假期别忘查血糖

<正>金秋十月,一年一度的十一黄金周来临了,在这个举国欢庆的日子里,很多人选择回家和父母团聚,也有很多人选择出去旅游。但无论做什么,在享受欢乐的同时也要关注自身的健康,尤其是糖尿病患者,假期在放松心情的时候不能放松对血糖的监测,一定要注意坚持用药,防止血糖波动。节日期间血糖容易波动难得放假,无论是亲友团聚,还是外出旅游,都少不了聚餐宴饮,但是聚餐时     

陈降化瘀胶囊治疗糖尿病脂肪肝临床观察

目的观察陈降化瘀胶囊治疗糖尿病脂肪肝的临床疗效。方法将2型糖尿病合并脂肪肝患者64例随机分为治疗组和对照组各32例。治疗组在常规降糖治疗基础上予陈降化瘀胶囊2.4g口服,每天3次;对照组在常规降糖治疗基础上加用血脂康2粒,每天2次。均2个月为1个疗程。检测2组肝脏B型超声,并比较2组空腹血糖(FBG)、餐后2h血糖(2h PG)、体质量指数(BMI)、胆固醇(TC)、三酰甘油(TG)及空腹胰岛素(FINS)水平。结果治疗组治疗后脂肪肝程度明显改善,且改善程度优于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组FBG、2h PG、BMI、TC、TG及FINS水平均下降,且BMI、TC、TG及FINS水平低于对照组,差异均有统计学意义(P<0.05);对照组仅FBG、2h PG水平较治疗前下降(P<0.05),其余指标比较差异均无统计学意义(P>0.05)。结论陈降化瘀胶囊对糖尿病脂肪肝具有较好的治疗作用。     

动脉硬化性脑梗死中医证候量化诊断标准研究

目的:建立动脉硬化性脑梗死中医证候量化诊断标准。方法:根据文献研究、专家咨询、临床流行病学调查获得动脉硬化性脑梗死四诊信息,将417例临床患者随机分为运算组(313例)与考核组(104例),以基于熵的复杂系统分划方法提取运算组患者症状信息,分析证候之间组合规律,确立症状对证候贡献度,以诊断性试验ROC曲线分析方法建立诊断阈值,并依据考核组数据对其进行前瞻性检验。结果:动脉硬化性脑梗死存在络气郁滞、络气虚滞、痰湿、血瘀、痰热、火热、阴虚、阳虚等基本证候,分别确立不同症状对证候诊断的贡献度,建立诊断阈值,前瞻性检验显示其具有良好的灵敏度、特异度及符合率。结论:基于熵的复杂系统分划方法可用于中医证候的量化研究,建立的动脉硬化性脑梗死量化诊断标准具有良好的诊断效能,为中医证候规范化及进一步开展络病与血管病变相关性研究奠定了基础。     

Bromelain and Cardiovascular Risk Factors in Diabetes: An Exploratory Randomized, Placebo Controlled, Double Blind Clinical Trial

Objective: To assess whether the dietary supplement(bromelain) has the potential to reduce plasma fibrinogen and other cardiovascular disease(CVD) risk factors in patients with diabetes. Methods: This randomized placebo controlled, double blind, parallel design, efficacy study was carried out in China and investigated the effect of 12 weeks of bromelain(1,050 mg/day) on plasma fibrinogen. This randomized controlled trial(RCT) recruited 68 Chinese diabetic patients [32 males and 36 females; Han origin, mean age of 61.26 years(standard deviation(SD), 12.62 years)] with at least one CVD risk factor. Patients were randomized into either bromelain or placebo group. While bromelain group received bromelain capsule, the placebo group received placebo capsule which consisted inert ingredient and has no treatment effect. Subjects were required to take 1,050 mg(3×350 mg) of either bromelain or starch-filled placebo capsules, two to be taken(2×350 mg) after breakfast and another(350 mg) after dinner, daily for 12 weeks. Plasma fibrinogen, CVD risk factors and anthropometric indicators were determined at baseline and at 12 weeks. Results: The change in the fibrinogen level in the bromelain group at the end of the study showed a mean reduction of 0.13 g/L(standard deviation(SD) 0.86g/L) compared with the mean reduction of 0.36 g/L(SD 0.96 g/L) for the placebo group. However, there was no significant difference in the mean change in fibrinogen between the placebo and bromelain groups(mean difference=0.23g/L(SD 0.22 g/L), P=0.291). Similarly, the difference in mean change in other CVD risk factors(blood lipids, blood pressure), blood glucose, C-reactive protein and anthropometric measures between the bromelain and placebo groups was also not statistically significant. Statistical differences in fibrinogen between bromelain and placebo groups before the trial despite randomization may have influenced the results of this study. Conclusion: This RCT failed to show a beneficial effect in reducing fibrinogen or influencing other selected CVD risk factors but suggests other avenues for subsequent research on bromelain.     

熵聚堆方法在络气虚滞诊断标准研究中的应用

目的:探索熵聚堆方法在络气虚滞诊断标准研究中的应用.方法:首先根据临床流行病学调查获得400例血管内皮功能障碍的四诊资料,以熵聚堆方法提取血管内皮功能障碍络气虚滞证的中医症状信息;然后计算络气虚滞证中各症状的关联度并确定血管内皮功能障碍络气虚滞证诊断阈值;最后根据临床流行病学诊断性试验研究方法,从灵敏度、特异度、符合率3个方面对此诊断标准进行回顾性和前瞻性检验.结果:建立的血管内皮功能障碍络气虚滞证的诊断标准有较好的诊断效能.结论:熵聚堆方法适用于中医证候诊断标准的研究,方法科学严谨,有临床实用价值.     

益气温阳法治疗癌性发热临床体会

目的:观察益气温阳法治疗癌性发热病人的临床疗效。方法:对中晚期恶性肿瘤发热病人应用益气温阳方剂进行治疗,每日1剂。结果:癌性发热病人服用益气温阳类方剂后,发热症状大都很快缓解。结论:癌性发热病因病机复杂,多属阳气亏虚,临床采用益气温阳法疗效满意。     

自体外周血干细胞移植治疗糖尿病下肢血管病变16例疗效观察

目的观察自体外周血干细胞移植治疗糖尿病下肢血管病变的症状及踝肱指数（ABI）和足背动脉血流量改善情况。方法 31例糖尿病下肢血管病变患者随机分为治疗组（16例）和对照组（15例）。2组患者均给予降糖、降压、降脂及前列地尔注射液治疗,治疗组应用重组人粒细胞集落刺激因子150～300μg/d进行骨髓动员3～5d,使白细胞达30.0×109/L（不超过50.0×109/L）。然后分离外周血干细胞,在患肢沿血管走形方向自上向下予以肌肉注射。2组均治疗观察3个月。结果治疗组在疼痛、冷感、麻木改善方面,ABI和足背动脉血流量均优于对照组（P〈0.05）,治疗组未见并发症及不良反应。结论自体外周血干细胞移植治疗糖尿病下肢血管病变是有效的,并具有可行性和安全性。     

芪地固肾丸对糖尿病肾病患者尿蛋白及C反应蛋白的影响

目的:观察芪地固肾丸对糖尿病肾病患者糖化血红蛋白(HbA1 c)、24h尿蛋白定量(24hPro)及C反应蛋白(CRP)的影响。方法:将105例临床糖尿病肾病期患者随机分为两组。对照组予以西医常规治疗,治疗组在常规西医治疗基础上加芪地固肾丸口服,共治疗8周。结果:治疗8周后,治疗组与对照组相比24hPro、CRP有显著性差异(P<0.05或P<0.01);两组HbA1 c变化无显著性差异(P>0.05)。24hPro治疗组好转较快平均为10天,对照组好转平均为22天,两组好转的天数比较有显著性差异(P<0.01)。结论:芪地固肾丸能较好的减少糖尿病肾病患者蛋白尿排出,降低CRP水平,表明芪地固肾丸对糖尿病肾病具有较好的治疗作用,其机制可能与抑制肾脏的炎症反应有关。