健脾止遗片对儿童遗尿症的临床疗效观察

目的验证健脾止遗片对儿童遗尿症的治疗作用。方法将诊断为脾肺气虚型遗尿症的412例患儿,随机分为2组,治疗组309例,采用健脾止遗片治疗,对照组103例,采用遗尿停胶囊治疗,2周为1个疗程。治疗4个疗程后,统计分析疗效。结果治疗组临床痊愈率43．67％,总有效率91．33％;对照组临床痊愈率36．00％,总有效率90．00％,组问比较,治疗组疗效优于对照组（P〉0．05）;在改善睡中遗尿、尿频量多方面,治疗组疗效优于对照组（P〉0．05）。结论健脾止遗片对脾肺气虚型儿童遗尿症具有显著的治疗作用,尤其在改善睡中遗尿、尿频量多方面具有较好的疗效。     

消瘤方加减治疗化疗后正虚痰凝型弥漫大B细胞淋巴瘤60例临床观察

目的观察消瘤方加减对化疗后正虚痰凝型弥漫大B细胞淋巴瘤(DLBCL)患者生活质量、肿瘤负荷情况及机体免疫的影响。方法收集化疗4~6个疗程结束临床评估为完全缓解或不确定的完全缓解的DLBCL患者60例,随机分为对照组与治疗组各30例。两组患者均遵医嘱随访观察定期复查,入组后每个月进行1次随访。治疗组在此基础上予消瘤方加减口服,2周为1个疗程,共治疗6个疗程。对比两组患者治疗前后中医症状积分、生活质量(EORTC-QLQ-C30)评分、KPS评分、肿瘤负荷指标[包括乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)]、免疫球蛋白[包括免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)]水平,并判定中医证候疗效、生活质量疗效,计算复发率。结果治疗组中医证候疗效总有效率为96.67%,明显优于对照组的33.3%,差异有统计学意义(P<0.05)。治疗组无复发,对照组复发率为16.67%,差异有统计学意义(P<0.05)。治疗组生活质量疗效中好转率(80.00%)高于对照组(13.33%),治疗组恶化率(0)低于对照组(6.67%,P<0.01)。与本组治疗前比较,治疗后治疗组疲倦、恶心呕吐、气促、失眠、食欲不振、便秘评分,中医症状积分,LDH、β2-MG水平均明显降低,社会功能、情绪功能、躯体功能、角色功能、总体健康状况评分,IgA、IgG、IgM水平均明显升高(P<0.05);对照组中医症状积分明显降低(P<0.05),其余指标差异均无统计学意义(P>0.05),两组各指标差值比较差异均有统计学意义(P<0.05)。结论消瘤方加减可以有效改善化疗后正虚痰凝型DLBCL患者中医证候,提高生活质量及机体免疫力,有效降低肿瘤负荷指标,并可减少复发。     

“Warming yang and invigorating qi” acupuncture alters acetylcholine receptor expression in the neuromuscular junction of rats with experimental autoimmune myasthenia gravis

Myasthenia gravis is an autoimmune disorder in which antibodies have been shown to form against the nicotinic acetylcholine nicotinic postsynaptic receptors located at the neuromuscular junction. “Warmingyang and invigoratingqi” acupuncture treatment has been shown to reduce serum inlfammatory cytokine expression and increase transforming growth factor beta expression in rats with experimental au-toimmune myasthenia gravis. However, few studies have addressed the effects of this type of acupuncture on the acetylcholine receptors at the neuromuscular junction. Here, we used confocal laser scanning microscopy to examine the area and density of immunoreactivity for an antibody to the nicotinic acetylcholine receptor at the neuromuscular junction in the phrenic nerve of rats with experimental autoimmune myasthenia gravis following “warmingyang and invigoratingqi” acupuncture therapy. Needles were inserted at acupressure pointsShou-sanli (LI10),Zusanli(ST36),Pishu (BL20), and Shenshu (BL23) once daily for 7 consecutive days. The treatment was repeated after 1 day of rest. We found that area and the integrated optical density of the immunoreactivity for the acetylcholine receptor at the neuromuscular junction of the phrenic nerve was signiifcantly increased following acupuncture treatment. This outcome of the acupuncture therapy was similar to that of the cholinesterase inhibitor pyridostigmine bromide. These ifndings suggest that “warmingyangand invigoratingqi” acu-puncture treatment increases acetylcholine receptor expression at the neuromuscular junction in a rat model of autoimmune myasthenia gravis.     

加减益气聪明汤治疗脑动脉粥样硬化的临床观察

目的 观察加减益气聪明汤治疗脑动脉粥样硬化的临床疗效.方法 将脑动脉粥样硬化属气血亏虚型患者60倒,随机分为两组,治疗组30例运用加减益气聪明汤治疗,对照组30例运用银杏叶片治疗.治疗28 d后观察并比较两组患者总体临床疗 效、治疗前后头晕等级改善程度.结果 治疗组与对照组总有效率差异无统计学意义(93.3％ vs 90.0％,P＞0.05),但治疗组头晕改善程度明显优于对照组(P＜0.05).结论 加减益气聪明汤治疗脑动脉硬化所致眩晕近期疗效确切.     

The Severity of Toxic Reactions to Ephedra: Comparisons to Other Botanical Products and National Trends from 1993–2002

Objective. Ephedra is a botanical product widely used to enhance alertness, as a weight loss aide, and as a decongestant. Its reported adverse effects led the Food and Drug Administration (FDA) to ban ephedra-containing products in the United States in 2004. This study's purpose was to compare toxicity from botanical products containing ephedra to nonephedra products. Methods. The Toxic Exposure Surveillance System (TESS), a national poison center database, was utilized to determine the number and outcomes of cases involving botanical products reported from 1993–2002. Cases listing both a botanical product and any other drugs or chemicals were excluded a priori. Ten-year hazard rates (moderate outcomes + major outcomes + deaths per 1000 exposures) were used to compare botanical product categories. Results. There were 21,533 toxic exposures with definitive medical outcomes reported over the 10 yrs where a botanical product was the only substance involved. Of these, 4,306 (19.9%) had moderate or major medical outcomes and there were two deaths, for an overall hazard score of 200 per 1000 exposures. The number of ephedra reports to poison centers increased 150-fold over the 10-yr period. The hazard rate for products that contained only ephedra was 250 per 1000 exposures and 267 per 1000 exposures for products that contained ephedra and additional ingredients; whereas the hazard score for only nonephedra botanical products was 96 per 1000 exposures. The rate ratios for multibotanical products with ephedra (RR 1.33; 95% C.I. 1.27–1.40) and for single-ingredient ephedra products (RR 1.25; 95% C.I. 1.11–1.40) were both two to six times higher than those of other common botanical products. Yohimbe-containing products had the highest hazard score (417) and rate ratio (2.08; 95% C.I. 1.59–2.80). Conclusion. Ephedra-containing botanical products accounted for a significant number of toxic exposures with severe medical outcomes reported to poison centers. Hazard rate analysis suggests poison center–reported events involving ephedra-containing botanical products were much more likely to result in severe medical outcomes than those involving nonephedra-containing botanical products. These data support recommendations by policymakers that the sale of ephedra should be prohibited to protect consumers. Our data suggest that the botanical product, yohimbe, may also be associated with unacceptably high risks of toxicity and should receive close scrutiny from health policymakers.     

片仔癀在治疗褥疮中的应用

褥疮是临床工作中常见的护理问题，应早期发现．早期治疗。一旦发生，除应加强基础护理外，一些药物的应用也可以促进炎症的吸收，增强机体免疫力，使创面迅速愈合。现介绍片仔癀治疗褥疮中的作用。     

补气祛风法治疗小儿咳嗽变异性哮喘38例

目的观察补气祛风法治疗小儿咳嗽变异性哮喘的临床疗效。方法38例咳嗽变异性哮喘患儿均以补气祛风法为治疗原则，口服中药汤剂，并随症加减，7d后统计疗效。结果临床治愈19例，有效16例，无效3例，总有效率为92．11％。结论采用补气祛风法治疗小儿咳嗽变异性哮喘，既可提高患儿抗病能力，又可减轻机体对过敏因素的应激反应，抗复发、防演变，疗效显著。     

《伤寒杂病论》"下法"探析

通过对《伤寒杂病论》中运用"下法"的统计与研究,认为张仲景治病首重祛邪,邪去则正安。张仲景之下法千变万化,有寒下、有温下、有峻下、有缓下、有润下、有导下、有攻补兼施,又有表里同治之解表兼攻里。具体运用中,又当根据患者的实际情况,燥热内结者用通便泻热攻下法,气滞中满者用行气导滞攻下法,痰水内结者用逐水涤痰攻下法,血瘀而结者用破积逐瘀攻下法,湿热郁蒸发黄者用清利退黄攻下法,寒实内结者则用温经散寒攻下法。临床只要辨证准确,选用方法精当,自可效如桴鼓。     

津原汤治疗原发性干燥综合征74例临床观察

目的探讨津原汤治疗原发性干燥综合征(PSS)的临床疗效及其对免疫功能的调节作用。方法将124例PSS患者随机分为治疗组(74例)、对照组(50例),另选24名健康人为健康组,进行对照观察。治疗组给予津原汤治疗,对照组用必嗽平治疗,两组疗程均为2个月。两组病例治疗前后检测免疫球蛋白及T淋巴细胞亚群,并对临床疗效作对比分析。结果治疗前两组患者免疫球蛋白均高于健康组,自然杀伤(NK)细胞、CD_4比例均低于健康组。治疗后两组IgG、IgM、IgA均有不同程度下降,治疗组治疗前后比较差异有显著性意义(P<0.01)。两组NK细胞、CD_4比例均有回升(P<0.05)。治疗后CD_3治疗组低于对照组(P<0.05)。临床缓解率治疗组为68.92%,对照组为26.00%;总有效率治疗组为97.30%,对照组72.00%,两组总有效率、临床缓解率比较差异有统计学意义(P<0.05或P<0.01)。结论津原汤治疗PSS临床疗效显著,具有调节免疫作用。     

中西医结合治疗小儿肠系膜淋巴结炎疗效观察

目的观察自拟中药理气化痰汤治疗小儿肠系膜淋巴结炎的临床疗效。方法将肠系膜淋巴结炎患儿40例随机分为中西医结合组20例和西药组20例，2组均应用青霉素G静脉滴注和利巴韦林片口服，必要时给予退热和解痘止痛等对症处理；治疗组同时加用自拟中药理气化痰汤，1周为1个疗程。治疗过程中观察临床症状改善或消失情况及退热和解痉止痛药等使用情况，判断近期疗效。结果2组腹痛治愈率比较差异具有统计意义（P〈O．05），伴随症状改善或消失时间比较有高度统计意义（P〈0．01），退热药、解痉药使用次数相比有高度统计意义（P〈0．01）。结论中西医结合治疗小儿急性肠系膜淋巴结炎疗效较好。