Comparative research between acupuncture and Climen in treatment of menopausal hot flashes: A randomized controlled trial: 针灸与克龄蒙治疗更年期潮热比较研究

ObjectiveTo compare the therapeutic effect on menopausal hot flashes between acupuncture and Climen so as to provide a new approach to the treatment of this disease.MethodsA total of 80 cases in line with inclusion criteria were randomized into a treatment group (treated with acupuncture) and a control group (oral administration with climen), 40 cases in each one. The treatment for 1 month was as 1 course and lasted consecutively for 2 courses. Before and after treatment, the contents of serum estrogen (estradiol, E₂) and 5-hydroxytryptamine (HT) and the scores of the attack frequency and severity scale of hot flashes and sweating, domestic modified Kupperman scale and traditional Chinese medicine (TCM) symptom scale were observed, and the clinical therapeutic effect was evaluated in the two groups separately.ResultsBefore treatment, there was no difference in the content of E₂ and 5-HT, the score of hot flashes and sweating, Kupperman score and TCM symptom score in the patients between two groups, indicating the comparability (all P > 0.05). Compared with the data before treatment, the contents of serum E₂ (treatment group vs control group: 22.24 ± 11.02 vs 33.12 ± 1.01; 22.11 ± 10.19 vs 25.29 ± 2.23) and 5-HT (treatment group vs control group: 96.12 ± 8.21 vs 131.21 ± 30.21; 96.98 ± 7.99 vs 108.29 ± 22.08), the score of hot flashes and sweating (treatment group vs control group: 8.24 ± 1.02 vs 3.12 ± 1.01; 8.11 ± 1.19 vs 5.29 ± 2.23), Kupperman score (treatment group vs control group: 26.12 ± 2.21 vs 11.21 ± 0.21; 26.98 ± 1.99 vs 18.29 ± 2.08) and TCM symptom score (treatment group vs control group: 18.97 ± 3.87 vs 10.12 ± 0.16; 19.01 ± 2.29 vs 15.61 ± 2.89) were statistically different after treatment in the two groups (all P < 0.05). After treatment, the contents of serum E₂ and 5-HT, the score of hot flashes and sweating, Kupperman score and TCM symptom score in the treatment group were all different statistically compared with the control group (all P < 0.05). There was statistical difference in clinical therapeutic effect in the patients between two group, in which, the therapeutic effect in the treatment group was better than that in the control group (90% vs 77.5%, P < 0.05).ConclusionAcupuncture effectively reduces Kupperman score and TCM symptom score in the patients and its therapeutic effect is better than climen. Regarding relieving hot flashes symptoms in menopausal patients of kidney yin deficiency and improving in attack frequency and severity of hot flashes and sweating, the effects of acupuncture are superior to Climen. Acupuncture obviously increases the contents of serum E₂ and 5-HT.     

穴位注射丹参联合中药面膜及左旋维生素C外用治疗黄褐斑的临床观察

目的:观察穴位注射丹参联合中药面膜及左旋维生素C外用治疗黄褐斑的临床疗效。方法:将100例黄褐斑患者随机分为背部俞穴注射丹参联合中药面膜及左旋维生素C治疗组(A组)和中药面膜联合左旋维生素C治疗组(B组),每组50例。观察两组患者的临床疗效,采用VISIA面部棕色斑评分法与传统评价法(评分计算法)评价两组有效率并进行比较。结果:按评分计算法评价A组和B组的临床总有效率分别为96%和94%,差异无统计学意义(P>0.05),但基本治愈率和显效率A组高于B组,差异有统计学意义(P<0.05)。按VISIA面部棕色斑评分法与评分计算法所得结果相当。结论:背部俞穴穴位注射丹参联合中药面膜及左旋维生素C外用治疗黄褐斑疗效较好。     

解毒活血法治疗溃疡性结肠炎急性发作期临床观察

目的 观察解毒活血法治疗溃疡性结肠炎急性发作期的临床疗效.方法 将65例溃疡性结肠炎急性发作期的患者,随机分为治疗组和对照组,对照组33例采用柳氮磺吡啶肠溶片灌肠治疗,治疗组32例采用白头翁汤联合血竭胶囊灌肠治疗.疗程均为2周.结果 治疗组总有效率为90.63％,高于对照组的72.73％;两组临床疗效、肠黏膜疗效比较,治疗组均优于对照组（均P＜ 0.05）.结论 解毒活血法治疗溃疡性结肠炎急性发作期有较好的临床疗效.     

小柴胡加味汤治疗类风湿关节炎活动期100例疗效观察

目的观察小柴胡加味汤治疗类风湿关节炎活动期的临床疗效。方法将100例类风湿关节炎活动期患者随机分为两组,每组各50例。对照组采用西医常规治疗手段,治疗组在西医常规治疗基础上加用小柴胡加味汤,疗程1个月。治疗1月后,观察治疗前后两组临床症状以及实验室指标如血沉（ESR）、类风湿因子（RF）改善程度。结果治疗组总有效率为92．00％,高于对照组的70．00％（P〈0．05）;两组ESR、RF均改善,治疗组改善更显著（P＜0．05）。结论小柴胡加味汤治疗类风湿关节炎活动期具有良好的疗效。     

虎杖苷对NRK-52E细胞缺血再灌注损伤时TLR-4表达的抑制作用

虎杖苷（polydatin,PD）是传统中药虎杖中提取的第四单体,具有利湿退黄,活血通经等功效。研究发现其对缺血再灌注（ischemia reperfusion,I/R）肾损伤其保护作用,目前虎杖苷在急性缺血性肾损伤中的具体作用尚不完全清楚。该实验通过培养肾小管上皮细胞（NRK-52E）,观察体外缺血再灌注损伤时虎杖苷对大鼠肾小管上皮细胞TLR4受体的干预作用并进一步探讨其对TLR4信号通路的作用机制。将体外培养的NRK-52E细胞采用缺氧复氧的方法,模拟肾I/R损伤过程。在缺氧复氧6 h/24 h时,采用realtime-PCR检测TLR4基因的表达变化,Western blot检测TLR4和NF-κB蛋白水平,ELISA检测炎症因子TNF-α,IL-1β水平。虎杖苷浓度依赖性下调TLR4的mRNA和蛋白表达水平,减少TLR4下游信号分子NF-κB的蛋白表达水平以及炎症因子TNF-α和IL-1β的蛋白表达水平。此外,TLR4阻断剂对缺氧复氧诱导的NRK-52E细胞NF-κB及炎症因子TNF-α和IL-1β的蛋白表达水平有部分抑制作用,虎杖苷可增强这一抑制作用。虎杖苷对NRK-52E细胞TLR4致炎信号通路的负性调节作用,可能是通过干预TLR4表达,影响胞内信号转导途径,抑制NF-κB表达,从而减轻肾脏炎症反应。     

重庆地区高血压风险评估和社区治疗分析

目的：分析重庆地区高血压的风险评估和社区治疗情况。方法：2007年1月至5月收集重庆地区健康人1605例和高血压患者1596例,其中高血压患者1596例随机分为治疗组805例和对照组791例。结果：高血压的危险因素依次为：BMI≥25kg／m2、腹型肥胖、大于60岁、是否锻炼、月收入低于1500元、受教育低于高中、男性、有高血压家族史和每日摄入高盐。经过3年的干预治疗,与对照组比,治疗组的体重指数、腰围、收缩压和舒张压下降明显（P〈0．05）。治疗组的心、脑血管事件发生较低（P〈0．05）。结论：社区综合强化干预对高血压患者血压的治疗管理更为有效。     

慢性肝病相关肌少症的影像学进展

肌少症是一组以骨骼肌质量减少、功能减退为主要特征的临床综合征,也是慢性肝病的并发症之一。影像学检查不仅能够反映肌肉结构和成分的变化,还可以定量评估肌肉的横截面积、体积以及肌肉内脂肪含量,是评估肌少症肌肉质量的重要工具。就双能X线吸收测定（DXA）、超声、CT、外周定量CT（pQCT）及MRI在慢性肝病肌少症中的临床应用及研究进展予以综述。     

检测氨基末端脑钠肽前体在心力衰竭患者中的临床意义

目的探讨心力衰竭(HF)患者血清N末端B型脑钠肽前体(NT-proBNP)水平的改变及其临床意义。方法采用金标法测定108例HF患者、40例健康对照者及45例HF患者经常规治疗后第3、10、20天血清NT-proBNP水平,并进行统计分析。结果 HF患者血清NT-proBNP水平高于健康对照组(P<0.05),且血清NT-proBNP水平随着病情的加重而升高(P<0.05);HF患者治疗后血清NT-proBNP水平逐渐下降(P<0.05)。结论血清NT-proBNP是可有效反映心功能状态的客观指标,对HF诊断、病情判断、疗效及预后评价有重要价值。     

Therapeutic effect of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients:a clinical two-center randomized controlled trial

OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients.METHODS:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were randomly divided into a group treated with standardized electric acupuncture and massage,and a group treated with rehabilitation therapy for 6 weeks.The primary indices evaluated were pain on passive movement of the shoulder using the numeric pain rating scale(NPRS),and the number of patients with shoulder-hand syndrome at Steinbrocker stage II or III after treatment.The secondary indices were Fugl-Meyer evaluation of functional movement of the upper limb and hand using the modified rankin scale(MRS).RESULTS:At post-treatment evaluation and a 12-week follow-up visit,NPRS score,number of patients with stage II or III shoulder-hand syndrome,and MRS score were all improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).On Fugl-Meyer evaluation,functional movement of the upper limb was also improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).CONCLUSION:Standardized acupuncture-massage therapy may have curative effects on shoulder-hand syndrome in hemiplegia patients.     

川芎嗪联合银杏达莫或丹参注射液治疗糖尿病肾病的疗效比较

目的:观察川芎嗪联合银杏达莫或丹参注射液治疗糖尿病肾病(DN)的疗效。方法:选取72例在我院治疗的DN患者,按随机数字表法分为2组,A组患者给予川芎嗪注射液80mg+丹参注射液10mL静脉滴注,qd;B组患者给予川芎嗪注射液80mg+银杏达莫注射液20mL静脉滴注,qd。2组均治疗14d。观察2组的疗效及各项实验室指标。结果:治疗后,2组空腹血糖、餐后2h血糖、肌酐、尿素氮等与治疗前比较,均有所下降,差异均有统计学意义(P<0.05);24h尿蛋白排泄量B组明显低于A组,差异有统计学意义(P<0.05)。2组均未见严重不良反应发生。结论:川芎嗪联合银杏达莫注射液能有效降低24h尿蛋白排泄量,疗效优于川芎嗪联合丹参注射液。