Effects of the Clearing the Lung and Dissipating Phlegm Method in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Objective: The objective of this study is to evaluate the efficacy and safety of the clearing the lung and dissipating phlegm method in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD) and to provide evidence for the treatment of the disease. Materials and Methods: Literature was searched from the United States National Library of Medicine(PubMed), Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database(Wanfang), and the Full?Text Database of Chinese Scientific and Technical Periodicals(VIP).A comprehensive collection was made of randomized controlled trials(RCTs) before June 2018, in which the treatment groups used either the clearing the lung and dissipating phlegm formulas only or combined it with routine Western medicine therapy, and the control group adopted routine Western medicine therapy only for the acute exacerbation of COPD. The Cochrane risk of bias method was used to evaluate the quality of the literature. The data were analyzed and retrieved independently by two reviewers before meta?analysis was carried out with RevMan 5.3 software to evaluate the primary outcome measures, including the total clinical effective rate, and the secondary outcome measures such as the pulmonary function(forced vital capacity [FVC], forced expiratory volume in the 1 s [FEV1], percentage of FEV1 [FEV1%], and FEV1/FVC)and blood gases(PaO_2 and PaCo_2). Results: A total of 13 RCTs involving 990 patients(496 in the treatment group and 494 in the control group)were included in this study. Meta?analysis revealed significant difference in the efficacy of the group that adopted solely the routine Western medicine method and the group that combined the Western medicine with the clearing the lung and dissipating phlegm method. Outcome measures including the pulmonary function(FVC, FEV1, FEV1%, and FEV1/FVC) and the blood gases(PaO_2 and PaCo_2) were significantly improved as compared to the control group(P 0.00001). However, adverse effects in the treatment group using combined traditional Chinese medicine were not reported due to the short observation time of the study. Conclusion: The clearing the lung and dissipating phlegm method can improve the efficacy in the treatment of acute exacerbation of COPD, the outcome measures of the pulmonary function and the blood gases,as well as the life quality of the patients. However, due to the fact that the existing studies are generally of poor quality in which randomization and its implementation were not properly carried out, more high?quality RCTs are necessary to confirm the findings of this study.     

新冠肺炎“动态清零”常态化下应急梯队护士体验的质性研究

目的 研究新型冠状病毒肺炎常态化疫情防控下应急梯队护士的真实体验。提出针对性改善护士的心理状况的方法和建议。方法 于2021年10月选取上海市静安区闸北中心医院应急梯队的护士11名为研究对象，对其进行半结构式面对面谈话，并采用Colaizzi七步分析法进行资料分析。结果 进入应急梯队的护士普遍存在着紧张焦虑，情绪低落，身心疲惫等心理问题。而执行完应急任务后的成就感，社会的认同，多方的理解支持，有利缓解心理压力。结论 通过对新型冠状病毒肺炎常态化疫情防控下应急梯队护士的真实体验的了解，护士普遍存在各种心理问题，需要给予针对性的干预措施，提高应急梯队成员的心理素质和应急能力。     

清开灵注射液治疗脑血管性痴呆32例

目的观察清开灵注射液治疗脑血管性痴呆的疗效.方法将中医学辨证属于实证的64例脑血管性痴呆患者随机分为治疗组(清开灵注射液组)和对照组(脑复康组),治疗5周后,将两组治疗前后在智力障碍程度、肢体功能、血液流变学指标、中医证型疗效方面的变化进行比较.结果经治疗后治疗组和对照组相比较,智力障碍程度变化(有效率、MMSE、ADL积分)、肌力、步行能力改变有显著性差异,p＜0.05.而治疗前后组内及组间血流变指标虽有一定下降,但无统计学意义(p＞0.05).结论清开灵注射液对脑血管性痴呆患者,在改善智力障碍、肌力、步行能力方面有较好的疗效.     

中西医结合疗法延缓慢性肾功能不全患者急性肾功能减退的临床研究

目的:探讨中医活血化瘀结合西医疗法是否具有延缓慢性肾功能不全患者急性肾功能减退的疗效.方法:回顾性分析未行透析的慢性肾功能不全患者32例,近期肾功能急性进行性减退,血尿素氮(blood urea nitrogen,BUN)、肌酐(serum creatinine,SCr)进行性升高.常规治疗基础上,均予以中药保留灌肠30 min,同时加静脉滴注活血化瘀等中西药物治疗14 d.观察治疗前后患者血常规、电解质、肝肾功能以及内生肌酐清除率(creatinine clearance rate,Ccr)的变化.结果:治疗后患者血常规、电解质无明显改变,大多数患者BUN和SCr较治疗前下降,而Ccr升高,总有效率达65.6%.结论:中西医结合疗法可有效逆转慢性肾功能不全患者伴发急性肾功能减退时肾功能的恶化.     

颅内血肿旋吸多导向清除装置

本装置提供一种对脑组织损伤轻清除脑血肿速度快的微创器械,以便更加有效地清除高血压脑出血后形成的脑血肿,减轻脑出血引起的脑损害,减少死亡;该装置由外套管、旋吸管、导向管和喷射管组成,用该装置可以对脑血肿实施旋转碎吸和多导向喷射冲洗;临床用该装置治疗400余例高血压脑出血病人,迅速减轻脑血肿占位效应,使大部分病人生命得到挽救,减少了后遗症,改善了生存质量;其疗效表明该装置是目前最为有效地脑血肿微创清除器械.     

中西医结合治疗慢性肾炎疗效观察及其与血液流变学和微循环的相关意义分析

本文对比观察了中西医结合治疗与单纯西药治疗慢性肾炎的临床疗效,结果表明,前者缓解率及总有效率分别为79.8%和92.1%,显著高于对照组(均P<0.01)。治疗组各临床类型及各中医证型的疗效亦均明显高于对照组相对应的各型肾炎(P<0.05～0.01)。治疗组各型肾炎之血液流变学及甲皱微循环改善均较对照组为显著。两组中完全缓解加基本缓解者,该两类检查指标改善极为显著(P<0.05～0.01),而好转及无效者则无明显改善(P>0.05)。提示临床疗效与之密切相关。     

活血化瘀中药联合血管内皮生长因子基因转移促进股骨头坏死处新生血管形成的实验研究

目的:观察活血化瘀中药联合血管内皮生长因子(VEGF)基因转移对促进股骨头缺血坏死处新生血管形成情况。方法:日本大耳兔40只,随机分为对照组、模型组、中药组、基因组和综合组。治疗8周后采用免疫组织化学方法观察股骨头滑膜VEGF阳性细胞率及数字减影血管造影股骨头血管数目改变情况。结果:模型组VEGF阳性细胞表达率减低,与对照组、基因组、综合组比较,差异有显著性意义(P<0.01),与中药组比较,有统计学差异(P<0.05),综合组VEGF阳性细胞表达率较高,与中药组及基因组比较,有统计学差异(P<0.05)。血管数目:在A区,各组与模型组比较,均无统计学差异;在B区,各组较模型组血管数目均有增加,对照组、基因组、综合组与模型组比较,有统计学差异(P<0.05)。综合组与基因组比较有统计学差异(P<0.05),中药组虽然血管数目较模型组多,但是无统计学意义。结论:活血化瘀中药及VEGF基因转移均可促进股骨头缺血坏死处局部新生血管形成和侧支循环的建立,尤以活血化瘀中药联合基因疗法效果为好,为临床应用活血化瘀中药联合基因疗法治疗股骨头缺血性坏死提供实验依据。     

中西医结合治疗肺心病心律失常40例疗效观察

为提高肺心病心律失常的临床疗效,采用中药清肺化痰活血剂配合抗菌素及氧疗法对40例肺心病并发心律失常患者进行了治疗观察,同时与单纯使用抗菌素及氧疗法治疗的40例患者进行对照。临床以心电图改善情况为观察指标,结果两组有效率分别为87.5％和67.5％。Ridit分析结果表明,治疗组疗效明显优于对照组,经显著性检验,两组差异显著(P<0.05)。     

活血通脉片对大鼠异丙肾上腺素心肌损伤的保护作用

目的：研究中药复方制剂活血通脉片（Huoxue TOngmai tablet,HXTMT)对异丙肾上腺素（isoproterenol,ISO)心肌损伤大鼠的保护作用,方法：用HXTMT给SD大鼠连续灌胃14d,第12日起动物sc ISO(48umol.kg^-1.d^-1),每日一次,连续3d,复制异丙肾上腺素性心肌损伤大鼠模型。结果：中药复方制剂HXTMT能明显减轻心肌损伤程度,血清CK活性,心肌MDA含量,心肌含水量分别减少14％,25％,2％,与模型组比较有显性差异（P＜0．05）,结论：HXTMT能稳定细胞膜,减轻心肌水肿程度,阻止脂质过氧化物的形成,提示HXTMT对心肌缺血性损伤有细胞保护作用。