四药联合应用治疗环形混合痔术后并发症

目的 观察马应龙麝香痔疮膏、金玄痔科熏洗散、地奥司明片和聚乙二醇4000散联合应用治疗环形混合痔手术后并发症的临床疗效.方法 对解放军第260医院外一科2008年1月-2009年6月收治的90例环形混合痔术后患者采用随机对照的方法均分2组.实验组:术后第1天开始,应用金玄痔科熏洗散55 g加1000 mL沸水冲化先熏后洗,马应龙麝香痔疮膏2.5 g纳肛,每日 2次;聚乙二醇4000散10 g加水200 mL冲服,地奥司明片1.0 g口服,每日2次,2种服用药间隔2 h服用.对照组:应用1:100无菌温盐水坐浴,马应龙麝香痔疮膏2.5 g纳肛,每日2次;酚酞片100 mg口服,每日2次.结果 两组患者肛门疼痛、出血、水肿方面,实验组优于对照组,有显著性差异(P<0.05).愈合时间与对照组相比明显缩短(P<0.01).结论 马应龙麝香痔疮膏、金玄痔科熏洗散、地奥司明片、聚乙二醇4000散联合应用对环形混合痔手术后肛门疼痛、出血、水肿方面有明显改善,明显缩短创面愈合时间.     

四药联合应用治疗环形混合痔术后并发症

目的 观察马应龙麝香痔疮膏、金玄痔科熏洗散、地奥司明片和聚乙二醇4000散联合应用治疗环形混合痔手术后并发症的临床疗效.方法 对解放军第260医院外一科2008年1月-2009年6月收治的90例环形混合痔术后患者采用随机对照的方法均分2组.实验组:术后第1天开始,应用金玄痔科熏洗散55 g加1000 mL沸水冲化先熏后洗,马应龙麝香痔疮膏2.5 g纳肛,每日 2次;聚乙二醇4000散10 g加水200 mL冲服,地奥司明片1.0 g口服,每日2次,2种服用药间隔2 h服用.对照组:应用1:100无菌温盐水坐浴,马应龙麝香痔疮膏2.5 g纳肛,每日2次;酚酞片100 mg口服,每日2次.结果 两组患者肛门疼痛、出血、水肿方面,实验组优于对照组,有显著性差异(P<0.05).愈合时间与对照组相比明显缩短(P<0.01).结论 马应龙麝香痔疮膏、金玄痔科熏洗散、地奥司明片、聚乙二醇4000散联合应用对环形混合痔手术后肛门疼痛、出血、水肿方面有明显改善,明显缩短创面愈合时间.     

新四联法治疗嵌顿痔的临床观察

为探讨金玄痔科熏洗散、地奥司明片、马应龙麝香痔疮膏和麝香痔疮栓联合应用（简称新四联法）治疗嵌顿痔的临床疗效，我科采用新四联法治疗嵌顿痔160例。具体方法为金玄痔科熏洗散55g用1000ml沸水冲开，熏洗坐浴，每次30min，2次／d；口服地奥司明片，前4d每次1．5g，2次／d，其后每次1．Og，2次／d；肛门外涂马应龙麝香痔疮膏2．5g，2次／d；肛内置麝香痔疮栓1枚，2次／d。同时选取采用旧四联法（1：5000高锰酸钾、槐角丸、红霉素软膏、吲哚美辛栓）治疗的100例嵌顿痔患者，进行疗效对比分析。结果显示，治疗后1周、2周治疗组的治愈率和总显敬率均明显高于对照组，P〈0．05。结果表明，新四联法治疗嵌顿痔疗效显著。     

金玄痔科熏洗散熏洗对急性炎性外痔的疗效观察

为观察金玄痔科熏洗散缓解炎性外痔水肿和疼痛症状的效果,将188例炎性外痔患者随机分为治疗组和对照组各94例,治疗组采用金玄痔科熏洗散每日早晚各熏洗1次,外涂马应龙麝香痔疮膏连用7d。对照组采用1：5000PP液坐浴,每天2次,外涂马应龙麝香痔疮膏连用7d。治疗前对所有患者均进行疼痛和病情轻重评估。结果显示,治疗组对炎性外痔的临床治愈率为53．2％,显效率为38．3％,总有效率为91．5％;对照组分别为30．9％、36．2％和67．1％;两组差异有统计学意义（P〈0．01）。肛门疼痛治疗组疗效优于对照组（P〈0．01）。结果表明,金玄痔科熏洗散对炎性外痔患者的肛门疼痛有明显的缓解作用,能改善炎性外痔的症状,疗效明显优于对照组,临床应用也比较安全。     

马应龙四联药物在肛肠疾病中的应用

为了观察马应龙麝香痔疮膏、麝香痔疮栓、金玄痔科熏洗散、地奥司明片（简称马应龙四联药物）在肛肠疾病中的临床疗效,对1580例门诊与住院（术后）肛肠病患者分别进行对比观察,门诊和住院治疗组应用马应龙麝香痔疮膏、马应龙麝香痔疮栓、金玄痔科熏洗散、地奥司明片,门诊和住院对照组用九华膏、醋酸氯己定痔疮栓、温盐水坐浴、槐角丸治疗。门诊组：主要用于痔类疾病,观察应用马应龙四联药物与应用九华膏、醋酸氯己定痔疮栓、温盐水坐浴、槐角丸3d、7d的疗效并进行对比分析。住院组：观察应用马应龙四联药物与九华膏、醋酸氯己定痔疮栓、温盐水坐浴、槐角丸的肛肠病患者术后2d、7d、14d肛门水肿、疼痛、便血、肛门坠胀及术后痊愈时间并进行对比分析。结果显示,门诊治疗组应用马应龙四联药物治疗痔类疾病治愈率和总显效率明显高于门诊对照组。住院治疗组应用马应龙四联药物在降低并发症（水肿、便血、疼痛、坠胀）、促进创面愈合等方面优于住院对照组。结果表明,在肛肠门诊痔类疾病与肛肠病术后应用马应龙四联药物,能明显提高治愈率和总显效率,减少术后肛门水肿、便血、疼痛、坠胀,促进肉芽组织生长,缩短创面愈合的时间。     

地奥司明片联合金玄痔科熏洗散治疗炎性外痔的临床观察

为观察地奥司明片联合金玄痔科熏洗散治疗炎性外痔的临床疗效,我们对150例炎性外痔患者分别采用地奥司明片联合金玄痔科熏洗散（治疗组）、单用地奥司明片（对照Ⅰ组）或金玄痔科熏洗散（对照Ⅱ组）治疗,各50例。治疗后3d、7d,比较三组患者水肿、疼痛改善情况。结果显示,治疗组总显效率明显高于对照Ⅰ组和Ⅱ组,P〈0．01;且治疗后疼痛、水肿评分方面,治疗组明显低于对照Ⅰ组和Ⅱ组,P〈0．05。结果表明,地奥司明片联合金玄痔科熏洗散治疗炎性外痔效果显著,优于单用地奥司明片、金玄痔科熏洗散。     

地奥司明片和金玄痔科熏洗散治疗血栓性外痔83例疗效观察

我科应用地奥司明片口服和金玄痔科熏洗散熏洗坐浴治疗血栓性外痔83例,取得满意疗效,总结报道如下。     

应用金玄痔科熏洗散熏洗换药治疗混合痔术后肛缘水肿、疼痛的疗效观察

目的探讨混合痔术后肛缘水肿、疼痛应用金玄痔科熏洗散熏洗换药的疗效。方法将86例混合痔术后肛缘水肿、疼痛患者分为2组,治疗组46例应用金玄痔科熏洗散外洗肛门,对照组40例应用聚维酮碘溶液外洗肛门。结果治疗组临床治愈率、显效率均高于对照组,2组比较,差异有统计学意义(P0.05)。结论对外痔术后肛缘水肿、疼痛患者应用金玄痔科熏洗散熏洗换药可促进伤口生长愈合,较少出血、水肿,缩短病程,疗效肯定。     

地奥司明片联合马应龙麝香痔疮膏治疗急性痔病的疗效观察

为研究地奥司明片联合马应龙麝香痔疮膏治疗急性痔病的临床疗效,将71例急性痔病患者随机分为3组：A组采用马应龙麝香痔疮膏外用治疗24例;B组采用地奥司明片口服治疗23例;C组采用地奥司明片口服联合马应龙麝香痔疮膏外用治疗24例,均治疗7d,比较临床疗效。结果显示,C组患者肛门水肿、疼痛、瘙痒、便血症状明显减轻,且优于A组和B组。A、B两组总有效率分别为66．7％和60．9％,同C组的79．1％相比,差异均有统计学意义（P〈0．05或〈0．01）。结果表明,地奥司明片联合马应龙麝香痔疮膏治疗急性痔病安全有效,可显著改善其症状。     

地奥司明片联合马应龙麝香痔疮膏防治痔术后肛周水肿的临床观察

肛周水肿是痔术后最常见的并发症之一,不仅加重了创口疼痛,同时也影响了创口的愈合,患者常因此拒绝手术治疗。我科自2007年起随机选取了部分痔术后患者,联合应用地奥司明片和马应龙麝香痔疮膏防治痔术后肛周水肿,效果满意,总结报道如下。     

止痛消肿贴膏抗炎作用研究

以中药牡丹皮的有效成分－牡丹酚为主要原料制成的止痛消肿贴膏，仍保持了牡丹酚抗炎的作用，能够有效地抑制大鼠足跖角菜胶所致急性炎症和大鼠亚急性炎症（肉芽肿）。同阳性对照药巴布剂关节镇痛膏、麝香解痛膏及扶他林乳胶剂相比，具有显著差异性。同时其高剂量组与低剂量组比较，抗炎作用显著提高。说明：止痛消肿贴膏，尤其是高剂量者，是一种较好的抗炎外用药膏，其作用一定程度上，优于上述阳性对照药物。     

三联法治疗慢性功能性便秘的疗效观察

为观察莫沙必利联合聚乙二醇4000散剂和酪酸梭菌活菌片口服（三联法）治疗慢性功能性便秘的f临床疗效,选择120例根据罗马Ⅲ标准确诊的慢性功能性便秘患者进行随机对照研究,分为治疗组和对照组,每组60例。治疗组采用三联疗法,即莫沙必利5rag／次,3次／d,口服;聚乙二醇4000散剂10g／次,2次／d,口服;酪酸梭菌活菌片2片／次,3次／d,口服。对照组单纯口服聚乙二醇4000散剂10g／次,2次／d。两组均以4剧为一疗程。观察两组总疗效及患者腹痛腹胀、排便频率、粪便性状等症状的缓解情况。结果显示．1个疗程后,治疗组总有效率明显高于对照组（93．3％vs76．7％,P〈0．05）;治疗组腹痛腹胀缓解率（P〈0．01）、排便频率及粪便性状改善率（P〈0．05）均明显高于对照组。结果表明,三联法治疗慢性功能性便秘效果优于单纯口服聚乙二醇4000散剂。     

Cefixime concentration in human prostatic tissue following 3-days of administration]

The penetration of Cefixime (CFIX) into the prostatic tissue and the serum was examined in 54 patients with benign prostatic hypertrophy treated with transurethral resection of the prostate. CFIX was administered orally in a dose of 200 mg 2 times daily for 3 days preoperatively. The blood samples were taken at the time of the tissue sampling. The patients were divided into 2 groups. In group 1 (16 patients), the tissue sampling was done about 17 hours after the final drug administration. The mean concentration of CFIX was 0.83 +/- 0.49 micrograms/g in the prostatic tissue and 0.84 +/- 0.63 micrograms/ml in the serum. In the prostatic tissue, CFIX was detected in only 4 patients, in the other 12 patients, CFIX was not detected. In group 2 (38 patients), tissue sampling was done 5.5 hours after the final drug administration. The mean concentration of CFIX was 1.08 +/- 0.47 micrograms/g in the prostatic tissue and 3.18 +/- 1.28 micrograms/ml in the serum.     

Effects of Beraprost Sodium on Subjective Symptoms in Diabetic Patients with Peripheral Arterial Disease

Background

This study evaluated the effects of Beraprost sodium (Berasil) on subjective leg symptoms in patients with peripheral arterial disease caused by diabetes mellitus.

Methods

Ninety-four diabetic patients with peripheral arterial disease were treated with Beraprost in a fixed-dose, prospective, multicenter, cohort study. Beraprost (40 µg) was administered orally 3 times daily (120 µg/day) for 12 weeks. We developed a new disease-specific symptom questionnaire, which evaluated the effect of peripheral arterial disease on leg discomfort in daily life and assessed therapeutic responses to treatment. Patients were asked for their subjective assessment of symptoms on a written questionnaire before treatment and after 12 weeks of therapy.

Results

There was significant improvement in all estimated subjective symptoms (burning, coldness, edema, exertional pain, stabbing, and paresthesias) in the lower extremities at 12 weeks (p < 0.001). There were 18 patients with neuropathy in whom significant improvement was noted for 6 subjective symptoms at 12 weeks (p < 0.05). Adverse events considered to be drug-related were observed in 4 patients (4.3%), all of which were mild and resolved with discontinuation of the medication.

Conclusions

Beraprost is effective as a treatment for improving various subjective symptoms in the lower extremities, such as burning, coldness, edema, exertional pain, stabbing, and paresthesias, in diabetic patients with peripheral arterial disease.     

Effect of Bile Acid Replacement on Endotoxin-induced Tumor Necrosis Factor-a Production in Obstructive Jaundice

There is a high incidence of perioperative morbidity and mortality in patients with obstructive jaundice due to sepsis. Tumor necrosis factor-a (TNF-a) is considered a crucial mediator in inducing and processing the inflammatory cascade. We hypothesize that obstructive jaundice leads to an increased endotoxin-induced TNF-a production and that intestinal bile acid replacement can prevent this phenomenon. Sprague-Dawley rats were randomized to three groups of 12 animals each. Group 1 underwent common bile duct ligation (CBDL) with oral intestinal bile acid (deoxycholic acid 5 mg/100 g body weight/3 times daily) replacement (CBDL + bile acid); group 2 underwent common bile duct ligation with the same amount of normal saline replacement orally (CBDL + saline); and group 3 underwent a sham operation (sham control). After 2 days, endotoxin was given to the animals, and after 90 minutes, tissues (liver and lung) and blood were collected for checking the TNF-a levels and biochemical analyses. Comparisons among these three groups were performed and recorded. While serum and tissue (liver and lung) TNF-a levels of group 2 (CBDL + saline) were significantly increased after endotoxin challenge, these elevations were reduced to control levels (sham control) following oral replacement of intestinal bile acid (CBDL + bile acid). Obstructive jaundice leads to an increased endotoxin-induced TNF-a production and intestinal bile acid replacement can inhibit this phenomenon.     

Dose-dependent onset and cessation of action of inhaled budesonide on exhaled nitric oxide and symptoms in mild asthma

BACKGROUND: Dose dependent anti-inflammatory effects of inhaled corticosteroids in asthma are difficult to demonstrate in clinical practice. The anti-inflammatory effect of low dose inhaled budesonide on non-invasive exhaled markers of inflammation and oxidative stress were assessed in patients with mild asthma. METHODS: 28 patients entered a double blind, placebo controlled, parallel group study and were randomly given either 100 or 400 micro g budesonide or placebo once daily, inhaled from a dry powder inhaler (Turbohaler), for 3 weeks followed by 1 week without treatment. Exhaled nitric oxide (NO), exhaled carbon monoxide (CO), nitrite/nitrate, S-nitrosothiols, and 8-isoprostanes in exhaled breath condensate were measured four times during weeks 1 and 4, and once a week during weeks 2 and 3. RESULTS: A dose-dependent speed of onset and cessation of action of budesonide was seen on exhaled NO and asthma symptoms. Treatment with 400 micro g/day reduced exhaled NO faster (-2.06 (0.37) ppb/day) than 100 micro g/day (-0.51 (0.35) ppb/day; p<0.01). The mean difference between the effect of 100 and 400 micro g budesonide was -1.55 ppb/day (95% CI -2.50 to -0.60). Pretreatment NO levels were positively related to the subsequent speed of reduction during the first 3-5 days of treatment. Faster recovery of exhaled NO was seen after stopping treatment with budesonide 400 micro g/day (1.89 (1.43) ppb/day) than 100 micro g/day (0.49 (0.34) ppb/day, p<0.01). The mean difference between the effect of 100 and 400 micro g budesonide was 1.40 ppb/day (95% CI -0.49 to 2.31). Symptom improvement was dose-dependent, although symptoms returned faster in patients treated with 400 micro g/day. A significant reduction in exhaled nitrite/nitrate and S-nitrosothiols after budesonide treatment was not dose-dependent. There were no significant changes in exhaled CO or 8-isoprostanes in breath condensate. CONCLUSION: Measurement of exhaled NO levels can indicate a dose-dependent onset and cessation of anti-inflammatory action of inhaled corticosteroids in patients with mild asthma.     

白头翁汤加减治疗大肠湿热型溃疡性结肠炎疗效观察

目的:观察我院自拟方白头翁汤加减治疗大肠湿热型溃疡性结肠炎临床疗效。方法:将120例大肠湿热型溃疡性结肠炎患者随机分为治疗组、对照组各60例,两组患者均口服美沙拉嗪肠溶片3次/d,2片/次,治疗组给予我院自拟方白头翁汤加减中药汤剂灌肠,对照组给予康复新液100 mL保留灌肠,两组均以10 d为1疗程,期间间隔2 d进入下一疗程,共治疗2个疗程。结果:治疗组总有效率90.00%,对照组总有效率81.67%,治疗组疗效优于对照组(P0.05),在改善排便次数、便血程度上治疗组优于对照组(P0.05),而对肠道黏膜修复上两组差异无统计学意义(P0.05),治疗组较对照组能有效减少治疗复发率(P0.05)。结论:自拟方白头翁汤加减对大肠湿热型溃疡性结肠炎有较好的治疗效果,值得临床推广。     

Efficacy and safety of keishibukuryogan,a traditional Japanese Kampo medicine,for hot flashes in prostate cancer patients receiving androgen deprivation therapy

BackgroundThe efficacy and safety of keishibukuryogan, a traditional Japanese medicine, were investigated for the treatment of hot flashes in prostate cancer (PC) patients receiving androgen deprivation therapy.MethodsThirty patients were enrolled and orally administered 2.5 g keishibukuryogan three times daily for 12 weeks. The frequency, strength, and duration of hot flashes were self-evaluated by the patients in a diary every 4 weeks. All patients also completed a questionnaire to determine their aging male symptoms (AMS) scale score and underwent blood biochemical testing.ResultsTwenty-five patients completed the 12-week treatment. Hot flash strength significantly improved 4, 8, and 12 weeks after treatment. Their frequency was significantly reduced at the 8-week visit, and duration was significantly shorter after the 8-week visit. In addition, the score of the AMS somatic subscale was improved at the 8- and 12-week visits. Among the somatic items, questions 3 (excessive sweating) and 5 (increased need for sleep) were significantly improved. Obesity, radiation, and a longer duration of PC were predictive factors for treatment response. Prostate specific antigen and total testosterone levels were unchanged, and no patients had severe adverse effects.ConclusionsKeishibukuryogan was an effective and safe treatment for hot flashes in PC patients.