中药灌肠配合超声介入治疗盆腔包裹性积液的效果及护理体会

目的探讨中药保留灌肠配合超声介入治疗盆腔包裹性积液的方法及护理措施。方法选取41例盆腔包裹性积液患者在阴道超声引导下穿刺抽液,术后行2～3个疗程的中药保留灌肠,10～15d为1个疗程,随访3个月至2年。结果41例患者共穿刺45次,无器官损伤、腹腔内出血及术后感染等并发症发生,术后配合完成中药保留灌肠2～3个疗程。随访结果：1个月治疗有效39例（95．1％）,3个月治疗有效40例（97．6％）,最长随访2年者无复发。结论经阴道超声引导下穿刺抽液配合中药保留灌肠为盆腔包裹性积液患者提供了经济、方便、有效的治疗方法,充分的心理护理、围术期护理和用药护理是提高和巩固治疗效果的重要保证。     

中草药液体型药贴研制及其治疗慢性肾衰竭临床研究

目的:自行研制中草药液体型药贴(CHDLP),观察其治疗慢性肾衰竭(CRF)的临床疗效及副作用.方法:将27例非透析CRF志愿患者随机分两组.对照组给予低蛋白饮食(LPD)和支持对症治疗;药贴组在LPD、支持对症治疗基础上加用CHDLP(由仙灵脾、枸杞子、紫河车、红参、律草、生大黄、甘草等中草药经特殊工艺加工制成)分别贴敷每侧肾区及脐下6 cm与前正中线交界处,每2 d用1套药贴.两组疗程均为1个月.观察用药前后两组患者的各种临床症状改善率,并测定尿素氮、血清肌酐、肾小球滤过率、血钙、血磷等指标,根据Mitch法观察两组治疗前后肾功能变化.结果:CHDLP能显著缓解非透析CRF患者的消化道症状、神经精神症状、呼吸道症状与皮肤瘙痒,改善CRF的高血压与贫血,增加CRF患者的尿量,显著降低尿素氮、血清肌酐、血磷水平,提高肾小球滤过率与血钙水平,并能显著延缓非透析CRF的病程进展.CHDLP使用过程中无不良反应.结论:用CHDLP治疗CRF是一种可行且有效的外治法,适合于胃肠道症状较为突出且经济条件不允许作维持性透析或肾移植的CRF患者.     

Psychological stress-induced oxidative stress as a model of sub-healthy condition and the effect of TCM

Distress-mediated tissue oxidative stress was examined as a model of sub-healthy condition defined in traditional Chinese medicine theory. Mice were subjected to psychologically stressful conditions by whiskers removal. Under this condition, spontaneous locomotive activity was significantly enhanced in the dark (P < 0.05 versus the control mice in three different movements), and granulocytes/lymphocytes balance shifted to granulocytes. At the same time, peroxynitrite level in blood plasma increased to approximately 180% from that of the control mice at 6 h after removal of the whiskers (P < 0.01), and was maintained even after 12 h. Both protein carbonyl formation and lipid peroxidation were significantly increased under this condition in brain, heart, liver and spleen at 6 h after removal of whiskers (P < 0.05 or P < 0.01), and these levels were maximized after 12 h (increased to 120-160%, P < 0.05 or P < 0.01). The oxidative tissue injuries observed at 12 h after the removal of the whiskers were effectively prevented by two traditional Chinese medicine formula: Shengmai San (SMS) and Ling Gui Zhu Gan Tang (LGZGT), when administered for 5 days before the removal of the whiskers. Therefore, this stress model is considered useful in assessing the preventive potential of antioxidants and antioxidant-based herbal mixtures in treating the pathophysiology associated with psychological or emotional distress.     

开展中西医结合整体护理的体会

推广实施中西医结合整体护理已成为中西医结合医院护理改革自々必然趋势,经过近二年的实践,取得了较好效果:转变了护士角色,改善了护患关系,改变了护士长期以来被动和从属的工作地位,充分调动护士的工作热情,提高了护理质量,同时也充分显示出中西医结合整体护理的优势。经问卷调查患者满意率达98％以上。     

神阙穴敷贴治疗肝炎肝硬化腹水的临床观察及护理

目的　探讨神阙穴中药敷贴治疗肝炎肝硬化腹水的临床疗效。方法　将 10 0例肝炎肝硬化腹水患者随机分为实验组和对照组 ,实验组应用基础治疗及护理加中药穴位贴敷 ,对照组用基础治疗及护理。结果　实验组的临床疗效显著优于对照组 (P <0 0 5 )。结论　神阙穴中药贴敷有一定的消退肝炎肝硬化腹水的作用 ,而在保证其治疗能否发挥最大效应上 ,护理非常关键     

针刺和中药治疗对基底节区出血患者肢体功能的影响

目的：探讨针刺和中药对脑出血急性期患者肢体功能康复的作用。方法：46例基底节区出血（〈30m1）患者，治疗前神志均为浅昏迷以上，患肢肌力≤3级，随机分为2组各23例，均按急诊常规处理及配合康复手段。针药组同时按中风急诊治疗与抢救方案给予内服中药，并在合理时机增加针刺治疗。结果：治疗1个月后脑出血病损评分（SIAS）和ADI。积分与治疗前比较2组均有改善（P〈0．05），2组问比较，针药组明显高于对照组（P〈0．01）。结论：脑出血急性期合理掌握时机配合针刺和中药等综合治疗，有利于稳定病情，保护和恢复病损脑组织。促进肢体功能的康复。     

中西医结合治疗单纯疱疹病毒性角膜炎的护理

目的观察中西医结合治疗单纯疱疹病毒性角膜炎的效果及相关护理方法。方法按随机数字表法将179例(186只病眼)单纯疱疹病毒性角膜炎患者分为治疗组93例(97只病眼),予以中医辨证分型治疗、中药超声雾化浴眼,并配合西药抗病毒治疗;对照组86例(89只病眼),予以抗病毒药物静脉滴注治疗。结果经精心治疗与护理,治疗组93例患者97只病眼中,显效65只眼、有效25只眼、无效7只眼;对照组86例患者89只病眼,显效49只眼,有效24只眼,无效16只眼,两组比较,差异有统计学意义(P<0.05)。结论中西医结合治疗单纯疱疹病毒性角膜炎具有病程短、复发率低、疗效好、视力恢复快等优点。     

探讨麻醉下手法松解联合中西医综合法治疗重症冻结期肩周炎的临床疗效

目的:回顾性分析麻醉下手法松解联合中西医综合法治疗重症冻结期肩周炎的效果。方法:重症冻结期肩周炎患者110例,综合组55例,主要运用麻醉下手法松解中西医综合方法治疗。单一组55例患者主要运用麻醉下手法松解治疗,比较两组患者的临床疗效。结果:综合组患者的各项生活质量评分与肩关节恢复程度评分均要明显好于单一组,且整体有效率比单一组高,P<0.05。结论:在麻醉下手法松解治疗重症冻结期肩周炎过程中,有效联合中西医综合疗法,能够让患者恢复良好的生活质量,肩关节功能得到有效恢复。     

中西医结合治疗早期糖尿病肾病31例临床观察

目的 :探讨加味知柏地黄汤治疗早期糖尿病肾病 (DN)的临床效果。方法 :将 62例患者随机分为治疗组和对照组 ,各 3 1例 ,分别采用中西医结合治疗和西医常规治疗 ,并对治疗前后的有关数据进行对比。结果 :治疗组总有效率80 65 % ,对照组有效率 64 5 2 % ,两组治疗前后空腹血糖 (FBG)、糖化血红蛋白 (HBA1c)、尿白蛋白排泄率 (UAER)、总胆固醇 (Tch)、三酰甘油 (TG)等指标的改善 ,治疗组优于对照组 ,差异有显著性 (P <0 0 5或P <0 0 1)。结论 :采用加味知柏地黄汤结合常规西医治疗早期DN ,效果优于单纯西医组。     

Inhibition of release of vasoactive and inflammatory mediators in airway and vascular tissues and macrophages by a chinese herbal medicine formula for allergic rhinitis

Herbal therapies are being used increasingly for the treatment of allergic rhinitis. The aim of this study was to investigate the possible pharmacological actions and cellular targets of a Chinese herbal formula (RCM-101), which was previously shown to be effective in reducing seasonal allergic rhinitis symptoms in a randomized, placebo-controlled clinical trial. Rat and guinea pig isolated tissues (trachea and aorta) were used to study the effects of RCM-101 on responses to various mediators. Production of leukotriene B(4) in porcine neutrophils and of prostaglandin E(2) and nitric oxide (NO) in Raw 264.7 cells were also measured. In rat and guinea pig tracheal preparations, RCM-101 inhibited contractile responses to compound 48/80 but not those to histamine (guinea pig preparations) or serotonin (rat preparations). Contractile responses of guinea pig tracheal preparations to carbachol and leukotriene C(4,) and relaxant responses to substance P and prostaglandin E(2) were not affected by RCM-101. In rat aortic preparations, precontracted with phenylephrine, endothelium-dependent relaxant responses to acetylcholine and endothelium-independent relaxant responses to sodium nitroprusside were not affected by RCM-101. However, RCM-101 inhibited relaxations to l-arginine in endothelium-denuded rat aortic preparations, which had been pre-incubated with lipopolysaccharide. RCM-101 did not affect leukotriene B(4) formation in isolated porcine neutrophils, induced by the calcium ionophore A23187; however, it inhibited prostaglandin E(2) and NO production in lipopolysaccharide-stimulated murine macrophages (Raw 264.7 cells).The findings indicate that RCM-101 may have multiple inhibitory actions on the release and/or synthesis of inflammatory mediators involved in allergic rhinitis.     

银屑病三种治疗方法的疗效及对血浆中cAMP和cGMP的含量影响

目的 :探求效果好、副作用小的治疗银屑病的方法。方法 :将不同时期就诊的银屑病患者 150例分为A、B、C 3组 ,分别给予中医辨证治疗、紫外线照射充氧自体血回输疗法 (UBIO) ;UBIO与中医辨证治疗 ,并观察患者血中环磷腺苷和环磷鸟苷的含量变化。结果 :C组疗效及升高血浆中环磷腺苷含量明显优于A、B组 (均P <0 .0 1)。结论 :UBIO结合中医辨证治疗银屑病能明显提高疗效 ,值得推广。     

中医情志护理加穴位按摩对晚期肺癌化疗患者睡眠障碍及不良反应的影响

目的:分析中医情志护理加穴位按摩对晚期肺癌化疗患者睡眠障碍与不良反应的影响.方法:选取2019年4—9月福建省肿瘤医院收治的晚期肺癌化疗患者76例作为研究对象,按照入院顺序单号与双号分为对照组和观察组,每组38例.对照组进行常规护理,观察组进行中医情志护理+穴位按摩.比较2组的睡眠质量[匹兹堡睡眠质量指数(PSQI)]...     

中药酒剂配合电磁治疗仪治疗颈肩腰腿痛效果观察与护理

目的：探讨中药酒剂配合电磁治疗仪治疗颈肩腰腿痛的疗效。方法将80例颈肩腰腿痛患者分为治疗组和对照组,每组各40例,治疗组使.用中药酒剂加电磁治疗仪治疗,对照组采.用单纯电磁治疗仪治疗。分别在治疗前,治疗3 d、7 d后,采.用数字等级评分（numerical rating scale,NRS）对两组患者进行测评。结果治疗后,治疗组患者NRS评分低于对照组,两组比较,差异具有统计学意义（均P＜0.01）。结论中药酒剂配合电磁治疗仪治疗颈肩腰腿痛效果满意,值得临床应.用推广。     

心肺复苏第3期的中西医结合疗法——附8例心脏停搏患者复苏成功体会

目的：总结８例心肺复苏成功患者中西医结合疗法的经验。方法：８例心脏停搏患者均按心肺复苏（ＣＰＲ）程序,在取得第２期复苏成功（恢复自动心搏）基础上,第３期抢救措施,治疗原发病及并发症均施行中西医结合疗法进行辨证施治。结果：１例急性心肌梗死、２例冠状动脉粥样硬化性心脏病、１例急性乙醇中毒患者在３小时后意识清醒,４８小时后生命体征平稳;１例（６７岁）心肌梗死患者３小时后自主呼吸恢复,５小时后意识清醒,因Ⅲ度房室传导阻滞安装临时心脏起搏器,于第２日后房室传导阻滞消失,于第４日去除起搏器,病情稳定;１例煤酚皂溶液中毒、１例肺源性心脏病患者分别于８小时和６小时后清醒;１例高血压脑出血患者第３日病情稳定,２周后意识逐渐清醒。８例患者１～２个月出院,均无后遗症。结论：在ＣＰＲ第１、２期复苏成功基础上第３期治疗施行中西医结合疗法,辨证施治,充分运用现代中西药物优势,可以最快速度实施复苏术,不失时机地治疗原发病及并发症,提高心肺复苏成功率。     

Efficacy and Safety of a Traditional Herbal Medicine, Hochu-ekki-to in the Long-term Management of Kikyo (Delicate Constitution) Patients with Atopic Dermatitis: A 6-month, Multicenter, Double-blind, Randomized, Placebo-controlled Study

Hochu-ekki-to is a traditional herbal (Kampo) medicine that has been shown to be effective for patients with Kikyo (delicate, easily fatigable, or hypersensitive) constitution. Previous case reports have suggested that this herbal drug was effective for a certain subgroup of patients with atopic dermatitis (AD). We aimed to evaluate the efficacy and safety of Hochu-ekki-to in the long-term management of Kikyo patients with AD. In this multicenter, double blind, randomized, placebo-controlled study, 91 Kikyo patients with AD were enrolled. Kikyo condition was evaluated by a questionnaire scoring system. All patients continued their ordinary treatments (topical steroids, topical tacrolimus, emollients or oral antihistamines) before and after their protocol entry. Hochu-ekki-to or placebo was orally administered twice daily for 24 weeks. The skin severity scores, total equivalent amount (TEA) of topical agents used for AD treatment, prominent efficacy (cases with skin severity score = 0 at the end of the study) rate and aggravated rate (more than 50% increase of TEA of topical agents from the beginning of the study) were monitored and evaluated. Seventy-seven out of 91 enrolled patients completed the 24-week treatment course (Hochu-ekki-to: n = 37, placebo: n = 40). The TEA of topical agents (steroids and/or tacrolimus) was significantly (P < 0.05) lower in the Hochu-ekki-to group than in the placebo group, although the overall skin severity scores were not statistically different. The prominent efficacy rate was 19% (7 of 37) in the Hochu-ekki-to group and 5% (2 of 40) in the placebo group (P = 0.06). The aggravated rate was significantly (P < 0.05) lower in the Hochu-ekki-to group (3%; 1 of 37) than in the placebo group (18%; 7 of 39). Only mild adverse events such as nausea and diarrhea were noted in both groups without statistical difference. This placebo-controlled study demonstrates that Hochu-ekki-to is a useful adjunct to conventional treatments for AD patients with Kikyo constitution. Use of Hochu-ekki-to significantly reduces the dose of topical steroids and/or tacrolimus used for AD treatment without aggravating AD.     

国家基本药物目录（2004年版）33种中药注射剂不良反应／不良事件文献分析

目的了解国家基本药物目录（2004年版）33种中药注射剂不良反应/不良事件（ADR/AE）的基本情况和文献研究趋势,为中药注射剂研发、合理使用与安全警戒,以及风险管理工作提供参考依据。方法电子检索中国生物医学文献数据库（1978.1～2009.4）、中国期刊全文数据库（1979.1～2009.4）、中文科技期刊数据库（1989.1～2009.4）、中国中医药数据库（1984.1～2009.4）。同时检索卫生部及国家食品药品监督管理局（SFDA）网站,收集《药品不良反应信息通报》第1～22期中药注射剂ADR/AE相关信息。描述性分析我国中药注射剂ADR研究文献的发表时间、期刊和文献类型及出现ADR的中药注射剂和相应管理措施。结果①上述4个数据库共检出5405篇文献,剔除重复文献2160篇后,再按纳入与排除标准筛查文题、摘要和全文,最终纳入1010篇。②自1991年起,中药注射剂ADR年文献发表总量和年文献累积量均明显递增。③纳入的1010篇文献分布在297种期刊,其中55种药学类期刊共发表399篇（占文献总量的39.50%）,64种中医、药类期刊共发表197篇（占19.50%）,《中文核心期刊要目总览（2008年版）》医药卫生类收录的22种期刊共发表129篇（占12.77%）。④该1010篇文献分属8种类型,包括348篇个案报告（34.46%）,254篇系列病例（25.15%）,119篇综述（11.78%）,116篇RCT（11.49%）,78篇横断面研究（7.72%）,61篇ADR文献分析（6.04%）,28篇非随机对照试验（2.77%）。⑤《药物不良反应杂志》《、医药导报》和《中国药业》ADR文献发表量居297种期刊前三位（分别占5.84%、3.76%和2.67%）。⑥双黄连、清开灵和鱼腥草ADR报道最多,均超过200篇文献,占总文献的41.95%,国家卫生部和SFDA分别对其ADR进行管制。⑦双黄连、刺五加、鱼腥草和茵栀黄4种中药注射剂分别被撤市或叫停,其ADR文献发表量与监管作用相辅相成。结论①中药注射剂ADR研究呈增长态势,但总的数量少、发表分散、质量不高;②迫切需要研究制定中药注射剂ADR的分级和风险评价标准;③应有组织地推动中药注射剂安全性再评价和合理用药的宣传普及。     

以"益活清下"为主的中西医结合综合疗法治疗重症急性胰腺炎1 161例疗效报告

目的：在中医热病理论指导下，探讨进一步规范重症急性胰腺炎（SAP）中西医结合非手术治疗的原则和方案。方法：回顾性分析四川大学华西医院1994年1月2003年12月综合运用中医益气救阴、活血化瘀、清热解毒、通里攻下（简称“益活清下”）疗法治疗的1161例SAP患者临床资料，评价该疗法对病死率、并发症发生率及手术率的影响，验证SAP的中医热病观理论框架及“益活清下”疗法对SAP的价值。结果：1161例患者的总体手术率为19．38％，主要并发症的总体发生率为34．71％，病死率降低至10．77％。结论：中医热病理论较好地诠释了SAP的证候特点和病机传变规律，“益活清下”非手术治疗对SAP是有效的治疗方法，中药治疗SAP具有多靶位、综合调节的特点，并贯穿于4期的始终，手术治疗主要针对病程后期继发的胰腺感染并发症，早期手术指征应从严掌握。