Research on the Progress of Treating Gastroesophageal Reflux Disease with Modified Classic Traditional Chinese Medicine Prescription

Gastroesophageal reflux disease (GERD) is a high-incidence digestive system disease. Western medicine mainly uses drugs such as proton pump inhibitors to inhibit gastric acid secretion, but some patients are accompanied by symptoms such as non-acid reflux and gas reflux, which cannot effectively treat the disease. It is necessary to actively explore other treatment schemes. Traditional Chinese medicine (TCM) has a long history of research on gastroesophageal reflux disease, which emphasizes the treatment based on syndrome differentiation as a whole. Through the treatment of various and multi-component TCM prescriptions, the patient’s body condition can be adjusted, and the treatment effect on gastroesophageal reflux disease is reliable, which has obvious therapeutic advantages. To further clarify the treatment of gastroesophageal reflux disease, this study reviewed and analyzed the research progress of the treatment of liver disease with modified prescriptions, and the report is as follows.

Evaluation of the Therapeutic Effect of Contrast-Enhanced Ultrasound on Different Types of Knee Osteoarthritis in the Elderly

Objective: To evaluate the curative effect of the Traditional Chinese Medicine (TCM) external therapy on knee osteoarthritis patients with different TCM constitutions using musculoskeletal ultrasonography and contrast-enhanced ultrasonography, and to explore the application value of contrast-enhanced ultrasonography in knee joint diseases. Methods: A total of 57 patients diagnosed with knee osteoarthritis in Shaanxi University of Traditional Chinese Medicine from December 2019 to May 2021 were collected, and they were divided into qi stagnation and blood stasis type group (23 cases) and cold-dampness obstruction type group (34 cases) according to the traditional Chinese medicine method. All patients were given acupuncture combined with TCM fumigation and washing. All patients underwent musculoskeletal ultrasonography and contrast-enhanced ultrasonography before and after treatment, observed and recorded relevant data, and compared the treatment effects between the two groups. Results: 85.96% (49/57) of knee osteoarthritis (KOA) patients had suprapatellar bursa effusion, 42.1% (24/57) had iliotibial band bursae effusion, some of which had poor sound transmission, and thickened synovium was seen in most effusions, 33.33% (19/57) had osteophyte formation. Compared with before treatment, the depth of suprapatellar sac effusion in the Qi stagnation and blood stasis type group decreased after treatment (P Conclusion: Musculoskeletal contrast-enhanced ultrasonography was used to quantitatively evaluate the efficacy of TCM external therapy on KOA for different TCM constitutions. Dynamic observation of synovial lesions of knee osteoarthritis provides a valuable imaging method for evaluating the efficacy of traditional Chinese medicine.

Exploring the biological mechanism of qi deficiency syndrome with chronic obstructive pulmonary disease(COPD)based on integrated pharmacology

Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental verification.Methods:Using an integrated pharmacology strategy to analyze the potential biological targets of COPD qi deficiency syndrome.Based on the established qi deficiency syndrome rat model of COPD,the biological targets of lung and skeletal muscle were detected by electron microscopy,adenosine triphosphate(ATP)content assays,and western blotting.Results:According to the integrated pharmacological results,it was found that the locations of cell components related to COPD qi deficiency syndrome were mainly mitochondria.Electron microscopy results using lung tissue showed that mitochondria in the lipopolysaccharide(LPS group)and pulmonary instillation of LPS combined with cigarette smoke(LPStCS group)were swollen,deformed,and fragmented,with disappearing or broken crista.Results also showed that the total content of ATP in the lung and skeletal muscle of both groups was significantly lower than that in the control group at the 12th week(P<.05).At the 12th week,the expression of dynamin-related protein 1(DRP1)and mitofusin 1(MFN1)protein was significantly difference than that of the control group(P<.05).At the 10th and 14th weeks,changes in fission and fusion proteins in mitochondria of the lung and skeletal muscle were further detected.There was also a significant difference in the expression between the two groups compared to that in the control group at the 10th week and 14th week(P<.05).Conclusion:These findings suggest that the changes in mitochondrial morphology and ATP content and the unbalanced expression of DRP1 and MFN1 might be the key mechanisms underlying qi deficiency syndrome in rats with COPD.

The influence of intestine-based treatment using Xuan Bai Cheng Qi Tang on the concentration of trace elements in the main organs of COPD rats

Objective:To test two theories from traditional Chinese medicine:'exterior -interior relationship between the lung and large intestine' and 'treating from the intestine principle for lung disorders'.The influence of intestine-based treatment using Xuan Bai Cheng Qi Tang (XBCQT) on the concentration of three trace elements-copper (Cu),zinc (Zn),and manganese (Mn)-was observed in the tissues of the lung,small intestine,large intestine,and stomach of rats suffering from chronic obstructive pulmonary disease (COPD).Methods:Thirty-five male Wistar rats were divided randomly and equally into five groups:control;model;Fei treatment (A);Chang treatment (B);and Fei-Chang treatment (C).A rat model of COPD was prepared by tracheal injection of lipopolysaccharide plus exposure to cigarette smoke.Treatments with medicinal herbs started day-22 of administration and exposure to cigarette smoke for 7 days.The control group and model group were administered physiologic (0.9%) saline solution via the stomach.After 7 days of intervention,the tissues of the lung,small intestine,large intestine,and stomach were removed.Inductively coupled plasma-atomic emission spectroscopy was used to detect the levels of Cu,Zn,and Mn in those tissues.Results:Compared with the control group,the Cu concentration in the tissues of the small intestine,large intestine,and stomach increased significantly in the model group (P <.05);the Mn concentration in the tissues of the lung,large intestine,and stomach increased significantly in the model group (P <.05);the Zn concentration in the tissues of the lung and large intestine decreased significantly in the model group (P <.05).In comparison of the model group:the Cu concentration in the tissues of the lung and large intestine decreased significantly in the B group (P <.05);the Mn concentration in the tissues of the lung,small intestine,and large intestine decreased significantly in the B group (P <.05);the Zn concentration in the tissues of the lung,small intestine,and large intestine increased significantly in the B group (P <.05).For the A group versus C group comparison,the Zn concentration in the tissues of the small intestine and stomach increased significantly in the latter (P <.05).Conclusion:This study showed that 'treating from the intestine' using Xuan Bai Cheng Qi Tang and its modified formulae can regulate the concentration of trace elements in the main organs of COPD rats.This may be one of the mechanisms for intestine-based treatment for COPD.

Efficacy of the method of tonifying Qi,resolving phlegm and eliminating stasis in thetreatment of AECOPD:A meta analysis

Objective:To systematically evaluate the efficacy and safety of the method of tonifying qi,resolving phlegm and eliminating stasis in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods:Search the China Knowledge Network(CNKI),VIP Chinese Science and Technology Journal Database(VIP),Wanfang Data Knowledge Service Platform,China Biomedical Literature Database(CBM),PubMed,Embase,Cochrane Library,and select the databases that meet the requirements for tonifying qi,resolving phlegm and eliminating stasis.The stasis method in the treatment of AECOPD was included in the standard literature,and RevMan 5.4 software was used for statistical analysis.Results:A total of 10 articles were included,with a total of 854 patients,435 in the treatment group and 419 in the control group.Systematic analysis shows that the method of tonifying qi,resolving phlegm and eliminating stasis combined with conventional Western medicine treatment of AECOPD is significantly different in total clinical effective rate than conventional Western medicine treatment alone[OR=3.98,95%CI(2.23,7.11),P<0.00001];In terms of lung function,FEV1/FVC[MD=6.08,95%CI(5.01,7.15),P<0.00001],FEV1[MD=0.07,95%CI(0.01,0.13),P=0.02],FEV1%[MD=4.56,95%CI(3.09,6.02),P<0.00001]is significantly higher than the control group;arterial oxygen partial pressure(PaO_(2))[MD=18.47,95%CI(16.77,20.16),P<0.00001]Significant improvement compared to the control group;arterial partial pressure of carbon dioxide(PaCO_(2))[MD=-7.48,95%CI(-8.7,-6.26),P<0.00001]was significantly lower than the control group.Conclusion:The current evidence shows that the method of tonifying qi,resolving phlegm and eliminating stasis combined with conventional Western medicine treatment of chronic obstructive pulmonary disease in acute exacerbations can improve clinical efficacy and improve the quality of life of patients.

Diagnostic value of traditional Chinese medical dialectical classification in hashimoto's thyroiditis complicated with suspicious nodules

Objective:To explore the diagnostic value of traditional Chinese medical(TCM)dialectical classification in Hashimoto's thyroiditis complicated with suspicious nodules.Methods:The clinical data of patients with Hashimoto's thyroiditis complicated with thyroid nodules in the Department of Breast and thyroid surgery of Weifang Hospital of traditional Chinese Medicine from January 2018 to December 2019 were collected.The patients were examined by 2 or more experienced TCM doctors,and the four diagnostic data were obtained,and then the relevant syndrome types of the patients were judged according to the data.According to the color Doppler ultrasonographic features of thyroid nodules,the patients who met the indication of fine needle aspiration biopsy of thyroid nodules were selected and underwent fine needle aspiration biopsy of thyroid nodules before operation.To analyze the clinical diagnostic value of that the ultrasonic mode used in this study and thyroid cytopathology Bethesda report system combine dialectical classification of traditional Chinese medicine in Hashimoto's thyroiditis complicated with suspected thyroid nodules.Result:A total of 89 patients with Hashimoto's thyroiditis complicated with thyroid nodules were collected.according to the ultrasonic mode,the difference between different modes was statistically significant(P<0.05).The mode of color ultrasound is also related to the dialectical classification of traditional Chinese medicine.The patients with high malignant risk score are mainly qi depression and phlegm stagnation,phlegm and blood stasis,while those with low score are exuberant liver fire and heart liver yin deficiency.According to the study of different The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC)classification,the dialectical classification of patients with higher TBSRTC classification was more inclined to qi depression and phlegm stagnation,phlegm and blood stasis,and there was significant difference between different classification(P<0.05).Conclusion:Qi depression and phlegm obstruction,phlegm and blood stasis have high ultrasound malignant risk score and high TBSRTC classification grade in patients with Hashimoto's thyroiditis complicated with suspected thyroid nodules,which has important clinical diagnostic value.

李延从脾胃论治冠心病的临床经验

冠心病为临床中常见的心血管疾病,可归属中医学的“胸痹”“心痛”等疾病范畴。李延教授认为本病之病性总属本虚标实之证,以脾虚、脾胃健运失常为本,标实在于痰浊、血瘀、气滞、寒凝等有形实邪痹阻心脉。治疗时重视调理脾胃,重用黄芪、白术、党参、五味子等健脾养心以治本,结合通阳化浊、活血化瘀、疏肝理气、温阳散寒等治法,标本兼治,通补兼顾,使脾气健旺,心气充沛,瘀去痰消,胸阳得以舒展,则心之血脉恢复畅通,胸痹心痛诸症得到缓解。李延教授从脾胃论治冠心病的经验可为中医临床诊治冠心病提供参考。

揿针治疗肺肾气虚型慢性阻塞性肺疾病稳定期疗效研究

目的:研究揿针治疗肺肾气虚型慢性阻塞性肺疾病(COPD)稳定期的临床疗效。方法:前瞻性选择COPD患者200例,随机分为两组,对照组给予常规西医治疗,观察组在其基础上加用予揿针治疗,疗程为8周。记录两组的临床疗效,并比较两组治疗前后中医症状积分、6 min步行距离和衰弱筛查量表评分、改良英国MRC呼吸困难指数问卷(mMRC)、肺功能及圣乔治呼吸问卷(SGRQ)评分。两组治疗后均随访6个月,记录两组急性加重的次数。结果:观察组与对照组临床总有效率分别为92.00%和71.00%,前者显著高于后者(P<0.05)。与治疗前比较,两组治疗后中医症状积分和衰弱筛查量表评分均明显降低,6 min步行距离增加(P<0.05),且观察组治疗后中医症状积分和衰弱筛查量表评分低于对照组,6 min步行距离大于对照组(P<0.05)。与治疗前比较,两组治疗后mMRC分级及平均分、SGRQ问卷总分及各维度评分均明显降低,第1秒用力呼气容积(FEV 1)、用力肺活量(FVC)、最大呼气流量(PEF)、第1秒用力呼气量/用力肺活量(FEV 1/FVC)均明显增大(P<0.05),且观察组治疗后的mMRC分级及平均分、SGRQ问卷总分及各维度评分均低于对照组(P<0.05),肺功能指标高于对照组(P<0.05)。两组治疗后均随访6个月,观察组急性加重次数显著低于对照组(P<0.05)。结论:揿针治疗肺肾气虚型COPD稳定期患者的疗效确定,不仅能改善其临床症状,改善疲劳衰弱状况与增强运动耐量,还能减轻呼吸困难程度并提高肺功能,显著改善生存质量,减少COPD急性发作次数。

Summary of 32 Patients with Cardiac Syndrome X Treated by TCM Therapy of Regulating Qi Relieving Chest Stuffiness and Promoting Blood Circulation

Objective： To evaluate the clinical effect of Liqi Kuanxiong Huoxue method （宽胸活血,LKH, traditional Chinese medicine, TCM therapeutic method for regulating qi, relieving chest stuffiness and promoting blood circulation） in treating patients with cardiac syndrome X （CSX）. Methods： The prospective, non-randomized controlled study was conducted on 51 selected patients with CSX, who were non-randomly assigned to 2 groups, the treated group treated with LKH in addition to the conventional treatment （32 patients）, and the control group treated with conventional treatment （19 patients） like nitrate, diltiazem hydrochloride, etc. The treatment course was 14 days. The changes of such symptoms as angina pectoris, TCM syndrome and indexes of treadmill exercise test before and after treatment were observed. Results： After treatment, such symptoms as chest pain and stuffy feeling and palpitation in the treated group were improved more than those in the control group （P〈0.05）; the total effective rate on angina pectoris and TCM syndrome in the treated group was better than that in the control group （P〈0.05）. The treadmill exercise test showed that the maximal metabolic equivalent （Max MET）, the time of angina onset and ST segment depression by 0.1 mV were obviously improved after treatment in both groups, but the improvement in the treated group was better than that in the control group respectively （P〈0.05）. Conclusion： The LKH method could reduce the frequency of angina attacks and improve the clinical condition of patients with CSX.

益气活血祛痰方治疗支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证的研究

目的评价益气活血祛痰方联合西医治疗慢性持续期支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证患者的临床疗效。方法选择2016年1月—2021年6月于泰州市第四人民医院就诊的80例慢性持续期支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证患者,根据随机数字表分成对照组及观察组各40例,对照组给予常规治疗及持续气道正压通气,观察组在对照组治疗基础上给予益气活血祛痰方水煎液口服,2组均持续干预3个月。观察2组患者治疗前后中医证候积分(包括气喘、咳嗽、咳痰、打鼾、憋醒、日间嗜睡、倦怠乏力)、哮喘控制测试问卷(ACT)评分、圣乔治呼吸问卷(SGRQ)评分、Epworth嗜睡量表(ESS)评分、匹兹堡睡眠指数(PSQI)评分、肺功能指标[呼气峰值流速(PEF)、第一秒用力呼气容积占预计值百分比(FEV_(1)%预计值)、第一秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)]、多导睡眠图参数[呼吸暂停低通气指数(AHI)、快速眼动睡眠期(REM)、氧减指数(ODI)、动脉血氧饱和度(SaO_(2))、最低SaO_(2)、觉醒指数]、炎症相关指标[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)水平和呼出气一氧化氮(FeNO)水平]变化,统计2组总体治疗效果及不良反应发生情况。结果2组治疗后中医证候积分、SGRQ评分、ESS评分、PSQI评分、AHI、ODI、觉醒指数及血清CRP、IL-6、TNF-α、VEGF水平和FeNO水平均较治疗前明显降低(P均<0.05),且观察组上述各项指标均明显低于对照组(P均<0.05);2组治疗后ACT评分、PEF、FEV_(1)%预计值、FEV_(1)/FVC、REM、SaO_(2)、最低SaO_(2)均较治疗前明显升高(P均<0.05),且观察组上述各项指标均明显高于对照组(P均<0.05)。观察组治疗3个月后的总有效率明显高于对照组[92.5%(37/40)比82.5%(33/40),P<0.05],治疗期间不良反应发生率明显低于对照组[10.0%(4/40)比27.5%(11/40),P<0.05]。结论益气活血祛痰方联合西医治疗支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证患者的效果优于单纯西医治疗,在减轻患者临床症状,控制哮喘发作,改善肺功能和睡眠质量方面具有明显优势,其作用机制可能与抑制炎症反应相关。

胸部定量CT对COPD患者治疗反应预测因素分析

目的分析胸部定量CT扫描对慢性阻塞性疾病(COPD)患者治疗反应的预测因素。方法回顾性分析2018年8月至2021年2月接受治疗COPD患者120例的临床资料,对其随访1年,根据肺功能检测结果将其分为有治疗反应组[n=24,第1秒用力呼气容积(FEV_(1))增加≥0.225 L]和非无治疗反应组(n=96,FEV_(1)增加<0.225 L)。对2组一般资料进行单因素分析,对其中差异有统计学意义的变量进行多因素Logistic回归分析,从而筛选出预测COPD患者治疗反应的因素。结果单因素分析结果显示,有治疗反应组和无治疗反应组在EI、ATI、Pi10、WA%、T方面的差异有统计学意义(P<0.05),而2组间性别比、年龄、体重指数、GOLD分期、入院肺功能检测的差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,Pi10为预测COPD患者治疗反应的因素(OR=2.321,P<0.05)。ROC曲线显示,Pi10在预测COPD患者治疗反应中具有极高的临床价值,ROC曲线显示,Pi10预测COPD患者治疗反应的曲线下面积为0.701,95%CI为0.610~0.781,约登指数为0.354,最佳截断值为4.65 mm,灵敏度为85.40%,特异度为50.00%。结论胸部定量CT扫描参数Pi10能够帮助预测COPD患者治疗反应。

益气复脉方治疗气虚血瘀、痰瘀互阻型室性期前收缩的临床疗效

目的:观察益气复脉方治疗气虚血瘀、痰瘀互阻型室性期前收缩的临床疗效。方法:选取2021年8月—2022年8月在北京中医药大学东方医院住院治疗的室性期前收缩病人60例,按照随机数字表法分为对照组和治疗组。在常规治疗基础上,治疗组采用益气复脉方(颗粒剂)治疗,对照组采用颗粒安慰剂治疗。评估并比较两组治疗前后室性期前收缩数量变化,中医证候积分及中医单项症状心悸、气短、神疲乏力、胸闷、胸痛、痰浊、自汗、食少纳呆积分变化。结果:治疗后,治疗组室性期前收缩数量较治疗前减少,且治疗组少于对照组,差异有统计学意义(P<0.05)。治疗后,两组中医证候总积分较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.001)。治疗后,两组心悸、气短、神疲乏力、胸闷、胸痛、痰浊、自汗、食少纳呆的症状积分均较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组总有效率高于对照组,差异有统计学意义(77.8%与24.0%,P<0.05)。结论:益气复脉方可减少气虚血瘀、痰瘀互阻型室性期前收缩病人室性期前收缩次数,改善中医证候。

自拟疏肝理气解郁汤对甲状腺癌术后患者的疗效观察

目的 探讨自拟疏肝理气解郁汤对甲状腺癌术后患者的疗效。方法 选取甲状腺癌术后患者85例,中医辨证为气郁痰阻证,随机数字表法分为研究组43例,对照组42例。对照组予以常规治疗(口服左甲状腺素钠片,并进行心理及健康行为指导),研究组在对照组基础上予以自拟疏肝理气解郁汤治疗,2组均治疗3个月。统计2组中医证候疗效,比较治疗前后中医证候积分、负性情绪[21项抑郁-焦虑-压力量表(DASS-21)评分]、免疫功能(CD4^(+)、CD8^(+)、CD3^(+)水平变化)。结果 研究期间研究组依从性差剔除1例,纳入42例;对照组自行退出1例,纳入41例。治疗后研究组主症、次症及舌脉积分低于对照组(P<0.05);治疗后研究组中医证候疗效总有效率(90.48%)高于对照组(73.17%)(P<0.05);治疗后研究组DASS-21评分低于对照组(P<0.05);治疗后研究组CD4^(+)、CD3^(+)水平高于对照组,CD8^(+)水平低于对照组(P<0.05)。结论 自拟疏肝理气解郁汤治疗甲状腺癌术后患者,可明显缓解患者临床症状,减轻负性情绪,调节免疫功能,提高临床疗效。

温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期的疗效及对NT-proBNP、ICAM-1和MCP-1的影响研究

目的:探讨温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期患者的疗效,以及对N末端脑钠肽前体(NT-proBNP)、细胞间黏附分子-1(ICAM-1)和单核细胞趋化蛋白-1(MCP-1)水平的影响。方法:以2021年5月至2022年5月该院收治的气虚血瘀痰阻型缺血性脑卒中急性期患者100例为研究对象,根据随机数字表法分为对照组和观察组,每组50例。对照组患者给予常规治疗,观察组患者在对照组的基础上给予温胆汤加减治疗。比较两组患者的临床疗效,NT-proBNP、ICAM-1和MCP-1水平,美国国立卫生院卒中神经功能缺损评分量表(NIHSS)评分、改良Rankin量表(mRS)评分及中医证候积分。结果:治疗1个月后,观察组患者的总有效率为94.00%(47/50),显著高于对照组的80.00%(40/50),差异有统计学意义(P<0.05)。治疗1个月后,观察组患者NT-proBNP、ICAM-1和MCP-1水平显著低于对照组,血液流变学各指标(血浆黏度、血低切黏度、血高切黏度、纤维蛋白原和红细胞压积)水平显著低于对照组,差异均有统计学意义(P<0.05)。治疗7 d、1个月后,观察组患者的NIHSS评分低于对照组;治疗1个月后,观察组患者的mRS评分、中医证候积分低于对照组,差异均有统计学意义(P<0.05)。结论:温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期患者的效果较好,可显著降低NT-proBNP、ICAM-1和MCP-1水平,促进血液流通和疾病的恢复,提高患者的生活质量。

穴位埋线联合茚达特罗/格隆溴铵对肺肾气虚型慢性阻塞性肺疾病的应用与研究

目的探究穴位埋线联合茚达特罗/格隆溴铵对肺肾气虚型慢性阻塞性肺疾病的应用效果。方法选择广西科技大学第一附属医院呼吸与危重症医学科2022年7月至2023年1月收治的60例肺肾气虚型慢性阻塞性肺疾病患者,采用随机数表法将其分为对照组和观察组,每组各30例,对照组患者采用茚达特罗/格隆溴铵吸入剂治疗,观察组患者采用穴位埋线联合茚达特罗/格隆溴铵治疗,比较两组患者治疗效果。结果治疗前,两组肺功能指标用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))水平比较,差异无统计学意义(P>0.05);治疗后,观察组肺功能指标FVC、FEV_(1)水平高于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论穴位埋线联合茚达特罗/格隆溴铵对肺肾气虚型慢性阻塞性肺疾病的应用效果显著。

从气血同治探讨慢性气道疾病的异病同治

支气管哮喘和慢性阻塞性肺疾病(简称慢阻肺)同属慢性气道炎症疾病,在病机和治法上有一定的相似性,其都可通过调节气血以恢复肺气宣肃,行使正常生理功能。针对肺的生理功能和气血的关系,探讨支气管哮喘和慢阻肺的共同病机:支气管哮喘的基本病机是痰伏于肺,外邪引动,痰气互结,肺失宣降,并可兼有瘀血阻络之象;慢阻肺的病机以久病肺虚为本,加之痰浊、水饮、瘀血等病理产物,使得肺失宣降,本虚标实的病机随病程持续进展;进而从气血同治角度探讨支气管哮喘和慢阻肺2种慢性气道疾病的异病同治,得出“气血同治,畅通气道”的治疗理念。结合成药的应用,分析以此病机为指导的丹龙口服液组方特点和功效主治,为丹龙口服液异病同治2种气道疾病提供理论依据。

低剂量胸部CT扫描在COPD相关肺动脉高压及其分级诊断中的应用价值分析

目的:分析低剂量胸部CT扫描在慢性阻塞性肺疾病(COPD)相关肺动脉高压及其分级诊断中的应用价值。方法:选择2022年6月—2023年6月济南市第三人民医院收治的219例COPD患者为研究对象,所有患者进行低剂量胸部CT扫描及超声心动图检查,根据有无肺动脉高压分为肺动脉高压组(112例)和无肺动脉高压组(107例),并根据肺动脉高压分级将肺动脉高压组患者分为中重度组(64例)和轻度组(48例)2个亚组。比较肺动脉高压组与无肺动脉高压组以及中重度组与轻度组患者低剂量胸部CT扫描结果,分析低剂量胸部CT扫描在COPD相关肺动脉高压及其分级诊断中的应用价值。结果:肺动脉高压组患者主肺动脉直径(MPAD),主肺动脉与降主动脉直径的比值(rPD)以及主肺动脉与升主动脉的比值(rPA)高于无肺动脉高压组(P<0.05);ROC曲线分析结果显示,MPAD、rPD、rPA诊断COPD相关肺动脉高压的AUC分别为0.929、0.791、0.892,应用价值较高;中重度组患者MPAD、rPD、rPA高于轻度组(P<0.05);ROC曲线分析结果显示,MPAD、rPD、rPA诊断COPD相关肺动脉高压分级的AUC分别为0.761、0.728、0.872,有一定应用价值。结论:低剂量胸部CT扫描中的相关参数MPAD、rPD、rPA在COPD相关肺动脉高压及其分级诊断中的应用价值较高。

化痰通络颗粒治疗不同中医证型稳定型心绞痛的疗效观察

目的:探讨化痰通络颗粒治疗不同中医证型稳定型心绞痛(SAP)的疗效差异。方法:纳入219例瘀证SAP患者,并根据中医证型分为气虚血瘀组53例、痰瘀互结组63例、气滞血瘀组56例、痰浊闭阻组47例,另纳入50例瘀证SAP患者为对照组。所有患者均接受常规治疗,除对照组外,其余患者均在常规治疗基础上予化痰通络颗粒治疗,连续治疗4周。观察治疗前后中医证候疗效、心绞痛情况、心功能、脂代谢、凝血功能。结果:治疗后,气虚血瘀组、痰瘀互结组、气滞血瘀组、痰浊闭阻组患者疗效均优于对照组(P<0.05),且痰瘀互结组和痰浊闭阻组患者疗效均优于气虚血瘀组和气滞血瘀组(P<0.05)。治疗后,5组患者心绞痛症状积分均低于治疗前(P<0.05),且气虚血瘀组、痰瘀互结组、气滞血瘀组、痰浊闭阻组患者心绞痛症状积分均低于对照组(P<0.05),痰瘀互结组、痰浊闭阻组患者心绞痛症状积分均低于气虚血瘀组和气滞血瘀组(P<0.05)。治疗后,5组患者左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均低于治疗前,射血分数(EF)、每搏输出量(SV)均高于治疗前(P<0.05),且痰瘀互结组、痰浊闭阻组患者LVEDD、LVESD均低于对照组,EF、SV均高于对照组(P<0.05)。治疗前痰浊闭阻组、痰瘀互结组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)水平均高于气虚血瘀组、气滞血瘀组、对照组;治疗后,5组患者TC、TG、LDL均低于治疗前,HDL均高于治疗前(P<0.05)。治疗后,5组患者纤维蛋白原(FIB)、凝血酶时间(TT)均低于治疗前,活化部分凝血活酶时间(APTT)均高于治疗前,且痰瘀互结组、痰浊闭阻组患者FIB、TT水平均低于气虚血瘀组、气滞血瘀组和对照组(P<0.05)。结论:化痰通络颗粒治疗不同中医证型的稳定型心绞痛均有一定效果,联合西医治疗应用优于单独西医治疗,且其更适用于痰瘀互结证和痰浊闭阻证两种证型。

基于肠道菌群探讨艾滋病免疫重建不良“气虚湿阻”的病机与治法

肠道菌群紊乱与艾滋病免疫重建不良(INR)的发病关系密切,中医理论和现代研究表明“气虚湿阻”为艾滋病INR的核心病机,且肠道菌群失调为中医气虚证和湿证的生物学基础之一,与“气虚湿阻”病机相通,故可从“气虚湿阻”和肠道菌群两方面为艾滋病INR的中医治疗提供理论依据。根据中医扶正祛邪原则,提出益气祛湿的治疗大法,并可通过调节肠道菌群,促进艾滋病INR患者免疫重建,改善临床症状。

大气下陷调治急性心肌梗死经皮冠状动脉介入治疗术后探析

著名中西医汇通派医家张锡纯所创“大气理论”被广泛用于各系统疾病。文章基于张锡纯先生对于大气理论之论述及临证经验,将其引入急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术后证治研究,从大气理论视角下对AMI PCI术后的认识及从大气下陷调治AMI PCI术后的方法两个方面阐述大气理论在AMI PCI术后的论治思路,并附医案1则,以期丰富AMI PCI术后的论治理论及调治方法。