破隘汤治疗外寒内热型小儿烂乳蛾临床疗效观察

目的:观察破隘汤治疗外寒内热型小儿烂乳蛾的临床疗效。方法:将2016年3月到2018年3月在北京中医药大学厦门医院诊治的外寒内热型烂乳蛾患儿,应用随机数字表法分为试验组与对照组,其中试验组60例给予破隘汤口服,对照组60例给予注射用青霉素钠静滴治疗,5 d为1个疗程,共治疗1个疗程,比较两组患者的症状、体征及实验室检验结果。结果:试验组疗效优于对照组(P 0. 05);治疗后,两组各症状体征评分、白细胞计数及CRP均较治疗前降低,且在发热、咽痛、扁桃体充血脓点及渗出物、白细胞计数及CRP等方面试验组比对照组降低更明显(P 0. 05)。结论:破隘汤对外寒内热型小儿烂乳蛾的疗效确切,优于应用注射用青霉素钠的对照组。     

肺脾肾三脏同调治疗小儿哮喘缓解期的临床研究

目的:观察中药肺脾肾三脏同调治疗小儿哮喘缓解期的临床疗效。方法:纳入80例在我院就诊的哮喘缓解期肺脾肾气虚患儿,将患儿随机分为两组,观察组40例,对照组40例。对照组给予沙美特罗/替卡松粉吸入剂吸入治疗,观察组在对照组治疗基础上,给予口服自拟益肺健脾补肾汤(补骨脂10g,胡桃肉10g,太子参15g,白术12g,茯苓10g,石菖蒲6g,当归3g,升麻4g,防风6g,炙甘草3g)治疗。两组均规范治疗3个月,治疗后及治疗后3个月统计两组患儿疗效及肺功能变化情况。结果:治疗后及治疗后3个月两组的总有效率比较,差异均有统计意义(P 0. 05);观察组治疗后及治疗后3个月最大呼气流速(PEF)、第一秒用力呼气容积(FEV1)显著高于对照组,两组比较差异有统计意义(P 0. 05)。结论:采用自拟益肺健脾补肾汤联合沙美特罗/替卡松粉吸入剂吸入治疗小儿哮喘缓解期可改善患儿肺通气功能,提高临床疗效。     

除湿止痒洗液治疗新生儿脓疱疮疗效观察

目的:观察除湿止痒洗液治疗新生儿脓疱疮的疗效。方法:将入选的100例新生儿脓疱疮患儿采用随机表非盲法分为治疗组(采用除湿止痒洗液)51例,对照组(采用莫匹罗星软膏)49例;各组按其所选药物外涂患处,3次/d,比较两组的72 h显效率及总有效率。结果:除湿止痒洗液组的显效率84%,总有效率96%;莫匹罗星软膏组的显效率49%,总有效率94%,;两组患儿治疗总有效率比较,差异无统计学意义(P>0.05),但显效率比较,治疗组优于对照组(P<0.01)。结论:除湿止痒洗液是治疗新生儿脓疱疮快速、有效且无明显不良反应的治疗方法。     

足三里穴注射胃复安治疗小儿呕吐的疗效观察

目的:观察足三里穴位注射胃复安治疗小儿呕吐的疗效。方法:将120例急诊科小儿呕吐患者,随机分为2组,实验组60例,在一侧足三里穴位注射胃复安0.05mg/kg;对照组60例,按常规肌肉注射胃复安0.1mg/kg。结果:实验组有效率为95.0%,对照组有效率为76.7%,实验组疗效明显优于对照组(P<0.01)。结论:足三里穴位注射胃复安能有效治疗小儿呕吐,并能减少药量,降低胃复安引起锥体外系反应的可能性,值得临床推广应用。     

从自然辩证法看中医的现代合法性身份

中医理论强调人与自然存在着非常密切的联系,而且这种联系不仅仅是个体与个体的简单串接,更是一种体系之间的复杂联系：这符合自然辩证法的要求。现代性反恩对于自然辩证法的不断更新,也给了我们一个反思唯科学立场的语境,中医的现代合法性在自然辩证法的新发展中得到了更好的证明。     

豚鼠声诱发短潜伏期负电位的来源初探

Objective To establish a model of acoustically evoked short latency negative response (ASNR) in guinea pigs, a model of profound hearing loss with normal saccular functions, and verify the correlation between ASNR and vestibular evoked myogenic potential (VEMP). Methods Thirty-two healthy guinea pigs were employed in the experiment, which were randomly divided into control group ( 16subjects) and deafened group (16 subjects). Each animal experienced auditory and vestibular tests including auditory brainstem response ( ABR), VEMP and caloric test. A quick treatment was employed for deafened group consisting of a subcutaneous injection of kanamycin at a dose of 400 mg/kg followed by a jugular vein injection of ethacrynic acid at a dose of 40 mg/kg one hour later. The animals were received ABR, VEMP and caloric test 7 - 10 days following the drug administration. The deafened group was further divided into ASNR group and non-ASNR group, based on the presence of ASNR. Results In deafened group, five subjects died postoperatively, 11 subjects (22 ears) provided full data, ASNR was elicited in eight ears (36.4%), the threshold was 120- 130 dB SPL with mean of (124.4 ±4.96) dB SPL. Its latency range was 1.75 - 2. 60 ms with mean of ( 2. 15 ± 0. 27 ) ms. The mean latency of threshold was (2. 34 ±0. 18) ms. All eight ASNR ears presented with VEMP. The VEMP threshold, positive and negative potential latencies proved no statistical difference (P ＞ 0. 05 ) between ASNR group and control group.Significant difference was detected between the VEMP presence of ASNR group and non-ASNR group ( P =0. 002). There was no statistically significant correlation between VEMP and caloric test neither between ASNR and caloric test in deafened group. Conclusions This study evoked ASNR in an ototoxicity guinea pig model which has profound hearing loss with normal saccular functions. The presence of ASNR correlated with VEMP, however, not correlated with caloric test, suggesting that ASNR and VEMP are both originated from the saccule.     

声诱发短潜伏期负电位豚鼠的内耳铺片研究

目的 在耳毒性损伤的豚鼠模型上诱发声诱发短潜伏期负电位( acoustically evoked short latency negative response,ASNR),通过内耳铺片观察ASNR豚鼠的基底膜球囊、椭圆囊及半规管壶腹的组织形态学特点,验证豚鼠ASNR的责任终器.方法 将45只健康豚鼠按随机数字表法分为2组,健康对照组15只(30耳),药物致聋组30只(60耳).致聋组给药(硫酸卡那霉素+利尿酸)致聋7～10d后,行听觉脑干反应(ABR)测试,根据ASNR引出情况进一步分为ASNR组和非ASNR组.三组豚鼠断头取颞骨,解剖显微镜下取出基底膜、球囊斑、椭圆囊斑和壶腹嵴,通过显微镜观察毛细胞数目和形态变化.结果 致聋组有27只动物(54耳)完成测试,其中45耳达到重度感音神经性聋,19耳引出ASNR(35.2％),阈值为110～125 dBSPL,平均阈值(121.7±4.5)dBSPL,潜伏期1.80～2.08 ns,平均潜伏期(1.93±0.07)ms.铺片观察显示,基底膜、球囊、随圆囊、壶腹嵴毛细胞密度按正常对照组、ASNR组、非ASNR组依次减低,毛细胞损伤程度依次加重.ASNR组球囊微纹区、周边区毛细胞密度与对照组差异无统计学意义(P值均＞0.05);其他各组的相应比较,差异均有统计学意义(P值均＜0.05).结论 豚鼠ASNR的责任终器是球囊,而不依赖于耳蜗、椭圆囊及半规管功能.