Evidence-Based Therapy May Improve Outcome in Glomerulonephritis—A Prospective Field Survey

Introduction and aims: Although glomerulonephritis is rare in the general population it is the second most important cause for end-stage renal failure. The therapy of glomerulonephritis is guided by a limited number of individual clinical trials and treatment recommendations are based on meta-analysis and Cochrane Systematic Reviews. The impact of such therapy standards on the prognosis of glomerulonephritis is not known. Methods: Between October 2002 and December 2008 patients with abnormal urine findings and/or decreasing renal function of unknown cause were referred for renal biopsy. In a collaboration of out-patient nephrologists with a major teaching hospital, all patients received treatment recommendations according to evidence-based therapy guidelines based on Cochrane Systematic Reviews. Patient charts were systematically reviewed and patients were re-examined for follow-up until November 2009. Cox Regression analysis was performed to identify independent prognostic factors. Results: Two hundred patients with primary or secondary glomerulonephritis were identified. Complete follow-up data were available from 196 patients with 324 therapeutic interventions. The mean follow-up was 2.8 ± 2.0 years. Among all patients, 37% remained unchanged ill, 13% died, 17% had progressing renal disease, while 19% had a complete and 14% a partial remission. Proteinuria declined in primary glomerulonephritis (5.0 ± 5.4 g/d to 2.1 ± 3.4 g/d, p Conclusions: In a multivariate model of standardised glomerulonephritis therapy the presence of tubulointerstitial fibrosis was associated with death or progresssive renal disease, while prednisolone-based therapy regimens and intensified nephrological follow-up resulted in a significant delay of endstage-renal failure. This result should direct future health care policies because glomerulonephritis accounts for nearly 20% of the dialysis population.

Differential Treatment for Membranoproliferative Glomerulonephritis with TCM Prescriptions Plus Triptoryph Tablets A Report of 30 Cases

Membranoproliferative glomerulonephritis is aglomerulopathy,which accounts for about 30% of thechronic glomerulonephritis in adults.TCMmedication with addition of triptoryph tablets(Tripterygium Wilfordii polyglycosidium) on thebasis of syndrome differentiation had yieldedsatisfactory results in 30 cases of this disease treatedfrom Jan 1998 to Aug 2002.A report follows.

Treatment of hepatitis B virus-associated glomerulonephritis:A meta-analysis

AIM:To evaluate the efficacy of antiviral or corticosteroid treatment on hepatitis B virus-associated glomerulonephritis(HBV-GN) . METHODS:Six and five trials were used respectively to evaluate the efficacy of either antiviral or corticosteroid treatment on HBV-GN.Pediatric patients were pooled separately to assess their response to the above treatment modalities.The primary and secondary outcomes were remission of proteinuria and clearance of Hepatitis B e-antigen(HBeAg) ,respectively.A fixed or random effect model was established to collect the data. RESULTS:The remission rate of proteinuria(RR=1.69,95%CI:1.08-2.65) and the clearance rate of HBeAg(RR =6.44,95%CI:3.11-13.35) were significantly higher in antiviral treatment group than in control group.The proteinuria remission was significantly associated with HBeAg clearance(P=0.002) .However,the difference in proteinuria remission rate was not statistically significant between corticosteroid treatment group and controlgroup(RR=1.45,95%CI:0.68-3.11) .Antiviral therapy could significantly promote the HBeAg clearance in pediatric patients,but neither antiviral nor corticosteroid therapy could significantly decrease proteinuria in pediatric patients compared to controls. CONCLUSION:Antiviral but not corticosteroid treatment can decrease proteinuria and promote HBeAg clearance in HBV-GN patients.

Clinical Observation on Treatment of Moderate and Severe Periodical Mastalgia with TCM Hot-wet Compress Therapy

[Objectives] To observe the clinical therapeutic efficacy of local hot-wet compress therapy of digestion ointment prescription on the patients with moderate and severe mastalgia. [Methods] Firstly,60 patients with mastalgia were selected,and divided into the experimental group and control group( 30 cases for each group). The control group was treated with acupuncture at distal point,and the experimental group was treated with TCM local hot-wet compress therapy combined with acupuncture at distal point. Then,the clinical therapeutic efficacy of two groups was compared. [Results]The experimental group was superior to the control group in relieving the breast pain,improving emotional integral,reducing breast lumps,improving lump texture,and improving TCM syndrome integral( P < 0. 05). [Conclusions]The digestion ointment prescription local hot-wet compress therapy has a significant therapeutic effect on treatment of mastalgia and can significantly improve the breast pain symptom of patients.

Clinical Effects of the Qi-acupuncture Therapy of TCM on Portal Hypertension

Objective:To explore the effective prevention and treatment of portal hypertension(PH).Methods:A total of 220 patients who came to our hospital from March 2015 to October 2018 were treated.They were randomly divided into the treatment group and the control group,each with 110 cases.Before treatment,there was no significant differences in age,sex,clinical symptoms,signs,laboratory tests and color Doppler ultrasound related examinations between the 2 groups(P>0.05).Among them,the treatment group on the basis of traditional Chinese and Western medicine treatment in our hospital,the Qi-acupuncture therapy of TCM was added.The extra meridian acupoints along with acupoints were selected.The control group received conventional treatment with traditional Chinese and Western medicine in our hospital.Results:There were significant differences in clinical symptoms,signs and chemistry between groups after treatment(P<0.01).There were significant differences in test,color ultrasound related examination and so on(P<0.01).Those in the treatment group was significantly better than the control group(P<0.01).Conclusion:On the basis of the Qi-acupuncture therapy of TCM,selecting extra meridian acupoint and acupoints can effectively treat PH.

Systematic review and meta analysis of the TCM therapy of Fuzheng and Kangai combined with chemotherapy in treating advanced NSCLC

Objective:To systematically evaluate TCM of Fuzheng and Kangai combined with chemotherapy in the treatment of Advanced NSCLC,including the efficacy and effect on the quality of life of patients.Methods:Two researchers independently searched the literature of clinical trails from Jan.2010 until Jun.2020 in the Cochrane Library,Pubmed,Embase,CBM,CNKI,WanFang Data and VIP database.Also,they had been evaluated and extracted strictly by REVMAN 5.3.Results:A total of 1303 patients were included in 15 articles.The meta analysis shows that the TCM of Fuzheng and Kangai combined with chemotherapy can improve the objective response rate[OR=2.14,95%CI(1.67,2.74),P<0.00001],disease control rate[OR=2.54,95%CI(1.88,3.42),P<0.00001]and KPS score[OR=3.28,95%CI(1.92,5.60),P<0.0001],decrease the incidence rate of liver injury[OR=0.34,95%CI(0.21,0.54),P=0.003],hemoglobin reduction[OR=0.53,95%CI(0.28,1.01),P=0.05],leukopenia[OR=0.22,95%CI(0.13,0.39),P<0.00001],thrombocytopenia[OR=0.32,95%CI(0.21,0.50),P<0.00001],toxic effects on the digestive systems[OR=0.30,95%CI(0.19,0.46),P<0.00001].Conclusions:the experimental group was better than control one in short-term efficacy and KPS score.Furthermore,the experimental group can reduce the incidence rate of myelosuppression,toxicity of digestive system and liver.

Non-pharmacological therapy of TCM for the treatment of essential hypertension

Non-pharmacotogicat treatment is an important means to control hypertension, with many advantages such as tow cost, tess medication, stable btood pressure, tess compHcations, and improved prognosis. This article reviews the research progress of non-drug treatment of hypertension in Chinese medicine in the past five years, and evaluates traditional Chinese medicine such as TCM Qigong, Wuhuo opera, Ba Duanjin and Taijiquan, and Chinese medicine acupuncture, moxibustion, massage, apptication, acupoint embedding and other traditional Chinese medicine. The effect of external treatment in hypertension control provides guidance for non-drug therapy to control hypertension.

血府逐瘀汤治疗冠心病研究进展

冠心病是临床常见的心血管疾病之一,其发病率和病死率呈上升趋势,严重危害居民健康,加重国家经济负担。血府逐瘀汤有活血化瘀、理气止痛的功效,主治胸中血瘀证。临床上根据其功效常用于治疗血瘀证冠心病,并取得良好疗效。此文旨在对血府逐瘀汤治疗冠心病的临床运用、作用机制及研究进展展开探讨,为深入挖掘血府逐瘀汤临床及实验研究提供新思路。

隐性听力损失中医病机及防治研究进展

隐性听力损失是以纯音听阈正常,噪声背景下言语识别能力降低为主要症状的疾病,噪声暴露、药物损伤、年龄老化是主要的致病危险因素,其发病隐匿,容易忽视,危险因素持续暴露可造成不可逆听力损伤,目前临床多无有效的治疗方法,以早期预防为主。根据隐性听力损失的致病因素及发病机制,探讨隐性听力损失的中医病机,认为脾虚湿滞、清窍蒙蔽、肾元不足、邪聚耳窍为致病的内在因素,毒邪犯耳、内毒留滞、毒瘀经络为病理机制,并对近年来隐性听力损失的预防与治疗研究概况做一总结,为中医药治疗隐性听力损失研究提供理论依据和临床经验。

中医外治法治疗痛风性关节炎研究文献可视化分析

目的 分析中医外治法治疗痛风性关节炎相关文献,了解该领域研究现状、研究热点和发展趋势,为该领域后续研究提供研究思路。方法 检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(VIP)2000年1月1日-2022年11月30日收录的中医外治法治疗痛风性关节炎研究文献,利用NoteExpress3.6.0软件对文献进行人工筛选,借助Excel2019绘制发文趋势图和期刊分布图;采用VOSviewer1.6.18软件绘制核心作者合作网络、机构合作密度视图和关键词共现图谱,使用CiteSpace6.1.R4软件绘制关键词聚类分析图、时间线图及关键词突现图谱,并对以上内容进行分析。结果 共纳入1 304篇文献,发文量总体呈增长态势;纳入文献涉及318本期刊、2 890位作者,发文量最多的是广州中医药大学;分析得出文献关键词1 181个,形成12个有意义的聚类,并展现出了湿热蕴结型、炎性因子、中医药疗法等20个突现词。结论 中医外治法治疗痛风性关节炎的研究热点主要集中于中药内服外敷、临床疗效观察及中药外敷、针刺、刺血疗法、电针、火针、针刀等中医外治法,备受关注的中医证型是湿热蕴结型。

芪葛威灵胶囊治疗糖尿病周围神经病变临床观察

目的:观察芪葛威灵胶囊治疗气阴两虚兼血瘀型糖尿病周围神经病变患者的临床疗效。方法:选取120例气阴两虚兼血瘀型糖尿病神经病变患者,按随机数字表法分为两组各60例。治疗组予芪葛威灵胶囊治疗,对照组予甲钴胺片口服。治疗8周后,比较两组患者临床疗效、中医证候积分、多伦多临床评分系统(TCSS)评分、神经传导速度、不良反应等。结果:治疗组总有效率91.67%,优于对照组的68.33%(P﹤0.05);治疗后,两组患者肢体麻木、疼痛及小腿抽搐证候积分均明显下降(P﹤0.05),两组TCSS评分均明显降低(P﹤0.05),腓总神经、胫后神经运动神经传导速度均明显提高(P﹤0.05),且治疗组改善程度均优于对照组(P﹤0.05)。结论:芪葛威灵胶囊可改善气阴两虚兼血瘀型糖尿病周围神经病变患者的临床症状,提高TCSS评分、改善神经传导速度,临床疗效良好。

七味白术散加味治疗肝硬化腹泻临床观察

目的:观察七味白术散加味治疗肝硬化腹泻的临床疗效。方法:选取确诊的96例肝硬化腹泻患者,随机分为两组各48例。两组均予肝硬化西医常规治疗,对照组在此基础上予双歧杆菌四联活菌口服,治疗组予七味白术散加味治疗,疗程均为2周,比较两组临床疗效以及肠道sIgA水平变化、肠道菌群的改善情况。结果:治疗组总有效率为95.83%,对照组总有效率81.25%,两组比较差异有统计学意义(P﹤0.05);治疗后,治疗组患者的ALT、AST、TBIL改善程度明显优于对照组(P﹤0.05);治疗组肠道sIgA水平、肠道菌群改善水平均明显优于对照组(P﹤0.05)。结论:七味白术散加味治疗肝硬化腹泻疗效较好,可改善患者肝功能水平及肠道有益菌群生长,增加患者肠道sIgA水平。

巴芪除痒止咳方治疗肺肾两虚兼风寒犯肺型咳嗽变异性哮喘疗效观察

目的:观察巴芪除痒止咳方治疗肺肾两虚兼风寒犯肺型咳嗽变异性哮喘的临床疗效。方法:选取门诊60名咳嗽变异性哮喘患者,随机分为两组各30例。对照组予布地奈德/福莫特罗粉吸入剂治疗,治疗组在对照组基础上予巴芪除痒止咳方治疗,疗程2周。比较两组临床疗效,VAS、CET、FeNO评分及中医证候积分变化情况。结果:治疗后,治疗组总有效率96.67%,高于对照组的80.00%,两组比较差异具有统计学意义(P﹤0.05);两组VAS、CET及FeNO评分均得到了改善(P﹤0.05),且治疗组VAS、CET评分较对照组改善更明显;治疗后治疗组咳痰、咽痒、恶风、自汗积分均小于对照组(P﹤0.05)。结论:巴芪除痒止咳方能减轻肺肾两虚兼风寒犯肺型咳嗽变异性哮喘患者气道炎症反应,缓解临床症状。

八段锦联合放松功对轻中度抑郁的影响研究

【目的】探究中医行为心理疗法八段锦联合放松功干预轻中度抑郁的效果。【方法】将40例轻中度抑郁患者随机分为干预组和对照组,每组各20例。干预组给予八段锦锻炼联合放松功干预治疗,对照组给予西药氢溴酸西酞普兰片治疗,疗程为6周。观察2组患者干预前后汉密尔顿抑郁量表(HAMD)评分、蒙哥马利抑郁量表(MADRS)评分、匹兹堡睡眠质量指数(PSQI)评分以及生活质量综合评定问卷(GQOL-74)评分的变化情况,并评价2组患者的抑郁改善疗效。【结果】(1)抑郁改善疗效方面,治疗6周后,干预组的总有效率为95.0%(19/20),对照组为90.0%(18/20),组间比较(χ2检验),差异无统计学意义(P>0.05)。(2)抑郁程度方面,治疗后,2组患者的HAMD评分和MADRS评分均较治疗前明显下降(P<0.01),但治疗后组间比较,差异均无统计学意义(P>0.05)。(3)生活质量方面,治疗后,2组患者的GQOL-74的躯体功能、心理功能、社会功能、物质生活等各项评分及总分均较治疗前明显改善(P<0.01),但治疗后组间比较,差异均无统计学意义(P>0.05)。(4)睡眠质量方面,治疗后,2组患者的PSQI的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物和日间功能等各项评分及总分均较治疗前明显改善(P<0.01),且干预组对PSQI的睡眠质量、入睡时间评分及总分的改善作用明显优于对照组(P<0.05)。【结论】八段锦锻炼联合放松功干预对轻中度抑郁症状的改善有明确的疗效,可以为轻中度抑郁症患者提供更广泛的选择可能,特别是对西药治疗不耐受的患者更具有一定的优势。

辨证施护联合热敏灸治疗肝硬化腹水临床观察

目的探究中医辨证施护联合热敏灸治疗肝硬化腹水的临床效果。方法选择肝硬化腹水患者60例,分为对照组(予常规治疗)和试验组(予热敏灸联合中药治疗),对比两组临床疗效及不良反应发生率。结果试验组治疗总有效率为96.67%(29/30),高于对照组的83.33%(25/30),差异有统计学意义(P<0.05)。对照组不良反应发生率为6.67%(2/30),而试验组患者未出现不良反应,差异有统计学意义(P<0.05)。结论中医辨证施护联合热敏灸治疗肝硬化腹水效果显著、安全高,值得临床推广应用。

中医药治疗特发性肺纤维化研究进展

特发性肺纤维化是原因不明的慢性进行性致纤维化间质性肺炎,主要见于中老年男性,局限于肺,临床上呈渐进性呼吸困难和肺功能恶化,组织病理学和胸部HRCT表现为特征性的寻常型间质性肺炎。特发性肺纤维化属中医学“肺痿、肺痹”范畴,中医对此病的认识历史悠久,优势明显,近年来受到越来越多的重视,通过对近5年多(2018年—至今)中医药在特发性肺纤维化的研究文献进行总结,主要从病机(“肺虚络瘀”论、“热毒滞络”论、“肺寒络凝”论、其他)、临床研究(古方、自拟方、中成药、六字诀呼吸操、热敏灸)2方面进行了综述,以期为此病的治疗提供有益的参考。

中和思想指导下苇茎汤治疗胸腔积液临床观察

目的 在中和医派思想的指导下探讨苇茎汤治疗胸腔积液的临床疗效。方法 选取2022年1月—2023年1月收治的胸腔积液患者60例,随机分为观察组和试验组,每组30例。观察组采用常规西医治疗,试验组在常规西医治疗的同时,联合应用苇茎汤进行治疗,3个疗程后观察2组临床疗效并对患者肺功能进行评价。结果 治疗后,试验组FVC、FEV1、FEV1/FVC、PEER均高于观察组(P<0.05)。结论 苇茎汤能够提高胸腔积液患者的肺功能,改善肺循环及气道阻塞,提高重症患者治愈率及生活质量。

平肝熄风胶囊联合耳穴压豆治疗中青年高血压疗效观察

目的:观察平肝熄风胶囊联合耳穴压豆治疗中青年高血压患者的临床疗效。方法:将100例中青年高血压患者随机分为两组各50例。对照组予生活方式干预及常规降压药物治疗,治疗组在对照组基础上予平肝熄风胶囊联合耳穴压豆治疗。两组均治疗8周。观察两组中医证候总有效率、降压总有效率情况,比较两组治疗前后24 h动态血压、尿微量白蛋白及生活质量评分变化。结果:治疗后,治疗组血压、24 h动态血压、尿微量白蛋白水平均明显低于对照组(P<0.05),治疗组中医证候疗效、降压疗效、生活质量均优于对照组(P<0.05)。结论:平肝熄风胶囊联合耳穴压豆治疗中青年高血压疗效较好,可降低患者血压,改善临床症状,提高生活质量。

王文萍从痰瘀论治肺癌经验

王文萍教授认为,肺癌病机为痰瘀互结,临证以活血化瘀、调畅气机为主,软坚散结、化痰祛瘀为辅,方用血府逐瘀汤合二陈汤化裁治疗肺癌,同时注重对患者进行心理疏导,减轻其精神压力,以达到标本兼治的目的。本文从病因病机、治法治则、遣方用药总结王文萍教授治疗肺癌的临证经验,并附验案一则,以期较为全面地分析王文萍从痰瘀论治肺癌的学术思想。

涤痰汤合桃红四物汤加减治疗痰瘀阻络型脑梗死恢复早期临床观察

目的:观察涤痰汤合桃红四物汤加减治疗痰瘀阻络型脑梗死恢复早期的临床疗效。方法:选取符合纳入标准的痰瘀阻络型脑梗死恢复早期患者96例,采用随机数字表法分为两组各48例。对照组予常规对症治疗及个体化康复综合训练,治疗组在对照组基础上予涤痰汤合桃红四物汤加减治疗。比较两组神经功能缺损程度、中医证候积分、神经损伤因子水平、脑血流动力学指标水平。结果:治疗后,两组卒中量表(NIHSS)评分、中医证候积分、各项神经损伤因子水平、各项脑血流动力学指标水平均较治疗前改善(P﹤0.05),且治疗组改善幅度均优于对照组(P﹤0.05)。结论:涤痰汤合桃红四物汤加减对痰瘀阻络型脑梗死恢复早期脑神经的保护作用较好,可有效改善脑血流动力学。