醒脾涤痰法治疗轻中度抑郁症75例

目的:观察醒脾涤痰法治疗抑郁症的临床疗效。方法:治疗组35例采用涤痰解郁汤(苍术、石菖蒲、栝楼、丹参、栀子、香附、半夏、川芎等),对照组40例采用盐酸帕罗西汀;以汉密尔顿量表HAMD、HAMD综合积分、汉密尔顿焦虑量表HAMA、PSQI匹兹堡睡眠质量指数、副反应量表SERS观察并判断疗效。结果:治疗组脱落3例,对照组脱落7例;治疗组总有效率为93.7%。对照组总有效率为91.0%。结论:涤痰解郁汤对肝郁脾虚痰阻型抑郁证具有较好的治疗作用,其临床疗效与盐酸帕罗西汀相当,且副作用小,具有更加稳定安全广泛的临床应用。     

沙利度胺联合FOLFIRI方案治疗晚期胃癌的临床观察

目的观察沙利度胺联合FOLFIRI方案治疗晚期胃癌的临床疗效和毒副反应。方法沙利度胺200 mg,睡前顿服,1～10 d;伊立替康150 mg/m2,静脉滴注90 min,第1天;甲酰四氢叶酸(CF)200 mg/m2,静脉滴注2 h,第1、2天,;5-氟尿嘧啶(5-FU),400 mg/m2,静脉推注,第1、2天,;5-FU 600mg/m2静脉滴注22 h,第1、2天。每2周重复,4周期后评定疗效。结果全组43例患者均可评价疗效,其中CR 4例(9.30%),PR 21例(48.84%),SD 13例(30.23%),PD 5例(11.63%),总有效率RR(CR+PR)58.14%,1年生存率71.88%。主要毒副作用为腹泻(9.38%)、白细胞降低(46.88%)、恶心呕吐(28.13%)。结论该方案治疗晚期结直肠癌有效率高,明显减轻了毒副作用。     

恶性肿瘤患者采用锁骨下静脉置管化疗的护理观察

肿瘤患者在化疗过程中,由于化疗药物的毒副作用,患者常常承受静脉炎及渗透性损伤的痛苦.建立一条好的静脉通道,可减少重复静脉穿刺的痛苦,还能避免化疗药物对外周静脉的破环和局部组织的刺激,为肿瘤患者提供了一条无痛性治疗途径,从而保证化疗的顺利进行.锁骨下静脉置管术由于导管开口于中心静脉,管口周围的血流量比末稍静脉大,压力高,液体容易输注,而对刺激性的药物输注时血管壁不会造成伤害,目前广泛用于临床[1].     

麻黄临床功用探悉

麻黄具有"发汗平喘利水"的功效;历代医家多以麻黄治疗外感风寒,恶寒发热,无汗,咳喘,水肿等症,是辛温解表中发汗作用最强的,害怕使用。结合历代本草、方书中对麻黄功用的记载,结合临床实践,发现麻黄的作用远远超出目前中药学教科书所记载的"发汗、平喘宣肺、通阳利水"功效,还具有较强的"温通阳气"作用,可以温通阳气,调和血脉,起到温阳通络止痛、止遗、止痒等作用。因此,从另外的角度探悉麻黄在临床的功用,临床上只要辨证准确,善用麻黄辛温走散之性,可以起到较好的疗效。     

抗疲劳中药对小鼠抗疲劳及调节免疫作用的研究

目的:探讨益气健脾、补肾调理复方中药对小鼠抗疲劳能力和免疫调节的作用。方法:6周龄清洁级昆明种小鼠随机分为4组:生理盐水组对照组、抗疲劳中药复方高、中、低剂量组,小鼠进行适应性运动训练1周,进行动物实验,每日灌胃1次,用药2周,通过爬竿试验、游泳试验、吞噬指数、免疫器官质量法(胸腺指数和脾脏指数)观察益气健脾、补肾调理中药复方抗疲劳的作用和增强免疫功能的作用。结果:抗疲劳中药复方能延长小鼠负重游泳的时间、延长爬竿时间,尤其是高剂量抗疲劳中药复方组能明显延长小鼠负重游泳持续时间,与生理盐水组比较有显著性差异,(P0.05);抗疲劳中药复方能增强巨噬细胞吞噬功能、脾脏指数(P0.05)。结论:抗疲劳中药复方具有增强小鼠抗疲劳能力和免疫功能作用。     

梅花针疗法应用中需注意的问题

梅花针疗法是用特制的浅刺针具叩击皮肤，通过叩击皮肤，以疏通经络，调节脏腑的虚实达到治疗疾病的一种外治方法。现将梅花针的具体应用以及应用中需注意的问题介绍如下。     

Efficacy Evaluation for Depression with Somatic Symptoms Treated by Electroacupuncture Combined with Fluoxetine

Objective： This study is to investigate the clinical therapeutic effects and safety of treating mild or moderate depression with somatic symptoms with electroacupuncture combined with Fluoxetine. Methods： 95 cases of mild or moderate depression with somatic symptoms were randomly divided into a Fluoxetine group, and an electroacupuncture plus Fluoxetine group. Hamilton Depression Scale （HAMD） was used for the assessment of clinical therapeutic effects and Treatment Emergent Symptom Scale （TESS） was used for assessment of adverse reactions. Results： The total effective rate was 77.27% in the Fluoxetine group and 78.26% in the electroacupuncture plus Fluoxetine group, showing no statistically significant difference between these two groups （P〉0.05）. However, the treatment took effect after two weeks in the electroacupuncture plus Fluoxetine group but after four weeks in Fluoxetine group. During this time, a better therapeutic effect on depression with mild or moderate somatic symptoms was found in the electroacupuncture plus Fluoxetine group, which also had fewer adverse reactions than the Fluoxetine group. Conclusion： Electroacupuncture combined with Fluoxetine takes effect faster for relieving the somatic symptoms with fewer adverse reactions. It is worth popularizing clinically.     

中性粒细胞明胶酶相关脂质运载蛋白与子痫前期及妊娠期糖尿病孕妇糖代谢和脂代谢指标的相关性

目的 通过测定正常妊娠孕妇、子痫前期糖代谢正常患者、妊娠期糖尿病( gestational diabetes mellitus,GDM)患者及子痫前期合并GDM患者血清中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)水平,探讨NGAL与子痫前期、GDM孕妇糖代谢和脂代谢的相关性. 方法 选取2009年12月至2010年11月在广州医学院附属广东省妇女儿童医院定期产前检查并分娩的单胎正常妊娠孕妇、子痫前期糖代谢正常患者及GDM患者各77例,子痫前期合并GDM患者32例.测定所有研究对象血清NGAL、空腹血精、空腹胰岛素、脂代谢参数、尿酸、肌酐、乳酸脱氢酶及24 h尿蛋白等指标,测量血压,计算体重指数(body mass index,BMI),用稳态模型评估法计算胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)评价胰岛索敏感性.正态分布资料用单因素方差分析及Student's t检验进行比较,非正态分布资料用Kruskal-Wallis H检验和Mann-Whitney U检验进行比较.采用Spearman相关分析和多元逐步回归法进一步分析. 结果 子痫前期合并GDM组孕妇血清NGAL水平高于子痫前期糖代谢正常组[(70.82±20.02) ng/ml与(56.17±18.22)ng/ml,t=3.65,P＜0.01]、GDM组[(43.99±14.82) ng/ml,t=5.97,P＜0.01]及正常妊娠组[(17.80±5.78) ng/ml,t=14.76,P＜0.01);子痫前期糖代谢正常组血清NGAL水平高于GDM组(t=5.90,P＜0.01);子痫前期合并GDM组和子痫前期糖代谢正常组中,子痫前期重度组血清NGAL水平均高于子痫前期轻度组[(76.44±28.06)ng/ml与(60.15±25.86) ng/ml,t=2.82,P＜0.05; (61.61±37.14) ng/ml与(46.30±13.97) ng/ml,t=4.74,P＜0.01].校正孕周、孕妇年龄后血清NGAL水平与孕前BMI(r=0.335,P＜0.01)、入组BMI(r=0.427,P＜0.01)、入组收缩压(r=0.648,P＜0.01),入组舒张压(r=0.664,P＜0.01)、空腹血糖(r=0.320,P＜0.01)、空腹胰岛素(r=0.381,P＜0.01)、HOMA-IR(r=0.399,P＜0.01)、甘油三酯(r=0.405,P＜0.01)、总胆固醇(r=0.145,P＜0.05)、游离脂肪酸(r=0.335,P＜0.01)、尿酸(r=0.292,P＜0.01)、肌酐(r=0.226,P＜0.01)及24 h尿蛋白(r=0.436,P＜0.001)呈正相关,与高密度脂蛋白胆固醇(r=-0.189,P=0.008)呈负相关.多元逐步回归分析显示,入组收缩压(β=0.251,P＜0.01),入组舒张压(β=0.351,P＜0.01)、HOMA-IR(β=0.265,P＜0.01)、24 h尿蛋白(β=0.140,P＜0.05)是血清NGAL的独立相关因素. 结论 子痫前期及GDM患者血清NGAL水平显著升高,与糖脂代谢及血管内皮功能失调相关,提示NGAL可能在子痫前期及GDM的病理生理过程中发挥作用.     

伊立替康联合FP方案治疗晚期食管癌疗效分析

Objective To evaluate the efficacy and adverse events of irinotecan (CPT-11)combined with PF in the treatmentof patients with advanced esophageal cancer. Methods A totalof 73 cases with advanced esophageal entered this trial. The patientswere randomly divided into trial group and control group, and 37 cases received chemotherapy of PIF regimen. 36 cases received chemotherapy of PF regimen. Each patient received at least 2 cyclesof chemotherapy. Results The efficacy and adverse events were evaluated in all patients. The overall response ratewas 59.46% in the PIF group and 46. 67% in the PF group, the difference between the two groups did not reach statistical significance(P ＞ 0. 05). The median time to progression(TTP)was 5.9 months in the PIF group and 4.4 months in the PF group. Themedian survival time(MST) was 12. 2months in the IP group and 9.3 months in the PF group. The main adverse events included elosuppression, nausea, vomiting and diarrhea. A lone diarrheawith statistically significant difference detected(P＜ 0. 05). Conclusion For advanced esophageal cancerpatients, PIF treatment achieves better therapeutic effects than PF treatment. it is toxicity is tolerable, It is valuable for clinical practicing.     

综合用药治疗脑血栓50例临床分析

脑血管病是危害人类健康的主要疾病之一,发病率、致残率高。如何防治心脑血管病是十分重要的。现将我院采用综合用药治疗脑血栓50例临床观察结果报告如下。