中医药治疗糖尿病肾病研究现状

糖尿病肾病病变部位在脾肾,病机为本虚标实,本虚以肾阴虚、脾气虚为主,标实以血瘀为主,肾虚为病机根本,血瘀是病机特点,贯穿始终。正虚毒损肾络为本病核心,益肾解毒通络为治疗大法。分期分型辨证是符合本病发展规律的方案,中成药及中药注射液也各具特色。目前虽已制定辨证分型及疗效判定标准,临证仍多种多样,治法方药纷呈各异,临床报告可比性差,难以开展循证医学多中心协作。药物不良反应的报道涉及甚少,缺乏机理研究。早期治疗尚可逆转。应严格科研设计,加强对DN早期研究。     

平肝固肾降逆法治疗中风后顽固性呃逆疗效观察

目的:观察运用平肝固肾降逆法治疗中风后顽固性呃逆临床疗效。方法:将47例患者随机分为治疗组24例,对照组23例,在中风常规治疗基础上,对照组给予常规的西医药物治疗;治疗组运用平肝固肾降逆法治疗。结果:治疗组总有效率91.7%,对照组总有效率60.9%(P<0.05)。结论:平肝固肾降逆法治疗中风后顽固性呃逆有较好疗效。     

Intractable vomiting and hiccups as the presenting symptom of neuromyelitis optica

Vomiting and hiccups can be due to peripheral or central causes. Neurological diseases causing vomiting and hiccups are due to lesions of medulla involving area postrema and nucleus tractus solitarius. Neuromyelitis optica (NMO) is one such disease which involves these structures. However refractory vomiting and hiccups as the presenting symptom of NMO is unusual. Here we report a patient with NMO in whom refractory vomiting and hiccups were the sole manifestation of the first attack. Diagnosis can be missed at this stage leading to delay in treatment and further complications. This case demonstrates the importance of considering NMO in any patient presenting with refractory vomiting and hiccups and with local and metabolic causes ruled out and linear medullary lesion on magnetic resonance imaging may indicate the diagnosis even when the classical clinical criteria are not met. Anti NMO antibody testing should be done and if positive appropriate treatment should be initiated to prevent further neurological damage.     

Efficacy of acupuncture for persistent and intractable hiccups: A protocol for systematic review and meta-analysis of randomized controlled trials

Background:Persistent and intractable hiccups are a common clinical symptom that cause considerable physical pain to patients and severely damage their quality of lives. An increasing number of studies have demonstrated that acupuncture applied at acupoints dominated by Cuanzhu (BL2) can be used as one of the nonpharmacological therapies for controlling intractable hiccups. However, there is insufficient evidence evaluating the safety and effectiveness of those interventions. Therefore, this study is intended to conduct a systematic review and meta-analysis to provide evidence for a further study investigating alternative treatment options for persistent and intractable hiccups.Methods and Analysis:Randomized controlled trials (RCTs) of adult patients aged >18 years who meet the criteria for intractable hiccup diagnosis will be included, regardless of gender, nationality, and education level. Eight electronic databases will be searched, including 4 Chinese databases (CNKI, SinoMed, Wanfang Database, and Chinese Scientific Journal Database), 4 English databases (Web of Science, Medline, Embase, and Cochrane Library), from their date of establishment to September 2020. Two independent reviewers will evaluate the title summary for each RCT. Disagreements will be discussed with a third commentator. Data integration, heterogeneity analysis, subgroup analysis, and sensitivity analysis, will be performed using R-3.3.2 software. The RevMan 5.3 software will be used for the meta-analysis, and the “risk of bias” assessment will be conducted based on the methodological quality of the included trials recommended by the Cochrane Handbook 5.1. The quality evaluation of this study will be completed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).Results:This study will summarize all the selected trials aimed at estimating the effectiveness, as well as safety, of applying acupuncture at acupoints dominated by Cuanzhu (BL2) to persistent and intractable hiccups.Conclusions:This systematic review will provide evidence to assess the validity and safety of applying acupuncture at acupoints dominated by Cuanzhu (BL2) for persistent and intractable hiccups, which may provide clinicians with more choices in the treatment of this disease.PROSPERO registration number:CRD42020114900.     

中药配方治疗脑卒中伴顽固性呃逆的疗效观察

目的观察一种中药配方治疗脑卒中伴顽固性呃逆的疗效及其预防并发症的效果,为临床治疗提供依据。方法将97例脑卒中伴顽固性呃逆患者采用随机数余数分组法将患者分成实验组及对照组,实验组49例应用中药配方水煎服服用,对照组48例应用甲氧氯普胺肌注,观察两组患者用药一周后的情况,比较两组治疗顽固性呃逆的显效情况、便秘的发生率、呼吸道感染率、消化道出血、肾功能损害、肝功能损害等。结果脑卒中伴顽固性呃逆患者实验组的总有效率达89．58％,明显优于对照组（P〈0．01）,差异有统计学意义。便秘（2．08％vs24．49％）、呼吸道（2．08％vs16．33％）、消化道出血（4．17％VS20．41％）、肝功能损害（2．08％VS16．33％）发生率较对照组明显减少,差异有统计学意义（P〈0．05）,而两组间肾功能损害发生率差异比较无统计学意义（8．33％VS8．16％,P〉0．05）。结论该中药配方能有效治疗脑卒中伴顽固性呃逆患者,有效预防并发症的发生。     

背部特定腧穴低频脉冲电针刺治疗顽固性呃逆疗效观察

目的:观察背部特定腧穴低频脉冲电针刺治疗顽固性呃逆的疗效。方法:将顽固性呃逆患者110例分为2组,观察组55例,对照组55例。观察组给予背部特定腧穴低频脉冲电针刺治疗,对照组采用常规取穴及针刺手法治疗,两组每次治疗时间相同。结果:经统计学处理,两组治疗效果有明显差异,观察组明显优于对照组。结论:背部特定腧穴低频脉冲电针刺可以有效治疗顽固性呃逆,在取穴简便,方法独特,缩短病程及消除病人极大痛苦上充分发挥作用。     

按压攒竹穴治疗中枢性顽固性呃逆28例分析

目的：评价攒竹穴治疗中枢性顽固性呃逆的有效性和安全性.方法：选择60例符合条件的顽固性呃逆患者,将其随机分为治疗组（30例）和对照组（30例）,治疗组给予按压攒竹穴治疗,对照组给予巴氯芬治疗.观察两组治疗前后临床症状疗效.结果：治疗组总有效率为98.1%,对照组总有效率为81.5%,两组之间疗效比较,差异有统计学意义（P〈0.05）.结论：按压攒竹穴治疗中枢性顽固性呃逆临床疗效确切,且操作简单,无任何副作用.     

丁香柿蒂汤+枳实导滞丸联合甲氧氯普胺足三里穴位注射治疗肿瘤化疗顽固性呃逆随机平行对照研究

[目的]观察丁香柿蒂汤合枳实导滞丸联合甲氧氯普胺足三里穴位穴位注射治疗肿瘤化疗顽固性呃逆疗效。[方法]使用随机平行对照方法,将80例住院患者按入院顺序分为两组。穴位注射:针头垂直刺入双侧足三里穴1.5~2.0cm,有酸胀感后,注入甲氧氯普胺,10mg/次,2次/d,连续治疗7d为1疗程。对照组40例多潘立酮片,10mg/次,3次/d。治疗组40例丁香柿蒂汤合枳实导滞丸,丁香柿蒂汤(丁香10g,柿蒂15g,党参20g,法半夏15g,生姜10g,旋覆花15g,代赌石先煎30g,五味子10g,麦冬15g);1剂/d,水煎200mL,早晚口服;枳实导滞丸(枳实12g,大黄后入、茯苓各15g,黄芩、黄连各10g,白术、泽泻、川芎各15g,地龙6g);磨粉,以蜜捏丸,3g/次,3次/d。观测临床症状、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组治愈15例,显效20例,有效3例,无效2例,总有效率95.00%。对照组治愈13例,显效18例,有效3例,无效6例,总有效率85.00%。治疗组疗效优于对照组(P0.05)。[结论]丁香柿蒂汤合枳实导滞丸联合甲氧氯普胺足三里穴位穴位注射治疗肿瘤化疗顽固性呃逆效果显著,值得推广使用。     

基于神经电生理与调控探讨针灸治疗中风后呃逆的选穴规律

目的 基于神经电生理与调控探讨针灸治疗中风后呃逆的临床选穴规律。方法 检索及梳理2000年1月1日-2021年12月31日4个中文数据库(CNKI、Wanfang、VIP、CBM)中针灸治疗中风后呃逆的相关文献，建立中风后呃逆的针灸处方数据库，利用SPSS 21.0和Clementine 12.0软件对数据进行描述性分析和关联规则分析，分析针灸治疗中风后呃逆的选穴规律。结果 经过筛选共有111篇文献符合纳入标准，统计出200条针灸治疗中风后呃逆的针灸处方，共涉及穴位88个，总频次1 143次，穴位使用频次最多的是内关、足三里、中脘，选穴位置以胸腹部为主，任脉穴位使用次数最多。通过关联规则技术得出穴位间相关性最高的是内关-中脘-足三里。结论 针灸治疗中风后呃逆组方具有规律性，且与单纯性呃逆的选穴规律的差别体现在选穴部位和穴位配伍上，中风后呃逆更注重脑腑协同作用及神经功能的调节，本研究为临床上使用针灸治疗中风后呃逆的选穴提供理论支持及参考依据。