体外培育牛黄联合三阶药物疗法治疗原发性肝癌晚期患者疼痛的临床研究

目的:观察体外培育牛黄联合三阶药物疗法治疗晚期肝癌患者疼痛的效果及不良反应。方法:晚期肝癌患者60例,随机分为两组,各30例。治疗组患者在各级常规阶梯镇痛药物上加用体外培育牛黄0.3g/次,1次/d,连用15天为1个疗程。结果:两组患者的总有效率比较,差异有统计学意义(P0.05);治疗组患者各级疼痛减轻效果比较,差异性有显著性意义(P0.05),治疗组患者不良反应发生率比对照组低,差异有统计学意义(P0.05)。结论:体外培育牛黄联合三阶药物疗法治疗晚期肝癌患者疼痛疗效良好,且不良反应少。     

郁消散外敷对癌痛患者生存质量及抑郁状态影响

目的探讨郁消散外敷对癌痛患者疼痛缓解、生存质量和抑郁状态的影响。方法将80例癌痛患者随机分为试验组和对照组各40例。对照组接受三阶梯止痛疗法,试验组接受郁消散外敷加三阶梯止痛疗法,1次/d,6 h/次,疗程7 d。治疗前后采用McGill疼痛问卷表(MPQ)评价疼痛程度,欧洲癌症研究治疗组织开发的生命质量核心量表(EORCT-QLQ C30)评价生存质量,抑郁自评量表(SDS)评价抑郁状态。结果试验组治疗后癌痛缓解率明显高于对照组(P0.01);整体健康状况得分明显升高,功能量表、症状量表得分明显降低(P0.01);无抑郁患者明显高于对照组(P0.01)。结论郁消散能有效缓解癌痛,具有较好改善患者生活质量和抑郁状态的作用。     

奥施康定治疗老年癌症患者中重度癌性疼痛50例临床观察

正癌性疼痛是一个全球范围的严重公共健康问题。在我国约40%~65%的肿瘤患者伴有癌痛,其中,中重度者占20%~([1])。1986年WHO制定了三阶梯止痛基本原则,即按阶梯给药、口服给药、按时给药、个体化给药和注意具体细节5项原则,推动了强阿片类止痛药在全球癌痛患者中的合理应用。本研究收集了盐酸羟考酮缓释片(奥施康定)治疗老年中重度癌性疼痛患者共50例,观察其止     

妊娠期糖尿病患者的临床疗效观察

目的探讨妊娠期糖尿病患者的临床疗效。方法选取2011年2月—2014年3月该院收治的妊娠期糖尿病患者67例作为实验组,健康妊娠患者67例作为对照组,分别进行综合治疗,两组进行疗效比较观察。结果实验组显效34例(50.75%),有效17例(25.37%),无效16例(23.88%),总有效率76.12%。对照组显效45例(67.01%),有效18例(26.87%),无效4例(5.97%),总有效率94.03%。两组数据比较,χ2为5.903,P值为0.025,P0.05,经统计学处理差异有显著性。结论临床上对于妊娠期糖尿病患者应早发现,早诊断,早治疗,制定个性化的给药方案,减少患者母婴并发症的发生,提高患者的生存质量。     

益气活血通痹汤治疗糖尿病周围神经病变的临床疗效

目的分析益气活血通痹汤治疗糖尿病周围神经病变的临床疗效。方法收集该院2013年2月—2014年4月期间诊治的糖尿病周围神经病变患者54例作为研究对象,以随机数字表分组的方式分为试验组(27例)与对照组(27例),对照组患者采用甲钴胺、维生素E1等常规治疗,试验组在对照组的基础上加用益气活血通痹汤治疗,对两组患者的治疗效果进行分析对比。结果研究结果显示,试验组中有10例显效,15例有效,2例无效,总有效率为92.59%,对照组中有4例显效,13例有效,10例无效,总有效率为62.96%,试验组患者的治疗效果明显优于对照组,差异有统计学意义(P0.05)。结论益气活血通痹汤治疗糖尿病周围神经病变具有良好的临床疗效,值得在临床应用上推广。     

益气复脉注射液对肥厚型梗阻性心肌病患者的疗效以及对血清相关因子的影响

目的探讨益气复脉注射液对肥厚型梗阻性心肌病患者的疗效以及对γ谷氨酰转移酶(GGT)的影响。方法入选中国人民解放军第二五一医院于2008年5月~2016年5月就诊的肥厚型梗阻性心肌病患者124例,其中男性69例,女性55例。随机分为试验组(62例)和对照组(62例)。试验组在常规治疗的基础上给予益气复脉注射液治疗,对照组在常规治疗的基础上给予灯盏花注射液治疗,治疗12周。检测治疗前后两组患者GGT水平以及评估疗效。结果经药物治疗后,两组GGT水平较治疗前均降低,但试验组较对照组GGT水平更低,数值为[(13.45±6.18)μmol/L vs.(28.63±12.37)μmol/L],差异有统计学意义(P均0.05)。试验组显效52例(83.87%),缓解5例(8.06%),无效5例(8.06%),总有效率91.94%;对照组显效32例(51.61%),缓解10例(16.13%),无效20例(32.26%),总有效率67.74%。试验组较对照组总有效率升高,91.94%vs.67.74%,差异有统计学意义(P0.05)。结论益气复脉注射液用于肥厚型梗阻性心肌病治疗疗效较好,显著降低血清GGT的水平。     

抗生素降阶梯治疗重症肺炎的临床疗效及安全性分析

目的 对重症肺炎患者采取抗生素阶梯治疗后的临床疗效以及安全性展开分析.方法 以我院2018年12月-2019年12月期间收治的61例重症肺炎患者进行研究,所有患者均给予抗生素治疗,按照抗生素给药方法 随机性分组.30例采取常规用药法(对照组),31例采取抗生素阶梯疗法(研究组),对比两种给药疗效.结果 研究组中不良反应发生率为(6.5%),低于对照组(30%);研究组症状消退时间以及总体住院时间均短于对照组(P<0.05).结论 对重症肺炎患者采取抗生素阶梯治疗后可以有效降低用药产生的不良反应,同时可以缩短症状消退时间,临床疗效显著.     

肝宁Ⅰ号治疗肝癌疼痛37例

疼痛是肝癌患者最常见最典型的症状之一.一般呈慢性持续闷痛,伴恶心、食欲不振、全身乏力等.主要由癌灶压迫正常组织、神经引起,常可放射至右肩或后背.50%～80%的肝癌患者有程度不同的疼痛.我科对74例肝癌疼痛患者分别采用肝宁1号贴敷疗法和三阶梯药物止痛法,并进行对比观察,现报告如下.     

复方苦参注射液联合止痛化疗治疗中晚期恶性肿瘤癌性疼痛临床观察

将120例中晚期恶性肿瘤患者随机分为治疗组(化疗、阶梯止痛联用复方苦参注射液)和对照组(单纯化疗和阶梯止痛).发现治疗组止痛有效率(81.36%)明显高于对照组(50%);治疗组在止痛、骨髓保护和提高患者生存质量方面取得了较为满意的效果.认为复方苦参注射液联合化疗和阶梯止痛治疗中晚期恶性肿瘤的癌性疼痛值得临床推广使用.     

中耳变压疗法治疗老年人分泌性中耳炎疗效观察

目的 探讨中耳变压疗法治疗老年人分泌性中耳炎的疗效.方法 选择56例(62耳)老年人分泌性中耳炎患者,按年龄、病程配对分为中耳变压疗法组(治疗组)和Valsava法组(对照组),治疗后随访3个月,比较其疗效.结果 治疗组纯音听阈均值和气骨导差明显低于对照组(均.P＜0.05).治疗组痊愈2耳,显效2耳,有效20耳,无效7耳,总有效率为77.42%(24/31耳),对照组痊愈1耳,显效1耳,有效14耳,无效15耳,总有效率为51.61%(16/31耳),两组间总有效率差异有统计学意义(P＜0.05);治疗组听力减退分级≥2级耳为6耳(19.35%),明显少于对照组的14耳(45.16%)(P＜0.05).结论 应用中耳变压疗法治疗老年人分泌性中耳炎疗效优于传统Valsava法,对老年人分泌性中耳炎听力康复十分有利.     

Tumorschmerz in der Palliativmedizin

During the course of cancer progression up to 90% of the patients suffer from pain of nociceptive, neuropathic or mixed nociceptive/neuropathic origin. Psychological, social or existential factors may additionally affect the intensity of pain (concept of "total pain"). The WHO "analgesic ladder" provides a large variety of effective drugs that can be used according to the specific pain type. Parenteral or peridural opioid therapy as well as neurodestructive methods can effectively support the analgesic treatment in selected cases.     

参苓白术散加味治疗老年肺癌患者癌痛的临床研究

目的 观察参苓白术散加味治疗老年肺癌患者癌性疼痛的疗效.方法 选择2016年1月-2018年12月于福建省肿瘤医院中西医结合科住院的老年肺癌合并癌痛症状的患者120例,按照随机数字表法分为观察组和对照组,每组60例.观察组采用参苓白术散加味联合三阶梯止痛治疗,对照组采用三阶梯止痛治疗.观察并比较2组的镇痛效果、达到理想...     

Tramadol in musculoskeletal pain--a survey

The three-step analgesic ladder, originally proposed for cancer pain relief by the World Health Organization (WHO), is now widely employed for all types of pain, including the chronic pain of musculoskeletal disease. Tramadol, an analgesic with weak opioid receptor affinity and possessing monoaminergic activity, has proved suitable for use at Step 2 of the WHO ladder. Owing to its pharmacological properties, tramadol is more appropriate than NSAIDs for patients suffering from gastrointestinal and renal problems. Importantly, the analgesic potency of tramadol is greater than that of NSAIDs and of other weak opioids (codeine, dextropropoxyphene). It also causes fewer opioid-type adverse effects, e.g. nausea, drowsiness, vomiting, dry mouth and constipation. In chronic musculoskeletal pain it is recommended that tramadol should be given by mouth and by the clock; the initial dose should be titrated upward gradually to reach the individual level required for suitable pain control. This dosage strategy will also minimise the usual opioid-type adverse effects encountered with tramadol. Four recent publications are reviewed to illustrate the efficacy of tramadol, alone or in conjunction with an NSAID, in the management of low back pain, osteoarthritis pain and breakthrough pain.     

Tramadol in Musculoskeletal Pain – A Survey

The three-step analgesic ladder, originally proposed for cancer pain relief by the World Health Organization (WHO), is now widely employed for all types of pain, including the chronic pain of musculoskeletal disease. Tramadol, an analgesic with weak opioid receptor affinity and possessing monoaminergic activity, has proved suitable for use at Step 2 of the WHO ladder. Owing to its pharmacological properties, tramadol is more appropriate than NSAIDs for patients suffering from gastrointestinal and renal problems. Importantly, the analgesic potency of tramadol is greater than that of NSAIDs and of other weak opioids (codeine, dextropropoxyphene). It also causes fewer opioid-type adverse effects, e.g. nausea, drowsiness, vomiting, dry mouth and constipation. In chronic musculoskeletal pain it is recommended that tramadol should be given by mouth and by the clock; the initial dose should be titrated upward gradually to reach the individual level required for suitable pain control. This dosage strategy will also minimise the usual opioid-type adverse effects encountered with tramadol. Four recent publications are reviewed to illustrate the efficacy of tramadol, alone or in conjunction with an NSAID, in the management of low back pain, osteoarthritis pain and breakthrough pain.     

Tramadol in Musculoskeletal Pain – A Survey

The three-step analgesic ladder, originally proposed for cancer pain relief by the World Health Organization (WHO), is now widely employed for all types of pain, including the chronic pain of musculoskeletal disease. Tramadol, an analgesic with weak opioid receptor affinity and possessing monoaminergic activity, has proved suitable for use at Step 2 of the WHO ladder. Owing to its pharmacological properties, tramadol is more appropriate than NSAIDs for patients suffering from gastrointestinal and renal problems. Importantly, the analgesic potency of tramadol is greater than that of NSAIDs and of other weak opioids (codeine, dextropropoxyphene). It also causes fewer opioid-type adverse effects, e.g. nausea, drowsiness, vomiting, dry mouth and constipation. In chronic musculoskeletal pain it is recommended that tramadol should be given by mouth and by the clock; the initial dose should be titrated upward gradually to reach the individual level required for suitable pain control. This dosage strategy will also minimise the usual opioid-type adverse effects encountered with tramadol. Four recent publications are reviewed to illustrate the efficacy of tramadol, alone or in conjunction with an NSAID, in the management of low back pain, osteoarthritis pain and breakthrough pain.

     

Guide to conservative, medical, and procedural therapies.

For patients without a specific diagnosis, treatment of low back pain begins with strategies to avoid re-injury and exacerbation. Most patients benefit from some form of medical therapy, guided by the three-step World Health Organization analgesic ladder. Opioid therapy is appropriate when needed for low back pain, especially in the acute period. Adjuvant medication (eg, an anticonvulsant or antidepressant) may help reduce or eliminate the need for opioid therapy. Side effects are common with opioid medications, although many resolve with time. Patient education in exercise, back protection, nutrition, and sexual concerns is an important component of treatment. Some patients may benefit from referral to a pain center for multidisciplinary management. Those with a structural or mechanical cause of pain may do well with surgery.     

Therapy of cancer pain--a comprehensive therapy concept

A comprehensive conception for cancer pain treatment is presented. The medical analgesic drug therapy representing the main point of this conception is applied as a three steps analgesic ladder as recommend by the WHO. This kind of therapy enables an individual adaptation resp. increase of the analgesic intensity by the use of non narcotic analgetics, weak and strong opioids as well as adjuvant drugs. Besides the explanation of the principles of its application and some detailed instructions for the dosage of several drugs, possible side effects and interactions are mentioned as well as some examples for its clinical application are quoted. A further increase of the analgesic intensity is reached by the local intraspinal application of morphine. For this purpose epidural and intrathecal long-term catheters are used. Also in these cases dosage, side effects and complications are mentioned and the possibilities and advantages of the continuous analgesia with implantable systems (pain ports) and external portable or implantable pumps are discussed. Furthermore the role of the neurolytic blocks, neurosurgical treatment and radiation therapy within this conception is mentioned.     

Prospective audit of short-term concurrent ketamine, opioid and anti-inflammatory ('triple-agent') therapy for episodes of acute on chronic pain

AIM: This prospective audit was undertaken in order to document the analgesic response and adverse effects of concurrent short-term ('burst') triple-agent analgesic (ketamine, an opioid and an anti-inflammatory agent--either steroidal or non-steroidal) administration, for episodes of acute on chronic pain. The clinical hypothesis in this study is that better pain control may be obtained by simultaneous multiple target receptor blockade. METHOD: The response of 18 patients is reported. The pain and analgesic requirement data for the 24 h before starting triple-agent therapy were compared with the last 24 h on the triple-agent therapy. Patients were then classified as responders or non-responders. RESULTS : According to stringent clinical criteria, 12 out of the 18 patients were classified as responders. The response rate was highest for somatic pain (7/9) and appeared to decrease with duration of prior uncontrolled pain. Only four out of the 18 patients reported adverse effects and all of these were minor. CONCLUSIONS: The results suggest that this 'burst' triple-agent approach is safe and effective in an inpatient palliative care population during episodes of poorly controlled acute on chronic pain, and warrants further investigation to ascertain whether it gives superior results compared to the 'gold-standard' WHO ladder approach.     

The long-term chemotherapy with erythromycin (EM) in chronic lower respiratory tract infections--third report: clinical study of cases administered EM over 3 years]

An investigation was made of the use of EM therapy which began in 1986 or earlier in 31 cases with chronic lower respiratory tract infections. 1) Of the 20 cases in which EM (Erythromycin stearate) administration (600-1200 mg/day) was continued for 3 years or more and its usefulness could be evaluated, treatment with this agent was judged markedly effective in three, effective in 14, somewhat effective in two, and ineffective in one. This amounted to an effectiveness rate (effective or better) of 85%. 2) Improved QOL was observed in 15 of the 20 cases. 3) In the Pseudomonas infected cases, a discrepancy was seen between the effectiveness rate of 87.5% and the disappearance rate of the organism (12.5%), while in the Haemophilus cases no such discrepancy was found (75%). 4) EM administration was stopped in 11 cases because of side effects in two (stomatitis, gastrointestinal disorder) death in five, desire of the patient in three, and transfer to another hospital in one. The cause of death cases had no connection with administration of EM. 5) In the three patients who stopped EM on their own, the agent was again administered because of exacerbation of symptoms, although this readministration proved ineffective in two of the cases. The above results suggest that long term EM therapy is useful and that its continued administration is important.     

丹红注射液治疗130例不稳定型心绞痛的临床疗效分析

目的 观察丹红注射液治疗不稳定型心绞痛的临床疗效.方法 将长江医院和如皋市第四人民医院内科就诊的130例不稳定型心绞痛患者分为两组,常规治疗的对照组（65例）和丹红注射液治疗组（65例）.观察治疗前后两组患者心绞痛发作次数、单硝酸异山梨醇酯用量及心电图ST-T改变.结果 与常规对照组比较,丹红治疗组患者心绞痛症状得到明显改善,65例中显效40例、有效21例、无效4例,总有效率达93.8%;对照组65例中显效34例、有效9例、无效22例,总有效率66.2%,两组比较差异具有统计学意义（P＜0.01）.心电图结果显示,丹红注射液治疗组显效36例、有效19例、无效10例,总有效率84.6%;对照组显效18例、有效24例、无效23例,总有效率64.6%,两组相比差异具有统计学意义（P＜0.01）.结论 丹红注射液能显著降低患者心绞痛发作次数,常规心电图改善明显,治疗不稳定型心绞痛安全有效.