痛疗效确切，可有效改善心绞痛症状及心电图表现，且安全性较好。     

Antimicrobial use in children under five years with diarrhea in a central region province, Thailand

This cross-sectional study aimed to estimate the prevalence of appropriate antimicrobial prescribing for treating childhood diarrhea within the public hospital system in a central region province, Thailand. Reported are findings of a prospective clinical audit of 424 cases treated by 38 physicians. Appropriate use of antimicrobials was defined as prescribing antimicrobials for managing an invasive bacterial-type, bloody diarrhea or not prescribing antimicrobials for managing a watery-type or non-bloody diarrhea. Among 424 cases with diarrhea, 12.5% were invasive bacterial-type. Of the 66 diarrheal episodes in which stool samples were cultured, 7 stool specimens were positive, two with Shigella sonnei, two with Vibrio cholerae Ogawa and three with E. coli. Based on the presence of mucus and blood in stools, 27.4% of 424 cases received appropriate antimicrobial drugs. Cotrimoxazole was the most commonly prescribed drug (51%), followed by colistin sulfate (15.3%), norfloxacin (11%), and nalidixic acid (0.5%). The average number of antimicrobials per case of inpatients was higher than outpatients (1.15 vs 0.84, p < 0.001). There was a trend toward prescribing norfloxacin in childhood diarrhea. The Ministry of Public Health should continue providing effective interventions aimed at improving physicians' knowledge of diarrhea treatment. Similar efforts should be directed toward improving caretakers' knowledge about home care for childhood diarrhea and encouraging widespread correct use of oral rehydration therapy (ORT) in the community. Hopefully, such activities will help reduce the inappropriate use of antimicrobial agents in treating diarrheal disease.     

固本益肠片治疗慢性结肠炎91例疗效观察

经纤维结肠镜及病理确诊的１３７例慢性结肠炎，以固本益肠片及补脾益肠丸对比治疗，４０天为１疗程。固本益肠片组９１例，治愈５８例（６３．７４），显效２５例（２７．４７），好转６例（６．６０），无效２例（２．１９），疗效优于对照组（Ｐ＜０．０１）。固本益肠片有明显的止痛止泻、健脾补肾作用。     

整肠生治疗急性腹泻的双盲对照临床观察

本文报告整肠生与氟哌酸随机双盲法治疗308例急性腹泻,其中急性肠炎292例,急性菌痢16例。急性肠炎中194例用整肠生治疗,显效率59％,有效率29.5％;对照组98例服用氟哌酸,其显效率和有效率分别为64％和29％。16例急性菌痢中7例用整肠生治疗均获显效,9例用氟哌酸者,7例显效,2例有效;11例获粪便培养阳性者治疗后全部转阴。其结果表明整肠生治疗急性肠炎及菌痢的疗效与氟哌酸相似且无明显副作用。     

Diarrheal disease among HIV-infected adults in Karnataka, India: evaluation of risk factors and etiology

The objectives of this study were to evaluate characteristics associated with diarrhea, the effect of trimethoprim-sulfamethoxazole (TMP/SMX) prophylaxis on diarrhea, the response to treatment with ciprofloxacin and tinidazole (Cipro-TZ), and presence of enteric pathogens. Adults infected with human immunodeficiency virus with and without diarrhea served as cases and controls, respectively. Participants provided a medical history and underwent a physical examination. Blood was collected for CD4 cell counts and stool for culture. Cases were treated with Cipro-TZ. Factors associated with a risk of diarrhea included crowded living and no toilet (all P < 0.05). Protective variables (P < 0.05) included a CD4 count greater than 200 cells/mm(3) and TMP/SMX prophylaxis. Cases were more likely to have a pathogen identified (P = 0.05). Eighty-six percent of the cases responded to treatment. Important risk factors for diarrhea were identified. Protection by TMP/SMX reinforces the importance of prophylaxis. These data suggest that treatment with an antibiotic and anti-parasitic medication may be effective.     

吉非替尼-线治疗晚期肺腺癌的临床观察

目的 探讨吉非替尼-线治疗晚期肺腺癌的疗效及不良反应.方法 选择住院及门诊确诊肺腺癌Ⅲb或Ⅳ期17例,每天一次口服吉非替尼250 mg,直至出现PD为止,根据WHO标准评价其疗效及毒性不良反应.结果 17例中1例达到完全缓解(CR),8例部分缓解(PR),3例病情稳定(SD),5例病情进展(PD),总有效率为52.9％,疾病控制率(PR+ CR+ SD)为70.6％.结论 吉非替尼对于晚期非小细胞肺腺癌具有较好的疗效和耐受性.     

Post-Cholecystectomy Diarrhea: Evidence of Bile Acid Malabsorption Assessed by SeHCAT Test

Although bile acid malabsorption (BAM) in post-cholecystectomy diarrhea (PCD) is a well-known clinical condition, its true etiopathogenetic role is not entirely clear. The SeHCAT (23-selena-25-homotaurocholic acid) test, a simple and reliable BAM test, was performed in 33 cholecystectomized patients, 26 with chronic diarrhea. The test revealed a marked degree of BAM in 25/26 cases. Cholestyramine in doses of 2-12 g/day was effective in 23/25, ineffective in two, and was not tolerated in one patient. When treatment was suspended, diarrhea recurred in nine, whereas bowel habit remained regular in 60%, with brief sporadic episodes of diarrhea in the other cases. The SeHCAT test was repeated in 11 cases after cholestyramine treatment interruption, and revealed the normalization of parameters in two patients and an improvement in three. We conclude that BAM is an important etiopathogenetic factor in PCD that responds favorably to cholestyramine. In 60% of the cases, it resolved diarrhea definitively, although without eliminating BAM in all cases: this suggests that existence of other factors associated with BAM. The SeHCAT test is essential for a differential diagnosis between PCD and the irritable bowel syndrome.     

健运冲剂治疗小儿脾虚泄泻的临床研究

将100例脾虚泄泻患儿双盲随机分两组，健运冲剂组（治疗组）60例，参苓白术散组（对照组）40例、结果治疗组及对照组总有效率分别为91．7％、77．5％，痊愈率分别为60．0％、32．5％（分别P＜0．05，0．01）。健运冲剂能促进患儿消化吸收功能，改善患儿贫血状况及低蛋白血症。     

Seasonal variation in etiology of travelers' diarrhea. Finnish-Moroccan Study Group.

The etiology of travelers' diarrhea was studied in 579 adult Finnish tourists participating in two packaged tours to Morocco in the winter (n = 233) and fall (n = 346) of 1989. A research team accompanied the travelers, and a laboratory for enteric pathogens was established in Agadir. At least one pathogen was found in 62% of the 60 diarrhea cases in winter and in 58% of the 111 diarrhea cases in fall. Multiple pathogens were found less often in winter (8%) than in fall (21%, P less than .05). Campylobacter strains were the leading cause of travelers' diarrhea in winter, found alone or with other pathogens in 28% of the cases (but in only 7% in fall), whereas enterotoxigenic Escherichia coli (ETEC) was the most common pathogen in fall, present in 32% of the cases (8% in winter). Both differences are highly significant (P less than .001). Salmonella enterica was almost as common as ETEC in fall (25% of diarrhea cases) but rare in winter (10%, P less than .05). Thus, the etiology of travelers' diarrhea varied according to the season in the same tourist destination. This finding has relevance to both antimicrobial treatment and prophylaxis.     

Ordinary and opportunistic enteropathogens associated with diarrhea in Senegalese adults in relation to human immunodeficiency virus serostatus.

OBJECTIVES: A survey was conducted in Dakar, Senegal, to identify major types and prevalences of bacteria, parasites, fungi, and Rotaviruses associated with diarrhea in relation to human immunodeficiency virus (HIV) serostatus with the goal to provide guidance to physicians for case management. METHODS: Etiologic agents were identified in a case control study: cases were HIV-infected patients with diarrhea (HIV+ D+) and HIV seronegative patients with diarrhea (HIV D+); controls were HIV-infected patients without diarrhea (HIV+ D ) and seronegative controls without diarrhea (HID D ). Ordinary enteric pathogens were identified by conventional methods. Different Escherichia coli pathotypes were characterized by polymerase chain reaction (PCR), identification of HEp-2 cell adherence pattern, Sereny test, GM1-ELISA, and the suckling mouse assay. Opportunistic parasites, such as Cryptosporidium and Microsporidium, were identified by the Kinyoun method and trichromic stain of Weber, respectively. Rotaviruses were identified with a commercial latex agglutination kit. Antimicrobial susceptibility testing was carried out by the disk diffusion method. RESULTS: Among the 594 patients examined, 158 were HIV+ D+, 121 were HIV2 D+, 160 were HIV+ D , and 155 were HIV D . The main etiologies of diarrhea were different according to HIV serostatus of patients. In immunocompetent adults the main causes of diarrhea were Shigella sp (12.4%), Entamoeba histolytica(10.7%), Salmonella enterica (6.6%), and Giardia (4.9%). In the immunocompromised host the more frequent pathogens were enteroaggregative E. coli (19.6%), Microsporidium (9.4%), Cryptosporidium sp (8.2%), Rotavirus (8.2%), Shigella sp (7.6%), Candida albicans (7.6%), E. histolytica (5.1%), S. enterica (4.4%), and Isospora belli (4.4%). Also, Blastocystis hominis has to be considered as an opportunistic parasite, because it was identified only in HIV-infected patients, with higher prevalence in adults with diarrhea (2.5% in HIV+ D+ patients; 0.6% in HIV+ D patients). High level of asymptomatic carriage of Ascaris lumbricoides and Trichuris trichiura and some cases of multiple infections were observed. Fungi, Cryptosporidium sp and Microsporidium sp, were often identified in patients with low CD4 counts (range, 79 250 cells/mL). Independently from HIV-serostatus, CD4 count was lower in diarrheic persons, suggesting that diarrhea is a debilitating illness and that effective management of diarrhea can prevent immunosuppression. Isolated enteropathogenic strains displayed high resistance to most antibiotics used in Senegal for treating diarrhea (ampicillin, tetracycline, cotrimoxazole); they were susceptible to amikacin, gentamicin, and norfloxacin. CONCLUSION: These epidemiologic data suggest that guidelines for the management of diarrhea during HIV infection in Dakar should be updated.     

艾滋病15例临床分析

目的　提高对艾滋病 (AIDS)的认识 ,为AIDS及时诊断提供基础资料。方法　分析经免疫印迹检测证实的 15例AIDS病人的临床资料。结果　本组病人 80 0 %经性接触感染 ;73 3 %以呼吸道感染起病 ,表现为持续发热、慢性咳嗽 ,严重者气急紫绀 ;2 6 7%以长程腹泻起病。可伴有体重进行性下降 (80 0 % )。病人从起病至确诊的时间较长。多为多种病原体混合性感染 ,单纯针对细菌治疗疗效常不理想 ,酌情采用综合治疗有66 7%的病人好转。结论　加强对AIDS的警惕性 ,对反复发热、慢性咳嗽、长程腹泻的病人应尽早行抗 HIV检查 ;尽早诊断、综合治疗是病情稳定之关键