基于中西医临床特点的感染后肠易激综合征动物模型分析

目的 基于感染后肠易激综合征的中西医临床诊断标准及症状特点,对现有的感染后肠易激综合征动物模型进行总结归纳及模型评价,以期寻找中西医临床吻合度高的动物模型,为感染后肠易激综合征的中医药防治提供精准动物模型。方法 通过查阅整理感染后肠易激综合征动物实验及其动物模型制备相关文献,基于感染后肠易激综合征的临床诊断特点及症状特征,将现有感染后肠易激综合征动物模型的动物品系、造模方法及机制进行归纳总结,并进行吻合度评价、分析模型制备的优缺点。结果 综合评价后发现,中西医临床吻合度相对较高的是空肠弯曲杆菌感染模型、旋毛虫感染模型以及病症结合模型中的肝郁脾虚证模型。结论 现有的感染后肠易激综合征模型普遍西医吻合度高于中医吻合度,造模过程中普遍对中医四诊及证候的体现及信息收集较少,中医诊断中的主症主要依靠观察动物表观行为,而对次症表现的观察则相对较少,导致中医证型的判断欠准确。因此,仍需进一步规范病证结合动物模型的症状评价标准和辨证方法。具备中西医临床病证特点的感染后肠易激综合征动物模型在未来具有较大的应用价值及应用前景,采用西医病理损伤+中医病因刺激的多因素复合方法造模可建立吻合度更高的感染后肠易激综合征模型,可为研究感染后肠易激综合征发病机制、证候差异、中西医结合防治提供理论支持,对指导感染后肠易激综合征的临床诊断和治疗具有重要意义。

糖尿病周围神经病变的中西医临床特点及相关性探讨

目的 :通过对 30 0例糖尿病周围神经病变 (DPN)患者的中西医临床特点分析 ,探讨中西医在发病及病理基础方面的相关性。方法 :对 30 0例DPN住院病人进行中医症状、舌象、脉象及西医临床表现 (症状、体征、血糖、血脂、血流变、神经传导速度测定 )的观察。结果 :在症状方面以麻木为多见 ;舌体以嫩为主 ,舌质以淡、暗为主 ,舌苔以薄白为主 ;中医证型以气虚血瘀最多见。现代医学方面 ,在有DPN并发症的同时 ,多合并其他大、微血管并发症 ,其中以糖尿病视网膜病变最多见。体征方面 ,以浅感觉、拇趾振动觉减退及踝反射减弱为主 ,虽自觉疲乏为主诉者较多 ,但肌力减退及肌萎缩者少见。实验室方面 ,血糖控制水平多不理想 ;有 5 0 %以上血脂升高 (甘油三脂和 或胆固醇和 或低密度脂蛋白 ) ;血流变异常者占 75 %以上 ,其中有 73 7%为血黏度升高 ;5 9 3%为纤维蛋白原升高 ;90 %以上神经传导速度减慢。结论 :DPN微循环障碍与中医的瘀血有着共同的发病及病理基础。无论是临床特点还是病理机制 ,中医与现代医学都有密切的相关性 。

基于中西医临床病证特点的子宫腺肌病动物模型分析

子宫腺肌病(AM)是临床上十分常见的一种女性疾病,对患者身心健康造成了极大的威胁。以“子宫腺肌病”为主题,设置年限为“2002-2022”,通过对CKNI、万方、维普网等近20年的动物模型进行分析,归纳各造模方法与中、西医临床病证的吻合程度,结果显示小鼠口服他莫昔芬法AM模型中西医临床吻合度较高,且具有操作简便、成本较低、成功率高等优点,是目前应用普遍、较为理想的动物模型。目前AM动物模型以西医的疾病模型为主,符合中医病证特点的模型少见。建立符合中医病证特点的模型是探寻中医中药防治的基础,因此构建中西医临床病证结合的动物模型是目前研究的首要任务。

基于中西医临床诊疗特点的烧(烫)伤动物模型分析

目的:分析基于中西医临床诊疗特点的烧(烫)伤及动物模型及应用。方法:通过查阅国内外近年来有关文献,从临床病症的烧(烫)伤特点及现代应用的烧(烫)伤动物模型等方面进行分析。结果:现有的烧(烫)伤动物模型表现出来烧(烫)伤程度与临床上主要的症状相似度比较高。结论:动物烧(烫)伤模型还有待改善,应更进一步的根据临床上患者的症状及指标进行改善,为临床提供更可靠的依据。

基于中西医临床病症特点变应性鼻炎动物模型分析

目的:基于变应性鼻炎临床病症特点,对目前现有的变应性鼻炎模型特点进行归纳分析。方法:通过整理分析中西医对变应性鼻炎的诊断标准及临床表现,总结变应性鼻炎动物模型的特点及造模方法,根据临床诊断标准及症状特点,对现有动物模型与临床症状的吻合程度进行探讨,明确其优缺点及应用前景。结果:变应性鼻炎动物模型造模方法多样,在一定程度虽反映了变应性鼻炎临床病症特点,但缺少能反映变应性鼻炎中西医特点的病症结合动物模型,无法充分体现变应性鼻炎中西医病因的动物模型。结论:探索能进一步反应变应性鼻炎临床病症特点,体现变应性鼻炎中西医病因,复制出能更加吻合临床病症特点的动物模型是今后的发展方向,为促进变应性鼻炎的防治提供可靠的模型。

基于中西医临床病症特点的癫痫动物模型分析

目的:基于癫痫疾病的中西医诊断标准,分析现有的癫痫动物模型,以期建立更加符合中西医临床病症特点的癫痫动物模型。方法:通过查阅国内外与癫痫动物模型相关的文献,对现有的造模方法进行总结;依据中西医临床诊断标准,对模型的吻合度进行判断并明确其优缺点。结果:癫痫常用的造模方法是电点燃和化学点燃,研究较多的慢性癫痫疾病模型为匹鲁卡品模型和海人酸模型,急性癫痫模型为最大电休克模型和戊四氮模型。现有的癫痫动物模型吻合度不高,缺乏中医干扰因素及评价体系。结论:现有的癫痫模型基本满足西医临床病证特点,但与中医病症吻合度低,在一定程度上限制了中医对该疾病的研究。因此建议在现有的癫痫模型上,施加中医干预因素,并建立完整的中医检测标准和评价体系,以期对癫痫疾病的实验室及临床研究提供参考。

Analysis of 610 cases inpatients with chronic heart failure

Objective： To analyze the clinical characteristics and medical treatment of hospitalized patients with chronic heartfailure, and provide medication for the patients. Methods： According to medical records of inpatients, demographicinformation, etiology, clinical features and treatment information were collected. Results： A total of 610 cases withheart failure from our hospital between July 2010 and June 2016 were analyzed. The average age of all the patientswas 63. Males accounted for 50.49%. There were 82.7% patients with NYHA functional classification at III-IV.31.3% patients with coronary artery disease, 28.4% with rheumatic heart diseases and 21.8% with expansion ofheart disease. 27.4 percent of the patients with the left ventricular ejection fraction lower than 40%. There were78.9% patients received aldosterone antagonist treatment, 63.4% received ACEI/ARB, 62.1% received digoxin,59.8% received beta blockers, and 75.4% patients received decoction, and 80.8% received Chinese patent medicine.Conclusion： The study has shown that high utilization of traditional Chinese medicine is to highlight theadvantages of the combination of traditional Chinese and western medicine in the treatment of heart failure. Theusage of spironolactone, ACEI/ARB, beta blockers in our hospital was lower than the ratio reported, higher thanthat of the national average. However, the use of diureticis is lower than that of national average, which may relateto the use of damp-clearing herbs. Clinicians should pay attention to the high utilization rate of digoxin. Patientswith the left ventricular ejection fraction 〉 50% accounted for 61.1%, which required more attention should be paidto the diagnosis and treatment of patients with heart failure of the ejection fraction remains.

Clinical characteristics of 96 patients with drug-induced acute liver failure:a comparison between Traditional Chinese and Western Medicine

OBJECTIVE: To compare the causes, clinical symptoms, laboratory test results, and prognosis in patients with acute liver failure(ALF) induced by traditional Chinese medicines(TCM) and by Western Medicines(WM).METHODS: The medical histories of patients who were diagnosed with drug-induced ALF(DALF)(n =96) after hospitalization in the 302 Military Hospital between January 2010 and December 2015 were retrospectively examined.RESULTS: Fifty-eight of the 96 DALF patients(60.4%) had a hepatocellular pattern of DALF, 16 patients(16.7%) had a cholestatic pattern, and 22 patients(22.9%) had a mixed pattern. DALF resolved in 24 patients(25.0%). Twenty-five patients(26.0%)developed chronic liver injury, 43 patients(44.8%)died, and 4 patients(4.2%) underwent liver transplantation. There were 42 ALF patients(43.8%) who received WM, and 32 ALF patients(33.3%) who received TCM. TCM-induced ALF patients had a higher average age [42.4 ± 18.4) vs(33.5 ± 17.9) years,P = 0.04] and higher creatinine and urine nitrogen levels [(155.2 ± 108.8) vs(97.5 ± 130.4) mmol/L, P =0.047;(9.1 ± 7.7) vs(4.3 ± 5.0) mmol/L, P = 0.002, respectively]. Patients with TCM-induced ALF exhibited an increased risk of renal injury [odds ratio(OR),3.75; 95% confidence interval(CI), 1.330-10.577].The 14 patients with TCM-induced ALF who died exhibited higher creatinine levels than the 18 patients with TCM-induced ALF patients who survived[(218.7 ± 111.6) vs(105.8 ± 78.4) mmol/L, P =0.002]. They were also more likely to exhibit ascites(85.7% vs 44.4%, P = 0.017) and hepatorenal syndrome(78.6% vs 22.2%, P = 0.002).CONCLUSION: TCM-induced ALF was more likely to be accompanied by renal injury than was WM-induced ALF, especially in TCM-induced ALF patients who died.