中药治疗小梁切除术后双眼睑水肿1例

患者覃某某,女,53岁,住院号:0014.因左眼视物模糊半年余,加重1月,于2005年1月27日以"左眼慢性闭角型青光眼"收入院.既往有17年前因车祸伤致右眼外伤并发青光眼而失明病史.……

Gemcitabine and cisplatin combined with the Chinese herbal medicine compound Fuzhenggubenfang improve quality of life and progression-free survival in patients with advanced non-small cell lung cancer

Objective： To assess the role of chemotherapy combined with the compound Chinese herbal medicine,Fuzhenggubenfang （FZGBF）, for treating advanced non-small-cell lung cancer. Methods： A total of 84 eligible patientswere enrolled from October 2013 to July 2016. Patients were randomized to receive either chemotherapy alone as thecontrol group or chemotherapy combined with FZGBF as the experimental group. The primary endpoint of the study wasquality of life （QOL） and progression-free survival （PFS）. Secondary endpoints were tumor response rate, toxicity,dropout rate, and univariate and multivariate analyses of clinicopathologic factors for QOL and PFS. Results： There wasa significant improvement in QOL, including better overall health （P 〈 0.001）, physical function （P 〈 0.001）, rolefunction （P 〈 0.001）, emotional function （P 〈 0.001）, cognitive function （P 〈 0.001）, and social function （P = 0.031）.Less fatigue, nausea or vomiting, insomnia, appetite loss, constipation, and alopecia were noted （All P 〈 0.001） whenFZGBF was combined with chemotherapy in comparison to chemotherapy alone. The experimental group had a betterPFS compared with the control group （P = 0.032）. There was no significant difference in tumor response rate. FZGBFsignificantly reduced chemotherapy-induced anemia （P 〈 0.001）, neutropenia （P = 0.023）, nausea and vomiting （P 〈0.001）. The use of Chinese herbal compounds had only mild side effects. In this study, factors influencing QOL were theuse of the Chinese herbal compounds （P 〈 0.001）, performance status score （P = 0.027）, clinical staging of cancer （P =0.009）, and sex （P = 0.044）. Use of traditional Chinese medicine （P = 0.043） and the number of previous chemotherapysessions （P = 0.003） were the factors influencing PFS in this study. Conclusion： FZGBF could improve QOL,compliance to treatment, relieved chemotherapy-related toxicities of patients, and consequently improved PFS, which isa promising drug combination in complementary medicine for the treatment of advanced NSCLC.

Long-term stroke rates after catheter ablation or antiarrhythmic drug therapy for atrial fibrillation： a meta-analysis of randomized trials

Background Atrial fibrillation （AF） is an independent risk factor for ischemic stroke and is associated with increased risk of death. Randomized studies suggest improved quality of life for patients with AF after successful catheter ablation compared to antiarrhythmic drug therapy. The value of ablation in long-term risk of ischemic stroke, however, has not been assessed. We conducted a meta-analysis to determine whether AF ablation reduces the long-term risk of stroke compared to antiarrhythmic drug therapy in randomized controlled trials. Methods ＆ Results PubMed and the Cochrane Central Register were searched for randomized trials from January 1990 to December 2014 comparing AF catheter ablation to drug therapy. The results are reported as risk differences （RDs） and 95% CI. Thirteen trials were analyzed with 1097 patients treated by catheter ablation and 855 patients received antiarrhythmic drug therapy. Overall, seven patients （0.64%） in the catheter ablation group had ischemic stroke or transient ischemic attacks vs. two patients （0.23%） in the drug therapy group. No difference was shown in the rate of stroke or transient ischemic attack between ablation and drug therapy （RD： 0.003, 95% CI： -0.006 to 0.012, P = 0.470）, and no evidence of heterogeneity was observed （I^2 = 0, P = 0.981）. No potential publication bias was found. There was also no difference in mortality between the two groups （RD： -0.004, 95% CI： -0.014 to 0.006, P = 0.472）. Conclusions This meta-analysis of randomized controlled trials showed similar rates of ischemic stroke or transient ischemic attack and death in AF patients undergoing catheter ablation compared to drug therapy. A larger prospective randomized trial to confirm this finding is warranted.

Therapy Response of Chinese Herbal Medicine in Advanced Liver Cancer： A Retrospective Observational Clinical Trial

Aiming at starting the ball rolling and contributing humble effort to promote CTM （Chinese traditional medicine）, we performed the present study to assess the therapy response of Chinese herbal decoction compared to conventional therapy on critical ill patients of advanced liver cancer. A total of 6 patients （1 female and 5 males） with histologically confirmed liver cancer were included in this retrospective observational clinical trial. We administered Chinese medicine （Gan Decoction, mixed with a variety of effective herbal components） to help them to recover from poor condition. In the meantime, conventional treatment of surgical resection and artery catheterization chemotherapy was applied in cases compared. In 3 cases of CTM combined treatment, the tumor marker level decreased. Residual intrahepatic metastatic sites reduced according to ultrasonography/CT imaging, and the patients felt free from the complaint of abdominal discomfort. The quality of life has been improved, we managed to have prolonged the PFS （Progression-Free-Survival） and TTP （Time-to-Progression） from the onset to date. While in 3 cases with conventional treatment only of surgical resection and artery catheterization chemotherapy, we were not able to decrease the level of tumor marker, metastatic lesions increased according to ultrasonography/CT imaging, and the patient＇s condition worsen more. We failed in having prolonged the PFS and TTP in the compared cases of conventional treatment only. The retrospective clinical study showed no OS （overall survival） benefit for liver cancer patients treated with Gan Decoction, while the QOL （quality of life） evaluation seemed to predict survival better. Chinese herbs might be an additional choice with its better benefits and tolerability in the treatment of primary liver cancer.

Application of Traditional Chinese Medicine injection in treatment of primary liver cancer:a review

OBJECTIVE:To investigate the application of Traditional Chinese Medicine Injections(TCMIs) for treatment of primary liver cancer(PLC).METHODS:A literature review was conducted using PubMed/Medline,Cochrane Library Controlled Clinical Trials Database,China National Knowledge Infrastructure(CNKI),China Scientific Journal Database(CSJD) and China Biology Medicine(CBM).Online websites including journal websites and databases of ongoing trials,as well as some Traditional Chinese Medicine journals that are not indexed in the electronic databases were also searched.RESULTS:The literature review showed that TCMIs as adjunctive medication for the treatment of PLC could regulate patient immunity,reduce bone marrow suppression,relieve clinical symptoms,and improve quality of life,as well as control disease progression and prolong survival time.CONCLUSION:Within the limitations of this review,we conclude that application of TCMIs as adjunctive medication may provide benefits for patients with PLC.Further large,high-quality trials are warranted.

Randomized controlled multicenter clinical trial for integrated treatment of community-acquired pneumonia based on Traditional Chinese Medicine syndrome differentiation

OBJECTIVE:To evaluate the efficacy and safety of treatment based on syndrome differentiation ofTraditional Chinese Medicine(TCM) for community-acquired pneumonia(CAP).METHODS:A total of 240 CAP patients were randomly divided into the following two groups:thecontrol group was treated by anti-infection plus conventional medicine treatment;and the trial group was treated by TCM plus the above-mentioned treatment given to the controls.The course of treatment was 14 days,and the patients were followed up for 7 days.RESULTS:Of the 240 patients,235 accomplished the whole process of treatment.The five patients who withdrew from the study were brought into an intent-to-treat analysis.The therapeutic effects of the trial group were superior to those of the control group(P<0.01).The trial group took less time to become clinically stable,with a higher score in the quality of life(P<0.01).There were no significant differences in mortality rate(P>0.05),white blood cell count(P>0.05),bacterial clearance rate(P>0.05),and adverse reactions between the two integrated groups.CONCLUSION:Treatment based on TCM syndrome differentiation for CAP has the advantages of resulting in less time to achieve a stable clinical condition,improvement of clinical symptoms and quality of life,and is comparatively safe.

Efficacy of Chinese herbal medicine for lumbar disc herniation: a systematic review of randomized controlled trials

OBJECTIVE： This is a review of the effects of Chi- nese herbal medicine （CHM） used alone to treat lumbar disc herniation （LDH）. METHORDS： A literature search of the following electronic databases from their inception to Febru- ary 2013 was conducted： Chinese Biomedical data- bases, Chinese National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Cochrane Library, Web of Sci- ence, MEDLINE, and EMBASE. Randomized con- trolled trials where CHM had been used to treat LDH were selected. Data extraction, quality assess- ment, and data analysis were carried out by two in- dependent reviewers. RESULTS： Of the 2415 studies identified, eight with complete data on 1146 patients were selected. The methodological quality was poor in all trials. Five studies reported that CHM was better than WesternMedicine [OR=2.81, 95% CI （1.27, 6.18）; OR=3.34, 95% CI （1.92, 5.79）; 0R=2.22, 95% CI （1.08, 4.57）; OR= 6.67, 95% CI （1.34, 33.28）; and OR=1.94, 95% CI （1.23, 3.06）]. Two studies reported that the clinical outcome was better in CHM groups than in physio- therapy and placebo groups, [OR=3.02, 9.5% CI （1.08, 8.46）; and OR=2.67, 95% CI （1.26, 5.64）, re- spectively], whereas one study reported no differ- ence between CHM and physiotherapy groups. One study reported that CHM resulted in higher Japanese Orthopedic Association scores [MD=7.78, 95% CI （6.67, 8.89）] than in a control group and an- other that participants treated with CHM had lower Visual Analogue Scale scores [MD=- 0.72, 95% CI （ - 0.86, 0.58）] than those in a control group. Three studies reported that the adverse effects of CHM and Western Medicine did not differ signifi- cantly [OR=0.10, 95% CI （0.01, 1.85）; OR=0.19, 95% CI （0.01,4.07）; and OR=O.07, 95% CI （0.00, 1.32）]. CONCLUSION： CHM may be more effective than other interventions for LDH; however, methodologi- cal weaknesses in the studies assessed in this re- view prevent a definitive conclusion. More high-quality large-scale studies are required to clar- ify this matter.