针药结合治疗多囊卵巢综合征临床观察

目的观察针药结合治疗多囊卵巢综合征(PCOS)的临床疗效。方法将82例PCOS患者随机分为2组:治疗组40例给予针刺结合中药内服治疗,对照组42例口服炔雌醇环丙孕酮片,疗程24周。观察两组临床疗效及治疗前后血清睾酮(T)、胰岛素(INS)、卵泡刺激素(FSH)、促黄体生成激素(LH)水平变化。结果治疗组总有效率为80.00%,对照组为71.43%(P<0.05);治疗后两组血清T值、LH值下降(P<0.05),组间差异无统计学意义(P>0.05);治疗组空腹INS值下降明显,与治疗前及对照组治疗后比较差异具有统计学意义(P<0.05)。结论针药结合疗法治疗PCOS疗效确切,且可缓解胰岛素抵抗。     

蔡氏通络法联合通液术治疗输卵管性不孕症临床效果分析

  目的：观察蔡氏通络法联合输卵管通液术治疗输卵管性不孕症的临床疗效  方法：将73例输卵管性不孕症患者分为单纯组(41例)和联合组(32例),分别给予蔡氏通络法和蔡氏通络法联合通液术治疗,疗程为6个月经周期。观察两组妊娠情况和输卵管通畅情况  结果：①单纯组总有效率为90.24%,联合组为100%;两组疗效无统计学差异(P>0.05)。②单纯组总妊娠率为36.59%,联合组为37.5%;两组总妊娠率无明显差异(P>0.05)。③单纯组3个月内妊娠率为26.67%,联合组为66.67%;两组3个月内妊娠率差异有统计学意义(P<0.05)。④单纯组输卵管复通率为38.00%,联合组为70.27%;两组复通率有显著差异(P<0.05)  结论：蔡氏通络法联合输卵管通液术能提高输卵管复通率和短期妊娠率。     

疯油膏结合热烘疗法治疗手部角化性湿疹的临床观察

目的:观察疯油膏结合热烘疗法治疗手部角化性湿疹的临床疗效。方法:选择符合入组标准的手部角化性湿疹患者,并随机分为治疗组与对照组。治疗组采用疯油膏结合热烘疗法治疗,对照组采用糠酸莫米松乳膏治疗。两组均以4周为1个疗程,连续观察2个疗程的皮损情况,并评价临床疗效及安全性。结果:两组在各疗程的JHS积分与VAS积分均较治疗前显著降低(P0.01),且治疗组JHS积分在第1、第2疗程均明显低于对照组(P0.05,P0.01),VAS积分在第2疗程后也较对照组明显降低(P0.05);2疗程中,治疗组的有效率分别为85.4%、93.8%,对照组为58.0%、64.0%,治疗组均显著优于对照组(P0.01)。治疗组有2例因出现局部皮肤刺激症状退出观察,其余未出现任何不良反应。结论:疯油膏结合热烘疗法治疗手部角化性湿疹疗效显著,且较少出现不良反应。     

电针治疗轻中度女性压力性尿失禁的近远期疗效观察

目的观察电针和盆底肌功能锻炼治疗轻中度女性压力性尿失禁的近远期疗效。方法将符合纳入标准的患者分为治疗组(33例)和对照组(33例),以1 h尿垫试验、ICIQ-SF量表为观察指标,4周为1个疗程,1个月和6个月后分别进行近远期疗效评定。结果近期疗效:治疗组总有效率达93.94%,对照组总有效率达54.55%;治疗组的总有效率明显高于对照组(P<0.05)。远期疗效:治疗组痊愈患者结束治疗后不采取任何后续措施,6个月后随访,复发率13.33%;对照组坚持锻炼6个月的疗效优于锻炼1个月(P<0.05)。结论电针治疗轻中度女性压力性尿失禁起效快、见效显著、患者依从性高,有较好的近期和远期疗效,值得临床进一步推广。     

雷公藤多甙对小鼠生育的影响及肉苁蓉干预作用的研究

目的:研究使用不同时间和剂量的雷公藤多甙(GTW)对昆明小鼠怀孕率的影响及肉苁蓉干预和停用GTW后的自愈倾向。方法:将90只成年雄性昆明鼠随机分为9组(每组10只)。对照组给予1%羧甲基纤维素(CMC)溶液;GTW各组分别给予45.0、30.0、22.5、15.0、7.5mg/(kg·d)GTW混悬液;肉苁蓉各组分别给予30.0、7.5mg/(kg·d)GTW混悬液;停药组给予30.0mg/(kg·d)GTW混悬液。以上各组先灌胃20d,20d后与成年雌鼠1∶2合笼7d。第28d起GTW各组按原剂量继续给药;肉苁蓉各组给原剂量GTW混悬液的同时分别给10.0、2.5g/(kg·d)肉苁蓉煎液;停药组停GTW,改为1%CMC溶液。20d后再次合笼7d。每次合笼后观察雌鼠怀孕率。结果:随着GTW给药时间的延长和剂量的增加,雌鼠怀孕率呈下降趋势。GTW45.0mg/(kg·d)组给药40d后怀孕率降为0%(P<0.01)。肉苁蓉10.0g/(kg·d)组怀孕率由20d时的25%上升到40d时的55%。停药组怀孕率由25%上升到56%,与对照组比较,差异无显著性(P>0.05)。结论:GTW对雄性小鼠的生殖毒性呈时间和剂量依赖性。肉苁蓉可以改善GTW对雄鼠生殖系统的抑制作用,提高雌鼠的怀孕率。停用GTW20d,怀孕率可以基本恢复正常。     

Urtica dioica in comparison with placebo and acupuncture: A new possibility for menopausal hot flashes: A randomized clinical trial

ObjectivesThe purpose of this research was to investigate the effect of Urtica dioica in comparison with placebo, acupuncture and combined therapy on hot flashes and quality of life in postmenopausal women.MethodsIn a double-blinded randomized controlled trial, patients were treated for 7 weeks then followed up 4 weeks. Seventy-two postmenopausal women who reported at least 20 hot flashes attacks per week were randomly allocated into one of the 4 groups of Urtica dioica 450 mg/day and acupuncture 11 sessions (A), acupuncture and placebo (B), sham acupuncture and Urtica dioica (C), and sham acupuncture and placebo (D). The primary outcomes were the change in hot flashes score from baseline to the end of treatment and follow up; and the change in the quality of life (MENQOL) from baseline to the end of treatment. Secondary outcomes included changes in FSH, LH, and ESTRADIOL levels from baseline to the end of treatment. The trial was conducted from October 2017 to July 2018 in Acupuncture clinic of a teaching hospital in Iran.ResultsA total of 72 women 45–60 years old were enrolled, and 68 were included in the analyses. The median (IQR) hot flashes score decreased in the A group by 20.2 (31.7) and 21.1 (25.1), B group by 19 (18) and 17.3 (27), C group by 14.6 (25.4) and 20.8 (13), and D group by 1.6 (11.6) and 1 (13.3) at the end of treatment and follow up (P < 0.0001, P < 0.0001); no significant difference between A, B and C groups. The mean (SD) of MENQOL score decreased in the A group by 42.6 (21.1), B group by 40.7 (29.8), C group by 37.8 (26.8) and D group by 9.8 (14.3) at the end of treatment (P = 0.001); no significant difference between A, B and C groups.ConclusionsUrtica dioica can decrease menopausal hot flashes and increase the quality of life of postmenopausal women better than placebo-sham control but same as acupuncture. The combination of Urtica dioica and acupuncture did not add to the effects of those therapies.     

电针预处理对心肌缺血再灌注大鼠线粒体能量代谢的影响

ObjectiveTo explore the effects of electroacupuncture pretreatment on mitochondrial energy metabolism in the rats with myocardial ischemia reperfusion injury (MIRI).MethodsA total of 60 SPF Wistar rats were randomly divided into a sham-operation group (sham group), a myocardial ischemia reperfusion injury group (MIRI group) and an electroacupuncture pretreatment group (EA group), 20 rats in each one. The rats in the sham group and the MIRI group were binded for 7 days, once a day, 20 min each time. On the 8^th day, the sample was collected after the heart exposed for 50 min in thoractomy in the sham group and the sample was collected after ischemia for 20 min and reperfusion for 30 min in thoractomy in the MIRI group. In the EA group, the pretreatment intervention with electroacupuncture was applied at "Nèiguān (内关PC6)", "Guānyuán (关元CV4)" and "Zúsānlĭ (足三里ST36)" in the rats for 7 days, once a day, 20 min each time. On the 8^th day, after ischemia for 20 min and reperfusion for 30 min in thoractomy, the sample was collected in the EA group. The changes in ST_Ⅱ segment of electroacardiogram (ECG) were observed and measured. Using enzyme-linked immunosorbent assay (ELISA), the concentrations of cardiac troponin T (cTnT) and cardiac troponin I (cTnI)were detected. Using nitro blue tetrazolium chloride monohydrate (NBT) staining, the myocardial infarction weight percentage was measured. Using ELISA, the concentrations of mitochondrial adenosine monophosphate (AMP), adenosine diphosphate (ADP)and adenosine triphosphate (ATP)were detected.Results(1) ST_Ⅱ changes: in 20 min of ligation, compared with the sham group, the ST_Ⅱ segment of electrocardiograph (ECG) was elevated significantly in the MIRI group and EA group (both P < 0.01), but the elevation range in the EA group was lower than that of the MIRI group (P < 0.01). After reperfusion for 30 min, the ST_Ⅱ segment was fallen by over 50% in the MIRI group and the EA group. Simultaneously, the ST_Ⅱ segment in the EA group was lower than that of the MIRI group (P < 0.01). (2) Regarding myocardial infarction weight percentage, compared with the sham group, the infarction weight was larger in the MIRI group and the EA group (both P < 0.05) and the infarction weight in the EA group was lower than that of the MIRI group (P < 0.05). (3) Regarding the levels of serum cTnt and cTnI, compared with the sham group, the levels of serum cTnT and cTnI were higher in the MIRI group and the EA group (all P < 0.01) and the levels of cTnT and cTnI in the EA group were lower than that of the MIRI group (both P < 0.01). (4) Regarding the concentrations of AMP, ADP and ATP, compared with the sham group, ATP concentration was lower in the MIRI group and the EA group (both P < 0.01) and the concentrations of AMP and ADP were higher (P < 0.05, P < 0.01). Compared with the MIRI group, ATP concentration was higher in the EA group (P < 0.05) and the concentrations of AMP and ADP were lower (both P < 0.01).ConclusionsElectroacupuncture pretreatment reduces the elevation of ECG ST_Ⅱ segment, decreases the concentrations of myocardial injury markers, cTnT and cTnI and regulates the transfer among AMP, ATP and ADP. The protective effect of electroacupuncture pretreatment may result from the regulation of mitochondrial energy metabolism.     

裘沛然治疗咳喘病经验

国医大师裘沛然先生以善治疑难杂病著称。裘老认为,疑难杂症的机制比较复杂,缠绵难愈的原因主要有以下几个方面：有的疾病,人体正气表现非常虚弱,失却制止病邪的能力,导致病情迁延;有的疾患,病邪相当峻厉,人体正气不能抗拒;病情出现复杂情况,或表里同病,或寒热错杂,或大虚大实和虚实夹杂;病邪深痼,     

祛痰定痫汤治疗癫痫30例临床观察

目的 观察祛痰定痫汤治疗癫痫的临床疗效。方法30例癫痫患者采用自拟祛痰定痫汤加减治疗,疗程1年。结果近期治愈8例,好转21例,未愈1例,总有效率为96．6％。结论祛痰定痫汤治疗癫痫疗效确切,且无不良反应。     

胆石症术后联合中药制剂对患者血清总胆汁酸及预后情况的影响

目的:考察胆石症患者术后联用中药制剂小柴胡汤对其血清总胆汁酸的影响及患者预后情况。方法:选择2014至2015年上海市中医院收治的148例胆石症患者作为研究对象,中医辨证症候均为肝郁气滞型。按随机数表法将患者分2组,每组74例。患者均经外科手术取石。术后观察组联用中药制剂小柴胡汤,对照组仅接受术后常规药物治疗。疗程2个月。术前(1~3 d)、治疗后(术后第1、2个月末)分别检测肝功能相关指标(ALT、As T、TBi L)和血清总胆汁酸浓度。考察治疗效果(指标:临床总有效率)和患者预后(指标:复发率)。结果:治疗后患者胁腹痛等不适症状均减轻或消除,肝郁、气滞症候得到明显改善;2个组临床总有效率比较的差异有统计学意义(P0.05)。术后第1个月末、第2个月末,患者肝功能指标、血清TBA浓度均较其术前显著降低;其中观察组在治疗后(P0.05)、每一时点(P0.05)与对照组在如上指标比较的差异均有统计学意义(P0.05)。持续随访患者,随诊率93.92%(139/148),复发率2.16%。结论:胆石症患者术后联用小柴胡汤可调节血清总胆汁酸浓度从而抑制胆石形成,对于预防胆石症、降低复发率有积极的临床意义。