中西医结合治疗急性疱疹性龈口炎的疗效

使用中西医结合的方式治疗急性疱疹性龈口炎,观察其实际疗效与传统方式治疗急性疱疹性龈口炎之间的区别。本组病例选自2007年以来入住我院诊治的148例急性疱疹性龈口炎患儿,将其分为治疗组与观察组,对两组患儿进行疗效对比。

Acupuncture for irritable bowel syndrome: A blinded placebo-controlled trial

AIM:Irritable bowel syndrome (IBS) is a common disorder and many patients fail to find adequate relief from conventional therapies for their symptoms. This study tests the claim that acupuncture is effective for a majority of these patients. METHODS: A prospective, blinded, sham acupuncture-controlled trial of traditional Chinese acupuncture was performed at a single postgraduate teaching hospital in Europe. Sixty patients with well-established IBS were recruited. The blinded comparator was sham acupuncture administered by the second of two acupuncturists who alone was aware of the randomization, and who otherwise followed the prescription of the first. The primary end-point was a defined fall in the symptom score at 13 wk (by intention to treat). The prior expectation was a 30% placebo response, and a response rate of 70% from acupuncture, for which the study was adequately powered. RESULTS: Patients in treated and sham groups improved significantly during the study-mean improvement in scores being equal (minus 1.9) and significant for both (P<0.05; one-tailed t test). There was a small numeric but nonsignificant difference between the response rate in patients receiving acupuncture (40.7%) and sham treatment (31.2%). Several secondary end-points marginally favored active treatment, but an improved symptom score of any degree of magnitude occurred more often with sham therapy (65.6% vs 59.2%). For no criterion was statistical significance approached. CONCLUSION: Traditional Chinese acupuncture is relatively ineffective in IBS in the European hospital setting, and the magnitude of any effect appears insufficient to warrant investment in acupuncture services.

In vitro screening of traditionally used medicinal plants in China against Enteroviruses

AIM： To search for new antiviral agents from traditional Chinese medicine, specifically anti-enterovirosuses agents. METHODS： The aqueous extracts （AE） of more than 100 traditionally used medicinal plants in China were evaluated for their in vitro anti-Coxsackie virus B3 activities with a MTT-based colorimetric assay. RESULTS： The test for AE of 16 plants exhibited anti- Coxsackie virus B3 activities at different magnitudes of potency. They can inhibit three steps （inactivation, adsorption and replication） during the infection. Among the 16 plants, Sargentodoxa cuneata （Oliv.） Rehd. et Wils., Sophora tonkinensis Gapnep., Paeonia veitchii Lynch, Spatholobus suberectus Dunn. and Cyrtorniurn fortunei J, sm. also have activity against other enterovirus, including Coxsackie virus 135, Polio virus I, Echo virus 9 and Echo virus 29. Cell cytotoxic assay demonstrated that all tested AE had CC50 values higher than their EC50 values. CONCLUSION： The sixteen traditionally used medicinal plants in China possessed antMral activity, and some of them merit further investigations.

Therapeutic effect of traditional Chinese medicine on coagulation disorder and accompanying intractable jaundice in hepatitis B virus-related liver cirrhosis patients

AIM： TO observe the therapeutic effects of new traditional Chinese medicine （TClVl） therapy on coagulation disorder and accompanying intractable jaundice in HBV-related liver cirrhosis patients. METHODS： Using stratified random sampling according to fibrinogen （Fib） levels, 145 liver cirrhosis patients due to hepatitis B complicated by coagulation disorder were treated. Of them, 70 in research group were treated with TCM by ＂nourishing yin, cooling blood and invigorating blood circulation＂ and Western medicine, 75 in control group were treated with conventional Western medicine. The indexes of liver function, coagulation function and bleeding events were observed and compared. RESULTS： The prothrombin time （PT） was shorter and the fibrinogen （Fib） level was higher in the research group than in the control group （Fib = 1.6-2.0 g/L, 1.1-1.5 g/L, and ≤ 1.0 g/L）. The total bilirubin （TBIL） level was significantly lower in the research group than in the control group, except for the subgroup of FIB ≤ 1.0 g/L. CONCLUSION： TCM therapy can improve coagulation fuction and decrease TBIL.

Comparison of integrated Chinese and Western medicine with and without somatostatin supplement in the treatment of severe acute pancreatitis

AIM: To evaluate the therapeutic effect of the combined use of early short-term somatostatin and conventional integrated Chinese and Western medicine in treating severe acute pancreatitis. METHODS: Sixty patients with severe acute pancreatitis were divided at random into a somatostatin group and a basic treatment group. Both groups received integrated traditional Chinese and Western medicine without surgery. For patients in the somatostatin group, somatostatin was infused intravenously 250 μg/h for 72 h; other medications were the same as in the basic treatment group. In both groups, comparisons of therapeutic effectiveness were made in terms of morbidity of organic dysfunction and mortality rate, and severity of the disease according to serum levels of C-reaction protein, scores of acute physiology and chronic health evaluation (APACHE Ⅱ), and scores of Balthazar-CT. RESULTS: The indexes for C-reaction protein levels on the fourth and seventh clays, and APACHE II scores on the seventh day after treatment, were significantly improved in the somatostatin group than in the basic treatment group. The morbidity of organic dysfunction was lower in the somatostatin group than in the basic treatment group, although the difference was not statistically significant. There was no significant difference in mortality between the two groups. CONCLUSION: We conclude that combined traditional Chinese and Western medicines with an early short-term use of somatostatin can improve the condition of patients with severe acute pancreatitis.

CLINICAL OBSERVATION ON THE TREATMENT OF CHRONIC FATIGUE SYNDROME WITH DEEPLY PUNCTURED ELONGATED NEEDLE COMBINED WITH COMPREHENSIVE NURSING

Objective： To observe the therapeutic effect of deep puncture of Zusanli （足三里 ST 36） and Qihai （气海 CV 6） with elongated needle combined with comprehensive nursing in the treatment of chronic fatigue syndrome （CFS） so as to provide new way and effective method for CFS. Methods： A total of 100 cases of CFS patients were evenly randomized into treatment group and control group which were treated with elongated needle puncture of ST 36 and CV 6 plus nursing and oral ackninistration of Shiquan Dobu Tong （十全大补汤 Decoction of Ten Powerful Tonics） separately. Acupuncture and medication were given once daily, with 7 sessions being a therapeutic course, 4 courses altogether. Results： After 4 courses of treatment, of the two 50 cases in treatment and control groups, 4 （8.0%） and 2 （4.0%） were cured, 37 （74.0%） and 16 （32.0%） experienced marked im- provernent, 6 （ 12.0 % ） and 19 （38.0 % ） had improvement, 3 （6.0 % ） and 13 （26.0 % ） tailed, with the total effective rates being 94.0% （47/50） and 74.0% （37/50） respectively. The total effective rate and markedly effective rate of treatment group were significantly higher than those of control group （P〈0.05, 0.01）. Conclusion; Deep puncture of Zusenli （ST 36） and Qihai （CV 6） with elongated needle combined with comprehensive nursing has a definite therapeutic effect in the treatment of chronic fatigue syndrome.

CLINICAL OBSERVATION ON 96 CASES OF PRIMARY DYSMENORRHEA TREATED BY MEDICINE-SEPARATED MOXIBUSTION AND INVESTIGATION ON ITS MECHANISMS

Objective： To observe the therapeutic effect of medicine-separated moxibustion for primary dysmenorrhea and its influence on plasma hormone level. Methods. Ninety-six patients suffering from primary dysmenorrhea were randomly and evenly divided into trealment group treated with medicine-separated moxibustion of Shenque （神阙 CV 8, 3-5 cones every time, beginning 1 week before onset of menstruation and stopping on the 3^rd day after onset, with 10 sessions being a therapeutic oourse, 3 courses all together）, and control group treated with oral administration of Yueyueshu （月月舒 menstruation-smoothing granule, 10 g/time, b.i.d, 3 courses altogether）. Menses prostaglandin E2（PGF2α） and plasma oxytocin （OT） during menstruation were determined by radioimmunoassay. Results; After the treatment, of the two 48 cases in treatment and control groups, 18 and 5 were cured, 24 and 9 had marked improvement in their symptoms, 6 and 26 had improvement, 0 and 8 failed in the treatment, with the total effective rates being 100. 096 and 83.3% respectively, the therapeutic effect of treatment group was markedly superior to that of control group （P〈0.05）. After the treatment, the contents of menses PGF2α in treatment group and plasma OT in both groups were significantly lower than those of pre-treatment （ P〈 0.01 ）. The therapeutic effect of moxibustion was significant- ly better than that of medication in lowering plasma OT. Conclusion： Medicine-separated moxibustion works well in treating primary dysmenorrhea, and moxibustion induced decrease of menses PGF2α and plasma OT may contribute to its effect in relieving dysmenorrhea.

A COMPARATIVE STUDY ON HYPOTHALAMIC MECHANISMS OF ANALGESIA INDUCED BY FOUR KINDS OF ACUPUNCTURE THERAPIES IN ADJUVANT ARTHRITIS RATS

Objective.. To compare the mechanisms of analgesia induced by four kinds of acupunture therapies at the trypothalamic level in adjuvant arthritic rats. Methods： Forty-eight SD rats were randomized into normal, model, electroacupuncture （EA）, filiform needle （FN）, pricking blood-letting （BL） and point injection （PI） groups, with 8 cases in each. EA （20-100 Hz, 2-4 V and duration of 20 min）, FN, BL PI were respectively applied to “Kunlun” （昆仑 BL 60）. Arthritis model was established by injecting complete Freund＇s adjuvant （0.1 mL） into the rat＇s right foot pad. Behavioral reactions, pain threshold （latancy of tail flick to heat stimulation） and local swelling severity （foot volurne） were detected; the cordents of β-endorphin （β-EP） and α- drenocortiootropin （ACTH） were assayed with radioimmunoassay; and the expression of pro-opi-omelanocortin （POMC） mRNA in hypot were determined with hybridization method. Results： The pain threshold was significantly enhanced by all the four kinds of acupuncture therapies, and the effects of EA and PI were more obvious （P〈0.05, P〈0.01）. The severity of local swelling was markedly alleviated by all the four kinds of acupuncture therapies （ P〈 0.01 ） without significant differences among them （P 〉 0.05）. The content of β-EP in the hypothalamus was obviously elevated by EA and FN （P〈 0.05, P 〈 0.01 ）, and the effect of EA was more obvious, but no marked effect of BL or PI on β-EP was found （ P 〉0.05）. The content of ACTH in hypothalamus was considerably elevated by PI （P〈0.05）, but not by the other three therapies. The expression of PCMCmRNA in hypothalamus was significantly strengthened by EA and FN （P〈0. 01）, but not by the other two therapies. Conclusion：EA, flliform needle, blood-letting and point-injection all can produce analgesic effect in adjuvant arthritis rats, the effect of EA and filiform needie may be related to their resultant increase of hypothalamic β-EP, and that of point-injectiON related to the increase of hypothalamic ACTH level.

EVALUATION ON THE THERAPEUTIC EFFECT OF DEEP PUNCTURE OF TIANSHU (ST 25) FOR SLOW TRANSIT CONSTIPATION

Objective： To evaluate the short-term and middle-long-term therapeutic effects of deep puncture of Tianshu （天枢 ST 25） for slow transit constipation （STC）. Methods： Sixty cases of STC patients were evenly randomized into Methods： group and medication group. In acupuncture group, electroaoupuncture （EA, 20 Hz, continuous waves and tolerable strength） was applied to bilateral Tienshu （ST 25） for 30 min after deep puncture. The treatment was given once daily, 5 sessions every week, two weeks altogether. Patients of control group were ordered to take Lactulose （ 10mL/time, b. i. d）, two weeks altogether. Cleveland Constipation Score （CCS） and colonic transit time （COT） were used to evaluate the therapeutic effect. Results： After treatment, both COS and COT showed that the therapeutic effect of acupuncture group was significantly superior to that of medication group （P〈0.05）. Six-months＇ follow up showed that the therapeutic effect of acupuncture still maintained in 13 of the 22 cases visited, while that of control group only maintained in 1 of the 19 cases. Conclusion： The therapeutic effect of deep puncture of Tianshu （ST 25） for STC is definite and has a middle-long-term effect. The patients have no any unfavorable reactions.

CLINICAL OBSERVATION ON THE TREATMENT OF 34 CASES OF SLOW TRANSIT CONSTIPATION WITH ELECTROACUPUNCTURE

Objective： To explore effective modelity for slow transit constipation （STC） and provide evidence for standardization of pattern identification of STC. Methods： Sixty eight cases of STC patients were randomly and evenly assigned into acupuncture group （n=34） and medication （control） group （n=34）. In acupuncture group, Tianshu （天枢 ST 25） and Zhigou （支沟 TE 6） were punctured and stimulated electrically by setting the parameters of 1 Hz, continuous waves, suitable strength and duration of 30 min. Patients of the control group were ordered to take Tongbionling （bowel-movernent promotion） Capsule, 5 cap sules/time, once daily. Results： After 28 days＇ treatment, symptom scores in both groups were decreased significantly and colonic ejection rates within 72 hours increased considerably in comparison with pre-treatment （ P〈 0, 01 ） ; and the therapeutic effects of acupuncture group were remarkably better than those of control group in lowering symptom score and raising colonic ejection rate （P〈0.01）. Conclusion： Acupuncture is a simple and practical method for the treatment of STC and its therapeutic effect is reliable.

Chinese medicine compound Changtong oral liquid on postoperative intestinal adhesions

AIM: The aim of this study was to observe the effect of a Chinese medicine compound Changtong oral liquid (CT) on tissue plasminogen activity (t-PA), plasminogen activator inhibitor (PAI), TGF-β1 and hydroxyproline (OHP). METHODS: Two sets of animal experiments were performed in the present study. Forty New Zealand rabbits and 48 Sprague-Dawley (SD) rats were assigned randomly to one of the five groups: sham adhesion, adhesion with saline, adhesion with low dosage of the CT, adhesion with middle dosage of the CT and adhesion with high dosage of the CT. t-PA and PAI activity in plasma, OHP and TGF-β1 expression in adhesion were investigated. Analysis of variance was used to test differences among groups. RESULTS: CT treatment increased plasma t-PA activity in rabbits but decreased TGF-β1 activity in rats. The data were expressed from low to high dose respectively as follows: t-PA, 46.1±8.6 μkat/L, 59.6±10.1 μkat/L, 64.0±11.5 μkat/L; TGF-β1 28±7.23%, 31±3.05%, 30±4.04%. There were significant differences compared with saline-treated animals (t-PA 26.4±5.1 μkat/L, TGF-β1 54±5.51%). OHP content in cecum of rabbits from middle and high but not low dose of CT lowered significantly as compared with saline-treated rabbits, 0.3641±0.1373, 0.3348±0.0321, 0.2757±0.0497 mg/g vs 0.4183±0.0883 mg/g of protein, P>0.05, P<0.05, P<0.05 respectively. The rabbit plasma PAI activity and OHP content in abdominal wall had no difference in all groups. CONCLUSION: CT treatment significantly enhanced t-PA activity in rabbits, but decreased TGF-β1 content in rats, OHP content in cecum of rabbits, and failed to affect the activity of PAI and OHP content in abdominal wall in rabbits, compared with saline group. The result suggests that CT could effectively prevent adhesions without interfering wound healina.

The Combined Use of Tonification and Purgation in Treatment of Fatty Liver

Fatty liver is a disease caused by excessive accumulation of fat in the liver due to long-term ort repeated affection of various causative factors'When the pathogenic factor prevails,the qi is sure to be deficient',Therefore,deficiency of the vital-qicontributes greatly to the occurrence of fatty liver.For many years,the author has concentrated ont the treatment of fatty liver with the tonificatioin method,or tonification followed by purgation,or the combination of tonificaytioin with purgation,so as to effectively prevent the liver from being injured by harmful substances ,and to benefit the recovery of fatty liver.The following is a report of his experience in treatment of fatty liver with the combined use of tonification and purgation.

OBSERVATION ON CLINICAL THERAPEUTIC EFFECTS OF SCALP ACUPUNCTURE FOR FACIAL SPASM

Objective; To observe clinical therapeutic effect of scalp acupuncture in the treatment of facial spasm. Methods： Sixty-five cases of facial spasm were randomly divided into control group （n = 31 ） and treatment group（n = 34）. Patients of the treatment group were treated with penetrative acupuncture from Qienshencong（前神聪 Extra） to Xuanli（悬厘 GB 6）, Baihui（百会 GV 20） to Qubin（曲鬓 GB 7）, etc., and those of control group treated with acupuncture of Taiyang（太阳 EX-HN 5）, Yengbai（阳白 GB 14）, Quanliao（颧髎 SI 18） and Xiaguan（下关 ST 7）, etc. once daily, 20 sessions altogether. Results. After treatment, of the 31 cases and 34 cases in control and treatment groups, 5 and 12 were cured, 8 and 13 had remarkable improvement, 11 and 8 had improvement, 7 and 1 failed, with the total effective rates being 77.42% and 97.06% respectively; and the therapeutic elfact of treatment group was significantly superior to that of control group（P〈0.01）. Conclusion; Scalp acupurcture has an obvious therapeutic effect for facial spasm.

ACUPUNCTURE FOR PRI MARY DYSMENORRHEA──A meta-analysis

Recent literature search showed that up to now there are a total of 9 theses abo ut clinical treatment of primary dysmenorrhea with acupuncture therapy, among th em 5 clinical trials are from Chinese journals and the rest 4 from foreign journals. Majority of the tri als have some methodological and/or reporting shortcomings. The frequency and in tensity of dysmenorrhea are divided into intermittent and continuous types. Resu lts of quantitative meta-analysis with Revman 4.1 software showed that the exis t ing evidence supports the value of acupuncture for the treatment of dysmenorrhea . However, the quality of evidence is not fully convincing. There is an urgent n eed for well-planned, large-scale and multiple-center studies to assess the e ffe ctiveness and cost-effectiveness of acupuncture under real-life conditions.

CLINICAL STUDY ON THE TREATMENT OF ACUTE CEREBRAL INFARCTION WITH ACUPUNCTURE COMBINED WITH MEDICINES

Objective： To observe the therapeutic effect of acupuncture combined with medicines for acute cerebral infarction and to study its mechanism. Methods; A total of 80 acute cerebral infarction patients were evenly randomized into treabnent and control groups. Patients of treatment group were treated with acupuncture of Baihui （百会 GV 20）, Fengchi （风池 GB 20）, Jiquan （极泉 HT 1 ）, Neiiguen （ 内关 PC 6）, etc. and those of control group treated with conventional medicines as low molecular dextran, compound Red Sage injection, Citicolinum, etc. Scores of clinical neurological deficits, blood flow velocity peak （Vp） and mean blood flow velocity （Vm） of the bilateral internal carotid artery （ICA）, middle cerebral artery （MCA）, anterior cerebral artery （ACA）, posterior cerebral artery （PCA）, basilar artery （BA） and vertebral artery （VA） were detected with transcranial Doppler （TCO） were analyzed before and after treatment. Results： After 12 days＇ treatment, the neurological deficit scores in both treatment and control groups decreased significantly, and the difference values of the score of the former group was significantly bigger than these of the later group （P〈0.01）. Vp and Vm of all the detected arteries in treatment group and bilateral ACA, MCA and PCA of control group increased significantly in comparison with pre-treatment （P〈0.05, P〈0.01） ; and the difference values of Vm of bilateral MCA and VA （between post- and pre-treatment） of treatment group were significantly bigger than those of control group （P〈0.01）. Conclusion; The therapeutic effect of acupuncture combined with medication is significantly superior to that of simple medication in the treatment of acute cerebral infarction.

DEVELOPMENT ON CLINICAL TREATMENT OF CONSTIPATION WITH ACUPUNCTURE AND MOXIBUSTION

In the present paper, the authors review recent developmarrt of clinical treatment of constipation with acupunctire and moxibustion from ① body acupuncture therapy including special needling manipulations, as Ziwu Daojiu Needling, etc. and acupoint combination,②electrcacupunture therapy, ③ scalp-acupuncture therapy, ④ auricular acupuncture therapy, ⑤ needleembedding and acupoint-catgut-embedding therapies, ⑥ acupoint-application therapy, ⑦ combinged acupuncture aud medication therapy, ⑧ other therapies such as cupping therapy and holo-therapy, and ⑨ considerations about the action of acupuncture in the treatmnt of constipation and its prospect. Up to now, researches on the effect of acupuncture in treating constipation are seldom seen, thus, much attention should be paid about this by clinical and experimental researchers.

CLINICAL OBSERVATION ON 40 CASES OF ANKYLOSING SPONDYLITIS TREATED WITH ACUPUNCTURE AND CHINESE DRUGS

Objective： To observe the clinical therapeutic effect of acupuncture plus Chinese herbal medicines for ankylceing Methods： A total of 80 cases of AS patients were evenly and randomly divided into treatment group and control group. In treatment group, patients were treated with acupuncture of Jiaji （夹脊 EX-B 2） and oral administration of Yishen Tongdu Won （益肾通督丸,Bolus for Reinforcing the Kidney and Dredging Governor Vessesl） and those of control group treated with oral administration of Sulfasalazin （0.5 g, twice daily）. Before and after treatment, the thoracic-dilaion scale, Schober test, Bath ankylceing spondylitis disease activity index （BASDAI）, Bath ankylosing spondylitis functional index （BASFI）, erythrocyte sedimentation rate （ESR） and C-reaction protein （CRP） were detected separately. Results： After 6 months of treatment, of the both 40cases in treatment and control groups, 27 （67.5%） and 13 （32.5%） were improved remarkably, 11 （27.5%） and 16 （40.0%） effective, and 2 （5.0%） and 11 （27.5%） failed, with the effective rates being 95.0% and 72.5% separately. The therapeutic effect of treatment group was significantly superior to that of control group （P〈 0.05）. After treatment, the thoracicdilaion scale and Schober test values increased significantly （ P〈 0.05）, while BASDAI, BASFI, ESR and CRP lowered considerably （P〈0.01, P〈0.05）. Comparison between two groups indicated that after treatment, the decreased values of BASDAI, BASFI, ESR and CRP of treatment group were significantly lower than those of control group （ P〈 0.01 ）, while those of the thoracio-dilaion scale and Schober test of treatment group were significantly higher than those of control group （ P 〈 0.05, P 〈 0.01 ）. Results displayed that both acupuncture combined with Chinese drugs and Sulfasalazin could lower BASDAI, BASFI, ESR and CRP, raise the thoracic-dilaion scale and Schober test values considerably in AS patients, and the therapeutic effect of combined acupunclure and Chinese drugs was apparently superior to that of Westem medicine. Conclusion： Joint application of acupuncture and Chinese drugs is superior to Western medicine in the therapeutic effect for AS and has fewer side effects.

COMMENTS ON THE THERAPEUTIC TIMETABLE OF ISCHEMIC APOPLEXY AND SUPER-EARLY INTERVENTION OF ACUPUNCTURE

According to the pathological process of ischemic apoplexy, which involves its onset and development, this paper expounds the great significance of adopting various active and effective measures within the therapeutic timetable for favorable prognosis and improvement of apoplexy. The author’s viewpoints differ from the conventional thinking towards the management of apoplexy, stressing super early intervention with acupuncture.

Personal Experience in TCM Treatment of Reflux Esophagitis

Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of the stomach and duodenum into the esophagus.