“中性疗法”治疗急性脑梗塞60例疗效观察

急性脑梗塞患者,采用脑血管扩张剂及溶栓剂治疗可因脑水肿加重及再灌注性脑损伤而致病情加重,影响病情的恢复及患者的预后。为避免这一现象的发生,我们对急性脑梗塞患者采用“中性疗法”(不使用脑血管扩张剂、溶栓药物及低分子右旋糖酐等)。经60例临床观察效果满意。对比既往采用常规疗法治疗的60例患者,显效率及有效率无明显差异(P>0.05)。现总结报道如下:

Extreme gastric dilation caused by chronic lead poisoning: A case report

Lead is a toxic metal that affects many organ systems and functions in humans. In the majority of adults, chronic lead poisoning comes from exposures to work places and can occur in numerous work settings, such as manufacturing, lead smelting and refinement, or due to use of batteries, pigments, solder, ammunitions, paint, car radiators, cable and wires, certain cosmetics. In some countries, lead is added to petrol. We present a rare case of gastric dilation caused by long-term petrol ingestion. A 16-year-old young man was admitted to our hospital due to a 6-mo history of exhaustion, dizziness, nausea, abdominal cramps and constipation. X-ray examination revealed dilated stomach descending into the pelvis and small bowel distension. After a long clinical observation, we found that the reason for the chronic lead poisoning of the patient was due to a 3-year history of petrol ingestion. The patient spontaneously recovered and stomach returned to its normal position and size. Lead poisoning should be taken into consideration in all unexplained cases of gastric dilation.

Protective effect of fufanghuangqiduogan against acute liver injury in mice

AIM: To study the effects and possible mechanisms of fufanghuangqiduogan (FFHQ) in mice with acute liver injury (ALI). METHODS: ALI was successfully induced by injecting carbon tetrachloride (CCl4) intra peritoneally and by tail vein injection of Bacillus Calmette Guerin (BCG) and lipopolysaccharide (LPS) in mice, respectively. Each of the two model groups was divided into normal group, model group, FFHQ (60, 120 and 240 mg/kg) treatment groups, and bifendate treatment group. At the end of the experiment, levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), content of malondialdehyde (MDA), activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-px) in liver homogenate were measured by biochemical methods. The activities of tumor necrosis factor-α (TNF-α) and interleukin-1 (IL-1) were determined by radio-immunoassay. Hepatic tissue sections were stained with hematoxylin and eosin and examined under a light microscope. RESULTS: In the two models of ALI, FFHQ (60, 120, 240 mg/kg) was found to significantly decrease the serum transaminase (ALT, AST) activities. Meanwhile, FFHQ decreased MDA contents and upregulated the lower SOD and GSH-px levels in liver homogenate. Furthermore, in immunologic liver injury model, FFHQ decreased levels of TNF-α and IL-1 in serum. Histologic examination showed that FFHQ could attenuate the area and extent of necrosis, reduce the immigration of inflammatory cells. CONCLUSION: FFHQ had protective effect on liver injury induced by either CCl4 or BCG+LPS in mice, and its mechanisms were related to free radical scavenging, increasing SOD and GSH-px activities and inhibiting the production of proinflammatory mediators.

EFFECTS OF RADIX ANGELICAE SINENSIS AND SHUANGHUANGLIAN ON A RAT MODEL OF CHRONIC PSEUDOMONAS AERUGINOSA PNEUMONIA

Objective. To study the effects of two kinds of Chinese herbal medicine, Radix angelicae sinensis(RAS)(当归)and Shuanghuanglian(SHL)(双黄连) on chronic Pseudomonas aeruginosa(PA)lung infection in a rat model mimicking cystic fibrosis(CF). Methods.Rats were divided into RAS, SHL and control groups. All rats were challenged intratracheally with alginate embedded PA and the treatments with herbal medicine started on the same day of challenge. The drugs were administered subcutaneously once a day for ten days and the control group was treated with sterile saline.The rats were sacrificed two weeks after challenge. Results. Significantly improved lung bacterial clearance(P<005, P<001) and milder macroscopic lung pathology (P<0005) were found in the two treated groups compared to the control group. In the SHL treated group, the neutrophil percent in the peripheral blood leukocytes(P<005), the antiPA IgG level in serum (P<005), the incidence of lung abscesses(P<0005) and the incidence of acute lung inflammation(P<005) were significantly lower than in the control group. The RAS treatment reduced fever(P<005), decreased the incidence of lung abscesses(P<0005) and lung mast cell number (P<005), and lowered antiPA IgG1 level in serum(P<005) when compared to the control group. The antiPA bacterial activity test in SHL was weakly positive whereas in RAS it was negative. Conclusion.The treatment with both herbal medicines could increase the resistance of the rats against PA lung infection and they therefore might be potential promising drugs for stimulation of the immune system in CF patients with chronic PA lung infection.

Professor Ouyang Heng's Experience in Treating Neurodermatitis

Neurodermatitis, also called chronic simple lichen,is a common chronic inflammatory dennatosis characterized by paroxysmal severe itching and cutaneous lichenification. In clinic, this disease is often seen with the symptoms caused by dampness,heat and blood stasis.

An herbal formula,CGX,exerts hepatotherapeutic effects on dimethylnitrosamine-induced chronic liver injury model in rats

AIM： To evaluate the therapeutic effect of Chunggan extract （CGX）, a modified traditional Chinese hepatotherapeutic herbal, on the dimethylnitrosamine （DMN）-induced chronic liver injury model in rats. METHODS： Liver injuries were induced in Wistar rats by injection of DMN （ip, 10 mg/mL per kg） for 3 consecutive days per week for 4 wk. The rats were administered with CGX Coo, 100 or 200 mg/kg per day） or distilled water as a control daily for 4 wk starting from the 15^th d of the DMN treatment. Biochemical parameters （serum albumin, bilirubin, ALP, AST and ALT）, lipid peroxides, hydroxyproline, as well as histological changes in liver tissues were analyzed. In addition, gene expression of TNF-α, TGF-β, TIMP-1, TIMP-2, PDGF-β, and MMP-2, all of which are known to be associated with liver fibrosis, were analyzed using real-time PCR. RESULTS： CGX administration restored the spleen weight to normal alter having been increased by DMN treatment. Biochemical analysis of the serum demonstrated that CGX significantly decreased the serum level of ALP （P 〈 0.05）, ALT （P 〈 0.02）, and AST （P 〈 0.02） that had been elevated by DMN treatment. CGX administration moderately lowered lipid peroxide production and markedly lowered hydroxyproline generation caused by DMN treatment in accordance with histopathological examination. DMN treatment induced a highly upregulated expression of TNF-α, TGF-β,TIMP-1, TIMP-2, PDGF-β, and MMP-2. Of these, the gene expression encoding PDGF-β and MMP-2 was still further enhanced 2 wk after secession of the 4-wk DMN treatment, and was remarkably ameliorated by CGX administration. CONCLUSION： CGX exhibits hepatotherapeutic properties against chronic hepatocellular destruction and consequential liver fibrosis.

Matrix metalloproteinases contribute to kidney fibrosis in chronic kidney diseases

Matrix metalloproteinases(MMPs) are members of the neutral proteinase family. They were previously thought to be anti-fibrotic because of their ability to degrade and remodel of extracellular matrix. However, recent studies have shown that MMPs are implicated in initiation and progression of kidney fibrosis through tubular cell epithelial–mesenchymal transition(EMT) as well as activation of resident fibroblasts, endothelial-mesenchymal transition(Endo MT) and pericyte-myofibroblast transdifferentiation. Interstitial macrophage infiltration has also been shown to correlate with the severity of kidney fibrosis in various chronic kidney diseases. MMPs secreted by macrophages, especially MMP-9, hasbeen shown by us to be profibrotic by induction of tubular cells EMT. EMT is mainly induced by transforming growth factor-β(TGF-β). However, MMP-9 was found by us and others to be up-regulated by TGF-β1 in kidney tubular epithelial cells and secreted by activated macrophages, resulting in EMT and ultimately kidney fibrosis. Therefore, MMP-9 may serve as a potential therapeutic target to prevent kidney fibrosis in chronic kidney disease. This review, by a particular focus on EMT, seeks to provide a comprehensive understanding of MMPs, especially MMP-9, in kidney fibrosis.

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.

Question & Answer

Chinese insect drugs are drastic in nature, capable ofclearing channels and collaterals to promote a freeflow of qi and blood, and effective in someintractable and obstinate diseases due to long-termstagnation of phlegm and blood, which are hard to betreated by ordinary Chinese drugs. In clinic, properuse of insect drugs can often help raise thetherapeutic effects. Some commonly used pairs ofinsect drugs are introduced in the following.

Treatment of 140 cerebral palsied children with a combined method based on traditional Chinese medicine(TCM)and western medicine

Objective:To observe and evaluate a method that is effective and practical for treatment of cerebral palsied(CP)children in China.Method:The patient's age and disease type and individual specific conditions were considered in choosingtherapy methods accordingly:Chinese herbs,acupuncture,auricnlar seed pressure,point finger pressing,massage,orthopedichand manipulation,physiotherapy,occupational therapy,language therapy,etc.Meanwhile we created a new CP treatment modelthat combines hospitalized treatment with family therapy.Results:The majority of CP patients improved greatly in motor andsocial adaptation capacities after treatment.Wilcoxon paired rank sum test analysis showed that there were significant differencesbetween the data before and after treatment(P<0.01).Conclusion:This combined therapy method,based on traditional Chinesemedicine and western medicine plus family supplemental therapy,is an effective and practical treatment strategy for CP children inChina.

TCM Treatment for 40 Cases of Rheumatoid Arthritis with Channel Blockage due to Yin Deficiency

To verify the therapeutic effects of the method of softening and lubricating the joints,and calming the endogenous wind in case of rheumatoid arthritis (RA) with the syndrome of channel blockage due to yin deficiency,60 RA patients with the syndrome of channel blockage due to yin deficiency were randomly divided into a treatment group (40 cases) and a control group (20 cases) and treated respectively by the above method for the former and with Zheng Qing Feng Tong Ning Tablets (正清风痛宁片) for the latter. The result turned out to be that the effect in the treatment group was very satisfying.The treatment group obtained a better result in the accumulated points of syndrome and RA,morning rigidity of the joints,grip strength,20m walking time and erythrocyte sedimentation rate (ESR) (P<0.01 or P<0.05).The above indicates that channel blockage due to yin deficiency is an important pathogenesis of RA,and calming the endogenous wind is a method of choice for treating RA.

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.

Effects of Huo Nao Fang in 60 Cases of Ischemic Apoplexy

To observe the therapeutic effects of the prescription of Huo Nao Fang (活脑方) on ischemic apoplexy,120 patients were divided into a treatment group and a control group, with 60 in each group, the formertreated with Huo Nao Fang while the latter with western medicine. The nervous function and bloodrheology were tested before and after treatment for both groups, and the effects of Huo Nao Fang wereevaluated. The results showed that the total effective rate was 91.7% in the treatment group and 61.6% inthe control group, with a significant difference (P＜0.01) between the two groups. The treatment group wassuperior to the control group in improving blood rheology, reducing blood lipid and restoring the nervousfunction (P＜0.05).

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.

OBSERVATION ON THE THERAPEUTIC EFFECT OF BIRD-PECKING MOXIBUSTION OF SPECIFIC ACUPOINTS IN THE TREATMENT OF FUNCTIONAL DYSPEPSIA

Objective: To observe the therapeutic effect of moxibustion of some specific acupoints for treatment of functional dyspepsia (FD, qi-distension type). Methods:A total of 50 cases of FD patients were randomly divided into treatment group (n=26) and medication group (n=24). In treatment group, bird-pecking moxibustion was applied to Zhongwan (CV 12), Qihai (CV 6), Neiguan (PC 6) and Gongsun (SP 4) 5～6 times in every treatment till the local skin got flush. The treatment was given once daily, continuously for 10 days. In control group, the patients were ordered to take Motilium 10 mg/time, 3 times daily. Following 10 days’ treatment the therapeutic effect was assessed.Results:After treatment, of the 26 cases in treatment group, 11 (42.3%) were cured, 7 (26.92%) had remarkable improvement in their symptoms, 6 (23.07%) had improvement and 2 (7.69%) failed, with a total effective rate of 92.31%. Of the 24 cases in medication group, 9 (37.50%) were cured, 6 (25.00%) experienced remarkable improvement in their symptoms, 6 (25.00%) were improved and 3 (12.50%) failed, with a total effective rate of 87.50%. Comparison between two groups showed that the therapeutic effect of moxibustion was significantly superior to that of medication (P<0.05). In addition, the difference value of the therapeutic effect index (TEI) between post-and pre-treatment in treatment group was also significantly higher than that of medication group (P<0.05). Conclusion: Bird-pecking moxibustion of specific acupoints can effectively improve clinical symptoms of FD patients.

Clinical Observation on Treatment of Rheumatoid Arthritis with Fengshi Xiandan in 53 Cases

We have successfully developed Fengshi Xiandan (风湿仙丹) and used it to treat 53 cases of rheumatoid arthritis (RA),with indomethacin used to treat another 53 cases of RA as the controls.The results showed that the rate of cure and obvious effect was 54.7% and the total effective rate was 92.4% in the treatment group,as compared to 26.4% and 66.0% respectively in the control group,with an obvious difference in curative effect between the two groups (P<0.01).The improvement of all the main clinical symptoms and signs except arthralgia in the treatment group was superior to that in the control group (P<0.05 or P<0.01). The improvement of erythrocyte sedimentation rate (ESR),rheumatoid factor (RF),C-reaction protein (CRP), immunoglobulin (Ig),T-lymphocyte subgroups,micro-circulation in nail fold,and red blood cell (RBC) and hemoglobin (Hb) of anemia patients in the treatment group was superior to that in the control group (P<0.05 or P<0.01).There was an obvious difference (P<0.05 or P<0.01) in superoxide dismutase (SOD) of RBC and lipid peroxide (LPO) of plasma before treatment in the two groups as compared to normal group (P<0.05 or P<0.01).The level of SOD and LPO after treatment in the treatment group obviously tended to normal as compared to that befbre treatment (P<0.05 or P<0.01).The reduction of LPO in the treatment group was obviously superior to that in the control group (P<0.01).The result shows that Fengshi Xiandan (风湿仙丹) with an obvious curative effect on RA can not only control the symptoms of RA but also improve its pathologic damage and prevent its development.

OCULO-ACUPUNCTURE TREATMENT OF CEREBRAL INFARCTION INDUCED HEMIPLEGIA

Objective: To observe the therapeutic effect of oculo acupuncture therapy in the treatment of cerebral infarction induced hemiplegia. Methods: 58 cases of stroke patients were randomly divided into treatment group (n=30) and control group (n=28). In treatment group, on the basis of medication plus rehabilitation treatment, patients voluntarily accepted oculo acupuncture therapy (acupuncture of Upper Jiao Area and Lower Jiao Area). In control group, patients only accepted medication and rehabilitation treatment. The therapeutic effect was evaluated with Brunstrom’s 6 stages Assessing Method. Results: After 24 sessions of treatment, the ratios of the diseased limbs reaching stage VI and more in functional activity in the patients of treatment group increased from 16.7% (upper limb) and 20.0% (lower limb) before treatment to 70.0% and 90.0% respectively; while in control group, those ratios of the upper and lower limbs increased from 10.7% and 28.6% before treatment to 39.2% and 60.7% separately. There was a significant difference between two groups in the therapeutic effect (P<0.05). Conclusion: Oculo acupuncture plus medication is superior to simple medication treatment in improving functional activity of the hemiplegic limbs.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE THERAPY FOR SIMPLE OBESITY COMPLICATED WITH PREMENSTRUAL TENSION SYNDROME

Objective: To observe the therapeutic effect of acupuncture therapy in the treatment of simple obesity complicated with premenstrual tension syndrome. Methods: A total of 39 cases of simple obesity complicated with premenstrual tension were treated by combination of body acupuncture and otoacupuncture based on syndrome-differentiation of traditional Chinese medicine (TCM). Symptoms, physical signs, obesity indexes and cumulative scores of clinical disease-syndrome before and after treatment were analyzed and compared. Results: After one, two and three courses of treatment, the effective rates were 69.23%, 79.49% and 87.18% respectively. Conclusion: Acupuncture therapy works well in the treatment of simple obesity with concurrent premenstrual tension syndrome.

ADVANCES IN CLINICAL AND EXPERIMENTAL STUDIES ON ACUPUNCTURE TREATMENT OF ACUTE CEREBRAL HEMORRHAGE

In the present paper, the authors review recent advances in clinical and experimental studies on acupuncture treatment of cerebral hemorrhage(CH). Regarding clinical studies, the resuscitation-inducing needling maneuver, and main points of Shuigou(水沟GV 26),Baihui(百会 GV 20) and scalp-points Motor Area(MS 6), Sensory Area(MS 7), etc. are often involved. Concerning experimental studies, the underlying mechanisms of acupuncture of GV-26+“Neiguan”(内关 PC 6), GV-20,GV-26+GV-20, etc. in improving acute CH are introduced. In a word, acupuncture therapy works well in improving clinical symptoms and signs of CH patients, and acupuncture stimulation induced ameilioration of cerebral blood flow, favorable modulation of some bioactive substances as excitatory and inhibitory amino acids, endothelin, CGRP, heat shock protein 70, etc. and neuro-endocrine-immune network may contribute to the effect of acupuncture on CH. In addition, acupuncture combined with medicine and earlier application of acupuncture therapy in the acute stage of CH are recommended in clinical practice.

Treatment of A Case of Spontaneous Rupture of Achille's Tendon

Mr. Guo, 51 years old, paid his first visit on November 7, 2001. The patient felt sudden pain in the right Achille's tendon in June 1999 with no apparent predisposing factors. Several months later he palpated a small pitting in the middle of the right Achille's tendon, which expanded gradually in size. In June 2000, two thirds of the tendon was diagnosed to be ruptured in a local hospital. Ten days later the tendon was ruptured completely when he felt sudden severe pain, numbness and distention, and he was unable to raise the heel. The lesion was healed three months later after being treated with a plaster model, but it was partially ruptured again 6 months later. Though the ruptured tendon was healed again with the help of a plaster model, he still suffered from local swelling and pain, which was aggravated during movement and made him difficult in walking, squatting down and standing up. During the examination, the right heel was found hyperemic and swollen with ecchymosis and tenderness. The tongue proper was dark red and the pulse thready and rapid. The condition was due to depletion and deficiency of liver-qi, stagnant blood with dampheat obstructing the collaterals. The principle of nourishing the liver and soothing the tendon was adopted, assisted by invigorating blood circulation and removing blood stasis, clearing heat and transforming dampness.