痰热清注射液治疗成人水痘18例

目的观察痰热清注射液治疗成人水痘的临床疗效。方法将36例成人水痘患者随机分为两组,治疗组予更昔洛韦注射液与痰热清注射液静滴,对照组单用更昔洛韦。结果治疗组能明显缩短体温下降及体温恢复正常时间;疱疹开始结痂、疱疹痊愈时间、咳嗽咯痰消失时间均明显短于对照组。结论痰热清注射液治疗成人水痘安全有效。     

抗糖灵胶囊治疗Ⅱ型糖尿病临床观察

糖尿病是由于多种原因引起的糖脂代谢紊乱所致的多系统多脏器损害的综合征，其临床特点以血糖升高、多饮、多尿、多食、消瘦等症状为主，是一种常见的终身性疾病。近年来，随着人民生活水平的不断提高，糖尿病的患病率不断上升，已成为仅次于恶性肿瘤和心血管疾病的第三大危害人类健康的疾病。因此如何有效地防治糖尿病，成为当今医学瞩目的课题。     

拉米夫定预防结核性胸膜炎合并乙型肝炎患者激素治疗后的乙型肝炎病毒再激活

HBV感染者应用糖皮质激素容易导致HBV再激活,其临床后果轻重不一[1].临床上结核性胸膜炎合并HBV感染者较为常见,在抗结核治疗时加用糖皮质激素,可引起HBV再激活,易发生急性肝炎甚至暴发性肝功能衰竭.本研究旨在对拉米夫定预防结核性胸膜炎合并HBV感染患者糖皮质激素治疗引起HBV再激活进行探讨.     

人猪链球菌感染一例

患者男,30岁,鞋厂工人.2004年因外伤致脾破裂行脾切除术.其家隔壁有个养猪场,没有与猪的密切接触史.2009年10月3日,患者因＂发热10 d,伴畏寒、寒战、腹痛1 d＂由温州市第二人民医院急诊科收住重症监护病房.入院检查：体温36.4℃,脉搏121次/min,呼吸40次/min,血压53/42 mm Hg （1 mm Hg=0.133 kPa）,神志清,对答切题,颈项强直,皮肤、巩膜无黄染,锁骨上浅表淋巴结未及,双肺未闻及干湿性哕音,心率121次/min,律齐,腹平软,右中上腹压痛,无反跳痛,墨菲征（±）,移动性浊音（-）,肠鸣音无亢进,双下肢无水肿.     

凯西莱治疗伤寒并发中毒性肝损害40例临床观察

目的观察凯西莱治疗伤寒并发中毒性肝损害的疗效。方法治疗组40例患者因伤寒并发的中毒性肝伤害，出现丙氨酸氨基转移酶（ALT）及天门冬氨酸氨基转移酶（AST）升高，在基础治疗相同时，治疗组给于凯西莱针剂，每次0．2g，1次／d，疗程1周，与对照8H（46例）比较，并观察ALT、AST变化及临床症状变化。结果治疗组经1周的凯西莱治疗后，血清ALT、AST下降明显，治疗组与对照组治疗比较差别有统计学意义（P〈0．01），两组临床疗效比较，治疗组优于对照组。结论凯西莱治疗伤寒并发的中毒肝损害疗效可靠。     

强化期联合静脉给药治疗支气管结核效果观察

目的探讨强化期联合静脉给药治疗支气管结核的效果。方法选取支气管结核患者87例,按信封法分为两组,观察组给予抗结核治疗方案2AHRZE/10HR,强化期A、H、R使用静脉滴注;对照组给予抗结核治疗方案2HRZE/10HR,全程采用口服治疗。比较两组患者治疗2个月末和12个月末总有效率、痰菌阴转情况及不良反应发生情况。结果观察组治疗2个月末总有效率、痰菌阴转率均明显高于对照组,差异有统计学意义;观察组治疗12个月末总有效率和痰菌阴转率均略高于对照组,但差异无统计学意义;两组患者不良反应发生率接近,差异无统计学意义。结论强化期联合静脉给药治疗支气管结核效果良好,可尽早杀灭结核分枝杆菌,减少传染源。     

血型播散型肺结核120例临床分析

目的回顾性调查血型播散型肺结核的临床特点。方法收集温州市第二人民医院2007年1月至2011年2月住院的120例初治成人血型播散型肺结核患者为血型播散组,选择同期住院浸润型肺结核患者120例为对照组,对两组患者的临床资料进行回顾性分析。结果血型播散型肺结核以青壮年居多,近年老年患者渐有增多趋势,60岁以上者29例（24.1%）。血型播散型肺结核痰标本涂片查抗酸杆菌阳性较浸润性肺结核低（P〈0.01）。血型播散型肺结核血清抗结核抗体阳性率较浸润性肺结核低（P〈0.01）。痰标本涂片抗酸杆菌检查阴性,血清抗结核抗体阴性易对早期诊断造成干扰。血型播散型肺结核患者以发热为主要症状,因结核菌由血液传播,易合并肺外结核（44.2%）,其中合并结核性脑膜炎的比例最高（29.2%）,2例重症结核性脑膜炎患者因脑疝死亡。血型播散型肺结核并发脑膜炎的比例较浸润性肺结核高（P〈0.01）。结论对于发热原因待查的患者,需动态观察胸CT或胸片变化,对于伴有头痛或脑膜刺激征阳性者,应及时进行腰椎穿刺术,进一步检查,早期诊断,积极治疗,是降低病死率的关键。     

拉米夫定联合还原型谷胱甘肽预防乙型肝炎病毒携带者抗结核的肝损害研究

Objective To explore the preventive effect of liver damage treated by lamivadine joint reduced glutathione for the tuberculosis patients with HBV infection. Methods 90 cases of tuberculosis patients with HBV infection were randomly divided into three groups (A, B, C), each group contained 30 cases. Patients in group A were treated by lamivudine combined with reduced glutathione to protect the liver before anti-tuberculosis treatment. Group B were treated with reduced glutathione. Group C were treated with Yiganling tablets. Both the liver function and serum HBV DNA levels before anti-tuberculosis treatment and 1 month and 2 months after treatment were observed and recorded. Results The cases of liver damage in group A, B, C were 1, 12, 18 respectively, there were statistical differences between group A and group B, group C (χ2 = 11.882, 22.259, P < 0.01). The cases of discontinued treatment due to different causes in group A,B,C were 0,4,11 respectively, there were statistical differences between group A and group B,group C(χ2 = 4.286, P < 0.05; χ2 = 13.469, P < 0.01). The cases of discontinue treatment in the no antivirus group were much more than the antivirus group. There were also statistical differences in both liver damage and discontinued treatment between group B and group C(χ2 = 5.455,4.356, P < 0.05). There was no statistical difference of baseline HBV DNA level between group A and group B (P > 0.05), and also no statistical difference between group A and group C ( P > 0.05), but there were statistical differences in HBV DNA level between group A and group B, as well as group A and group C after 1-month and 2-month therapy( t = - 6.542, - 6.746 and t = - 9.358, - 10.085, P < 0.01). Conclusions Tuberculosis patients coinfected with HBV can use reduced glutathione to prevent liver damage while antitubercular therapy, and simultaneous application of lamivudine therapy can restrain HBV replication and improve the prognosis obviously.     

经支气管镜治疗喉结核的临床应用研究

随着结核病的发病率回升,喉结核的发病率也有明显的增加,常常因声嘶而发现有喉结核,治疗喉结核方法的选择各家报道不一.近年来,纤维支气管镜作为一种高科技的检查手段,该项技术已普遍应用于临床.现不仅仅作为一项检查手段,而且是一项重要的治疗手段.我科采用相同的药物,不同的治疗手段对喉结核伴声嘶患者进行局部给药,以促进喉结核患者的有效治疗,疗效满意,现报告如下.     

杨友鹤老中医糖尿病辨治经验

杨友鹤主任医师从事中医临床６０余载,对于糖尿病的诊治颇具经验,现择其要者,简介如下。１辨治大法１１阴阳分型,注重肝郁糖尿病即中医之消渴,历代医家多认为其阴虚为本,燥热为标,并倡上、中、下三消分型,如《证治准绳》中所云：“渴而多饮为上消,消谷善饥为中...