Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idi...Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.展开更多
Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiag...Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiagnose.Two cases of VBD that were initially diagnosed as posterior circulation watershed infarction are reported here.Absence of common causes of stroke including hypoperfusion,blood system diseases,carotid and aortic dissection,and eosinophil elevation,the symptoms of the 2 patients met the diagnostic criteria of VBD.Both patients displayed symptoms that were in line with the Traditional Chinese Medicine(TCM)syndrome pattern of"Qi deficiency and blood stasis".Accordingly,they were comprehensively treated with Supplementing Qi and activating blood circulation method.The clinical manifestations of the 2 patients were remarkably improved and no recurrence of watershed infarction was found in a 1-year follow-up.A detailed medical history and laboratory examination are capable of improving diagnostic accuracy of VBD.TCM treatment based on syndrome identification might be a promising candidate for VBD management.展开更多
目的探讨益气通络、健脾补肾法联合穴位贴敷在慢性阻塞性肺疾病(简称慢阻肺)稳定期患者中的应用效果。方法采用随机数字表法将于2020年1月—2021年12月在河北省张家口市中医院接受治疗的180例慢阻肺稳定期患者分为A组、B组和C组,各60例...目的探讨益气通络、健脾补肾法联合穴位贴敷在慢性阻塞性肺疾病(简称慢阻肺)稳定期患者中的应用效果。方法采用随机数字表法将于2020年1月—2021年12月在河北省张家口市中医院接受治疗的180例慢阻肺稳定期患者分为A组、B组和C组,各60例。3组均给予常规西医治疗,A组给予穴位贴敷治疗,B组给予益气通络、健脾补肾方治疗,C组给予益气通络、健脾补肾法联合穴位贴敷治疗。3组均持续治疗9个月。比较治疗9个月后的临床疗效,治疗前、治疗9个月后的6min步行距离(6 min walking distance,6MWD)、劳累程度、生活质量、呼吸困难指数、血气指标及炎性因子。结果治疗9个月后,C组总有效率为88.33%(53/60),高于A、B组的55.00%(33/60)、73.00%(44/60),B组高于A组(P<0.05)。与治疗前比较,治疗9个月后,3组6 MWD均延长,且C组长于A、B组,B组长于A组;劳累评估量表(Borg)评分、慢阻肺患者评估测试(COPD patient assessment test,CAT)评分、改良英国医学研究会呼吸困难指数(modified British medical research council,mMRC)、动脉血二氧化碳分压(PaCO_(2))、血清白细胞介素-8(interleukin-8,IL-8)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及C反应蛋白(C-reactive protei,CRP)水平均降低,且C组低于A、B组,B组低于A组;3组血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))均升高,且C组高于A、B组,B组高于A组(P<0.05),而3组酸碱度(pH)治疗前后及组间比较,差异无统计学差异(P>0.05)。结论益气通络、健脾补肾法联合穴位贴敷可有效缓解慢阻肺稳定期患者呼吸困难症状,减轻患者劳累程度及炎症反应,并改善患者血气指标,提高患者步行能力及生活质量,进而提高治疗效果。展开更多
基金Scientific Research Special Project of Capital Health Development in 2018(No.First issues 2018-1-4192)TCM Science and Technology Development Fund of Beijing in 2020(No.JJ-2020-42)。
文摘Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.
基金the 2019 Major Difficult Diseases Clinical Collaboration Capacity Building Project of Traditional Chinese and Western Medicine-cerebral Infarction(No.YW082)。
文摘Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiagnose.Two cases of VBD that were initially diagnosed as posterior circulation watershed infarction are reported here.Absence of common causes of stroke including hypoperfusion,blood system diseases,carotid and aortic dissection,and eosinophil elevation,the symptoms of the 2 patients met the diagnostic criteria of VBD.Both patients displayed symptoms that were in line with the Traditional Chinese Medicine(TCM)syndrome pattern of"Qi deficiency and blood stasis".Accordingly,they were comprehensively treated with Supplementing Qi and activating blood circulation method.The clinical manifestations of the 2 patients were remarkably improved and no recurrence of watershed infarction was found in a 1-year follow-up.A detailed medical history and laboratory examination are capable of improving diagnostic accuracy of VBD.TCM treatment based on syndrome identification might be a promising candidate for VBD management.
文摘目的探讨益气通络、健脾补肾法联合穴位贴敷在慢性阻塞性肺疾病(简称慢阻肺)稳定期患者中的应用效果。方法采用随机数字表法将于2020年1月—2021年12月在河北省张家口市中医院接受治疗的180例慢阻肺稳定期患者分为A组、B组和C组,各60例。3组均给予常规西医治疗,A组给予穴位贴敷治疗,B组给予益气通络、健脾补肾方治疗,C组给予益气通络、健脾补肾法联合穴位贴敷治疗。3组均持续治疗9个月。比较治疗9个月后的临床疗效,治疗前、治疗9个月后的6min步行距离(6 min walking distance,6MWD)、劳累程度、生活质量、呼吸困难指数、血气指标及炎性因子。结果治疗9个月后,C组总有效率为88.33%(53/60),高于A、B组的55.00%(33/60)、73.00%(44/60),B组高于A组(P<0.05)。与治疗前比较,治疗9个月后,3组6 MWD均延长,且C组长于A、B组,B组长于A组;劳累评估量表(Borg)评分、慢阻肺患者评估测试(COPD patient assessment test,CAT)评分、改良英国医学研究会呼吸困难指数(modified British medical research council,mMRC)、动脉血二氧化碳分压(PaCO_(2))、血清白细胞介素-8(interleukin-8,IL-8)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及C反应蛋白(C-reactive protei,CRP)水平均降低,且C组低于A、B组,B组低于A组;3组血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))均升高,且C组高于A、B组,B组高于A组(P<0.05),而3组酸碱度(pH)治疗前后及组间比较,差异无统计学差异(P>0.05)。结论益气通络、健脾补肾法联合穴位贴敷可有效缓解慢阻肺稳定期患者呼吸困难症状,减轻患者劳累程度及炎症反应,并改善患者血气指标,提高患者步行能力及生活质量,进而提高治疗效果。
