OCTA定量分析补阳还五汤加味对非增殖型糖尿病视网膜病变患者视盘血流的影响

目的：观察补阳还五汤加味治疗气阴两虚、络脉瘀阻型非增殖型糖尿病视网膜病变(NPDR)的临床疗效,并应用光学相干断层扫描血管成像(OCTA)定量分析治疗前后视盘旁血流密度的变化。

方法：采用前瞻性随机对照试验。收集2022-06/11期间我院收治的符合气阴两虚、络脉瘀阻型NPDR患者58例99眼,随机分为对照组29例48眼,采用2019年美国眼科学会发布的糖尿病视网膜病变推荐方案进行基础治疗(对于轻度NPDR患者进行控制血糖、糖尿病健康教育、定期随访; 中度NPDR患者必要时增加局部或格栅样激光光凝治疗),观察组29例51眼在对照组的基础上加用补阳还五汤加味口服治疗1mo。比较两组患者治疗前后最佳矫正视力(BCVA)、中医证候疗效、视盘旁放射状毛细血管网血流密度(ppVD)及视盘旁视网膜神经纤维层(pRNFL)厚度变化。

结果：治疗1mo后观察组BCVA(LogMAR)为0.20(0.10,0.30),较对照组0.30(0.20,0.40)明显改善(P<0.05)。治疗1mo后观察组中医证候疗效优于对照组(P<0.05)。观察组治疗1mo后各象限ppVD均较治疗前明显提高,且观察组各象限ppVD均高于对照组(P<0.05)。观察组治疗1mo后上方、颞侧象限及全周平均pRNFL厚度较治疗前升高,且观察组上方、颞侧、下方象限和全周平均pRNFL厚度均高于对照组(P<0.05)。

结论：气阴两虚、络脉瘀阻型NPDR患者服用补阳还五汤加味后可改善视力、提高中医证候疗效,可能与其能提高视盘旁放射状毛细血管网血流密度和减少视盘旁神经纤维层的损伤有关。     

身痛逐瘀汤配合斜扳法治疗腰椎间盘突出症

目的：观察身痛逐瘀汤配合斜扳法治疗腰椎间盘突出症的临床疗效。方法：将本院128例腰椎间盘突出症患者随机分为治疗组（76例）和对照组（52例）,治疗组采用口服身痛逐瘀汤配合斜扳法,对照组采用斜扳法治疗。观察两组治疗后的临床疗效。结果：治疗2个疗程后两组临床疗效比较,治疗组总有效率为97.4%,对照组为86.5%,治疗组优于对照组,差异有统计学意义（P〈0.05）。结论：身痛逐瘀汤配合斜扳法治疗腰椎间盘突出症是一种较为理想的方法。     

柴葛解肌汤治疗小儿上呼吸道感染的临床效果及对高热炎性反应和免疫应答的影响

目的:比较柴葛解肌汤辅助西药和单纯西药治疗小儿上呼吸道感染高热的疗效。方法:选取2016年1月至2018年1月武汉市红十字会医院收治的上呼吸道感染高热患儿192例作为研究对象,随机分为对照组和观察组,每组96例。2组患者均采用物理降温,并给予布洛芬混悬液、利巴韦林颗粒口服治疗,观察组加用柴葛解肌汤治疗,均治疗5 d。观察2组患者治疗前、完成治疗后炎性反应指标白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)、降钙素原(PCT)、超敏C反应蛋白(CRP)、细胞间黏附因子(ICAM-1)、血管细胞黏附因子(VCAM-1)含量并进行比较;观察治疗前、完成治疗后2组患者的免疫应答标志物IgA、IgM、IgG、C3、C4的含量并进行比较;比较2组患者热退起效时间、热退消失时间、住院时间;对治疗过程中进行不良反应监测;完成治疗后进行疗效评定。结果:1)2组患者治疗前IL-1β、IL-10、PCT、CRP、ICAM-1、VCAM-1比较,差异无统计学意义(P0.05),2组患者完成治疗后以上指标均较治疗前均显著下降(P0.05),完成治疗后观察组患者以上指标显著低于对照组(P0.05)。2)2组患者治疗前IgA、IgM、IgG、C3、C4比较,差异无统计学意义(P0.05),2组患者完成治疗后以上指标均较治疗前均显著升高(P0.05),完成治疗后观察组患者以上指标显著高于对照组(P0.05)。3)观察组在热退起效时间、热退消失时间、住院时间上明显短于对照组,2组比较差异有统计学意义(P0.05)4)观察组总有效率上显著高于对照组,2组比较差异有统计学意义(P0.05)。5)2组患者恶心呕吐、腹泻、便秘、过敏等不良反应发生率比较,差异无统计学意义(P0.05)。结论:柴葛解肌汤能抑制上呼吸道感染高热患儿炎性反应,提高免疫力,疗效显著。     

二陈汤合三子养亲汤辅治痰浊阻肺型喘证疗效观察

目的：观察二陈汤合三子养亲汤辅治痰浊阻肺型喘证的疗效。方法：42例分为对照组21例和治疗组21例,两组均给予持续低流量吸氧、抗感染、止咳、化痰、平喘、维持水电解质酸碱平衡等常规西药治疗,治疗组加二陈汤合三子养亲汤治疗。结果：总有效率对照组76．19％,治疗组90．47％,两组比较有显著性差异（P〈0．05）。结论：二陈汤合三子养亲汤辅治痰浊阻肺型喘证患者临床疗效确切。     

利咽消滞汤联合奥美拉唑及多潘立酮治疗喉咽反流合并慢性胃炎临床观察

目的观察利咽消滞汤联合奥美拉唑及多潘立酮治疗喉咽反流(LPR)合并慢性胃炎的临床疗效。方法将150例LPR合并慢性胃炎患者随机分为治疗组和对照组,各75例,2组均予奥美拉唑肠溶胶囊20 mg,每日2次口服,多潘立酮片10 mg,每日3次口服,治疗组加服利咽消滞汤化裁。2组疗程均8周,观察治疗前后症状、体征及特殊检查评分变化情况,并评定疗效。结果治疗组总有效率92%,对照组总有效率76%,2组比较差异有统计学意义(P<0.01),治疗组疗效优于对照组。2组治疗后症状、体征及特殊检查评分比较差异均有统计学意义(P<0.01)。结论利咽消滞汤联合奥美拉唑及多潘立酮治疗LPR合并慢性胃炎较单用西药疗效确切,起效快,副作用小,值得临床推广。     

清肝通窍汤联合声频共振治疗突发性聋42例

目的:观察清肝通窍汤联合声频共振治疗突发性聋的临床疗效。方法:选择本院2013年3月—2015年1月收治的突发性聋患者84例,按随机数字表法分为观察组与对照组,各42例。对照组给予舒血宁联合声频共振治疗,观察组在对照组治疗的基础上加用清肝通窍汤治疗。结果:观察组有效率为95.24%,对照组有效率为76.19%,观察组优于对照组(P0.05);观察组治疗后头痛眩晕、耳鸣、烦躁易怒、口苦咽干评分优于对照组(P0.05);观察组治疗1个疗程、2个疗程、4个疗程后血浆内皮素水平均优于对照组(P0.05);观察组不良反应发生率为4.76%,对照组不良反应发生率为7.12%,两组不良反应发生率比较,差异无统计学意义(P=0.6720.05);观察组复发率为2.38%(1/42),对照组复发率为7.14%(3/42),两组复发率比较,差异无统计学意义(P=0.6080.05)。结论:清肝通窍汤联合声频共振治疗突发性聋疗效显著,可有效改善患者内耳微循环及供血情况,缓解症状,降低血浆内皮素水平。     

四妙勇安汤治疗冠心病的临床和基础研究概述

四妙勇安汤由金银花、玄参、当归、甘草四味药组成,原为治疗热毒型脱疽的一则古方,由于冠状动脉粥样硬化性心脏病(冠心病)和脱疽在西医理论中均属于血管病变,近年来许多医家运用四妙勇安汤治疗冠心病取得良好的疗效,认为其作用机制和抗炎、抗动脉粥样硬化、促进血管新生以及抗凝作用相关。研究证实四妙勇安汤中单味药物也有类似作用,当归可以改善冠脉血流,保护心肌细胞,减轻心肌缺血再灌注损伤,抗血小板聚集等功能;金银花具有抗炎和抗血小板聚集的作用;玄参具有改善冠脉血流,减轻心肌缺血损伤,抗血小板聚集的作用;甘草主要成分甘草酸具有降血脂与抗动脉粥样硬化作用,阻止动脉粥样硬化的形成。     

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??Objective    To investigate the influence of Bushen Zhuanggu Decoction on the bone healing after teeth extraction in osteoporotic dogs. Methods    Totally 9 female adult dogs whose bilateral ovaries were surgically removed to establish osteoporosis models were randomly divided into 3 groups ??control group??Western medicine group and traditional Chinese medicine group??. Bilateral mandibular premolars were extracted 3 months after castration. Osteoporosis treatment was started the third day after tooth extraction. The dogs in the traditional Chinese medicine group??the Western medicine group and the control group were respectively fed with Bushen Zhuanggu Decoction??Estradiol Valerate Tablets and nothing. The bone mineral density??BMD?? value of dog′s lumbar spine and mandible of each group were detected before and after 3 months of castration and 3 months after teeth extraction. The tissue morphology of the mandible was observed at 1??2 and 3 months after teeth extraction. Results    Three months after teeth extraction??the BMD values of the lumbar spine and mandible in the traditional Chinese medicine group and the Western medicine group were significantly increased compared with those before the osteoporosis treatment??and there was no significant difference compared with the preoperative ones. One month after teeth extraction?? the new bone and the trabecular bone were observed in irregular patterns in the control group and the Westen medicine group??and those were arranged in a mesh pattern in the Chinese medicine group. Two months after teeh extraction??the trabecular bone structure was sparse in the control group??the Western medicine group was more than that of the new bone??and the number of trabecular bone in the Chinese medicine group was more robust. Three months after teeth extraction??the bone trabecular structure was relatively compact in the control group and the gap is small??the new bone tissue and the original bone tissue roughly fused together in the Western medicine group??the new bone tissue of the traditional Chinese medicine group was more similar to the structure of the original bone. Conclusion      Bushen Zhuanggu Decoction can make cancellous bone around the teeth extraction of the osteoporosis canine and significantly increase the amount of bone tissue??so as to promote bone reconstruction and bone healing after teeth extraction.