倍他乐克治疗老年冠心病心绞痛的临床疗效观察

[目的]观察倍他乐克治疗老年冠心病心绞痛的临床疗效.[方法]选取确诊为冠心病心绞痛的老年患者100例,随机分成对照组和治疗组.对照组给予常规治疗,服用阿司匹林、硝酸酯和他汀类药物.治疗组除给予对照组相同治疗的基础上再给予倍他乐克治疗.观察治疗后两组的临床疗效和不良反应.[结果]①治疗组的总有效率为94.0％,明显高于对照组(64.0％),且两组相比差异有显著性(P＜0.05).②治疗组心电图改善的总有效率为86.0％,明显高于对照组(38.0％),且两组相比差异有显著性(P＜0.05).③两组患者均未见不良反应.[结论]倍他乐克治疗老年冠心病心绞痛临床疗效明显,无明显不良反应.     

益气活血通络法拟方佐治冠心病心绞痛临床观察

目的:观察益气活血通络法治疗冠心病心绞痛的临床疗效.方法:将70例冠心病心绞痛患者随机分成2组各35例,治疗组在西药治疗的基础上,加服益气活血通络中药治疗,对照组则单纯采用西药治疗,4周疗程为1个疗程,1～2个疗程观察疗效.观察2组治疗效果,中医症候的改善情况,心绞痛症状、心电图缺血性ST-T改变情况,T波变化情况以及硝酸甘油的消耗量.结果:治疗组心绞痛缓解有效率和症候评分有效率分别为85.7%、88.6%.对照组为65.7%、62.9%,治疗组优于对照组(P＜0.05,P＜0.05);2组对心电图缺血性ST-T改变均有改善,但组间比较差异无统计学意义(P＞0.05),2组对硝酸甘油的消耗量均有减少,治疗组优于对照组,且有统计学意义(P＜0.05).结论:益气活血通络法治疗冠心病心绞痛有较为显著的疗效.     

通脉降脂片对老年冠心病的疗效观察及机制探讨

目的:观察通脉降脂片治疗老年冠心病心绞痛的临床疗效,初步探索其作用机制。方法:将80例老年冠心病心绞痛患者随机分为通脉降脂片组(40例,常规西药加通脉降脂片)与单纯西药治疗组(40例,单用西药治疗),观察治疗前后血浆内皮素(ET)与降钙素基因相关肽(CGRP)含量,临床症状和心电图的变化,并选择30例门诊健康体检者为正常组进行对比。结果:治疗前与治疗后两组患者ET明显高于健康人(P<0.01),CGRP明显低于健康人(P<0.01),通脉降脂片组临床疗效总有效率及心电图疗效总有效率明显优于西药对照组(P<0.01);两组患者ET均明显降低,CGRP明显升高,但是通脉降脂组优于西药对照组(P<0.01)。结论:通脉降脂片可抑制血浆ET过量释放,同时提高血浆CGRP浓度,具有良好的抗心肌缺血作用,对老年冠心病心绞痛有较好的疗效。     

人参三七散治疗冠心病不稳定性心绞痛60例临床观察

目的：观察人参三七散治疗冠心病不稳定性心绞痛的临床疗效。方法：将符合纳入标准的患者60例,随机分为治疗组30例、对照组30例。对照组给予西药常规治疗;治疗组在西药常规治疗基础上加服人参三七散。2组均以30d为1个疗程,治疗2个疗程后评价疗效。结果：2组均能显著改善患者的临床症状,治疗组,有效率93.33%;有效率73.33%。治疗组优于对照组（P〈0.05）;心绞痛发作次数、硝酸甘油停减率、心电图改善方面,治疗组均优于对照组（P〈0.05）。结论：人参三七散配合西药常规治疗冠心病不稳定性心绞痛疗效优于单用西药常规组。     

麝香保心丸合丹参酮注射液治疗冠心病心绞痛临床观察

目的:观察麝香保心丸联合丹参酮注射液治疗冠心病心绞痛临床疗效。方法:将确诊的76例冠心病心绞痛患者随机分为治疗组和对照组各38例,对照组采用常规西药治疗,治疗组在对照组治疗的基础上加用麝香保心丸口服或含服及丹参酮注射液静脉滴注治疗。2周为1个疗程,共观察2～3个疗程。结果:治疗组临床症状缓解、心电图的变化均优于对照组(P(0.01或0.05)。结论:麝香保心丸联合丹参酮注射液治疗冠心病心绞痛,疗效优于单纯的西药治疗。     

自拟活血通脉汤对冠心病不稳定性心绞痛的治疗作用

目的:观察自拟活血通脉汤对冠心病不稳定性心绞痛的治疗作用.方法:将80例患者随机分为2组各40例,对照组40例给予西药常规治疗,治疗组40例在此基础上加用自拟活血通脉汤口服.15天为1个疗程,2个疗程观察疗效.结果:治疗组疗效显著,2组比较具统计学差异(P<0.05),结论:自拟活血通脉汤合西药治疗冠心病不稳定性心绞痛疗效优于单纯西医治疗.     

瓜蒌薤白养心汤联合西药治疗冠心病心绞痛的疗效观察

目的：探讨瓜蒌薤白养心汤联合西药治疗冠心病心绞痛的临床疗效。方法：选取2017年4月~2018年6月收治的74例冠心病心绞痛患者,利用随机数字表法分为对照组和观察组,各37例。对照组采用西药治疗,观察组在对照组的基础上加用瓜蒌薤白养心汤治疗,对比两组临床疗效、中医证候积分、心绞痛发作情况及不良反应发生情况。结果：观察组治疗总有效率高于对照组,差异有统计学意义（P＜0.05）;治疗后,两组中医证候积分、心绞痛发作次数及每次发作持续时间均改善,且观察组中医证候积分更低,心绞痛发作次数更少,每次发作持续时间更短,差异有统计学意义（P＜0.05）;两组不良反应发生率对比,差异无统计学意义（P＞0.05）。结论：冠心病心绞痛患者采用瓜蒌薤白养心汤联合西药治疗可有效提升临床疗效,改善临床症状,减少心绞痛发作次数,缩短每次发作持续时间,且用药安全性较高。     

双解泻心汤治疗老年冠心病心绞痛30例临床观察

目的：观察双解泻心汤治疗老年冠心病心绞痛的临床疗效。方法：采用单盲随机设计，将60例老年冠心病心绞痛患者随机分为治疗组和对照组各30例，治疗组口服双解泻心汤，对照组口服复方丹参片溶液，疗程均为4周。根据疗程前后心绞痛及其他主要症状、心电图变化和硝酸甘油停减率评定疗效。结果：治疗组对胸痛、胸闷、气短症状的改善优于对照组(P＜0.05)，而对心悸的改善2组比较无显著差异(P＞0.05)；治疗组对心绞痛疗效、心电图改善及硝酸甘油用量停减方面均优于对照组(P＜0.05或P＜0.01)。结论：双解泻心汤对老年冠心病心绞痛的疗效确切。     

四逆散加味配合西药常规治疗胆汁反流性胃炎60例

目的:观察四逆散加味治疗胆汁反流性胃炎的临床疗效.方法:116例患者随机分成2组,治疗组60例应用四逆散加味配合常规西医方法治疗,对照组56例单用西药治疗.15d为1个疗程,2个疗程后观察疗效.结果:2组治愈率和有效率比较,均有显著性差异(P＜0.01或P＜0.05).治疗组对症状的缓解明显优于对照组(P＜0.05).结论:四逆散加味配合常规西药治疗胆汁反流性胃炎,疗效及症状缓解率优于西医治疗.     

中西医结合治疗冠心病心绞痛临床观察

目的观察中西医结合治疗冠心病的临床疗效。方法将75例冠心病心绞痛患者随机分为治疗组和对照组。均给予常规西医治疗，治疗组加用中药桃红四物汤加味治疗。两组均以4周为一个疗程，一个疗程后观察疗效。结果治疗组在改善心绞痛症状及心电图方面疗效均优于对照组（P〈0．05）。结论中西医结合治疗冠心病心绞痛疗效明显优于单纯西药治疗。     

超声评分对膝骨性关节炎患者病变特点的评估价值

目的 探讨超声评分对膝骨性关节炎患者病情严重度的诊断价值。方法 回顾性收集我院收治的膝骨性关节炎患者52例,同期收集50例健康成人,分析超声评分与膝骨性关节炎患者病情严重度的相关性。结果 膝骨性关节炎患者超声评分显著高于健康成人(6.93±1.76 vs. 1.73±0.56,P=0.000)。膝骨性关节炎患者超声评分与髌上囊液体深度、髌下囊液体深度、关节腔液体深度、滑膜厚度显著正相关(r=0.265、0.216、0.310和0.255,P=0.004、0.035、0.000和0.012),与Lyshsolm显著负相关(r=-0.381,P=0.000)。与增生滑膜内血管阴性的患者相比,增生滑膜内血管阳性的患者超声评分显著增加(7.43±1.61 vs. 5.58±1.42, P=0.000)。结论 超声评分与膝骨性关节炎患者病情严重度相关。     

Use of the Role Checklist with the patient with multiple personality disorder

A paucity of occupational therapy evaluation tools exists for use with patients with multiple personality disorder. The Model of Human Occupation (Kielhofner & Burke, 1980), particularly the volition and habituation subsystems within this model, proved useful for the identification of the many facets of patients with multiple personality disorder on a short-term treatment unit. The Role Checklist (Oakley, Kielhofner, Barris, & Richler, 1986), a tool derived from the Model of Human Occupation, was adapted for use with this population and was found to be beneficial in the identification of common goals held by most of the personalities of each patient with multiple personality disorder. The use of the Role Checklist is illustrated with a case example.     

Living with a woman with fibromyalgia from the perspective of the husband

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome, which affects mostly middle-aged women. The syndrome is poorly understood and treatment is mainly palliative. The diagnosis is established from diagnostic criteria. Living with FM means living a life greatly influenced by the illness in various ways for people affected. Aim of the study. The aim of this study was to describe the experiences of living with a woman with FM from the husbands' perspective. METHODS: Five men married to women with FM were interviewed using a narrative approach. The interviews were analysed using qualitative thematic content analysis. FINDINGS: The analysis resulted in the following seven themes: increasing responsibility and work in the home; being an advocate for and supporting the wife; learning to see the woman's changing needs; changing relationship between spouses; changing relationship with friends and relatives; deepening relationship with the children and lacking information and knowledge about FM. The findings show that the women's illness had a great impact on husbands' lives, and that husbands lacked information about the woman's illness. CONCLUSION: This study shows that it is not only the women with FM who experience a changed life; the whole family life is influenced and limited by FM. The husband's role in the family changes, first and foremost concerning responsibility and workload within the family. This must be taken into consideration in care planning. This study also highlighted the need of information and knowledge about FM expressed by the participants, information that health care personnel have a great responsibility to give.     

Experience with the use of plasmapheresis in the combined treatment of children with the crush syndrome

Plasmapheresis (PP) was applied to the treatment of 5 children aged 6-14 years with the crush syndrome. The multimodality treatment using antibiotics, erythrocytic mass, rheologically active preparations, hemodialysis and blood rheologically active preparations, hemodialysis and hemoperfusion carried out for 6-7 days before PP did not bring about any appreciable improvement of the patients' status. The patients failed to get rid of anuria and manifested the signs of increasing intoxication. The treatment with PP consisted of 1 to 6 procedures, in the course of which 70 to 85 of the design volume of the circulating plasma was removed. The use of PP resulted in the disappearance of myoglobin from the patients' blood and urine, in the normalization of the coagulogram, a considerable decrease of the content of medium molecules, and in the appearance of the first urine towards the end of the procedure. Thus, the introduction of PP into multimodality treatment of the crush syndrome made it possible to eliminate anuria, disseminated intravascular coagulation, and to noticeably reduce intoxication and to clear the blood off myoglobin.