Clinical distribution and molecular profiling on postoperative colorectal cancer patients with different traditional Chinese medicine syndromes

Background:Traditional Chinese medicine(TCM)syndrome,also named syndrome,are comprehensive and integral analyses of clinical information which helps to guide different individualized treatment prescriptions.Methods:Thirty healthy controls and 80 colorectal cancer(CRC)patients(including 33 Spleen Qi Deficiency syndrome,23 Dampness Heat syndrome,17 Blood Stasis syndrome and 7 other syndrome)were enrolled into this study.Human mRNAs were extracted from peripheral blood mononuclear cells.The gene expression for CRC patients with different TCM syndrome was determined by microarray and qRT-PCR.Results:Spleen Qi Deficiency,Dampness Heat and Blood Stasis were the most common syndromes in CRC patients.There is a significant difference was found in mRNA expression levels(especially for PIK3CA,STAT3,SOX9 and KDM5C)among Spleen Qi Deficiency,Dampness Heat and Blood Stasis syndrome groups.The higher mRNA levels of JNK1,TP53,MLH1,MSH6,PMS2,SOCS3,TCF7L2,FAM123B,PSAP,FBXW7,SALL4 and the lower expression of inflammatory cytokine IL-6 were found in Spleen Qi Deficiency group but not other syndrome types.The higher mRNA levels of KRAS,MUC16,EGFR,GRASP65,PIK3CA,MAPK7,CD24,STAT3,SLC11A1,Bcl-2,TXNDC17 and some inflammatory cytokines(IL-6,IL-23,TNF-a,CXCR4)were found in Dampness Heat group but not other syndrome types.Blood Stasis syndrome showed higher expression of SOX9,MLH1,MSH6,KDM5C,PCDH11X,PSAP and SALL4,and lower mRNA levels of PIK3CA,CD24,STAT3,CXCR4,TXNDC17 and TP53.The CRC patients with Dampness Heat syndrome might have a poor prognosis than other syndrome types.Conclusion:The identification of syndrome conditions had different impacts on CRC prognosis,and which might be related with different mRNA expression levels.Some oncogenes and pro-inflammatory cytokines were highly expressed in Dampness Heat group but not other syndrome types,suggesting that the CRC patients with Dampness Heat syndrome might have a poor prognosis.Our results prelimitarily uncovered the molecular basis of syndrome differences in CRC prognosis,a better understanding for TCM treatment of CRC.

Distribution patterns and industry planning of commonly used traditional Chinese medicinal plants in China

Medicinal plants are the primary material basis for disease prevention and treatment in traditional Chinese medicine(TCM).The conservation and sustainable utilization of these medicinal plants is critical for the development of the TCM industry.However,wild medicinal plant resources have sharply declined in recent decades.To ameliorate the shortage of medicinal plant resources,it is essential to explore the development potential of the TCM industry in different geographical regions.For this purpose,we examined the spatial distribution of commonly used medicinal plants in China,the number of Chinese medicinal material markets,and the number of TCM decoction piece enterprises.Specifically,multispecies superimposition analysis and Thiessen polygons were used to reveal the optimal range for planting bulk medicinal plants and the ideal regions for building Chinese medicinal material markets,respectively.Furthermore,we quantitatively analyzed mismatches between the spatial distribution of commonly used medicinal plant richness,Chinese medicinal material markets,and TCM decoction piece enterprises.We found that the areas suitable for growing commonly used medicinal plants in China were mainly distributed in Hengduan Mountain,Nanling Mountain,Wuling Mountain,and Daba Mountain areas.The Thiessen polygon network based on Chinese medicinal material market localities showed there are currently fewer markets in southwestern,northwestern,and northeastern China than in central and southern China.TCM decoction piece enterprises are concentrated in a few provinces,such as Hebei and Jiangxi.We found that the distribution of commonly used medicinal plants,Chinese medicinal material markets and TCM decoction piece enterprises are mismatched in Henan,Shaanxi,Hunan,Hubei,Zhejiang,Fujian,Chongqing,and Xizang.We recommend strengthening development of the TCM industry in Henan,Hunan,Zhejiang,Shaanxi,Hubei,Chongqing,Fujian,and Xizang;building more Chinese medicinal material markets in southwestern,northwestern,and northeastern China;and establishing medicinal plant nurseries in resource-rich provinces to better protect and domesticate local medicinal plants.

Effect of Traditional Chinese Medicine inImproving Hot Flashes Symptom ofBreast Cancer

Breast cancer (BC) is the most common malignant tumor in women. Around 50% of BC receptor-positive patients are hormone-dependent cases, and it is necessary for them to use endocrine after operation. Through inhibition of estrogen level

Systematic evaluation on curative effects of traditional Chinese medicine retention enemas for patients with radiation proctitis

Objectives： To systematically evaluate the curative effects of traditional Chinese medicine retention enemas for patients with radiation proctitis. Methods： Reports on randomized controlled trials （RCTs） on traditional Chinese medicine retention enemas in the treatment of radiation proctitis were searched in the Cochrane Library, PubMed, EMBASE, EBSCO, ISI, CNKI, V1P, WanFang Data and CBM databases. The publication dates were from inception to May 2014, and a literature screening, data extraction, quality evaluation and cross checks were inde- pendently conducted by two reviewers in accordance with the inclusion and exclusion criteria. A meta- analysis was then carried out using RevMan 5.3 software. Remits： In total, 14 RCTs were included, and of these, only 10 RCTs involving 702 patients were included in the meta-analysis. The meta-analysis showed that the total efficacy of traditional Chinese medicine retention enemas was higher for patients with radiation proctitis compared with that in control group, RR - 4.83, 95% C1 （2.98, 7.84）, P 〈 0.000 01 ; the results from four studies indicated that the improvement of clinical symptoms due to traditional Chinese medicine retention enemas was higher than that of the control group. Conclusions： The implementation of traditional Chinese medicine retention enemas could improve the total efficacy of treatment and provide relief in patients with radiation proctitis.

Effects of ginger moxibustion combined with Chinese medicine iontophoresis on patients with primary dysmenorrhea

Objective:To observe the effects of Ginger moxibustion combined with iontophoresis with traditional Chinese medicine on the improvement of symptoms, serum platelet activating factor (PAF) level and uterine artery pulsation index in patients with primary dysmenorrhea.Methods 114 patients with primary dysmenorrhea who were treated in our hospital from August 2017 to February 2019 were divided into two groups according to the different treatment schemes. 57 patients in the control group were treated with ibuprofen capsules, and 57 patients in the study group were treated with Ginger moxibustion combined with iontophoresis with traditional Chinese medicine. After three menstrual cycles of treatment, the curative effect was evaluated and the improvement of symptoms was counted. PAF, PAF-AH and platelet adhesion rate were compared, uterine artery hemodynamics was measured, and levels of serum hs-CRP and IL-6 were measured.Results The overall response rate of the study group was significantly higher than that of the control group (P < 0.05). After treatment, the scores of different symptoms in the two groups were significantly lower than those before treatment (P < 0.05), and the scores of different symptoms in the study group were significantly lower than those in the control group (P < 0.05). After treatment, PAF and platelet adhesion rate in the two groups were significantly lower than those before treatment (P < 0.05), PAF-AH was significantly higher than that before treatment (P < 0.05), and PAF and platelet adhesion rate in the study group were significantly lower than those in the control group (P < 0.05), PAF-AH was significantly higher than that in the control group (P < 0.05). After treatment, the pulsation index, resistance index and peak systolic-diastolic ratio in the study group were significantly lower than those before treatment (P < 0.05), and the pulsation index, resistance index and peak systolic-diastolic ratio in the study group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of serum hs-CRP and IL-6 in the two groups were significantly lower than those before treatment (P < 0.05), and the levels of serum hs-CRP and IL-6 in the study group were significantly lower than those in the control group (P < 0.05).Conclusions Ginger moxibustion combined with iontophoresis with traditional Chinese medicine is helpful to improve the overall response rate of primary dysmenorrhea treatment, reduce the score levels of different symptoms, rationally improve PAF, PAF-AH, platelet adhesion rate, and the pulse index, resistance index, peak systolic-diastolic ratio are decreased significantly, and serum hs-CRP and IL-6 levels tend to be normal.

Combination of symptoms, syndrome and disease: Treatment of refractory diabetic gastroparesis

AIM:To assess effect of combination of symptoms,syndrome and disease on treatment of diabetic gastroparesis with severe nausea and vomiting.METHODS:Professor Tong Xiaolin’s clinical electronic medical records of patients who were treated between January 1,2006 and October 1,2012 were used as a database.Patients who met the inclusion criteria were enrolled.General information(name,sex and age),symptoms and blood glucose levels were obtained from the clinic electronic medical record,which was supplemented by a telephone interview.The patient-rated Gastroparesis Cardinal Symptom Index(GCSI)was used to evaluate the severity of the symptoms of gastroparesis.The effects of the treatment were assessed by the change in the severity of the symptoms of gastroparesis and the change in blood glucose between the baseline levels and the post-treatment levels at 1,2,4,8 and 12 wk.RESULTS:Forty-five patients had a mean GCSI nausea and vomiting severity score of 4.21±0.67 and a total GCSI score of 2.77±0.63 before treatment.There was a significant improvement in the nausea and vomiting score at every return visit compared with the baseline score(1 wk:3.02±1.04 vs 4.18±0.71,P<0.001;2wk:2.32±1.25 vs 4.16±0.73,P<0.001;4 wk:2.12±1.26 vs 4.12±0.73,P<0.001;8 wk:1.79±1.09vs 4.24±0.77,P<0.001;12 wk:0.69±0.92 vs 4.25±0.70,P<0.001).Twenty-five of the 45 patients had complete resolution of vomiting during the observation period(mean time to resolution was 37.9±27.3 d).The postprandial fullness and early satiety subscale,bloating subscale and total GCSI scores were also improved.Finally,the blood glucose levels improved after treatment,although the change was not significant.CONCLUSION:Use of the combination of symptoms,syndrome and disease to treat diabetic gastroparesis with refractory nausea and vomiting may be a new treatment option.

基于批数据过采样的中医临床记录四诊描述抽取方法

中医临床记录四诊描述抽取对中医临床辨证论治的提质增效具有重要的应用价值,然而该任务尚有待探索,类别分布不均衡是该任务面临的关键挑战之一。该文围绕中医临床记录四诊描述抽取任务展开研究,首先构建了中医临床四诊描述抽取语料库;然后基于无标注的中医临床记录微调通用预训练语言模型实现该模型的领域适应;最后利用小规模标注数据,采用批数据过采样算法,完成中医临床记录四诊描述抽取模型的训练。实验结果表明,该文提出的抽取方法的总体性能均优于对比方法,并且与对比方法的最优结果相比,该文方法将少见类别的抽取性能F1值平均提升了2.13%。

Effect of Traditional Chinese Medicine for Treating Human Immunodeficiency Virus Infections and Acquired Immune Deficiency Syndrome:Boosting Immune and Alleviating Symptoms

To respond to the human immunodeficiency virus （HIV）/acquired immune deficiency syndrome （AIDS） epidemic in China, the integration of antiretroviral therapy （ART） and traditional Chinese medicine （TCM） has important implications in health outcomes, especially in China where the use of TCM is widespread. The National Free TCM Pilot Program for HIV Infected People began in 5 provinces （Henan, Hebei, Anhui, Hubei, and Guangdong） in 2004, and quickly scaled up to 19 provinces, autonomous regions, and municipalities in China including some places with high prevalence, 26,276 adults have been treated thus far. Usually, people with HIV infection seek TCM for four main reasons： to enhance immune function, to treat symptoms, to improve quality of life, and to reduce side effects related to medications. Evidences from randomized controlled clinical trials suggested some beneficial effects of use of traditional Chinese herbal medicine forHIV infections and AIDS. More proofs from large, well-designed, rigorous trials is needed to give firm support. Challenges include interaction between herbs and antiretroviral drugs, stigma and discrimination. The Free TCM Program has made considerable progress in providing the necessary alternative care and treatment for HIV-infected people in China, and has strong government support for continued improvement and expansion, establishing and improving a work mechanism integrating Chinese and Western medicines.

耳部全息铜砭刮痧联合耳穴埋豆对社区肝阳上亢型高血压患者的干预效果评价

目的观察耳部全息铜砭刮痧联合耳穴埋豆对社区肝阳上亢型高血压患者的干预效果。方法选取2023年1月—6月厦门大学附属第一医院思明区中华道社区卫生服务中心参与慢病管理的肝阳上亢型高血压患者76例,按照随机数字表法分为对照组及研究组,各38例。对照组给予口服降压药物及常规高血压慢性病管理,研究组在对照组基础上采用耳部全息铜砭刮痧联合耳穴埋豆治疗。对比分析两组干预前后血压水平和中医症候总积分。结果干预后,两组患者收缩压和舒张压均较干预前下降,且研究组患者收缩压明显改善效果优于对照组,差异有统计学意义(P<0.01)。干预后,两组患者中医证候评分均较干预前降低,且研究组中医证候评分低于对照组,差异有统计学意义(P<0.01)。结论耳部全息铜砭刮痧联合耳穴埋豆对社区肝阳上亢型高血压患者的血压水平控制及中医症候的改善具有明确效果,对提高社区高血压慢性病管理质量具有重要促进作用,值得社区推广运用。

中西医结合治疗腰椎间盘突出术后残余症状临床疗效的Meta分析

目的:应用Meta系统评价在常规西医治疗(抗感染、消肿、营养神经等)基础下加入中医疗法对腰椎间盘突出症(lumbar disc herniation,LDH)患者术后残余症状的临床疗效。方法:检索知网、万方、维普、Pubmed等中英文数据库中有关中西医结合对治疗腰椎间盘突出术后残余症状临床疗效的相关文献,研究方法均为随机对照试验(randomized controlled trial,RCT),检索时间2018年1月1日至2023年9月1日。文献质量评估依照Cochrane偏倚风险评价工具,RevMan5.3软件进行分析。结果:共纳入10篇文献,737例患者,Meta分析结果示:治疗组的总体临床疗效高于对照组(RR=1.19,Z=5.22,P<0.00001),疼痛视觉模拟评分(visual analogue scale,VAS)、腰椎功能障碍评分(oswestry dability index,ODI)均低于对照组(SMD=-1.30,Z=14.29,P<0.00001;SMD=-1.71,Z=12.40,P<0.00001),日本骨科协会腰痛疾病疗效评分高于对照组(SMD=1.66,Z=15.74,P<0.00001)。结论:中西医结合治疗能够改善腰椎间盘突出患者的术后残余症状,进一步减轻疼痛,改善生活质量。

耳针疗法辅助治疗急性期周围性面瘫疗效观察

目的观察耳针疗法辅助治疗急性期周围性面瘫的临床疗效。方法将94例急性期周围性面瘫患者按照随机数字表法分为2组,对照组47例采取常规西医治疗,治疗组47例在对照组基础上联合耳针疗法治疗。2组均治疗4周。比较2组治疗效果,比较2组治疗前后面部神经传导速度、红外热成像(前额区、耳周区、口角区、颧区及患侧全区温度)、面瘫改良Portmann评分、面部残疾指数躯体(FDIP)评分、免疫炎性指标[免疫球蛋白(IgA)、IgM、IgG、白细胞介素6(IL-6)、IL-21]水平及世界卫生组织生活质量测定量表简表(WHOQOL-BRFF)评分变化情况,治疗后随访1年,统计对比2组复发率。结果治疗组总有效率95.74%(45/47),对照组总有效率80.85%(38/47),治疗组临床疗效优于对照组(P<0.05)。2组治疗1、2、3、4周面部神经传导速度均较本组治疗前升高(P<0.05),且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05)。2组治疗1、2、3、4周前额区、耳周区、口角区及患侧全区温度均较本组治疗前升高(P<0.05),且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05);2组治疗1、2、3、4周颧区温度均较本组治疗前升高(P<0.05),但2组组间同期比较差异无统计学意义(P>0.05)。2组治疗1、2、3、4周改良Portmann、FDIP评分均较本组治疗前升高,且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05)。2组治疗后血清IgA、IgM、IgG、IL-6、IL-21水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后WHOQOL-BRFF各维度评分均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组复发率比较差异无统计学意义(P>0.05)。结论采用耳针疗法辅助治疗急性期周围性面瘫患者,能显著提高治疗效果,进一步改善患者面部肌群恢复情况,有效改善患者面部温度、神经功能及面部神经传导速度,且能有效抑制免疫炎性损伤,降低复发率,有助于改善患者预后。

中国急性ST段抬高型心肌梗死患者院前应用硝酸甘油或中成药对症状改善及梗死相关动脉血流影响的比较研究

目的:比较中国急性ST段抬高型心肌梗死(STEMI)患者院前应用硝酸甘油或中成药对症状改善及对梗死相关动脉(IRA)血流的影响。方法:依托中国急性心肌梗死注册研究于2013年1月1日至2014年3月31日期间,纳入全国108家医院7 d内发病且明确报告院前使用或不使用硝酸甘油或中成药的13064例STEMI患者(已排除共用两类药物患者),其中5280例患者接受了急诊冠状动脉造影。对比使用两类药物对患者症状缓解及IRA的TIMI血流分级水平的影响,其中症状缓解包括完全缓解(症状消失)和部分缓解(不同程度缓解)。结果:13064例患者中,2892例(22.1%)院前应用了硝酸甘油或中成药,其中1149例(8.8%)使用了硝酸甘油,1743例(13.3%)使用了中成药,10172例院前未用药。应用硝酸甘油或中成药的患者,6 h内到达医院的比例(57.4%vs.60.8%vs.50.3%,P<0.0010),与使用院前急救系统的比例(11.8%vs.12.2%vs.9.5%,P=0.0004)均高于未用药的患者。使用硝酸甘油的患者部分缓解比例高于使用中成药的患者(33.8%vs.25.1%,P<0.0010)。多因素Logistic分析显示,使用硝酸甘油较使用中成药完全和部分缓解的可能性较高(OR=1.331,95%CI:1.129~1.569,P=0.0007)。使用硝酸甘油或中成药的患者与未用药患者的院内死亡率相似。在接受急诊冠状动脉造影的患者中,使用中成药或硝酸甘油及未用药患者IRA的TIMI血流达到2~3级的比例分别为21.6%、15.8%和19.3%(P=0.0405)。多因素Logistic回归分析显示,与未用药患者相比,使用中成药患者的TIMI血流达到2~3级水平无明显优势(OR=0.856,95%CI:0.705~1.040,P=0.1171),使用硝酸甘油的患者TIMI血流达到2~3级水平可能性降低(OR=0.666,95%CI:0.495~0.895,P=0.0071)。结论:中国约有22.1%的STEMI患者院前单用硝酸甘油或中成药,含服硝酸甘油对症状改善作用优于中成药,与未用药患者相比,应用这两类药物的患者的TIMI血流未见明显改善。

间者并行,甚者独行——国医大师皮持衡辨治慢性肾衰临证思路发微

慢性肾衰病机复杂,症候繁多,混淆疑惑,辨证难明,此为“疑”;多脏腑虚损,气血阴阳不调,津液输布失常,病理产物相兼为病,处方不定,此为“难”。因其病情复杂性和多变性,且单一治法容易顾此失彼,故临床不可简单的扶正或祛邪,应有计划有层次多角度多途径施治。皮持衡教授从事肾病研究四十余年,认为慢性肾衰为本虚标实之证,治疗需紧扣病机、标本兼顾、病证结合、中西合参,以调阴阳平衡。皮持衡教授认为“间者并行、甚者独行”理论可有效指导临床,根据该理论采取扶正与祛邪交替给药的治疗方法,使药物既各自独行,又并行其治,既用药精专,又无犯虚虚实实之弊,取效颇佳,值得借鉴。现将皮老临证思路稍作探析,并结合医案进一步佐证,以飨同道。

桥本甲状腺炎并发甲状腺毒症人群临床症状及证型分布规律研究

背景中国传统医学对桥本甲状腺炎并发甲状腺毒症的发生、发展和诊疗已经有了系统的认识,但是目前关于本病人群中医临床症状和证型分布情况研究甚少,国家行业标准中亦缺乏关于本病的证型分布及证候诊断标准的描述。目的运用因子分析联合聚类分析探讨桥本甲状腺炎并发甲状腺毒症人群临床症状及证型分布规律,为临床辨证提供依据,促进桥本甲状腺炎并发甲状腺毒症证候标准化研究。方法收集2020年12月—2021年12月就诊于北京中医药大学东直门医院东城院区、通州院区、北京中医药大学孙思邈医院甲状腺病科门诊符合诊断标准的171例桥本甲状腺炎并发甲状腺毒症患者,使用《桥本甲状腺炎并发甲状腺毒症中医四诊信息采集表》对症状/体征、舌、脉等四诊信息进行采集,基于因子分析和聚类分析研究桥本甲状腺炎并发甲状腺毒症的症状及证型分布规律。结果171例桥本甲状腺炎并发甲状腺毒症患者中男17例、女154例,平均年龄(39.98±13.30)岁,其中20~60岁患者占87.72%。症状分布方面出现频率较高的症状有神疲乏力、心慌心悸、烦躁或急躁易怒,体征有颈前肿大、手指震颤,频率较高的舌象有舌红、舌瘦薄和舌有齿痕,苔质为苔白和苔薄,脉象是脉弦、脉数。收集调查表的82个四诊条目因子分析,提取出25个公因子,累计方差贡献率为70.562%,筛选出具有意义的症状62项。利用因子分析得到的25个公因子结果作为变量对其进行R型系统聚类分析,共得到5类证候分型,分别是:肝郁痰凝证、阴虚火旺证、脾肾阳虚证、肝郁气滞证、气阴两虚证。结论桥本甲状腺炎并发甲状腺毒症的基本中医证候可分为肝郁痰凝证、阴虚火旺证、脾肾阳虚证、肝郁气滞证、气阴两虚证。

基于TabNet的周仲瑛教授辨治甲状腺功能亢进病机预测模型及用药规律研究

目的以周仲瑛教授治疗甲状腺功能亢进(甲亢)的临床病案为研究对象,探索运用基于神经网络的TabNet模型发现甲亢的诊疗规律,为传承名老中医学术思想、辅助临床诊疗提供方法参考。方法基于周仲瑛教授及其团队的临床甲亢诊疗医案,构建标准化、结构化训练数据,研究基于注意力机制和稀疏特征选择机制的算法,通过输入标准化临床表现,标准化舌象、脉象构建病机预测模型,分析核心症状、病机和药物以及三者之间的联系。结果通过训练好的预测模型对肝郁、肝火、痰饮、肾虚、阴虚、瘀血6个病机进行预测,与决策树、随机森林等经典算法构建的多标签分类模型相比,本模型分类和预测指标均较好。通过决策树算法进行挖掘,总结6个核心病机对应中药社团:醋柴胡、夏枯草、牡蛎、炙鳖甲、玄参、天冬、麦冬等。结论在临床医案数据上运用TabNet算法,构建基于临床表现、舌象和脉象的病机预测模型,可有效地预测核心病机,进而发现“症-机-药”之间的联系,为名老中医学术思想的传承和临床辅助诊疗决策提供方法学参考。

中药灌肠对急性期溃疡性结肠炎的临床疗效及肠道黏膜修复作用的Meta分析

目的评价中药灌肠治疗急性期或活动期溃疡性结肠炎(UC)的有效性及对黏膜修复作用的疗效。方法检索中英文数据库,包括中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP)、万方数据库、临床试验注册登记库、PubMed、Embase等,时间为建库至2023年10月,筛选随机对照试验(RCTs),采用RevMan5.3软件对纳入的研究进行Meta分析。结果共纳入17篇RCTs,Meta分析结果示:总有效率[RR=1.22,95%CI=(1.15,1.28),P<0.01];腹泻积分[SMD=-1.38,95%CI=(-2.00,-0.77),P<0.01];脓血便积分[SMD=-1.09,95%CI=(-1.64,-0.53),P<0.01];Baron评分[SMD=-1.38,95%CI=(-2.05,-0.70),P<0.01];黏膜组织评分[SMD=-2.00,95%CI=(-3.35,-0.66),P<0.01];白细胞介素-6(IL-6)水平[SMD=-3.11,95%CI=(-5.71,-0.50),P=0.02];白细胞介素-10(IL-10)水平[SMD=1.65,95%CI=(1.35,1.95),P<0.01];肿瘤坏死因子-α(TNF-α)水平[SMD=-1.93,95%CI=(-2.48,-1.39),P<0.01]。结论中医药灌肠辅助治疗急性期或活动期UC有助于提高治疗效果,缓解腹泻及脓血便的临床症状,促进肠道黏膜修复,抑制炎性因子的释放。

新型冠状病毒感染疫情中医肺养生康复思路探讨

新型冠状病毒感染(corona virus disease 2019,COVID-19)(简称新冠感染)疫情中医肺养生康复以“辨质养生”“辨症/证康复”等中医理论基础为支撑,凭借中医养生康复“形神兼顾,标本同治”“三因制宜,辨证论治”“疗养结合,调节康复”优势,以“五脏相关,以肺为要”“肺体金魄,形神共养”“天人合一,杂合以治”为整体原则,采用鼻部保养、肠道调护、中药、针灸、按摩、气功等基本方法,缩短患者康复时间、有序回归社会,结合当前新冠恢复期特点建立多方法多途径科学全面的新冠感染中医肺养生康复方案以充分发挥中医药全程深度介入新冠疫情工作的重大作用。

中医穴位定向透药对糖尿病足临床证候及踝肱指数的影响

目的观察中医穴位定向透药对改善糖尿病足患者临床证候及踝肱指数(ABI)的影响。方法选取商丘市第一人民医院2021年1月至2023年1月收治的121例糖尿病足患者为研究对象,采用抽签法分为观察组(n=70)和对照组(n=51)。对照组予以常规西药治疗,观察组采用中医穴位定向透药联合西药治疗,比较两组疗效,分析ABI指数与治疗效果间的相关性。结果治疗后,观察组的中医主证积分、中医次证积分、C-反应蛋白(CRP)水平低于对照组,胰岛素生长因子-1(IGF-1)、胰岛素生长因子-2(IGF-2)水平高于对照组,差异均具有统计学意义(P<0.05)。治疗3 d、7 d、14 d后,观察组的ABI指数均高于对照组(P<0.05)。经Spearman相关性系数检验,ABI与中医主证积分、中医次证积分、CRP水平负相关,与IGF-1、IGF-2水平正相关。结论中医穴位定向透药可改善糖尿病足临床证候及ABI指数。

自拟温经通络汤治疗腰椎间盘突出症的临床效果

目的 探讨自拟温经通络汤治疗腰椎间盘突出症的临床效果。方法 选取2020年2月至2022年12月四川省眉山市中医医院收治的122例腰椎间盘突出症患者为研究对象,按照随机数字表法将其分为对照组和观察组,各61例。对照组以靶点射频热凝术治疗,观察组增加自拟温经通络汤治疗。两组均治疗3个疗程。评价两组临床疗效。比较两组治疗前后中医症候积分、表面肌电图水平[左侧积分肌电值(iEMG)、右侧iEMG、左侧平均功率频率(MPF)、右侧MPF]、炎症因子水平[基质金属蛋白酶-7(MMP-7)、缺氧诱导因子-2α(HIF-2α)、前列腺素E_(2)(PGE_(2))]及不良反应总发生率。结果 观察组临床疗效优于对照组(P<0.05)。治疗后,两组中医证候积分均低于治疗前,且观察组低于对照组(P<0.05)。治疗后,两组左侧iEMG、右侧iEMG、左侧MPF、右侧MPF均高于治疗前,且观察组高于对照组(P<0.05)。治疗后,两组MMP-7、HIF-2α、PGE_(2)水平均较治疗前降低,且观察组低于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 自拟温经通络汤治疗腰椎间盘突出症效果良好,可改善患者中医症候,提高腰椎部肌电图指标水平,抑制炎症因子表达,治疗安全性良好。

中药熏洗结合针刺治疗糖尿病血管病变临床观察

目的 观察中药熏洗结合针刺治疗糖尿病血管病变临床效果。方法 研究纳入合计151例糖尿病血管病变患者(2020年1月—2023年2月收治)进行分组研究,分组方法为随机数字表法,将患者分为观察组(76例)与对照组(75例),对照组患者采取西医常规治疗,观察组患者西医常规治疗结合中药熏洗及针刺治疗,各组数据观察:治疗效果、治疗前后患者血糖指标变化空腹血糖(Fasting blood glucose, FPG);餐后2 h血糖(2 hour postprandial plasma glucose, 2hFPG);糖化血红蛋白(glycosylated hemoglobin, HbAlc)、中医证候积分(下肢麻木疼痛、疮面肉芽不新鲜、面色无华、心悸气短、神疲乏力等)变化、足背温度变化及踝/肱指数(ankle brachial index, ABI)变化、下肢动静脉彩超相关指标(血管内径、血管狭窄程度以及血流速度)变化、耐受疼痛最大行走距离变化及血液流变学指标(红细胞比容、血浆黏度值、全血高切黏度及全血低切黏度)变化、不良反应。结果 观察组与对照组治疗总有效率分别为96.05%、86.67%,前者更高,P<0.05;治疗前各组患者血糖指标(FPG、2hFPG、HbAlc)、中医证候积分(下肢麻木疼痛、疮面肉芽不新鲜、面色无华、心悸气短、神疲乏力等)、足背温度、ABI、下肢动静脉彩超相关指标(血管内径、血管狭窄程度以及血流速度)、耐受疼痛最大行走距离、血液流变学指标(红细胞比容、血浆黏度值、全血高切黏度及全血低切黏度)等比较,P>0.05,治疗后各组患者血糖指标(FPG、2hFPG、HbAlc)、中医证候积分(下肢麻木疼痛、疮面肉芽不新鲜、面色无华、心悸气短、神疲乏力等)、足背温度、ABI、下肢动静脉彩超相关指标(血管内径、血管狭窄程度以及血流速度)、耐受疼痛最大行走距离、血液流变学指标(红细胞比容、血浆黏度值、全血高切黏度及全血低切黏度)等指标均改善,观察组患者治疗后血糖指标(FPG、2hFPG、HbAlc)、中医证候积分(下肢麻木疼痛、疮面肉芽不新鲜、面色无华、心悸气短、神疲乏力等)、足背温度、ABI、下肢动静脉彩超相关指标(血管内径、血管狭窄程度以及血流速度)、耐受疼痛最大行走距离、血液流变学指标(红细胞比容、血浆黏度值、全血高切黏度及全血低切黏度)等指标均优于对照组,P<0.05;对照组与观察组不良反应率分别为2.66%、2.64%,均较低。结论 中药熏洗结合针刺治疗糖尿病血管病变效果显著,患者症状缓解,安全可靠,值得应用。