Progress on the Pathogenesis and Treatment of OCD, AD and Depression

Background: Obsessive-compulsive, anxiety disorder, and depression are the most common negative emotions. The incidence rate is high and spread across all age groups. With the rapid development of the world economy and the increasing competition in social life, the incidence rate has also increased rapidly, more and more young suffer from these three kinds of mental illnesses. Many studies have been carried out to investigate the pathogenesis and therapeutic method. It is necessary to summarize the progress for references to further research and treatment. Method: Based on a series of literature, the studies on the pathogenesis and therapeutic method of the three kinds of illnesses are summarized and analyzed. The points and results either of West medicine (WM) or traditional Chinese medicine (TCM) are collected and compared to find the best tendency of study and the best therapeutic method. Results: Obsessive-compulsive disorder, anxiety disorder and depression are common in recent years and severely affect people’s lives. In view of WM. These three kinds of illnesses are all related to the changes or damage of part of brain and nervous system. While TCM thinks that they are due to Qi stagnation or deficiency of heart Yin. Many methods of treatment have been presented and used clinically, but the effect is limited. Conclusion: The most promising and effective methods are those combining WM and TCM.

CLINICAL STUDY ON THE TIME OF TREATING CHEMOTHERAPY INDUCED TOXIC AND SIDE EFFECTS IN MALIGNANT TUMOR PATIENTS BY ACUPOINT INJECTION OF ASTRAGALUS ROOT INJECTION

Objective: To investigate the suitable time of treating virulent and side effects of chemotherapy for malignant tumor by acupoint injection of Astragalus Root injection. Methods: Sixty three patients with malignant tumor were divided into three groups: prevention treatment (PT) group (n=23 cases),post chemotherapy treatment (PCT) group( n=22 cases), Western medicine (WM) group ( n=18 cases). The patients in PT, PCT and WM groups were treated respectively from the fifth day on before chemotherapy and from the first day on after chemotherapy, 18 days in all. The patients in WM group were administered Batilol and Leucogen from the first day on after chemotherapy. Changes of leukocytes and immunoglobulin before and after treatment were observed. Results: 1) Acupoint injection of Astragalus Root injectio could increase the number of leukocytes and immunoglobulin content and its effect was better than that of Western medicine (P<0.05); 2) The effect of PT group was better than that of PCT group in preventing and treating virulent and side effects of chemotherapy (P<0.05). Conclusion: It should be stressed on prevention of malignant tumor by using acupoint injection of Astragalus Root for relieving virulent and side effects of chemotherapy.

Therapeutic effect of Zijin capsule in liver fibrosis in rats

AIM To confirm the therapeutic effect of Zijin capsule on liver fibrosis in rat model. METHODS Model group: bovine serum albumin (BSA) Freund′s incomplete adjuvant 0 5ml was injected subdermally at d 1, d 15 , d 22 , d 29 and d 36 for primary sensitization. Seven days after the fifth injection, BSA antibody in the serum was detected by double agar diffusion method. Normal saline of 0 4ml was injected through cauda vein to BSA antibody positive rat twice a week for fifteen times. Traditional Chinese medicine (TCM) decoction group and Zijin capsule group: In the attack injection period, Chinese medicinal decoction or Zijin capsule was given ig, the others were the same as in the model group. NS was used in the control group. The collagen content of rat liver was determined by Bergman′s method and expressed as ±s . The liver pathological changes were divided into four grades and expressed as the avarage of the total rank sum. RESULTS The collagen content (mg/g) of the liver in the control group (7 2±1 9) was significantly lower than that in the other groups; it was higher in the model group (31 7±16 6) than that in the two therapeutic groups; and lower in Zijin capsule group (9 7±2 8) than that in the TCM decoction group (11 5±5 3). The pathological changes were more aggravated in the model group (37 4) than those in the two therapeutic groups; and more severe in the TCM decoction group (30.2) than in the Zijin capsule group (22.9) CONCLUSION The therapeutic effect of Zijin capsule on the model was confirmed.

Yizhining elixation improves sustained attention deficit and impulsiveness of spontaneous hypertensive rats

BACKGROUND： The core symptoms of attention deficit, impulsiveness, hyperactivity of attention deficit hyperactivity disorders （ADHD） can concurrently present in spontaneous hypertensive rats. Neuropathological, biochemical and pharmacological studies also support it. Spontaneous hypertensive rats are one kind of best ADHD animal models, which has been accepted at present. Yizhining elixation can reinforce kidney and calm liver, strengthen spleen and nourish heart, benefit intelligence and focus attention, but its therapeutic effect on treatment of ADHD needs to be further investigated. OBJECTIVE： To observe the effect of Yizhining elixation on the persistent active attention deficit and impulsiveness of rats with spontaneous hypertension. DESIGN： Observational and controlled analysis. SETTING： Department of Pediatrics, the First Affiliated Hospital of Guangzhou University of Chinese Medicine. MATERIALS： Thirty-six male rats with spontaneous hypertension, of clean grade, were involved in this experiment. The involved rats were provided by Shanghai SLAC Laboratory Animal Co., Ltd., and they did not undergo any experiments; Yizhining elixation was composed by Guiban, Shenglonggu, Yuanzhi, Shichangpu, Yejiaoteng, Shudi, Dangshen, Yunling, Fuxiaomai, Wueizi. etc. Crude drug, provided by Outpatient Dispensary, Affiliated Hospital of Guangzhou University of Chinese Medicine, was prepared into water elixation, which contained crude drug of 1.154 g/mL. METHODS： This experiment was carried out in the Department of Pediatrics, First Affiliated Hospital of Guangzhou University of Chinese Medicine between March and July 2005. The involved rats were randomized into 3 groups： Yizhining high dose group, Yizhining low dose group and blank control group, with 12 rats in each. Changes in sustained attention and impulsiveness of rats were detected before and after administration of Yizhining elixation by ＂5-choice serial response time task＂ method. Following above-mentioned training and detection, rats in each group were daily drenched with Yizhining elixation once for 14 days successively. Rats in the Yizhining High-dose and low-dose groups we, e drenched with 12.6 mL/kg and 6.3 mL/kg Yizhining elixation （diluted to 25 mL/kg） respectively, and those in the blank control group were drenched with 12.5 mL/kg normal saline. On the 14^th day after administration, the ratios of correct and immature response of rats were re-detected for 3 days successively by formal detection method for later analysis. The sustained attention of rats was evaluated with ratio of correct response： Ratio of correct response=[times of correct response/（times of correct response ＋ times of incorrect response）]; impulsiveness was evaluated with the ratio of immature response： ratio of immature response=[times of immature response/ （times of correct response＋times of incorrect response＋times of omission＋times of immature response） ]. MAIN OUTCOME MEASURES： The effects of different doses of Yizhining elixation on the sustained attention （ratio of correct response） and impulsiveness （ratio of immature response） of spontaneous hypertensive rats. RESULTS： Thirty-six spontaneous hypertensive rats were involved in the final analysis. The ratio of correct response of rats in the Yizhining high dose and low dose groups after administration was （98.9±2.30）% and （96.6±4.00） %, respectively, which was significantly higher than that before administration [ （80.4±11.5 ） %, （839±8.90） %, P 〈 0.01] and that in the blank control group[ （83.3±6.30） %, P 〈 0.01]. The ratio of immature response of rats in the Yizhining high dose and low dose groups after adminisWafion was （5.04 ±1.04 ） %, （7.23 ± 1.22 ） %, respectively, which was lower than that before administration [ （9.85 ±2.50） %, （9.40±1.73 ） %, P 〈 0.05] and that in the blank control group [ （ 9.42 ±1.64） %, P 〈 0.01 ]. CONCLUSION： Yizhining elixation can improve the sustained attention and impulsiveness of spontaneous hypertensive rats.

Therapy of acute severe pancreatitis awaits further improvement

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扶正消癌Ⅰ号方联合OFL方案治疗中晚期胃癌的临床观察

目的:观察扶正消癌Ⅰ号方对OFL方案治疗中晚期胃癌的减毒增效作用。方法:将60例患者随机分为2组各30例,对照组单纯采用OFL方案化疗,治疗组在对照组治疗的基础上给予扶正消癌Ⅰ号方。治疗3周为1疗程,治疗3疗程后评价近期疗效、毒副反应、生活质量和中医辨证分型疗效。结果:近期疗效治疗组为50.00%,对照组为43.33%,2组近期疗效比较,差异无显著性意义(P>0.05);毒性反应发生率、生活质量改善情况、中医辨证分型疗效2组分别比较,差异均有显著性意义(P<0.05)。结论:扶正消癌Ⅰ号方联合OFL方案治疗中晚期胃癌能显著降低毒副反应发生率,提高患者生活质量,显著改善中医临床症状,具有肯定的减毒增效作用。

参术冠心方治疗冠心病稳定型心绞痛临床研究

【目的】观察参术冠心方治疗冠心病稳定型心绞痛的疗效。【方法】采用多中心、随机、双盲、安慰剂对照的临床研究方法,共纳入病例120例,随机分为试验组和对照组。2组均给予相同的西医标准治疗,试验组同时给予参术冠心方中药复方颗粒剂,对照组给予参术冠心方安慰剂,2组疗程均为90 d。观察各时点的心绞痛发作情况、中医证候计分、西雅图心绞痛量表评分的变化情况。【结果】(1)完成随访114例,其中试验组55例,对照组59例。(2)心绞痛发作情况比较:治疗后第30、60、90天3个时点试验组心绞痛发作次数的改善作用优于对照组,差异均有统计学意义(P<0.05);治疗后第30、60天2个时点试验组的心绞痛发作持续时间的改善作用优于对照组,差异均有统计学意义(P<0.05);试验组第30天硝酸甘油的使用总量少于对照组,差异有统计学意义(P<0.05)。试验组治疗后第30、90天诱发心绞痛的体力活动程度的改善作用优于对照组,差异有统计学意义(P<0.05);试验组治疗后第30、60、90天3个时点心绞痛疼痛程度的改善作用优于对照组,差异均有统计学意义(P<0.01)。(3)试验组治疗后各时点中医证候计分和西雅图心绞痛量表各维度积分的改善均优于对照组,差异均有统计学意义(P<0.05)。【结论】参术冠心方能改善冠心病稳定型心绞痛患者的心绞痛症状,改善中医证候计分,提高患者的日常活动耐量。

中西医结合治疗狼疮性肾炎74例疗效观察

本研究探讨了中西医结合治疗狼疮性肾炎（ＬＮ）。结果表明，中西医结合组（７４例）有效率达９５．９％，复发率仅４．１％，副作用发生率仅为３７．９％；而对照组（６６例）有效率为８０．３％，复发率为２１．２％，副作用发生率达７７．３％。由此可见，中西医结合组在提高疗效，减少复发和减少副作用方面，均显著优于西医组。

帕金森病抑郁中西医结合诊断与治疗专家共识(2021年版)

抑郁是帕金森病最常见的非运动症状,帕金森病抑郁发病机制尚未完全阐明。为规范疾病诊断体系并提高临床疗效,通过组织全国7个省、直辖市中医和西医领域相关专家进行多次讨论和修改,共同制定《帕金森病抑郁中西医结合诊断与治疗专家共识(2021年版)》(以下简称共识)。共识中西医并重,参考帕金森病、抑郁症等相关诊断标准制定帕金森病抑郁西医诊断、评估量表和西医治疗的专家共识;同时参考中医颤证、郁证等相关中医诊断标准制定帕金森病抑郁中医辨证诊断体系和辨证论治的专家共识,并针对疾病早期和进展期采取不同的中西医结合治疗方法,有确切的临床优势且安全性较高,可供临床医师参考应用。

中西医结合治疗190例老年胰腺癌的预后分析

目的通过临床回顾性研究对以清胰化积方为主的中西医综合治疗老年胰腺癌进行疗效评估,探讨可行性治疗模式。方法采用Kaplan-Meier方法计算生存期,Log-rank检验进行组间比较,并通过应用Cox比例风险模型对2002年1月至2008年12月期间接受中西医结合治疗的190例老年胰腺癌患者进行多因素分析。结果本组190例老年胰腺癌患者:1年生存率28.42%;3年生存率6.32%;5年生存率2.11%。中位生存期为7.1个月。其中清胰化积组102例,中位生存期8.7个月;非清胰化积方88例,中位生存期4.7个月,差异有统计学意义(P<0.05)。KPS评分<80、CA19-9≥500 U/ml、消瘦(体重在6个月内减轻≥10%)、肝转移、手术方式、全身化疗和清胰化积中药是影响该治疗模式预后的独立影响因子。结论根治手术、全身化疗和清胰化积中药是老年胰腺癌长期生存保护因素。老年胰腺癌Ⅲ期患者可化疗结合清胰化积方中药治疗,Ⅳ期老年胰腺癌患者则应以中药及最佳对症支持治疗为主。

中西医结合治疗成人常复发性原发性肾病综合征疗效观察

采用中西医结合方法治疗成人常复发性原发性肾病综合征（ＰＮＳ），并与西医治疗该病对照观察。西医治疗组（对照组）３２例，中西医结合治疗组（中西组）３０例。结果对照组缓解后６个月、１２个月和４７个月时复发率分别为１１．８％、２３．５％和３５．３％，平均缓解期为１２．４±３．２个月；中西组复发率分别为０、３．３％和１３．３％，平均缓解期为３５．９±３．７个月。中西组各期复发率显著低于对照组（Ｐ＜０．０１），缓解期显著长于对照组（Ｐ＜０．０１）。表明中西医结合治疗常复发性ＰＮＳ疗效较为满意。

虚实辨证推拿治疗小儿急性非细菌感染性腹泻的临床对照研究

【目的】观察虚实辨证推拿治疗小儿急性非感染性腹泻的临床疗效。【方法】将113例小儿急性非感染性腹泻患儿随机分为试验A组37例、试验B组38例及对照组38例。3组均给予基础治疗(包括喂养指导、预防脱水及纠正脱水),试验A组在基础治疗的同时给予内服固定处方中药汤剂,试验B组在A组的基础上配合虚证推拿法或实证推拿法,对照组在基础治疗的同时口服思密达。3组均以3 d为1个疗程,疗程结束后观察临床疗效。【结果】全分析集(full analysis set,FAS)和符合方案集(per protocol set,PPT)的分析结果一致,3组的疗效基本相当,组间比较差异均无统计学意义(P﹥0.05)。治疗期间3组病例均未见明显不良反应。【结论】基础治疗是治疗小儿急性非细菌感染性腹泻的关键,中药辨证施治能起到与思密达基本相同的作用,而虚实辨证推拿治疗并不能显著提高中药辨证治疗的疗效。

中西医结合治疗肝硬化腹水疗效观察

[目的]探讨中西医结合方法治疗肝硬化(LC)腹水的疗效。[方法]LC腹水患者62例,对照组28例,采用西医治疗;治疗组34例,西医治疗联合中医药治疗,比较两组患者的腹水消退情况。[结果]治疗组与对照组腹水消退率比较无统计学差异(P>0.05);治疗组腹水消退时间明显短于对照组,差异具有统计学意义(P<0.05)。[结论]中医药在LC腹水的患者治疗中,对腹水的消退疗效显著。

中西医结合在心脏康复中的优势分析

心血管病已经成为危害人类健康的头号杀手,但是目前临床上主要是针对其治疗展开一系列研究,而对其预防和康复均研究不足,因此加快临床心脏康复研究与落实的步伐势在必行。目前,国内心脏康复的指南多参考国外,但国外有些指南的实施需要大量的设备和专业人士的指导,其投入十分巨大,并不适合我国的实际情况。因此我国心脏康复医学模式必须充分结合国情,发挥我国中医康复疗法的优势,同时借鉴并融合国外先进科学技术和人类文明成果,真正形成具有中国特色的中西医结合心脏康复模式,做好心脏康复治疗。本文从中医、西医心脏康复的特点入手,分析其利弊,并最终提出相较于两种独立的医学模式,中西医结合在心脏康复中存在的优势。

中西医结合治疗HBV相关慢加急性肝衰竭合并肝性脑病的效果分析

目的探讨中西医结合治疗HBV相关慢加急性肝衰竭(ACLF)合并肝性脑病(HE)患者8周病死率情况,分析影响其预后的独立危险因素。方法选取2012年1月-2015年2月18家医院收治的HBV-ACLF患者,采用随机对照设计分为试验组和对照组,分别给予中西医结合治疗和单纯西医综合治疗,纳入所有0周合并HE的患者125例。观察2组8周病死率情况。计量资料2组间比较采用t检验或Mann-Whitney U检验,计数资料2组间比较采用χ2检验,生存分析采用Kaplan-Meier方法及logrank检验,危险因素分析采用Cox比例风险回归模型。结果试验组及对照组8周病死率分别为27.5%、50.0%(χ~2=5.630,P=0.018),8周内中位生存时间分别为41.2 d、28.4 d,累积生存概率分别为60.4%、32.5%(χ~2=6.187,P=0.013);Cox回归分析结果显示与对照组相比,试验组是HBV-ACLF合并HE患者预后的保护因素[风险比(HR)=0.424,P=0.018,95%可信区间(95%CI):0.208~0.864],高TBil(HR=1.063,P=0.042,95%CI:1.002~1.128)、低PTA(HR=0.942,P=0.044,95%CI:0.890~0.998)、ACLF分期晚期(HR=2.737,P=0.009,95%CI:1.287~5.818)、合并消化道出血(HR=5.291,P=0.003,95%CI:1.736~16.126)是8周死亡的独立危险因素。结论中医药治疗可显著降低HBV-ACLF合并HE患者的8周病死率,提高8周生存概率,延长生存时间。TBil、PTA、疾病分期、消化道出血是该组患者的独立预后影响因素。

中西医结合治疗激素性股骨头坏死的实验研究

目的 探讨中西医结合治疗激素性股骨头坏死的作用机制。方法 将 40只兔子随机分为对照组、模型组、中药组、介入组和综合组。于治疗后 8周 ,分别进行血液流变学、血脂、股骨头空骨陷窝数测定及观察。结果 中药组和介入组动物血浆和全血粘度、红细胞聚集指数、总胆固醇、甘油三脂和股骨头空骨陷窝率均明显低于模型组 (P <0 0 5)。综合组与模型组比较 ,全血高、中切粘度、红细胞聚集指数和甘油三脂明显降低 ,有显著差异 (P <0 0 1 ) ,与中药组和介入组比较亦有差异 (P <0 0 5) ,全血低切粘度、血浆粘度、总胆固醇降低 ,与模型组比较仍有差异 (P <0 0 5) ,空骨陷窝率较模型组显著降低 (P <0 0 1 )。结论 中药组、介入组和综合组治疗股骨头缺血性坏死 ,均可以降低血脂 ,改善血液循环 ,促进坏死骨修复和新生骨再生 。

中西医结合治疗输卵管阻塞性不孕症有效性和安全性的系统评价

目的系统评价中西医结合治疗输卵管阻塞性不孕症的有效性和安全性。方法计算机检索Pub Med、EMBase、Cochrane图书馆对照试验资料库、中国期刊全文数据库(CNKI)、中国生物医学文献服务系统(CBM)、维普信息资源系统(VIP)中关于中西医结合治疗输卵管阻塞性不孕症有效性和安全性的文献。检索时间均为建库至2014年5月。采用Rev Man 5.1统计软件对符合纳入及排除标准的文献进行统计学分析。结果共纳入文献19篇,共计患者数2 503例。Meta分析结果显示:中西医治疗组和西医治疗组的妊娠率比较,差异有统计学意义〔OR(95%CI)=1.42(1.30,1.56),P<0.01〕;非腹腔镜手术亚组中,两组妊娠率比较,差异有统计学意义〔OR(95%CI)=1.47(1.30,1.66),P<0.01〕;腹腔镜手术亚组中,两组妊娠率比较,差异有统计学意义〔OR(95%CI)=1.36(1.18,1.56),P<0.01〕。中西医治疗组和西医治疗组的总有效率比较,差异有统计学意义〔RR(95%CI)=1.39(1.29,1.50),P<0.01〕;非腹腔镜手术亚组中,两组总有效率比较,差异有统计学意义〔RR(95%CI)=1.41(1.29,1.55),P<0.01〕;腹腔镜手术亚组中,两组总有效率比较,差异有统计学意义〔RR(95%CI)=1.34(1.16,1.54),P<0.01〕。中西医治疗组和西医治疗组的输卵管再通率比较,差异有统计学意义〔RR(95%CI)=1.34(1.20,1.50),P<0.01〕。中西医治疗组和西医治疗组的异位妊娠率比较,差异有统计学意义〔OR(95%CI)=0.32(0.15,0.68),P<0.01〕;非腹腔镜手术亚组中,两组异位妊娠率比较,差异有统计学意义〔OR(95%CI)=0.23(0.08,0.68),P<0.01〕。中西医治疗组和西医治疗组的术后再粘连率比较,差异有统计学意义〔RR(95%CI)=0.38(0.25,0.59),P<0.01〕。仅有3篇文献对患者治疗期间的不良反应进行了描述,且不良反应症状均较轻,休息后可自行缓解。结论与单纯西医治疗相比,中西医结合治疗可以提高输卵管阻塞性不孕症患者的妊娠率、总有效率及输卵管再通率,降低其术后再粘连率和非腹腔镜手术治疗患者的异位妊娠率,不良反应较少,有效性和安全性较高。