中药复方托毒生髓方治疗慢性骨髓炎的实验研究

目的：观察中药复方托毒生髓方治疗慢性骨髓炎的疗效。方法：45只家兔随机分成4组：空白对照组正常饲养;其余3组制备慢性骨髓炎动物模型：右胫骨内侧钻开0．5cm×1．0cm骨窗,注入鱼肝油酸钠0．5ml和5×10^6CFu／ml金黄色葡萄球菌悬液0．5ml,骨蜡封闭骨缺损,3周后X线检查证实模型复制成功。托毒生髓方组以托毒生髓方提取液灌胃（5ml,每日2次）和局部外洗（10ml,每日4次）,庆大霉素组和模型组分别以庆大霉素稀释液10m1或生理盐水10ml外洗,每日2次或4次。治疗2个月,于治疗开始后第20、40、60天行白细胞计数、血清溶菌酶含量检测和动物病变肢体X线检查。结果：模型组白细胞计数和血清溶菌酶含量于各观察时间点均较空白对照组明显下降（P〈0．01）,庆大霉素组虽有所恢复,但仍明显低于空白对照组,托毒生髓方组则较模型组和庆大霉素组明显升高（P〈0．01）,治疗第60天均接近空白对照组（P〉0．05）。治疗第60天,托毒生髓方组X线诊断分型明显轻于模型组和庆大霉素组（P〈0．01）。治疗第20天X线影像显示,模型组则出现新的骨内脓肿及高密度坏死骨影像,庆大霉素组髓腔狭窄或消失,而托毒生髓方组炎症反应消退,原有的骨干畸形重新塑形。结论：托毒生髓方对于慢性骨髓炎兔模型病变部位的炎症控制以及骨结构恢复和髓腔再通有较好疗效,其机制可能与提高免疫力和促进成骨（没有检测促进成骨的指标,建议删除）有关。     

小柴胡颗粒治疗经期外感38例临床观察

经期外感为妇女在月经前1d或行经期间出现低热、体痛、咽干、乏力等类似外感症状,属于经前期综合征的主要症状之一,并且呈周期性反复发作［1］。其临床表现与一般感冒类似,但病因病机、治法方药与之又有明显区别,临床容易出现误诊,进而影响治疗效果［2］。2010-10-2012-04,我们运用小柴胡颗粒治疗经期外感38例,并与酚麻美敏片治疗38例对照观察,结果如下。     

柏黛膏的体外抗菌活性及其与青霉素的协同抑菌作用

目的评价柏黛膏抗菌活性及其与青霉素的协同抑菌效能。方法最低抑菌浓度(MIC)测定用琼脂二倍稀释法。结果柏黛膏与青霉素对金黄色葡萄球菌与大肠杆菌具有很好的抗菌活性,柏黛膏+青霉素对金黄色葡萄球菌与大肠杆菌抗菌MIC50和MIC90值分别为0.25,4.00 mg.L-1;1,4 mg.L-1。结论柏黛膏与青霉素对金黄色葡萄球菌、大肠杆菌均有协同抗菌功效。     

钱丽旗教授治疗月经不调用药规律

目的:归纳总结钱丽旗教授诊治月经不调临床用药,挖掘其治疗月经不调的常用药物及组方规律。方法:选取2019年9月至2020年9月钱丽旗教授门诊的月经不调有效处方83首,运用Office 2016软件统计分析治疗月经不调常用药物的频次及性味归经,以SPSS Modeler 18.0、SPSS 22.0软件进行聚类分析、关联规则分析。结果:共纳入83首处方,142味中药,总用药频次达1310次,频次≥10的药物共35味,高频药物主要为柴胡、郁金、蒲公英、黄芩、女贞子、墨旱莲、生地等。聚类分析得到治疗月经不调的常见药物组合四组,将月经不调大致归纳为肝郁气滞、痰湿瘀阻、气血亏虚、肝肾不足四种证型。高频药物关联规则分析得出常用药对有柴胡-郁金、益母草-泽兰、女贞子-墨旱莲、桃仁-红花、当归-川芎、胆南星-竹茹、蒲公英-黄芩等。结论:钱丽旗教授治疗月经不调重视肝、肾、气、血,善调阴阳虚实,法以养血活血、化瘀为主,并佐疏肝理气、平调阴阳之品,滋肾养血、活血化瘀。     

中医辨证用药结合心理干预治疗女性更年期综合征疗效评价

目的评价中医辨证用药结合心理干预对治疗女性更年期综合征的疗效。方法选择符合入选标准的女性更年期综合征患者,随机分为试验组、中药对照组和心理对照组3组,每组100例,试验组给予中医辨证用药的同时,结合相应的心理干预治疗,对照组分为单纯中医辨证用药及单纯心理干预治疗2组,采用症状自评量表（SCL-90）比较治疗前后的临床疗效。结果试验组总有效率达89％,愈显率75％;中药对照组总有效率85％,愈显率32％;心理对照组总有效率42％,愈显率5％。试验组愈显率明显高于两对照组（P〈0．01）。试验组在治疗焦虑抑郁、急躁易怒、周身疼痛、记忆力下降、强迫恐惧、敌对偏执等方面明显优于中药对照组（P〈0．01）。结论中医辨证用药结合心理干预综合治疗更年期综合征疗效显著,尤其对改善更年期患者的神经症状有独特的作用。     

联合疗法治疗糖尿病周围神经病变的临床观察

目的探讨参芪降糖颗粒、甲钴胺片口服配合艾灸联合疗法治疗糖尿病周嗣神经病变的临床疗效。方法将69例糖尿病周围神经病变患者随机分为2组。治疗组在基础治疗的同时加参芪降糖颗粒,每次3g,每日3次;甲钴胺片每次500μg,每日3次口服;配合外用穴位艾灸（选取双侧足三里、太溪穴、三阴交,艾灸每个穴位5～7min,至皮肤微微泛红,每周3次）;对照组在基础治疗的同时口服参芪降糖颗粒和甲钴胺片,与治疗组相同剂量。疗程为3个月。观察两组的临床疗效,治疗前后多伦多临床神经病变评分（TCSS）和肌电图神经传导速度（NCV）的变化。结果2组总有效率比较差异有统计学意义（P〈0．01）。2组治疗后TCSS评分与本组治疗前比较显著降低（P〈0．01）,治疗组差值高于对照组,2组差值比较差异有统计学意义（P〈0．01）。2组治疗后正中神经、腓总神经的感觉神经传导速度（SNCV）和正中神经、腓浅神经的运动神经传导速度（MNCV）均升高,2组治疗前后比较差异有统计学意义（P〈0．01）;治疗组差值高于对照组,2组差值比较差异有统计学意义（P〈0．01）。结论参芪降糖颗粒与甲钴胺片口服配合艾灸联合疗法治疗糖尿病周嗣神经病变疗效优于单纯口服药治疗。     

化滞柔肝颗粒治疗非酒精性脂肪性肝病疗效观察

目的观察化滞柔肝颗粒治疗非酒精性脂肪性肝病（NAFLD）的临床疗效。方法将60例NAFLD患者随机分为2组,对照组30例口服水飞蓟宾葡甲胺片,治疗组30例口服化滞柔肝颗粒,2组均治疗12周。比较2组患者治疗前后症状积分、血清肝酶、血脂、体质量指数和肝脏B超分度情况。结果治疗组总有效率为87％,对照组为67％,2组比较差异有统计学意义（P〈0．05）;治疗组症状积分、体质量指数、血脂和肝脏B超分度改善情况均明显优于对照组（P均〈0．05）;2组治疗后肝功能均有改善,但组间比较差异无统计学意义（P〉0．05）。结论化滞柔肝颗粒治疗NAFLD疗效较好,其疗效机制有待进一步探讨。     

A Randomized Trial of Chinese Medicine Lirukang Granule (利乳康颗粒) Combined with Psychological Intervention for Cyclomastopathy and Menoxenia

Objective:To observe the influence of therapy with Chinese medicine Lirukang Granule（利乳康颗粒）,LRKG) combined with psychological intervention on anxiety states and sex hormones in patients with cyclomastopathy and menoxenia.Methods:A total of 470 subjects were randomly assigned to three groups by the net-central randomization system,the treatment group（161 patients,treated with LRKG and psychological intervention）,the Chinese medicine group（157 patients,treated with LRKG）,and the psychological intervention group（152 patients,treated with psychological intervention）.The dose of LRKG was 12 g three times per day; psychological intervention included establishing relations,cognitive intervention and psychological persuasion, 30-40 min per session,once a week.The therapy duration for all groups was three months.The efficacy was compared and anxiety state/State-Trait Anxiety Invertory（STAI） scoring was measured before and after treatment.The serum estradiol（E₂）,progesterone（P）,prolactin（PRL） and follicle stimulating hormone（FSH） levels of 60 patients selected randomly from each group during the luteal phase were measured before and after treatment,and a group of 20 healthy women were evaluated for comparison.A follow-up was arranged for one year after treatment.Results:Thirty subjects were lost to follow-up.（1） Comparison of efficacy:the markedly effective rate and the total effective rate of the treatment group were 86.67%（131/150） and 98.00%（147/150）, respectively;of the Chinese medicine group,64.58%（93/144） and 90.27%（130/144）,respectively;and of the psychological intervention group,0%（0/146） and 3.42%（5/146）,respectively.The markedly effective rate and the total effective rate in the treatment group were significantly higher than those in the Chinese medicine and psychological intervention groups（P<0.05）.（2） Comparison of STAI scoring:STAI scoring was decreased dramatically in the treatment group after treatment compared with that of the Chinese medicine group（P<0.01）, but there was no significant difference compared with the psychological intervention group.（3） Comparison of levels of sex hormones:E₂,P,PRL and FSH of the three patient groups were disordered before treatment,and significantly different from healthy women（P<0.01）.After treatment,the levels of P and FSH of the treatment group were significantly increased（P<0.01）,E₂ and PRL were significantly reduced,which were also significantly decreased compared with the psychological intervention groups（P<0.01）.（4） Follow-up:the markedly effective rate and the total effective rate of the treatment group remained higher than those of the other two groups after one year of treatment（P<0.05）.（5） Adverse reactions:no obvious adverse reactions were found among the three groups.Conclusions:Therapy with Chinese medicine combined with psychological intervention was effective for short-term and long-term treatment of cyclomastopathy and menoxenia.The mechanism might be related to the regulation of sex hormones.     

扁咽口服液治疗急性咽炎疗效观察

目的：探讨扁咽口服液治疗急性咽炎的临床疗效与安全性。方法：收集我院2010年9月~2012年6月中医科门诊急性咽炎患者200例,随机分为对照组100例和观察组100例,观察组给予扁咽口服液10 ml,po,bid治疗,对照组给予金莲花颗粒3 g,po,tid治疗,治疗5 d后观察并比较两组患者的症状积分、有效率、兼症变化情况以及安全性指标。结果：观察组治疗后症状积分、有效率明显优于对照组（P〈0.05）,观察组对于大小便改善效果与时间优于对照组（P〈0.05）,两组各出现1例恶心、胃脘不适病例,但停药后未经特殊处理症状自行消失。结论：扁咽口服液具有清热解毒、滋阴生津,标本兼治之功,是治疗急性咽炎的良好药物。