中西医结合治疗成人原发性肾病综合征50例

[目的]观察采用中西医结合方法治疗原发性肾病综合征的临床疗效。[方法]全部96例病人随机分为中西医组(n=50)和西医组 (n=46)。西医组给予常规治疗,中西组在此基础上应用中药治疗,均用活血化瘀治疗 (血府逐瘀汤加减或血府逐瘀胶囊加减)。[结果]中西医组总有效率为86 9%,西药组总有效率为53 3%,两组比较有显著性差异(P<0.01)。两组均有不同程度的糖皮质激素或/和细胞毒性药物副作用,中西医组副作用发生明显轻于西医组,两组比较有显著性差异(P<0.01)。[结论]采用中西医结合方法治疗成人原发性肾病综合征可以提高疗效,降低副作用发生。     

Chinese Medicine Herbal Treatment Based on Syndrome Differentiation Improves the Overall Survival of Patients with Unresectable Hepatocellular Carcinoma

Objective:To investigate the effects of Chinese medicine(CM) herbal treatment based on syndrome differentiation on patients with unresectable hepatocellular carcinoma(HCC).Methods:A total of 94 patients with unresectable HCC were reviewed between June 2008 and June 2011.Survival analysis was performed between patients who received CM with/without non-curative antitumor treatments of Western medicine(WM)(CM group,30cases) and patients who were not treated with CM but with non-curative antitumor treatments of WM or supportive treatment alone(non-CM group,64 cases).Then,survival analysis was performed between patients treated with CM combined with non-curative antitumor treatments of WM(combination therapy group,25 cases) and patients with non-curative antitumor treatments of WM alone(non-curative antitumor treatments group of WM,52 cases).The survival analysis was performed by Kaplan-Meier method and prognostic factors for overall survival(OS) were assessed by the Cox proportional hazards regression model.Results:The median survival time(MST),1- and 2-year survival rates of the CM group and the non-CM group were 36 months,76.7%,56.1%and 12 months,48.4%,26.6%,respectively.The Log-rank test revealed significant difference between the two groups in OS(P<0.01).Cox proportional multivariate analysis revealed that CM was an independent favorable prognostic factor for OS.The MST,1- and 2-year survival rates of combination therapy group and non-curative antitumor treatments group of WM were 36 months,76.0%,55.5%and 13 months,55.8%,30.8%,respectively.There was significant difference in OS between the two groups(P=0.004).Conclusions:CM herbs based on syndrome differentiation have positive effects on survival of patients with unresectable HCC.Furthermore,combination therapy of CM and WM are recommended in HCC treatment.     

中医药临床试验受试者招募的影响因素分析

[目的]受试者招募是药物临床研究中最困难、最具挑战却必不可少的"限速环节",影响受试者招募的影响因素有很多,包括试验方案、激励措施等,而目前对于中医临床试验受试者招募的资料相对较少。本研究通过问卷调查分析影响中医药临床试验潜在受试者的因素,试图探索中医临床更有效的受试招募手段,为中医药临床受试者招募提供指导。[方法]对于2018年7月-8月,在北京中医药大学3所三甲医院就诊的400例门诊患者进行问卷调查。[结果]多因素结果显示,试验方案中的干预措施种类、中医药的毒副作用大小、激励补偿措施、受试者对实施研究医生的信任程度及医院信誉是影响调查对象是否愿意参加试验的主要因素(P<0.05)。[结论]调查对象对中医药临床试验的认知程度、权利实现以及医患间的信任程度是影响中医药临床受试者招募的主要因素,应通过新媒体等形式向受试者普及相关医学知识、充分保护受试者的权益、增强医生和患者间的沟通等措施对中医药临床试验受试者招募进行完善。     

Classical Chinese Herbal Formulas in the Treatment of Coronary Heart Disease: A Narrative Review

Objective:To summarize the current evidence for 8 frequently prescribed Chinese herbal formulas(CHF)as treatments for angina pectoris in patients with coronary heart disease(CHD)and the associated adverse reactions.Methods:Seven electronic databases were screened from their inception through July 2018 for all evidence related to classical CHF for the treatment of patients with CHD.Results:CHF improves CHD outcomes in terms of angina pectoris,electrocardiogram results,Chinese medicine syndromes and biomarkers iomarkers.The combination of CHF and Western medicine(WM)is more effective on CHD than WM alone.The use of CHF to treat CHD shows the same or better clinical effects as the use of WM alone.The 8 investigated CHF do not induce hepatic and renal toxicity or other serious adverse effects.Conclusions:The safety and efficacy of 8 frequently prescribed herbal formulas for treating CHD have been confirmed in many studies.The findings of these studies are positive but should be interpreted cautiously due to the poor methodological quality of the randomized controlled trials(RCTs)and meta-analyses.Additional high-quality,multi-center,large-sample RCTs should be performed to confirm these results.     

中医辨证施治配合西药治疗渗出期和吸收期传染性非典型肺炎10例临床报告

[目的]观察中西医结合治疗渗出期和吸收期传染性非典型肺炎的临床疗效。[方法]渗出期治以清热宣肺,开闭平喘,解毒化瘀,吸收期治以益气养阴,健脾除湿清热;并辅以西医抗菌、抗病毒、对症支持疗法、镇咳祛痰、保肝及补充人体白蛋白、免疫增强治疗及应用激素甲基强的松龙、吸氧或无创呼吸机辅助治疗等。[结果]10例患者中9例痊愈出院,1例好转。患者完全退热(平均6.0d),患者X光胸片炎症较快吸收,血清ALB及A/G经治疗恢复正常,PO₂、O₂sat较治疗前明显提高(P<0.01),WBC计数恢复正常(平均9.67在d)。[结论]中西医结合治疗渗出期和吸收期“非典”患者有效,值得进一步深入研究。     

Therapeutic Effect of Integrative Traditional Chinese and Western Medicine on 51 SARS Patients and Its Influence on Their TLymphocyte Subsets

Severeacuterespiratorysyndrome(SARS)isanewlyariseninfectiousdiseasewithrespiratorytractasthechiefpathwayoftransmission.Thisisespecial lytrueforSARSpatientsofseveretypeduetoitsse riouscondition,whichresultsinhighmortalityandgreatdifficultiesinitstreatment.InordertoexploretheeffectivewaysintreatmentofSARS,clinicalstudiesontreatmentofSARSbyintegrativeChineseandwesternmedicine(ICWM)havebeencarriedoutbytheauthorsandthepreliminarysummaryisre portedasfollows.METHODSClinicalMaterials　　 T…     

中药熏泡合糖皮质激素外用治疗手足部慢性角化性湿疹32例

目的：观察中药熏洗治疗手足部慢性角化性湿疹的临床疗效。方法：将符合纳入标准的88例手足部慢性湿疹患者随机分为中药组、西药组、中西医结合组。中药组外用自拟中药煎剂熏洗,西药组外用丙酸氯倍他索软膏,中西医结合组采用中药组与西药组两种疗法相结合进行治疗结果：中西医结合组临床总有效率为100．0％,西药组为61．5％,中药组为80．0％。中药组与西药组总有效率比较,差异无统计学意义（P=0．127）;中西医结合组总有效率显著高于西药组（P=0．000）,高于中药组,但差异无显著性（连续校正x^2检验,P=0．026）。结论：中药熏泡配合糖皮质激素外用可显著提高手足部慢性角化性湿疹的临床疗效。     

Cohort Study on the Effect of a Combined Treatment of Traditional Chinese Medicine and Western Medicine on the Relapse and Metastasis of 222 Patients with Stage Ⅱ and Ⅲ Colorectal Cancer after Radical Operation

Objective： To evaluate the effectiveness of a comprehensive therapy of traditional Chinese medicine （TCM） in reducing the relapse and metastasis of stage Ⅱ and Ⅲ colorectal cancer based on conventional Western medicine （WM） therapy. Methods： Two hundred and twenty-two patients in total, diagnosed as stage Ⅱ and Ⅲ colorectal cancer from February 2000 to March 2006, were recruited from Xiyuan Hospital, China Academy of Chinese Medical Sciences and the General Hospital of Beijing Military Area. They were followed-up once every 3-6 months. Twenty cases dropped out from the cohort. The remaining 202 patients were all treated with routine WM treatment [including R0 radical operation, or chemotherapy or/and radiotherapy according to national comprehensive cancer network （NCCN） clinical guidelines]. These patients were assigned to two groups based on whether or not they were additionally treated with TCM comprehensive therapy （orally administered with a decoction according to syndrome differentiation, combined with a traditional patent drug over one year）. Ninety-eight patients from Xiyuan Hospital were treated with WM and TCM （combined group）, and 104 patients from the General Hospital of Beijing Military Area were treated with WM alone （WM group）. The demographic data at baseline were comparable, including the operation times, age, sex, TNM staging, and pathological types. The patients were followed-up for one to five years. Up to now, there are 98, 98, 77, 64, and 47 patients with 1, 2, 3, 4, and 5 years of follow-up in the combined group, respectively; and 104, 104, 97, 81, and 55 patients in the WM group, respectively. The results of the 5-year follow-up of all the patients will be available in 2011. Results： The relapse/metastasis rate of 1-, 2-, 3-, 4-, and 5-year were 0 （0/98）, 2.04% （2/98）, 11.69% （9/77）, 14.06% （9/64）, and 21.28% （10/47） in the combined group, and were 4.80%（5/104）, 16.35% （17/104）, 21.65% （21/97）, 25.93% （21/81）, and 38.     

Clinical Study on Preventing and Treating Left Ventricle Remodeling after Acute Myocardial Infarction with Integrative Chinese and Western Medicine

Objective: To explore the clinical efficacy of Xuefu Zhuyu (血府逐瘀, XFZY) oral liquid combined with western medicine (WM) in reversing left ventricle remodeling (LVR) after acute myocardial infarction (AMI) in patients and its therapeutic mechanism. Methods: Sixty patients conforming to criteria were divided into the treated group and WM control group with randomly stratified method. Thirty cases were assigned to each group, they were given XFZY WM general treatment and WM general treatment respectively. Color Doppler ultrasonography was used to study the changes of LVR before and after treatment.Results: In both groups, before and after treatment the P value of such parameters as the changes of their left diastolic volume (LDV), left systolic volume (LSV), left ventricle ejection fraction (EF) was ＜0. 05, suggesting that the difference of various parameters was significantly different; but when compared with the results of the 12th week after medications, the change of LDV, LSV, EF showed that the LDV, LSV of the treated group were lower than that of the control group, the EF of the treated group was higher than that of the control group, and the P value of various groups was all ＜0. 05, suggesting that the different data of various groups showed significant difference. Conclusion: Conventional WM treatment and XFZY combined with WM could both, in treating AMI, effectively reverse the patients′ LVR; yet the use of integrative Chinese and western medicine on reversing patients LVR showed even better results than that of simple WM treatment.     

MAO Ze-dong's View on Traditional Chinese Medicine and Its Modern Significance

MAO Ze-dong''s view on traditional Chinese medicine (TCM) can be divided into the scientific view on TCM, the development view on TCM and the future view on TCM. The core of MAO Ze-dong''s view on TCM lies in its scientific nature. The basic content of MAO Ze-dong''s development view on TCM includes unity of TCM and Western medicine (WM), advocating the multi-angle development of TCM from the height of Chinese national dignity, independence and self-confidence. MAO Ze-dong''s future view on TCM is targeted at WM learning from TCM, integrating TCM and WM and establishing new Chinese medicine. The contemporary enlightenment of MAO Ze-dong''s view on TCM is to start from reforming the medical education system before establishing new Chinese medicine.     

以脑安滴丸为示范的偏头痛中成药临床适应症状群研究

[目的]研究脑安滴丸治疗偏头痛的临床适应症状群,探讨中成药适应症状群的研究方法。[方法]采用观察性研究的方法,纳入394例患者,治疗4周后,对一般情况、疾病史及全身四诊信息进行评价,应用Logistic回归分析方法,研究脑安滴丸治疗偏头痛的中成药临床适应症状群。[结果]具备以下特征有效性相对较好:偏头痛伴纳差;具备以下特征有效性相对较低:内向型性格、劳累后加重、中午头痛发作、少腹胀满窜痛。[结论]中成药临床适应症状群是以中医病机为内涵,一般情况、中医症状及西医学症状为表现的概念,可以准确判断偏头痛的中成药适应症状群及非症状群,对于中成药的合理使用具有指导意义。     

基于数据挖掘探究中药古方治疗肺癌用药规律

[目的]基于数据挖掘技术探究中药古方治疗肺癌的用药规律。[方法]以中国方剂数据库为检索库,检索治疗肺积或息贲的中药方剂,建立中药古方治疗肺癌方剂数据库,并采用Excel、SPSS 22.0及SPSS Modeler 14.0软件进行频数及频率分析、聚类分析、关联分析,进而对中药古方用药规律进行定量、定性分析。[结果]中药古方治疗肺癌涉及方剂40首,中药110种,高频中药38味,甘草、人参、槟榔、木香等较为常用;温里药、补气药、理气药、止咳平喘药较常选用;核心药物聚类分析结果形成5个类别;经关联规则分析,支持度≥10%,得出药对关联规则21条,3味药配伍关联规则60条。[结论]中药古方治疗肺癌以扶正祛邪为主要治则,多采用温阳益气,滋阴养血结合清热、化痰、止咳、解表、行气活血等方法选取相应中药组方治疗。     

益气活血法治疗冠心病气虚血瘀证的用药规律分析

目的 挖掘益气活血法治疗气虚血瘀型冠心病的频次和特征,为该类患者的治疗提供参考。方法 利用计算机检索中国期刊全文数据库（CNKI）,将符合标准的文献中的数据进行药的频次、主治的统计,并总结用药规律及特征。结果 检索到符合标准的文献48篇,经过统计用药频次前3位的益气药的分别是黄芪、党参、人参。使用频次在前5位的活血化瘀药有丹参、川芎、红花、桃仁、郁金。结论 利用文本挖掘的方法,可以从冠心病气虚血瘀证临床试验文献中探索中医诊疗规律,为临床辨证用药及研究的深入开展提供参考依据。     

中西医结合治疗机械通气伴胃肠功能障碍20例疗效观察

<正>慢性阻塞性肺疾病患者在进行机械通气的治疗过程中,胃肠功能障碍的发生几率高达50%以上[1],且明显增加患者的死亡率。西医治疗多采用在综合治疗的基础上加用多潘立酮等胃肠动力药治疗有一定的疗效。笔者采用中西医结合治疗慢性阻塞性肺疾病伴发机械通气过程中发生胃肠功能障碍患者20例,并与西医综合治疗进行对比,现报道如下。1临床资料1.1一般资料40例均为我科2013年6月—2015     

中西医结合早期干预对SARS肺部炎症的影响

[目的]以X线胸片为主要观察指标,对中西医结合治疗SARS的临床疗效进行客观评价,为SARS临床筛选有效的干预方案提出科学依据。[方法]采用多中心前瞻性队列研究的方法,通过对参加国家863重大项目“中医结合治疗SARS临床研究”的北京地区11家医院361例确诊SARS患者的1561张X线胸片的研究,阐明中西医结合治疗对SARS肺部炎症的影响。[结果]从总体疗效来看,X线胸片总积分西医组平均为5.85±6.5。中西医结合组为6.67±7.61;普通型西医组为4.79±5.6。中西医结合组为5.40±6.86;重型西医组为7.67±6.34,中西医结合组为8.16±7.60,以上两组间比较均未见显著性差异 (P>0.05)。但发病7d内开始干预的胸片总积分西医组平均为6.39±6.48、中西医结合组为4.40±4.97,中西医结合组X线胸片总积分明显低于西医组 (P=0.0004);普通型西医组为4.59±5.22、中西医结合组为3.99±4.67,两组间比较未见显著性差异 (P=0.12);重型西医组为9.14±7.24、中西医结合组为5.30±5.48,组胸片总积分明显低于西医组(P=0.034);说 明发病7 d内对SARS患者进行中西医结合治疗,肺部炎症的吸收明显优于西医组,总体疗效与重型患者的疗效均具有统计学意义。[结论]中西医结合早期干预对SARS肺部炎症吸收的临床疗效具有明显的优势。     

成人不寐患者中医证候临床流行病学预调查

[目的]初步了解临床中成人不寐患者的一般情况、睡眠情况及中医证候特征与规律。[方法]利用研制的成人不寐中医证候临床流行病学调查问卷和匹兹堡睡眠质量指数(PSQI)对2017年8月—2018年2月以不寐为主诉的成人患者进行预调查,用Excel建立数据库,并运用SPSS及Modeler进行统计分析。[结果]共回收有效问卷75份,其中被调查者66.67%为女性,平均(56.20±14.19)岁,以60~79岁年龄的人数最多,61.33%的患者是高中及以上学历,44%的患者是脑力劳动为主者;76%的患者有既往病史,涉及43个疾病。90.67%的患者为慢性不寐,81.33%为入睡困难,92%为混合型不寐,PSQI(15.12±3.22)分。73.33%患者的病因病机是情志失调,37个常见中医症状,30.67%属心脾两虚证。[结论]本次预调查的成人不寐患者以女性、老年人、脑力劳动者为主,文化程度较高,常伴有多种内科疾病;以慢性病程为主,以入睡困难者最多,多为混合型不寐;最主要的病因病机是情志失调,常见中医症状除睡眠相关主症外,常伴随精神情绪及日间功能下降症状,证候类型以心脾两虚最多。     

中医药对原发性肝癌微波消融后生存状态影响的回顾性队列研究

目的 探讨中医药治疗对原发性肝癌微波消融后患者生存状态的影响。方法 以消融时间在2008年1月1日~2010年7月31日间的原发性肝癌微波消融治疗后患者为研究对象,随访中详细记录患者使用中药情况,根据服用中药时间分高暴露、低暴露和无暴露3个队列。结果 总共入组336例,失访31例,纳入统计305例,其中男性253例,女性52例;患者年龄56.24±11.19岁;高暴露队列105例、低暴露队列93例、无暴露队列107例。3组在性别、年龄、病灶数目、病灶大小、最大直径、基础肝病类型、病理分化程度、Child分级等方面差异无统计学意义（P>0.05）。高暴露、低暴露及无暴露组的总的复发、转移率分别为69.2%（74/107）、50.5%（47/93）、61.9%（65/105）,低暴露组的1、2年复发、转移率与无暴露组相比差异有统计学意义（P值分别为0.014、0.009）,高暴露组的1年复发、转移率与无暴露组相比差异有统计学意义（P=0.025）,2年的复发、转移率虽低于无暴露组,但差异无统计学意义（P=0.131）。高暴露组与低暴露组相比,1、2年的复发、转移率均差异无统计学意义（P值分别为0.880、0.306）。3组总的病死率分别为39.3%（42/107）、30.1%（28/93）、28.6%（30/105）。3组的1年生存率均>90%,差异无统计学意义（P>0.05）,高暴露组3年的累计生存率与无暴露组相比差异有统计学意义（P=0.043）。多因素Cox回归分析表明,服用中药为保护因素,低暴露与高暴露的相对危险度分别为0.648、0.693,回归系数分别为-0.434、-0.367。结论 对于微波消融术后的原发性肝癌患者,联合中医药治疗可以减少微波消融治疗后的复发转移,并由此提高3年生存率。     

中西医结合治疗肝郁脾虚型抑郁症30例临床疗效观察

[目的] 观察以疏肝健脾法中药复方快胃舒肝丸结合抗抑郁西药氟西汀治疗肝郁脾虚型抑郁症的临床疗效.[方法] 选择2010年6-12月期间,在天津中医药大学第一附属医院病房及门诊连续就诊的患者60例.按随机数字表法将60例患者分为治疗组、对照组,每组30例.对照组患者服用抗抑郁药物氟西汀胶囊,治疗组患者在对照组治疗基础上加服中药复方快胃舒肝丸,治疗4周后观察临床疗效.[结果] 两组在治疗后2、4周时的汉密尔顿抑郁量表(HAMD)评分、中医证候评分的减分疗效差异有统计学意义,且随着治疗时间的延长,治疗组和对照组的减分疗效均不断提高,并以治疗组的前后变化为明显,两组在治疗后第2、4周时不良反应量表(TESS)评分有显着差异,说明治疗组较对照组不良反应较少,中药可以减轻西药的不良反应.[结论] 治疗组在加用中药复方快胃舒肝丸后,能够更有效的改善肝郁脾虚型抑郁症患者所伴发的消化系统症状,从而能够更好的改善精神症状.     

中药调周法联合针灸治疗排卵障碍性不孕症临床疗效观察

[目的]中药调周法联合针灸治疗排卵障碍性不孕症临床疗效观察。[方法]将符合标准的96例患者按随机数字表法随机分为两组,治疗组48例,采用中药调周法联合针灸疗法治疗;对照组48例采用中药调周法加克罗米芬(CC)治疗,比较治疗后排卵率、基础体温(BBT)复常率、受孕率、中医症状积分、轻度卵巢过度刺激综合征(OHSS)发生率及中医症状积分及各自治疗前后比较。[结果]治疗后的排卵率、BBT复常率比较,无统计学意义(P0.05),治疗后的受孕率、中医症状积分、OHSS发生率比较,差异有统计学意义(P0.05)。[结论]中药配合针灸治疗排卵障碍性不孕症疗效显著,可显著提高受孕率及缓解中医临床症状,降低轻度OHSS发生率,更加安全可靠。     

中医外治法治疗便秘型肠易激综合征的Meta分析及试验序贯分析

[目的]运用循证医学的方法评价中医外治法治疗便秘型肠易激综合征（IBS-C）的临床疗效。[方法]计算机检索Pubmed、Embase、Cochrane library、万方、中国知网（CNKI）、维普（VIP）、中国生物医学数据库（CBM）等中文及英文数据库中所有关于中医外治法治疗便秘型肠易激综合征的随机对照试验,提取资料并运用RevMan 5.3软件进行数据分析。[结果]最终纳入17篇文献,1 246例患者。Meta分析结果提示：中医外治组有效率及治愈率均高于西药对照组[OR=2.76;95% CI：2.01,3.79;P<0.000 01、OR=2.24;95% CI：1.63,3.08;P<0.000 01]且复发率低[OR=0.14;95% CI：0.05,0.39;P=0.000 2];中医外治组总体症状积分较西药组明显下降[MD=1.58;95% CI：1.46,1.69;P<0.000 01],且排便及腹痛的改善也均优于西药组[MD=0.30;95% CI：0.12,0.47;P=0.000 8、MD=0.43;95% CI：0.25,0.61;P<0.000 01];但在粪便性状上,两组疗效无差异[MD=-0.02;95% CI：-0.71,0.67;P=0.96]。试验序贯分析表明,中医外治法治疗肠易激综合征疗效证据确切。[结论]中医外治法治疗IBS-C疗效可能优于常规西药,且安全性较高,不良反应少。但上述结论仍有待更多大样本、多中心、随访时间长的高质量RCT研究加以验证。