中西医结合治疗女童特发性中枢性性早熟36例临床分析

[目的]比较中西医结合治疗与单纯西医治疗女童特发性性早熟(ICPP)的临床疗效。[方法]选取天津市南开医院儿科内分泌门诊符合ICPP诊断的女童患儿72例,随机分为中西医结合组和西医治疗组。中西医结合组服用中药(滋阴泻火法,以大补阴丸为基础方加减),并辅助促性腺激素释放激素类似物(Gn RHa);西医治疗组采用常规Gn RHa治疗。两组均治疗1.5 a后评估疗效与经济负担,统计两组治疗ICPP的总有效率。[结果]中西医结合组总有效率为77.78%,西医治疗组总有效率为80.56%,两组间疗效差异无统计学意义。但中西医结合组的经济负担明显低于西医治疗组,且不良反应少于西医治疗组。[结论]中西医结合方法治疗女童ICPP在临床疗效上和西医常规治疗相当,且对生长轴抑制作用降低、不良反应少、经济负担更小。     

Clinical study of sudden deafness treated with integrated traditional Chinese and Western medicine

Objective: To explore the mechanisms of integrated traditional Chinese and western medicine (TCM-WM) in treating sudden deafness.Methods: One hundred and forty-six patients suffered from sudden deafness were divided into two groups, 64 cases in the treated group were treated with TCM-WM therapy and the other 82 cases treated with western medicine alone for control.Results: The total effective rate of the treated group was 92.19%, that of the control group was 75.61%. The difference between the two groups was significant,P < 0.01.Conclusion: The TCM-WM therapy is very effective in treating sudden deafness. Its mechanism might be: (1) Decrease of the blood viscosity and increase of the red blood cell’s tenacity, so that the blood stream could pass through unimpededly. (2) Decrease of the plasma TXA₂ level and increase of the PGI₂ level, to benefit the blood supply for inner ear. (3) Increase of the activity of SOD and clearing away the free radicals so as to reduce the damage to the inner ear.     

Clinical study of ectopic pregnancy treated with integrated traditional chinese and western medicine

Ｉｎｒｅｃｅｎｔｙｅａｒｓ,ｔｈｅｉｎｃｉｄｅｎｃｅｏｆｅｃｔｏｐｉｃｐｒｅｇｎａｎ ｃｙ（ＥＰ）ｈａｓｉｎｃｒｅａｓｅｄ．ＥＰｃｏｕｌｄｌｅａｄｔｏｓｅｒｉｏｕｓｃｏｍ ｐｌｉｃａｔｉｏｎｓ,ａｎｄｃｏｎｔｉｎｕｅｓｔｏｂｅａｎｉｍｐｏｒｔａｎｔｃａｕｓｅｏｆｍａｔｅｒｎａｌｄｅａｔｈ．ＤｉａｇｎｏｓｔｉｃａｃｃｕｒａｃｙｆｏｒＥＰｈａｓｂｅｅｎｉｍｐｒｏｖｅｄｂｙｔｈｅｃｏｍｂｉｎｅｄｕｓｅｏｆｓｅｒｕｍ β ｈＣＧ（ｈｕ ｍａｎｃｈｏｒｉｏｎｉｃｇｏｎａｄｏｔｒｏｐｉｎ）ａｓｓａｙｓａｎｄｖａ…     

益气活血解毒法对溃疡性结肠炎血浆血小板活化的临床及实验研究

[目的]探讨益气活血解毒法对溃疡性结肠炎(UC)血浆血小板活化的影响。[方法]分临床研究及动物实验两部分;临床研究以90例溃疡性结肠炎复发患者按随机数字表法随机分为2组,中药治疗组45例,西药对照组45例。治疗3个月后对完全缓解及有效病例(其中治疗组39例,对照组32例)进行为期6个月的随访。治疗组给予益气活血解毒立法的中药汤剂,对照组给予柳氮磺胺吡啶治疗,并各与20例作正常对照。动物实验用三硝基苯磺酸(TNBS)复制实验性大鼠UC模型,将其随机分为模型组、西药对照组、中药治疗组,并设正常对照组。进行反映血小板活化程度的特异性标志物P-选择素的检测。[结果]临床研究中,治疗前UC患者血浆P-选择素水平明显高于正常健康人(P<0.01);治疗组治疗后及随访时含量明显低于西药对照组(P<0.05或P<0.01)。动物实验中,在治疗10 d时,两治疗组皆可降低血浆P-选择素水平,西药组水平明显低于中药组(P<0.05);治疗30 d时中药组与西药组相比无显著差异(P>0.05);停药10 d时,中药组明显低于西药组(P<0.05)。[结论]以益气活血解毒立法的中药溃结复发方与西药比较,可有效降低血浆P-选择素水平,从而阻抑血小板活化,可能是抗溃结复发作用机制之一。     

青紫合剂联合常规西医治疗过敏性紫癜的疗效分析

目的 观察青紫合剂联合常规西医治疗过敏性紫癜（HSP）的疗效。方法 选取2017年3月—2019年2月榆林市中医医院收治的140例HSP患儿。采用随机数字表法分为治疗组和对照组,每组70例。对照组予以常规西医治疗,治疗组在对照组基础上加用青紫合剂,两组均连续治疗14 d。观察两组临床疗效、各临床症状消失时间,以及治疗前后测定HSP患儿血常规、凝血功能、C反应蛋白（CRP）、红细胞沉降率（ESR）及免疫功能等,记录不良反应发生情况。结果 治疗组患儿治疗后总有效率高于对照组（88.57% VS 77.14%）（P <0.05）;而皮疹消退时间、腹痛消失时间、消化道症状缓解时间及关节症状缓解时间短于对照组（P <0.05）。治疗组患儿治疗后ESR、免疫球蛋白A、免疫球蛋白G、白细胞计数、血小板、D-二聚体及CRP均低于对照组（P <0.05）。结论 青紫合剂联合西医治疗HSP患儿疗效确切,能够有效改善患儿临床症状及实验室指标。     

骨蚀汤加减联合塞来昔布胶囊治疗非创伤性股骨头坏死的临床疗效观察

目的 探讨骨蚀汤加减联合塞来昔布胶囊治疗非创伤性股骨头坏死的临床疗效。方法 选取2015年3月—2018年3月在深圳市宝安中医院（集团）治疗的非创伤性股骨头坏死患者120例,按就诊顺序分为对照组和观察组,每组60例。对照组采用西医常规结合塞来昔布胶囊治疗,观察组在对照组基础上联合骨蚀汤加减治疗,均连续治疗6个月,随访12个月。比较两组患者的Harris评分、健康调查简表（SF-36）评分、影像学评分,关节疼痛采用视觉模拟评分法（VAS）;比较两组患者的总有效率、复发率及不良反应总发生率。结果 研究期间对照组患者脱落4例,观察组患者脱落2例。观察组治疗后的Harris评分、SF-36评分及影像学评分高于对照组（P <0.05）;观察组治疗后关节疼痛VAS评分低于对照组（P <0.05）。观察组总有效率为94.83%,高于对照组的78.57%（P <0.05）;随访12个月观察组的复发率为8.62%,低于对照组的23.21%（P <0.05）。观察组不良反应发生率为10.34%,低于对照组的32.14%（P <0.05）。结论 骨蚀汤加减联合塞来昔布胶囊治疗非创伤性股骨头坏死临床疗效更优,复发率更低,更有利于减轻服药后带来的不良反应,值得临床推广应用。     

Intratubal Methotrexate Injection Combined with Chinese Herbal Medicine for Tubal Pregnancy and Following Pregnancy Prognosis

Objective: To compare the effects of treatment of tubal pregnancy (TP)and its following second pregnancy by intratubal methotrexate injection(IMI) alone and combination of IMI with Chinese herbal medicine. Methods: Thirty-five patients suffering from unruptured TP were divided into two groups at random, to the 19 patients in the treated group, the treatment of combined IMI with Ectopic Pregnancy decoction No. 2 (EP2, a traditional Chinese medical decoction) was applied, and to the other 16 patients in the control group, IMI alone was applied for control. Serum concentrations of human chorionic gonadotro-pinβ(β-HCG), size of the gestational sac, existent time of fetal cardiac beat and peritoneal fluid were measured before and after treatment. And hysterosalpingography were performed 6 months after ending the treatment to verify the presence of tubal obstruction and the condition of relapse.Results: The treatment of all the 35 women was successful. The recovery duration of serumβ-HCG, disappearance dur     

活血解毒法治疗慢性支气管炎60例临床观察

[目的]探讨活血解毒法治疗慢性支气管炎的临床疗效和机制。[方法]对照组按常规西医治疗,治疗组在对照组基础上加用活血解毒法方药。均连续用药4周,用药前后分别记录患者症状,进行血液流变学、肺通气功能检测,并随访6个月。[结果]对照组显效率为40.5%,总有效率为67.1%;治疗组显效率为53.3%,总有效率为91.4%,两组总有效率相比有显著性差异。治疗组在降低血黏度及改善肺通气功能方面亦均优于对照组,有显著性差异(P<0.05)。[结论]活血解毒法治疗慢性支气管炎可明显提高其综合疗效。     

Effect of buyang huanwu decoction on plasma thromboxane b2, 6-keto-prostaglandin f1α, endothelin and calcitonin gene related peptide in primary nephrotic syndrome patients

Objective: To explore the mechanism of Buyang Huanwu Decoction (BYHWD) in treating primary nephrotic syndrome (PNS).Methods: Based on the treatment of prednisone acetate and cytoxan, two groups of PNS patients were treated with aspirin and persantin (western medicine group, WM, 35 patients) and BYHWD plus WM (TCM-WM group, 35 patients) respectively. The effect on anticoagulation was observed and compared. Plasma levels of thromboxane B₂ (TXB₂ ), 6-keto-prostaglandin F_1α (6-K-PGF_1α), endothelin (ET), calcitonin gene related peptide (CGRP) were determined before and after treatment, at the reducing dose and shifting to maintenance dose of prednisone. The therapeutic effect of the two groups were also observed. Another group of 30 healthy subjects was established for control.Results: The differences of TXB₂, 6-K-PGF_1α, ET and CGRP between patients and healthy subjects were very significant before treatment (P < 0. 001). The above-mentioned 4 parameters improved synchronously with the clinical improvement in the therapeutic course and they were better in the TCM-WM group than those in the WM group (P < 0.001 ), and the complete remission rate of the former group was also higher than that of the latter (62.9 % vs 37.1 %, χ² = 4.63, P < 0.05).Conclusion: BHD could improve the therapeutic effect in treating PNS through the mechanism of improving TXB₂, 6-K-PGF_1α, ET and CGRP levels.     

Clinical study of drugresistant pulmonary tuberculosis treated by combination of anti-tuberculosis chemicals and Compound Astragalus Capsule

Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB).Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared.Results: In the treated group, the sputum bacterial negative conversion rate was 84.8%, focal absorption effective rate 91.3%, cavity closing rate 58.7% and 10-day symptom improving rate 54.4%, while in the control group, the corresponding rates were 65.2%, 73.9%, 37.0% and 26.1%, respectively. Comparison between the groups showed significant difference in all the parameters (P<0.05,P<0.05,P<0.05 andP<0.01). The incidence of adverse reaction and 2-year bacteriological recurrence rate in the treated group were 23.9% and 2.6% respectively, while those in the control group 50.0% and 16.7%, which were higher than the former group with significant difference (P<0.01 andP<0.05, respectively).Conclusion: The therapeutic effect of combined treatment with anti-TB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice.     

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…     

Fifty- four infantile intractable diarrhea patients treated with integrated traditional chinese and western medicine

Ｉｎｆａｎｔｉｌｅｉｎｔｒａｃｔａｂｌｅｄｉａｒｒｈｅａ（ＩＩＤ）ｗａｓｕｓｕａｌｌｙｃｏｍｐｌｉｃａｔｅｄｗｉｔｈｍａｌｎｕｔｒｉｔｉｏｎ,ｇｒｏｗｔｈｒｅｔａｒｄａｔｉｏｎａｎｄｐｕｌｍｏｎａｒｙｉｎｆｅｃｔｉｏｎ,ｅｔｃ．Ｉｔｉｓｄｉｆｆｉｃｕｌｔｔｏｃｕｒｅ,ａｎｄｍｏｒｔａｌｉｔｙｉｓｒａｔｈｅｒｈｉｇｈ．ＴｈｅａｕｔｈｏｒｓｕｓｅｄｉｎｔｅｇｒａｔｅｄｔｒａｄｉｔｉｏｎａｌＣｈｉ ｎｅｓｅａｎｄｗｅｓｔｅｒｎｍｅｄｉｃｉｎｅｔｈｅｒａｐｙｔｏｔｒｅａｔｉｔ,ａｎｄｓａｔｉｓｆａｃｔｏ…     

穴位埋线对变应性鼻炎患者疗效及生活质量影响的临床研究

目的: 观察穴位埋线治疗变应性鼻炎﹙Allergic rhinitis,AR﹚的临床疗效及对患者生活质量的影响。方法: 将90 例AR患者随机分为埋线组﹙45例﹚与西药组﹙45例﹚。埋线组采用埋线治疗,西药组口服西替利嗪。两组均治疗2月,并于治疗前、后及治疗结束后6月随访,观察AR疗效及鼻结膜炎生活质量量表评分(RQLQ);并观察AR患者治疗前、后血清IgE水平。结果: 治疗中,埋线组脱落5例,西药组脱落6例。治疗后埋线组有效率为62.5％,西药组为 87.2％,西药组有效率优于埋线组﹙P﹤0.05﹚;治疗后6月随访时埋线组有效率为92.5％,西药组为59％,埋线组的远期疗效优于西药组﹙P﹤0.01﹚;RQLQ评分方面,两组患者治疗后及治疗后6月随访时各项评分均较治疗前改善﹙P﹤0.05﹚;但随访时埋线组在睡眠、鼻部症状、情感方面改善优于西药组﹙P﹤0.05﹚;两组患者治疗后血清IgE水平均较治疗前降低﹙P﹤0.05﹚,但组间比较无明显差异﹙P﹥0.05﹚。结论:穴位埋线能有效治疗AR,较西医药物有更好的远期疗效,能更好地提高AR患者的生活质量。     

Evaluation of the clinical efficacy of Qingqiao Capsule in treating patients with secretory otitis media

Objective: To observe the clinical efficacy of Qingqiao Capsule (QQC) in treating patients with secretory otitis media (SOM).Methods: A total of 90 patients were randomly assigned into the treated group (n = 45) and the control group (n = 45). Patients in the treated group were administrated with QQC, 5 capsules each time, 3 times a day for totally 10–14 days, and those in the control group were given per os cefaclor capsules 0.5g each time for adult, 3 times a day, or 20mg/(kg.d) for children, for 10–14 days. The therapeutic efficacy of treatment on the patients was observed and compared after treatment and followed up for 3–6 months.Results: (1) The clinical efficacy in the treated group was superior to that in the control group with significant statistical difference (P< 0.01); (2) Comparison of the efficacies in patients of three different TCM syndrome types (the external pathogenic wind invasion caused auditory orifice stuffiness type, the Gan-Dan damp-heat steaming up auditory orifice type and the Pi-deficiency dysfunction induced dirty dampness blocking ear type) showed no statistically significant difference(P> 0. 05); (3) The vanishing rate and time needed of the main symptoms and signs in the treated group were superior to those in the control group on ear muffle, tinnitus, hearing impairment, hydrotypanum, pure tone threshold and abnormal tongue figure, and the difference was statistically significant (P< 0.05 or P< 0.01), only those of earache, otopiesis and abnornal pulse figure were insignificantly different between the two groups (P> 0.05).Conclusion: QQC is an effective Chinese composite medicine on patients with SOM, and shows no obvious adverse reaction.     

Clinical study on treatment of incipient diabetic nephropathy by integrated traditional Chinese and Western medicine

Ｄｉａｂｅｔｉｃｎｅｐｈｒｏｐａｔｈｙ（ＤＮ）ｉｓｏｎｅｏｆｔｈｅｃｈｉｅｆｃｈｒｏｎｉｃｃｏｍｐｌｉｃａｔｉｏｎｓｏｆｄｉａｂｅｔｅｓｍｅｌｌｉｔｕｓ（ＤＭ）．Ｉｔｉｓｎａｍｅｄａｓｉｎｃｉｐｉｅｎｔｄｉａｂｅｔｉｃｎｅ ｐｈｒｏｐａｔｈｙｗｈｅｎｔｈｅａｌｂｕｍｉｎｅｘｃｒｅｔｉｏｎｒａｔｅ（ＡＥＲ）ｉｓｂｅｔｗｅｅｎ 30 - 30 0ｍｇ 2 4ｈｒｓｕｒｉａａｎｄｄｉａｇｎｏｓｅｄａｓｍｉｃｒｏａｌｂｕｍｉｎｕｒｉａ（1）,ｔｈｅｐｒｏ ｇｒｅｓｓｉｏｎｏｆｄｉｓｅａｓｅｍｉｇｈｔｂｅｒｅｔａｒｄｅｄ…     

天津中医学院五年制医学生临床实践能力培养模式的调研分析*

随着新世纪的到来,为了提高全民素质和适应社会发展的需要,各高等院校先后对教学过程中的前期理论教学进行了大幅度改革,天津中医学院亦已实行了新的课程体系,初步实现了立体、多维的授课方式,取得了一定成绩.     

成人原发性肾病综合征中西医结合治疗探讨

目的 :探讨成人原发性肾病综合征 (PNS)中西医结合治疗的方法及效果。方法 :将 64例PNS病人随机分为两组。西医组 3 2例 ,主要用激素治疗 ;中西医结合组 3 2例 ,在西医治疗基础上加用中药治疗。结果 :中西医结合组总有效率 87 5 % ,显著高于西医组的 5 6 3 % (P <0 0 5 )。中西医结合组不良反应发生率及复发率分别为 15 6%和 2 1 9% ,明显低于西医组的 5 9 4%和 5 6 3 % (P <0 0 1)。结论 :中西医结合治疗PNS在增加疗效、减少不良反应及降低复发率方面均明显优于单纯西医组     

信迪利单抗、贝伐珠单抗联合肝动脉化疗栓塞术在中晚期肝癌患者中的临床应用

目的 探究信迪利单抗、贝伐珠单抗联合肝动脉化疗栓塞术(TACE)治疗中晚期肝癌患者的临床疗效。方法 选取2018年12月—2019年12月庆阳市中医医院收治的中晚期肝癌患者84例,采用随机数字表法分为研究组和对照组,每组42例。所有受试者接受TACE治疗,对照组采用贝伐珠单抗治疗,研究组在对照组基础上联合信迪利单抗治疗。治疗3个月后,评估两组临床疗效、肿瘤标志物[甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)]、免疫指标[CD3⁺、CD4⁺/CD8⁺、自然杀伤细胞(NK)]及药物不良反应。随访3年,记录患者无进展生存期(PFS)和总生存期(OS)。结果 研究组客观缓解率为83.33%,高于对照组的61.90%(P <0.05)。研究组、对照组疾病控制率分别为92.86%和85.71%,差异无统计学意义(P>0.05)。研究组治疗前后AFP、CEA、CA199、CD3⁺、CD4⁺/CD8⁺、NK的差值均高于对照组(P <...     

Clinical study on therapy of clearing hallow viscera in treating critical patients with gastro-enteric function disorder

Gastro entericfunctiondisorder(GEFD)isoneoftheoftenencounteredill nessofdigestivesystemincriticalpatients,andalsoanexpressioninthedigestivetractofmultipleorgandysfunctionsyndrome(MODS).TopreventandtreatGEFDef fectivelyisakeypointinprohibitingtheoc currenceanddevelopmentofMODSandinreducingitsfatalityrate.Researcheshaveshowedthattherapyofclearinghallowvis cera(CHV)intreatingGEFDcouldpro motethemovementofstomachandintes tine,inhibittheabsorptionofendotoxinandeliminatetheinflammatoryreact…     

肾衰方治疗90例脾肾气虚湿浊内蕴证CKD4期患者的临床观察

[目的] 观察肾衰方联合包醛氧淀粉胶囊及缬沙坦片对慢性肾脏病（CKD）4期患者残余肾功能及生活质量的干预作用。[方法] 选择2020年10月—2021年9月天津中医药大学第一附属医院收治的90例CKD4期患者,根据随机数字表法随机分为对照组（45例）和中药组（45例）。对照组予包醛氧淀粉胶囊及缬沙坦片治疗,中药组予肾衰方联合包醛氧淀粉胶囊及缬沙坦片治疗,连续服用3个月。观测治疗前后2组临床疗效、血清肌酐（Scr）、尿素氮（BUN）、肾小球滤过率（GFR）、24 h尿蛋白定量、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）的变化、症状积分以及不良反应生率。[结果] 治疗3个月后,中药组总有效率为82.2%,对照组总有效率为62.2%,中药组临床疗效优于对照组（P<0.05）;症状积分、Scr、BUN、24 h尿蛋白定量水平均较治疗前降低,且中药组优于对照组（P<0.05）;GFR较治疗前上升,且中药组优于对照组（P<0.05）;治疗前后ALT、AST无明显变化（P>0.05）,且均在正常范围之内;中药组及对照组治疗前后未见明显不良反应。[结论] 肾衰方联合西药治疗能够更好地保护CKD4期患者残余肾功能,一定程度上提高患者生活质量,延缓进入终末期肾病的时间,提高临床疗效。