当归补血汤治疗肿瘤化疗不良反应随机对照临床试验的Meta分析

目的 系统评价目前当归补血汤治疗肿瘤化疗不良反应的疗效和安全性。方法 电子检索中国期刊全文数据库（CNKI）、万方数据库、中文科技期刊全文数据库（VIP）、中国生物医学文献服务系统（SinoMed）、美国国立医学图书馆（PubMed）、TheCochrane Library,截止2017年12月。应用Cochrane Risk of bias量表评价纳入研究的质量,釆用RevMan5.3软件进行Meta分析。结果 最终纳入14篇文献,包括1369例患者,Meta分析结局指标结果显示:白细胞水平升高[     

葛根在颈椎病中的应用

颈椎病是骨伤科临床常见病、多发病,是严重影响人类生存质量的一种疾病。随着人类社会的进步,以及人们生活方式和工作环境的巨大变化,颈椎病的发病率逐年提高,发病人群逐渐扩大,发病年龄日益年轻化。而葛根因其独特的疗效,被广泛地应用于颈椎病的治疗中。本文总结葛根及其复方在颈椎病中的应用情况,以期进一步挖掘其重要的医疗价值。     

康复新液治疗消化道溃疡随机对照试验的系统评价

目的对康复新液治疗消化道溃疡的疗效和安全性进行系统评价。方法计算机检索Pubmed数据库、中国学术期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、中文生物医学期刊数据库(CMCI),检索日期为各数据建库时间起至2011年5月30日止。纳入的试验类型为随机对照试验,康复新液与三联疗法、抗菌药、抑制胃酸药比较的试验,或康复新液联合三联疗法、抗菌药、抑制胃酸药与后者比较的试验。采用Cochrane协作网的质量评价标准并用其提供的软件RevMan 5.1软件进行资料分析。结局的效应指标为胃镜下溃疡痊愈情况、临床症状痊愈情况、临床症状有效情况、幽门螺杆菌(HP)根除情况以及不良反应。结果共纳入22篇随机对照试验(2 224例患者)进行系统评价,所纳入的文献质量偏低。统计分析结果显示在溃疡痊愈、临床症状痊愈方面康复新液联合质子泵抑制剂或加用抗幽门螺杆菌药物与单用质子泵抑制剂或加用抗HP药物相比,结果均有统计学意义,单用康复新液与质子泵抑制剂或H2受体拮抗剂比较以及康复新液联合抗HP药物与抗HP药物比较,疗效相当,结果无统计学意义。结论康复新液可以更有效地促进消化道溃疡愈合以及改善临床各种症状,但方法学方面亟待提高。     

Systematic review of randomized controlled trials of traditional Chinese medicine treatment of non-acute bronchial asthma complicated by gastroesophageal reflux

OBJECTIVE:To assess the effectiveness and safety of Traditional Chinese Medicine(TCM) treatment of non-acute bronchial asthma complicated by gastroesophageal reflux.METHODS:We searched databases from MEDLINE,Cochrane Library,CNKI,VIP,CBM,Wanfang Data,and TCM Database Systems.All randomized,controlled trials(RTCs) of TCM treatment of non-acute asthma complicated by gastroesophageal reflux were included.Data were independently collected by two reviewers.The standards for assessing quality described in the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate articles.Meta-analyses were conducted using RevMan 5.0.17 software.Heterogeneity was assessed,and a corresponding effects model was used to merge and analyze results.Indexes used to evalu-ate curative effects were:clinical efficacy,symptom scores,pulmonary function values,and adverse incidents.Effectiveness was indicated using risk ratio(RR) or mean difference(MD),and 95% confidence intervals(CIs) were calculated.RESULTS:Six RCTs were included,involving 304 patients with non-acute asthma complicated by gastroesophageal reflux.The treatment groups received Chinese drugs alone or TCM combined with standard Western medical treatment,and the control groups received standard Western medical treatment alone.Standard Western medical treatment included anti-inflammatory drugs and bronchodilators for asthma,and drugs to promote gastric peristalsis and inhibit gastric acid production for gastroesophageal reflux.Methodological quality was low in all six RCTs.Two RCTs showed that clinical efficacy was higher in the treatment group than in the control group(RR:1.43,95%CI:1.10 to 1.87 vs RR:1.51,95% CI:1.09 to 2.08).One RCT showed that the asthma score was lowered more effectively in the treatment group than in the control group(MD:-1.10,95% CI:-2.04 to-0.16).Two RCTs showed that the gastroesophageal reflux score was reduced more effectively in the treatment group than in the control group(RR:-3.70,95% CI:-4.30 to 3.10 vs RR:-5.30,95% CI:-6.32 to-4.28).One RCT showed that some pulmonary function values were improved more effectively in the treatment group than in the control group(P< 0.05).No differences were seen in the various indexes between groups in the other RCTs.No adverse reactions,dropout rates,or follow-up rates were reported in any of the RCTs.CONCLUSIONS:The clinical symptoms ofnon-acute asthma complicated by gastroesophageal reflux can be improved by some Chinese drugs.Curative effects can be increased by combining the use of TCM with Western medicine.Because of the small quantity and low quality of research reported to date,it is necessary to conduct further RCTs to confirm these results.The results of this systematic review indicate that the quality of future clinical trials should be improved by including larger patient numbers,correctly randomizing patients into study groups,using blinding methods to measure and assess outcomes,and using accepted indexes to evaluate curative effects.     

临床中药学教改中教与学的几点思考

传统的临床中药学教学模式已不能完全满足中医药学生的需求，通过多年教学经验以及与学生的探讨，针对临床中药学教学改革，从“教”与“学”两个方面进行阐述，为临床中药学教改提供参考。     

三加减正气散治疗慢性浅表性胃炎20例

慢性浅表性胃炎属于中医"胃脘痛"的范畴,根据临床所见,尤以湿热型患者为多.我们采用三加减正气散治疗本病,取得良好疗效.现报道如下.     

六味地黄丸治疗2型糖尿病的研究近况

2型糖尿病(非胰岛素依赖型)属于中医"消渴"病范畴.祖国医学认为本病多由嗜食酒类肥甘之品,酿成燥热,致阴液耗损;情志刺激,气机郁结,久郁生热;生活失常,肾阴虚损,或体质素虚,脏腑柔弱导致本病发生.如刘河间云:"此乃五志过极,皆从火化,热盛阴伤,致令消渴".[1]其病机系阴虚为本,燥热为标.六味地黄丸是滋阴补肾的代表方剂,出自宋代著名儿科医家钱乙<小儿药证直诀>,原为治疗小儿肝肾不足而出现的各种临床证候而设立,经后世医家的发展创新,被广泛应用于治疗临床各科疾病.研究表明六味地黄丸具有调节机体免疫功能、抗肿瘤、抗衰老等作用,在心血管系统和泌尿生殖系统、糖代谢异常等疾病的防治中均有一定作用.本文仅就其治疗2型糖尿病的研究近况作一综述.     

中药药性理论新课程的构建

中药药性是中药性质与功能的高度概括,是中药理论的基础与核心。针对目前中药学教学中普遍存在着轻理论、重功效的现象,开设中药药性理论课程成为必要。本文就开设中药药性理论课程的背景、教学内容及意义进行探讨。     

甘麦合剂治疗心脾两虚型围绝经期失眠症的临床研究

目的:观察甘麦合剂治疗心脾两虚型围绝经期失眠症的临床疗效。方法:纳入心脾两虚型围绝经期失眠症患者30例,予甘麦合剂颗粒剂冲服,每日2次,连续治疗4周。治疗前后应用身体活动记录仪测定,评定PSQI量表。结果:甘麦合剂可提高患者睡眠总时间(P0.05),降低患者入睡后觉醒时间(P0.05),提高患者睡眠效率(P0.05),降低PSQI分值(P0.05),总有效率为86.70%(26/30)。结论:甘麦合剂临床疗效较好,可延长睡眠总时间,减少入睡后觉醒时间,提高患者睡眠效率。     

痛泻要方加味治疗溃疡性结肠炎

中医认为溃疡性结肠炎与肝郁脾虚关系最为密切，故用痛泻要方加味治疗溃疡性结肠炎，取得较满意的疗效。