中西医疗法在慢性盆腔炎临床治疗中的效果观察

目的：了解中西医结合疗法在慢性盆腔炎治疗中的效果。方法对2013年7月~2014年7月接诊的86例慢性盆腔炎患者给与分组治疗观察。对照组43例接受常规西医治疗,实验组43例在对照组的基础上搭配中医治疗,比较观察两组患者的康复效果。结果实验组痊愈15例、显效20例、有效7例、无效1例,有效率为97.6%;对照组痊愈11例、显效16例、有效13例、无效3例,有效率为93.0%。结论中西医结合治疗慢性盆腔炎效果出色,具有临床推广价值。     

慢性便秘的生物反馈训练与护理

目的　旨在探讨生物反馈训练与护理在治疗慢性便秘中的作用。方法　使用瑞典CTD Synectics公司提供的PcPolygrafID多功能消化道压力检测仪 ,对 2 3例慢性便秘患者 ,进行肌电图及压力指导下生物反馈训练 ,训练前教会患者识别自己的异常和正常肌电信号 ,再有针对性的进行自我训练 ,并配合便秘的健康教育和心理护理 ,再每周训练 3～ 4次 ,每次 30～ 6 0分钟 ,每个疗程做 10～ 2 0次 ,同时在家中进行同步练习。结果　 2 3例病人在完成生物反馈训练后 ,依据上述症状评分 ,治愈者 11例 ;有效 7例 ;总有效率78 2 % ;无效 5例 (2 1 8% )。便秘均…     

中西医结合治疗慢性鼻窦炎164例疗效观察

目的 探讨中西医结合治疗慢性鼻窦炎的临床疗效.方法 对164例单纯性慢性鼻窦炎患者采用中西医结合的方法治疗,阿奇霉素口服、局部应用减充血剂和糖皮质激素、鼻窦置换治疗、上颌窭穿刺冲洗,同时配以中药方剂清热解毒、通窍排脓.结果 痊愈66例(40.2%),显效42例,(25.6%),有效37例,(22.6%),无效19例,(11.6%).总有效率88.4%.结论 中西医结合治疗慢性鼻窦炎具有较好的临床应用价值.     

慢性宫颈炎的临床护理心得

目的对慢性宫颈炎患者接受临床护理的具体效果进行观察研究。方法选取我院2011年6月~2012年6月收治的60例慢性宫颈炎患者，经过相关的临床诊治后，在治疗中与治疗后阶段均对患者进行临床护理。结果60例患者在接受及时的临床护理之后，痊愈56(93.33%)例，有效3例(5%)，无效1例(1.67%)。结论慢性宫颈炎患者在临床诊治过程中通过接受临床护理措施，能够进一步地提高该病症的临床治愈率，护理方法安全可靠，高效快捷，能有效缓解患者痛苦，值得在临床诊治工作中推广应用。     

复方毛冬青治疗急性呼吸道病毒感染临床观察

目的观察复方毛冬青对急性呼吸道病毒感染的疗效.方法随机将符合标准的病例组分为治疗组(52例)和对照组(42例),治疗组用复笔毛冬青,对照组不用任何抗病毒药,其他治疗方法相同.结果治疗组痊愈31例(59.6%),显效13例(25%),有效4例(7.7%),无效3例(5.8%),总有效率为84.6%;对照组痊愈7例(16.7%),显效9例(21.4%),有效17例(40.5%),无效9例(21.4%),总有效率为38.1%.各组治疗3d后症状、体征总评分较治疗前有显著下降.治疗3d与5d临床总评分两组间有显著差异.结论早期使用复方毛冬青具有较好的抗病毒作用.     

盆底生物反馈电刺激治疗女性轻中度压力性尿失禁的疗效观察

目的探讨盆底生物反馈电刺激治疗对女性轻、中度压力性尿失禁的临床疗效。方法选择2012年3月~2013年5月大连市妇幼保健院诊治的120例轻、中度压力性尿失禁患者,年龄33~77岁。将患者分2组,每组60例。60例接受盆底生物反馈电刺激治疗的患者作为治疗组,60例仅作常规盆底肌肉锻炼的患者作为对照组。记录治疗组患者治疗前后盆底肌的肌电变化客观指标,进行对比分析。结果治疗组症状缓解明显,痊愈率为48.3%,显效率为46.7%,无效率为5.0%,总有效率95.0%。对照组治疗效果较差,痊愈率为10.0%,显效率为26.7%,无效率为63.3%,总有效率36.7%;治疗组有效率明显高于对照组,差异有统计学意义(P0.05)。治疗组患者接受治疗后,盆底肌2s快速收缩表面肌电图(sEMG)最大值、盆底肌持续10 s收缩sEMG平均值、盆底肌肉60 s耐受收缩sEMG平均值均较治疗前有明显提高,差异有统计学意义(P0.05)。结论盆底生物反馈电刺激治疗是安全、有效的治疗女性轻、中度压力性尿失禁的方法。     

2.141 功能性便秘及盆底肌功能紊乱的动力学特点及生物反馈治疗

目的本研究是对功能性便秘及盆底肌功能紊乱患者进行肛管动力学检查, 了解其动力特点及肌电改变,探索非药物治疗肛直肠动力异常所致排便困难的临床疗效. 方法 1.对象32例功能性便秘及盆底肌功能紊乱患者,其中男性15例、女性17例,平均年龄46.7岁,均有持续1年以上排便困难或排便不畅,所有患者经电子肠镜或钡灌肠检查排外直肠肛门器质性疾病.盆底肌功能紊乱为便秘和/或盆底肌电图描记出现腹前斜肌与盆底肌矛盾运动.正常对照组20例,女10例,男10例,平均年龄44.2岁,近两年内无消化道及神经系统症状体征.2.方法所有患者行不透X线标志物胃肠道通过时间(G ITT)测定及肛肠测压,最后选择生物反馈治疗.使用美国天柱公司生产的Orion PC/12mEMG 生物反馈治疗仪.治疗仪包括柱状肛管内肌电感受器、3个腹前斜肌体表电极和一台与之相连的生物反馈治疗机.纵行插入肛管电极与腹前斜肌体表电极构成电流回路,进行直肠电和盆底肌电(EMG)描记分析,评估肌电活动,最后在肌电图指导下,选择生物反馈课程,指导患者训练.生物反馈治疗疗程1月,每周2～3次.结果 1. 24h GITT结果所有患者24h钡条排出率20.2%.其中出口梗阻型 17例(17/32,53.1,15.6%),慢通过型5例(5/32,15.6%),混合型10例(10/32,31.3%) .2.健康对照组和便秘组肛肠测压结果见下表.3.直肠电和盆底肌电(EMG)评估32例患者不论为出口梗阻型或慢通过型、混合型便秘均出现腹前斜肌-盆底肌的矛盾运动,且两者收缩幅度明显降低.其中15例患者(15/32,46.8%)腹前斜肌收缩幅度明显降低(＜50mmHg ).4.生物反馈治疗后临床症状改善情况32例患者生物反馈治疗1疗程后,显效21例、有效10例,1例老年男性(慢通过型患者)无效,总有效率96.9%.治疗后便秘患者每周自主完全排便次数由治疗前的0.8±3次/周提高到3.8±1.1次/周(P＜0.01).32例患者中有10例随访1年,其中8例患者每周排便次数恢复正常,2例半年后复发,每周排便次数减少至1～2次,经一疗程生物反馈治疗后随访至今一年余无复发.5.生物反馈治疗后EMG评估 全部患者治疗后盆底肌与腹前斜肌矛盾运动消失,且运动幅值增加＞50mmHg.表健康组和便秘组肛肠测压参数结论功能性便秘及盆底肌功能紊乱患者存在肛门直肠动力异常,盆底肌电评估有腹前斜肌-盆底肌的矛盾运动,生物反馈治疗后矛盾运动消失,每周排便次数见增加 .     

呼吸功能训练在吸入性损伤患者护理中的应用及效果观察

目的观察呼吸功能训练在吸入性损伤患者护理中的应用及临床效果。方法选取烧伤面积小于全身体表面积的50%,并发吸入性损伤的患者60例,根据治疗措施随机分为呼吸功能训练组(30例)和对照组(30例)。两组患者均接受常规治疗,呼吸功能训练组进行缩唇呼吸、腹式呼吸和有效咳嗽排痰训练,对两组患者治疗后的肺功能改善情况和气管套管拔管时间进行比较。结果呼吸功能训练组拔管时间明显提前,最大通气量、潮气量和肺活量明显高于对照组(P<0.05),肺部感染的发生率低于对照组。结论吸入性损伤患者进行呼吸功能训练可缩短气管套管的留置时间,改善肺功能及降低并发症的发生。     

美托洛尔治疗慢性阻塞性肺病合并心血管疾病的疗效观察

目的观察美托洛尔治疗慢性阻塞性肺病合并心血管疾病的疗效。方法将我院112例慢性阻塞性肺病合并心血管疾病患者随机分为两组,分别是对照组与观察组,每组56例。对照组采用氨茶碱、沙丁胺醇治疗。观察组采用氨茶碱、沙丁胺醇治疗的同时加用美托洛尔治疗。结果对照组（氨茶碱、沙丁胺醇治疗）中痊愈16例,显效12例,有效22例,无效3例,总有效率89.28％,观察组（氨茶碱、沙丁胺醇、美托洛尔治疗）中痊愈18例,显效12例,有效22例,无效2例,总有效率96.43％。两组相比较具有临床效果差异（P<0.01）。结论美托洛尔治疗慢性阻塞性肺病合并心血管疾病具有更好的疗效。     

分析清肝降压胶囊联合硝苯地平缓释片治疗老年性高血压的临床疗效

目的探讨清肝降压胶囊联合硝苯地平缓释片治疗老年性高血压的疗效。方法选取于2011年3月~2013年3月在我院接受治疗的老年性高血压患者90例,随机平均分为三组,每组30例,分别口服清肝降压胶囊、硝苯地平缓释片、清肝降压胶囊联合硝苯地平缓释片,比较治疗前后患者的血压情况。结果清肝降压胶囊联合硝苯地平缓释片组的治疗效果更加明显,显效患者23例(76.6%),有效患者5例(16.7%),无效患者2例(6.7%),总有效率93.3%;硝苯地平缓释片组次之,显效患者15例(50.0%),有效患者11例(36.7%),无效患者4例(13.3%),总有效率86.7%;清肝降压胶囊组治疗效果欠佳,显效患者8例(26.7%),有效患者13例(43.3%),无效患者9例(30.0%),总有效率70.0%。治疗前三组血压无明显差异(P>0.05),治疗后均有所降低,且清肝降压胶囊联合硝苯地平缓释片组效果更明显(P<0.05)。结论清肝降压胶囊联合硝苯地平缓释片治疗老年性高血压的效果显著,不良反应少,安全性高,明显优于单纯清肝降压胶囊和硝苯地平缓释片。     

Treatment of chronic urticaria with a beta2-adrenergic stimulant

Twenty-four patients with chronic urticaria resistant to conventional therapy were treated orally with terbutaline, a specific β₂ stimulant. This therapy was much more effective than antihistamines. At the dose of 1.25 mg three times a day, there were few side effects. The efficacy was independent of the IgE levels; it seemed greater in idiopathic cases than in cholinergic or pressure induced urticaria.     

胎儿生长受限治疗效果影响因素分析

目的分析影响胎儿生长受限治疗效果的因素。方法统计1998年至2006年治疗185例B超结合临床诊断为胎儿生长受限的病例,治愈率为83.24%。分析31例治疗失败的病例,与154例治愈病例在孕妇年龄,合并症,治疗起始时间及胎儿性别等方面进行比较,并进行统计学分析。结果治疗晚于32周,有妊娠合并症及并发症者,治疗效果明显降低,女性胎儿FGR发生率高,但治愈率也高于男性胎儿FGR,孕妇年龄不影响疗效。结论有妊娠合并症及并发症者,应加强胎儿生长受限的监测及筛查,早期干预,以改善围生儿预后。     

慢性荨麻疹患者幽门螺杆菌检测的意义

目的：研究慢性荨麻疹与幽门螺杆菌（Helicobacter pylori ,HP）感染的相关性,探讨HP检测在慢性荨麻疹患者诊疗中的意义。方法：选取2014年4月至2015年7月门诊治疗的慢性荨麻疹患者420例,并随机选取同期体检中心健康体检者450例为健康对照组,采用胶体金法检测患者及健康体检者血清HP尿素酶抗体,分析慢性荨麻疹组和健康对照组两组HP的阳性情况;同时将162例慢性荨麻疹HP阳性患者分为实验组88例和对照组74例,对照组患者应用常规荨麻疹治疗,实验组患者在对照组治疗基础上增加抗HP三联疗法,分析HP检测阳性的慢性荨麻疹患者采用不同治疗方法的临床疗效。结果：慢性荨麻疹组HP阳性率为38.6%,健康对照组HP阳性率为14.4%,差异有统计学意义（P<0.05）;HP检测阳性患者实验组临床疗效有效率显著高于对照组的有效率,差异有统计学意义（P<0.05）。结论：慢性荨麻疹与HP感染之间存在密切的相关性, HP检测对慢性荨麻疹患者的诊疗具有重要的临床意义。     

The thyroid and urticaria

PURPOSE OF REVIEW: Although it is generally accepted that thyroid autoimmunity is more prevalent in patients with chronic urticaria than in the general population, the importance of this finding is unclear. In addition, there are reports that chronic urticaria remits in some but not all patients who have evidence of thyroid autoimmunity and are treated with l-thyroxine. This review will summarize the history of this controversy and suggest a possible role for thyroid autoimmunity in the pathophysiology of chronic urticaria. RECENT FINDINGS: Important subsets of patients with chronic urticaria have autoantibodies to the high-affinity receptor for IgE (FcepsilonRI), anti-IgE, and antithyroid antibodies. Patients with chronic urticaria and biochemical evidence of thyroid autoimmunity may have active thyroid disease or may be clinically euthyroid. These patients are often poorly responsive to conventional therapy of urticaria and may have more chronic disease. New findings on the pathogenic effects of anti-FcepsilonRI auto-antibodies and of antithyroid antibodies have revealed a role for complement activation. SUMMARY: Currently, there are no compelling arguments to decide whether or not thyroid autoimmunity plays a significant role in the pathogenesis of chronic urticaria. New developments concerning a role for complement activation in the pathogenesis of chronic urticaria may, however, lead to better understanding of this phenomenon in the future.     

穴位埋线治疗慢性荨麻疹的中医护理对策及效果观察

目的 观察穴位埋线治疗慢性荨麻疹的中医护理对策及效果。方法 选取2014年3月~2017年3月本院收治的70例慢性荨麻疹患者,随机分为对照组和观察组各35例。两组患者均给予穴位埋线治疗,对照组给予常规护理,观察组给予中医护理,对比两组患者的复发和护理满意情况。结果 观察组复发率（2.86%）与对照组（17.14%）相比,差异有统计学意义（P＜0.05）;观察组护理满意度（97.14%）与对照组（80.00%）相比,差异有统计学意义（P＜0.05）。结论 对穴位埋线治疗的慢性荨麻疹患者使用中医护理对策,可明显降低复发率,提高护理质量,临床意义重大。     

Successful Treatment of Chronic Eosinophilic Pneumonia with Anti-IgE Therapy

Anti-IgE therapy, using recombinant humanized anti-IgE antibodies, is clinically effective in patients with eosinophil-related disorders such as allergic asthma, allergic rhinitis, and chronic urticaria. Chronic eosinophilic pneumonia tends to respond promptly to systemic corticosteroid therapy, however; relapses are common following corticosteroid tapering. We treated two patients (17- and 19-yr-old males) of chronic eosinophilic pneumonia whose symptoms were cough and dyspnea on exertion. The symptoms were recurrent while tapering off corticosteroid. They were treated with anti-IgE antibody without recurrence for 2 yr and 15 months. Here, we first describe clinical experience of the 2 cases of chronic eosinophilic pneumonia.     

The natural history and response to therapy of chronic urticaria and angioedema

Previous reports have suggested that the etiology of chronic urticaria/angioedema (greater than 6 weeks) can be identified 10% to 30% of the time while few reports have addressed the natural history of chronic urticaria/angioedema. An analysis of all patients referred to the authors' practice between 1983-1985 with a diagnosis of urticaria/angioedema was performed. Patients with hereditary angioedema were excluded. Eighty-six of the 214 patients had chronic urticaria/angioedema. In the remaining 128 cases of acute urticaria there were four exercise induced, nine contact, six cold induced, six drug induced, 11 food induced, one viral hepatitis associated, 29 with dermographism, and 62 undetermined. An etiology could not be determined in any of the patients with chronic urticaria/angioedema. Laboratory tests, including CBC, chemistry panel, urinalysis, ANA, rheumatoid factor, complement studies, sedimentation rate, and skin tests were all noninformative. Chronic angioedema without urticaria occurred in only nine cases, 31 cases had chronic urticaria alone, and 46 cases had both chronic urticaria and angioedema. Of the patients followed over the 3-year period, 27 resolved while 48 continued to have urticaria/angioedema. Response to medications was variable and will be discussed. Our study suggests that an etiology is determined in much less than 10% of patients with chronic urticaria; fortunately, 32% of our cases resolved over a 3-year period.     

Vitamin D supplementation: a potential booster for urticaria therapy

Chronic urticaria is a common skin condition whereby the etiology remains largely idiopathic and the mainstay therapy is symptomatic control with antihistamines. There have been a limited number of small studies suggesting a potential role for vitamin D in chronic urticaria, and this this editorial review will discuss the current supporting evidence. Associations for decreased serum vitamin 25 hydroxyvitamin D levels in subjects with chronic urticaria have been reported. In addition to observational reports, there has been a randomized, prospective, blinded trial demonstrating symptom improvement when high vitamin D3 supplementation was utilized as an add-on therapy for urticarial management. More research is needed to address mechanisms of action and to investigate vitamin D supplementation in larger and longer duration human trials.     

The treatment of glucocorticosteroid-dependent chronic urticaria with stanozolol

In this study, four patients presented with chronic urticaria that required glucocorticosteroid therapy for control. In the first patient, the urticaria began during pregnancy and persisted after delivery with symptoms flaring premenstrually thereafter. Danazol was selected in an attempt to suppress progesterone levels, theoretically by inhibiting ovulation. The patient's urticaria markedly improved, however, within 24 hours. Several months later, she was switched to stanozolol with further improvement. Three other individuals were treated with stanozolol with dramatic improvement. In all, three patients have experienced the induction of five remissions (there were two recurrences), and one patient remains much improved. All subjects have stopped both stanozolol and glucocorticosteroids. Stanozolol appears to act synergistically with glucocorticosteroids, and together, they may be capable of inducing remission in some patients.     

Urticaria in Thai children

In this study, 142 patients under 12 years of age with the diagnosis of urticaria accompanied or not by angioedema were examined. In all 72.6% of the patients were under 6 years of age. Boys and girls were equally affected, 13.4% of the cases had chronic urticaria, 56.3% had a previous history of urticaria, 88.0% had generalized urticaria, and about half of the cases had associated angioedema. The causes of the urticaria were identified or suspected in 32.4% of the cases. Drugs, foods, insect bites and stings, infections and cold were the most common or associated precipitating agents in that order. Histories revealed 27.5% of the cases had records of other allergic diseases, and 76.1% had allergic diseases in the family. Dermographisms were found in 16.2% of the cases, and 22.5% of cases had eosinophilia. The means of IgE levels in both acute and chronic urticaria were within normal limits, and there was no statistically significant difference between the two groups. Skin testing was of little practical value in evaluating the etiology of the urticaria. Clinical trials of drugs for symptomatic treatment revealed that clemastine, ketotifen and hydroxyzine gave approximately equally high response rates. All these three medications gave significantly greater response rates than chlorpheniramine.