补阳还五汤煎剂联合西药治疗气虚血瘀证急性脑梗塞的临床研究

目的探讨补阳还五汤煎剂联合西药治疗气虚血瘀证急性脑梗塞的疗效。方法将我院收治的120例气虚血瘀证急性脑梗塞患者根据随机数字表法分为对照组与观察组各60例,对照组接受西医常规治疗,观察组则在西医常规治疗基础上再加用补阳还五汤治疗,对比分析两组患者的疗效。结果 (1)观察组疗效总有效率(95.00%)显著高于对照组(83.33%),有显著性差异(P0.05)。(2)治疗前组间比较显示:两组患者血浆纤维蛋白原(Fbg)、红细胞压积(HCT)、全血低切粘度、血浆粘度相比差异无统计学意义(P0.05);组内治疗前后比较显示:观察组与对照组患者血浆Fbg、HCT、全血低切粘度、血浆粘度治疗后均显著下降(P0.05);治疗后组间比较显示:观察组血浆Fbg、HCT、全血低切粘度、血浆粘度显著低于对照组(P0.05)。(3)治疗前组间比较显示:两组患者美国国立卫生院神经功能缺损评分(NIHSS)、FuglMeyer运动功能评定量表(FMA)评分、日常生活能力量表(ADL)评分相比差异无统计学意义(P0.05);组内治疗前后比较显示:观察组与对照组患者NIHSS均显著下降(P0.05),FMA评分、ADL评分均显著升高(P0.05);治疗后组间比较显示:观察组NIHSS显著低于对照组(P0.05),FMA评分、ADL评分显著高于对照组(P0.05)。结论补阳还五汤煎剂联合西药可以改善气虚血瘀证急性脑梗塞患者的血液流变学指标,疗效显著,值得临床推广应用。     

针灸联合补阳还五汤治疗缺血性脑卒中有效性分析

目的:探讨针灸联合补阳还五汤治疗缺血性脑卒中的有效性分析。方法:将2018年1月—2019年1月在脑病康复科治疗的120例缺血性脑卒中患者按随机数字表法分为两组,对照组给予常规西医治疗,在此基础上观察组给予针灸联合补阳还五汤治疗。比较两组患者的临床疗效,神经功能缺损程度,运动能力及日常生活能力变化,血液流变学指标变化,各项血清因子水平变化,中医证候积分变化。结果:观察组治疗有效率为95%,明显高于对照组的80%(P0.05);观察组治疗后的美国国立卫生研究院卒中量表(NIHSS)评分明显低于对照组,而Fugl-Meyer运动功能评分(FMA)和Barthel指数(BI)明显高于对照组(P0.05);观察组治疗后全血高切黏度、全血低切黏度、血浆黏度、红细胞变形指数、红细胞聚集指数、血小板聚集率明显低于对照组(P0.05);观察组治疗后CRP、Hcy、D-二聚体水平明显低于对照组,而TGF-β1、VEGF水平明显高于对照组(P0.05);观察组治疗后半身不遂、偏身麻木、口舌歪斜、舌强言蹇、头晕目眩、疲乏无力、饮水呛咳、共济失调等中医证候积分明显低于对照组(P0.05)。结论:针灸联合补阳还五汤治疗缺血性脑卒中的有效性显著,能有效促进受损神经功能的修复,降低血液黏稠度,改善机体炎症水平,改善运动能力及日常生活能力,缓解中医证候,具有积极的临床意义。     

补阳还五汤治疗缺血性卒中患者的效果

目的:观察补阳还五汤治疗缺血性卒中患者的效果。方法:选取90例缺血性卒中患者为研究对象,依据随机数字表法分为观察组和对照组各45例。两组均行常规治疗,在此基础上,对照组行阿司匹林治疗,观察组在对照组基础上行补阳还五汤治疗,比较两组治疗总有效率,治疗前后中医证候积分、神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]评分、基质金属蛋白酶-9(MMP-9)水平、C反应蛋白(CRP)水平和不良反应发生率。结果:观察治疗总有效率为97.78%(44/45),高于对照组的80.00%(36/45),差异有统计学意义(P<0.05);治疗后,两组中医证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组NIHSS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组MMP-9、CRP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在阿司匹林治疗基础上采用补阳还五汤治疗缺血性卒中患者可提高治疗总有效率,降低中医证候积分、NIHSS评分、MMP-9水平和CRP水平,效果优于单纯阿司匹林治疗。     

补阳还五汤防治急性缺血性脑卒中早期神经功能恶化的临床研究

目的研究补阳还五汤防治急性缺血性脑卒中早期神经功能恶化的疗效。方法选取本院2012年3月至2016年8月急性缺血性脑卒中患者60例,按照入院顺序编号,采取随机数字表法将患者分为观察组与对照组,每组30例,给予对照组患者常规西药治疗,观察组患者在对照组治疗基础上联合补阳还五汤治疗,比较两组患者临床治疗有效率,比较治疗前后血液流变学指标、血同型半胱氨酸(Hcy)、C反应蛋白(CRP)、D-二聚体水平以及美国国立卫生院神经功能缺损评分(NIHSS)、日常生活活动能力(Barthel)评分变化情况。结果观察组临床治疗总有效率为86.67%,显著高于对照组63.33%(P0.05);治疗后,观察组血小板聚集率、纤维蛋白原水平、全血粘度、血浆粘度较对照组显著降低(P0.05);观察组Hcy、CRP、D-二聚体水平较对照组显著降低(P0.05);观察组NIHSS评分较对照组显著降低(P0.05),Barthel评分较对照组显著升高(P0.05)。结论补阳还五汤联合西药防治缺血性脑卒中早期神经功能恶化疗效确切,能通过改善患者血液流变学指标水平降低血脂、降低炎性水平达到提高脑神经功能水平的目的,值得临床推广应用。     

补阳还五汤联合针灸治疗脑血栓的临床效果分析

目的:分析补阳还五汤联合针灸治疗脑血栓的临床效果。方法:选取2015年2月—2016年2月我院收治的脑血栓患者84例,按照随机双盲法分为两组,采用补阳还五汤治疗的42例患者作为对照组,采用补阳还五汤联合针灸治疗的42例患者作为观察组。观察两组治疗效果。结果:观察组患者纤维蛋白原、全血黏度、红细胞压积低于对照组(P<0.05);观察组患者治疗总有效率为88.10%,高于对照组的69.05%(P<0.05);观察组患者NIHSS评分低于对照组,Barthel评分高于对照组(P<0.05)。结论:脑血栓患者应用补阳还五汤联合针灸治疗,有利于改善血液指标和神经功能,提高治疗效果,提升生活质量,值得临床推广和应用。     

补阳还五汤合清脑方联合阿司匹林肠溶片治疗气虚血瘀型脑梗死恢复期患者的效果

目的:观察补阳还五汤合清脑方联合阿司匹林肠溶片治疗气虚血瘀型脑梗死(CI)恢复期患者的效果。方法:选取102例CI恢复期患者为研究对象,按照随机数字表法分为观察组与对照组各51例。对照组予以阿司匹林肠溶片治疗,观察组在对照组基础上给予补阳还五汤合清脑方治疗,比较两组疗效、中医证候积分、美国国立卫生研究院神经功能缺损量表(NIHSS)评分、Fugl-Meyer运动功能评分表(FMA)评分、Barthel指数评分、血液流变学指标(血浆黏度、全血低/高切还原黏度)水平和不良反应发生率。结果:观察组治疗总有效率为96.08%,明显高于对照组的80.39%,差异有统计学意义(P<0.05);治疗后,两组半身不遂、偏身麻木、舌歪语蹇、手足肿胀、心悸自汗和气短乏力等中医证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组NIHSS评分低于治疗前,且观察组低于对照组,FMA评分、Barthel指数评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组血浆黏度、全血高/低切还原黏度低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗期间均未见明显不良反应。结论:补阳还五汤合清脑方联合阿司匹林肠溶片治疗气虚血瘀型CI恢复期患者可提高治疗总有效率、FMA评分和Barthel指数评分,降低中医证候积分、NIHSS评分和血液流变学指标水平,效果优于单纯阿司匹林肠溶片治疗效果。     

补阳还五汤对缺血性脑卒中患者恢复期的疗效评价

目的评价补阳还五汤对缺血性脑卒中(CAT)患者恢复期的临床疗效和安全性。方法2014年1月至2015年12月收治气虚血瘀证CAT患者170例,随机分为研究组和对照组,各85例。两组患者均给予常规治疗,研究组额外给予补阳还五汤。比较两组患者治疗前后中医证候积分,神经功能缺损(NIHSS)评分,日常生活能力(ADL),血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],血液流变学[全血高切黏度(η高)、全血低切黏度(η低)、血浆黏度(η浆)、红细胞比容(HCT)、纤维蛋白原(FIB)]指标和中医临床疗效情况。结果与对照组比较,治疗后研究组的中医证候积分、NIHSS评分、TC、TG、LDL-C、η高、η低、η浆、HCT和FIB降低更为显著(P0.05),ADL评分和HDL-C增加更为显著(P0.05)。研究组总有效率为95.29%,明显高于对照组的77.65%,差异具有统计学意义(P0.05)。研究组不良反应发生率为4.71%,对照组为3.53%,差异无统计学意义(P0.05)。结论补阳还五汤治疗恢复期气虚血瘀证的CAT患者,可以明显改善临床症状和神经功能,提高生活质量及临床疗效,降低血脂和改善血液流变学指标。     

加味补阳还五汤对缺血性脑卒中患者血清VEGF的影响

目的:观察加味补阳还五汤治疗缺血性脑卒中的临床疗效。方法:将40例患者随机分为治疗组与对照组,每组20例。对照组予常规疗法,治疗组在此基础上予加味补阳还五汤,疗程均为2周。观察两组的临床疗效、神经功能缺损评分(NIHSS)及血清VEGF水平的改变。结果:治疗组和对照组的总有效率分别为90%和75%,两组比较差异有统计学意义(P<0.01)。治疗后,两组患者的神经功能缺损评分较治疗前均显著降低(P<0.01),且治疗组的神经功能缺损评分较对照组降低显著(P<0.01);治疗组患者的VEGF水平较治疗前显著升高(P<0.05),且治疗组患者的VEGF水平较对照组亦显著升高(P<0.05)。结论:加味补阳还五汤能够改善缺血性脑卒中患者的神经功能,提高其血清VEGF水平。     

补阳还五汤联合康复训练对急性脑血栓患者的治疗效果

目的探讨补阳还五汤联合康复训练对急性脑血栓患者的治疗效果。方法选取2016年12月-2018年12月我院收治的急性脑血栓患者80例,随机分为两组,对照组应用康复训练,研究组联合应用补阳还五汤。观察比较两组的临床疗效、治疗前、后不同时间点下的神经功能缺损(NIHSS)评分的变化情况、两组治疗前、后的相关凝血指标(Fbg、aPTT、PT、TT)水平的变化情况。结果研究组有效率为97.5%,显著高于对照组的67.5%(P0.05);研究组不同时间点下的NIHSS评分显著低于对照组(P0.05);研究组aPTT、PT、TT水平显著高于对照组(P0.05),研究组Fbg水平显著低于对照组(P0.05)。结论给予急性脑血栓患者进行康复训练的基础上联合应用补阳还五汤,可显著提高患者的临床疗效,降低患者的NIHSS评分,改善患者的凝血功能。     

加味补阳还五汤联合双补通络丸治疗气虚血瘀型中风后遗症效果分析

目的研究加味补阳还五汤联合双补通络丸对气虚血瘀型中风后遗症患者神经功能缺损(NIHSS)评分及日常生活能力(BI)指数的影响。方法选取济源市精神卫生服务中心2015年1月至2017年3月收治的126例气虚血瘀型中风后遗症患者,按治疗方案分为两组,各63例。对照组接受加味补阳还五汤治疗,观察组接受加味补阳还五汤+双补通络丸治疗。比较两组治疗效果,治疗前后NIHSS评分BI指数。结果观察组总有效率为95.23%,高于对照组的82.54%,差异有统计学意义(P<0.05);治疗前,两组NIHSS评分、BI指数比较,差异无统计学意义(P>0.05);治疗3个月后,两组NIHSS评分与BI指数较治疗前均升高,且观察组高于对照组,差异有统计学意义(P均<0.05)。结论加味补阳还五汤联合双补通络丸治疗气虚血瘀型中风后遗症效果显著,可改善患者神经功能,提高其日常生活能力。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.