谈中西药并用当注意的不利因素

从10个方面论述了中药与西药并用时当注意的不利因素。1、要注意形成难溶性物质,降低吸收率,影响药效;2、酸碱中和,改变原有中西药的酸碱环境;3.改变酶的活性,影响药物代谢;4.影响药物的排泄;5.产生毒性物质,导致药源性疾病;6、产生相加作用,使药效过强;7.产生拮抗作用,降低药效;8.用药重复累加,加重或诱发并发症;9.破坏成分,导致失效;10.炒炭类中药,要防止其吸附作用。

愈肝胶囊治疗慢性乙型活动性肝炎早期肝硬化临床观察

目的:探讨愈肝胶囊对慢性乙型活动性肝炎、早期肝硬化的治疗作用。方法:将153例随机分为2组,观察组78例,对照组75例。2组病人均给予西药治疗,(乙肝疫苗30ug肌注一月一次,肝泰乐片0.2,一日三次,口服,维生素C片0.2,一日3次,口服,潘生丁片25mg,一日3次。观察组在治疗组的基础上服用愈肝胶囊(主要成份:生黄芪、胎盘、人工牛黄、水蛭、乳香、没药、鳖甲、水牛角、珍珠粉)于治疗前后观察生化指标、肝纤维化指标变动情况。结果:观察组与对照组比较总有效率分别为:88.5%和78.7%,症状也有明显的改善。结论:愈肝胶囊配合西药治疗慢性乙型活动性肝炎早期肝硬化,疗效优于西药组。

Sirolimus inhibits growth of human hepatoma cells alone or combined with tacrolimus, while tacrolimus promotes cell growth

AIM: Standard immunosuppression after organ transplantation stimulates tumor growth. Sirolimus has a strong antiproliferative and a tumor inhibiting effect. The purpose is to assess the effect on tumor growth of the immunosuppressive compounds sirolimus and tacrolimus alone and in combination on cells of human hepatocellular carcinoma.METHODS: We used the human cell lines SK-Hep 1 and Hep 3B derived from hepatocellular carcinoma. Proliferation analyses after treatment with sirolimus, tacrolimus, or the combination of both were performed. FACS analyses were done to reveal cell cycle changes and apoptotic cell death. The expression of apoptosis-related proteins was estimated by Western blots.RESULTS: Sirolimus alone or combined with tacrolimus inhibited the growth of both cell lines after 5 d by up to 35% in SK-Hep 1 cells, and by up to 68% in Hep 3B cells at 25 ng/mL. Tacrolimus alone stimulated the growth by 12% after 5 ng/mL and by 25% after 25 ng/mL in Hep 3B cells. We found an increase of apoptotic Hep 3B cells from 6 to 16%, and a G1-arrest in SK-Hep 1 cells with an increase of cells from 61 to 82%, when sirolimus and tacrolimus were combined. Bcl-2 was down-regulated in Hep 3B, but not in SK-Hep 1 cells after combined treatment.CONCLUSION: Sirolimus appears to inhibit the growth of hepatocellular carcinoma cells alone and in combination with tacrolimus. Sirolimus seems to inhibit the growth stimulation of tacrolimus.

Jamu-A Healthy Drink of Indonesia

Jamu is traditional herbal medicine and a healthy drink considered by some Indonesians to be a primary element in their lives. The term ofjamu may be derived from ancient Javanese language ＂Djampi＂ that means a healing method using herb during the era of Ancient Java emerged since the 9th century AD. Jamu is consume either in fresh or in processed one. Some jamu sellers still found carrying their wares, in a basket fastened to their torsos using a sling made of fabric, and visit door to door in local neighborhoods. The name is Jamu gendong. The use of the j amu remains the same as the ancestors did. The visible proof is the use of traditional herbal medicine of various type of ＂medical plants＂, either from the leaves, the fruits, the roots, the flowers or the barks, etc. It is truly back to nature. These herbal medicine had been used since the ancient time up to now, it is largely consumed by people of different levels： lower, middle and upper, in the villages and in the big cities. Jamu as a cultural heritage has a big potential asset of Indonesia and is also one of Indonsia＇s cultural products based on local resources and the creativity of the nation. Indonesia has natural resourses of plants totaling about 30,000 species of flowering plants, which is the third largest in the world after Brazil and Zaire, including 7,000 species of medicinal plants, 940 species one could buy easily readymade jamu packed modernly in the form of powder, pills, capsules, drinking liquid and ointments. Of course there are still jamu shops, which only sell for those have been identified, 283 species are listed as raw materials that are used routinely in the medicine industry. Jamu from time to time has been widely accepted in almost every country in the world. It is not only as a preventive maintenance, but also as a curative treatment for acute and chronic treatment. At present ingredients ofjamu and its preparation spot as required by buyers. Some women are roaming the street to sell jamu, which is a common view across the country. At present time, jamu has also been produced in mass by manufacturers for export, and mostly concerns on quality, consistency, and cleanliness either locally or internationally distributed.

中西医结合治疗椎动脉型颈椎病96例

目的：观察平肝熄风、活血化瘀、涤痰定眩类中药配合西医支持、对症疗法（脱水、支持、扩张脑血管改善脑部血液循环等）治疗椎动脉型颈椎病眩晕的疗效。方法：治疗组在西医脱水、支持、扩张脑血管改善脑供血的基础上，加用自拟平肝化痰活血方（半夏、白术、云苓、陈皮、天麻、枳壳、砂仁、勾丁、葛根、丹参、川芎、赤芍）治疗本病96例，对照组予脱水、支持、扩管（20％甘露醇脱水、能量类药物支持、灯盏花素粉针、西比灵胶囊扩张脑血管改善脑部供血）治疗90例。结果：治疗组总有效率98．9％，对照组88．8％。（P〈0．05）提示：本方法对本病具有平肝熄风、活血化瘀、涤痰定眩，显著改善椎动脉供血，对解除患者临床症状具有明显疗效。

Effects of Chinese herbs in children with Henoch-Schonlein purpura nephritis:a randomized controlled trial

OBJECTIVE:To research the curative effect of Chinese herbs for clearing away heat,promoting diuresis,nourishing the kidney,and consolidating essence in children with Henoch-Schonlein purpura nephritis(HSPN)with internal accumulation of damp-toxin using randomized controlled observations on large samples.To seek the mechanism of the therapy and its scope of indications.METHODS:Overall,186 children with HSPN were randomly divided into two groups:treatment group(n=126)treated with Chinese herbs for clearing heat and promoting diuresis and a control group(n=60)treated with Western Medicine.The treatment was carried out for three courses of 4weeks each.We recorded changes in patient urine routines,24 h urinary protein,blood-coagulating series,immunoglobulin and T-cell subgroups,and improvements in main symptoms.We evaluated the alleviation of clinical symptoms and the improvement of proteinuria,hematuria,and other lab-oratory test results.Finally,we analyzed the patient population suitable for this therapy according to the relationship between the grouping of patient body weight and curative effect.RESULTS:Damp-heat syndrome improved in the treatment group,with a significant difference in total effective rate after a 4-week treatment(χ2=13.5220,P=0.0002)and in curative rate after a12-week treatment(χ2=6.3410,P=0.0118),compared to those in the control group.The curative effect in the treatment group was greater than that in the control group but there was no statistical difference between the two groups.The curative effect after a 4-week treatment of patients in the treatment group weighing 30 kg or less based on Traditional Chinese Medicine(TCM)signs and urinary protein was significantly greater than that in the control group.However,there was no statistical difference in the curative effect on urinary red cells and various indexes after a 12-week treatment between the two groups.CONCLUSION:Therapy for clearing away heat,promoting diuresis,nourishing the kidney,and consolidating essence using TCM is effective in children with HSPN from internal accumulation of damp-toxin.The therapy is especially suitable for patients weighing 30 kg or less.The curative effect may be related to the improvement of immune function and blood-coagulation.

Integrated Chinese-western therapy versus western therapy alone on survival rate in patients with non-small-cell lung cancer at middlelate stage

OBJECTIVE: To compare the effects of integrated Chinese-Western therapy versus Western therapy alone on the survival rate of patients with non-small-cell lung cancer (NSCLC) at middle-late stage and to evaluate prognostic factors. METHODS: We selected 98 inpatients with middle-late stage NSCLC diagnosed from March 2009 to March 2011 and randomly divided them into two groups, with 49 cases in each group, and the clinical data were analyzed retrospectively.The control group was treated by the combined methods of Western Medicine, including chemotherapy, supportive treatment and symptomatic treatment. The observation group was treated by injection and prescriptions of Chinese medicine based on Traditional Chinese Medicine syndrome differentiation and by the same combined methods of western treatment used in the control group. After treatment, the survival rates of the patients were compared by the stage of cancer and evaluation of 24 prognostic factors analyzed by a Cox regressionmodel, and the clinical data were statistically analyzed. RESULTS: The survival rates of all patients were over 90.0% at 1 and 3 months after treatment with no significant differences between the two groups (P>0.05); In the observation group the survival rates at 6 months and 1 year were 93.4% and 42.8%, respectively, being superior to 85.6% and 18.3% in the control group (P<0.05). The median survival time in the observation group was superior to the control group (P<0.05); The effects of 24 prognostic factors were significantly better in the observation group than in the control group (P<0.05). CONCLUSION: Integrated Chinese-western therapy can significantly improve the survival rate in patients with middle-late stage NSCLC and improve prognostic factors compared with western therapy alone.

Meta-analysis on integrative medicine for the treatment of malignant ascites: a comparative study

OBJECTIVE: To compare the efficacy of integrated Chinese and Western Medicine with that of only Western Medicine for the treatment of malignant ascites.METHODS: All randomized controlled trials(January 2004 to March 2013) from the China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, and Wanfang Database were searched with keywords. Meta-analysis was conducted by combining the odds ratios of the individual studies. Review Manager 5.0 was used for the analysis.RESULTS: One thousand one hundred and fifty-six patients from 19 randomized controlled trails were included. Of them, 630 patients were treated with integrated Chinese and Western Medicine(the integrative group), and 526 patients were treated with Western Medicine alone(the control group). The Meta-analysis showed that the total effective rate was 78.73% in the integrated group, and 59.13% in the control group. The effective percentage was sig-nificantly higher in the integrative group than that of the control group [OR = 2.85, 95% CI(2.16,3.74),P < 0.01].CONCLUSION: The short-term curative effect in the integrative group was better than that in the control group. Integrative medicine may be beneficial for malignant ascites.

Efficacy and safety of puerarin injection in treatment of diabetic peripheral neuropathy: a systematic review and Meta-analysis of randomized controlled trials

OBJECTIVE: To systematically evaluate the clinical efficacy and safety of puerarin injection in the treatment of diabeticperi pheral neuropathy(DPN).METHODS: Randomized controlled trials investigating the efficacy of puerarin injection on DPN were searched for in China National Knowledge Infrastructure Database, Chinese Scientific Journals Database, Wanfang Database, Chinese Biomedical Literature Database, PubMed, and Cochrane Library from establishment to April 30.Two reviewers independently retrieved and extracted the information.The included studies were assessed by the Cochrane risk of bias and analyzed by Review Manager 5.2 software.RESULTS: Twenty-two studies involving 1664 participants were included. The quality of the studies was found to be relatively low. Meta-analysis showed that puerarin injection combined with western medication was more effective than conventional therapy for rate, nerve conduction velocity(NCV), and hemorheology index. Six adverse drug reactions(ADRs) from puerarin injection were reported in two studies. Reactions included facial flushing, palpitations, and pain at infusion locations. However,noserious ADRs were reported.CONCLUSION: Puerarin injection was effective for the treatment of DPN. Puerarin can improve the total effective rate, correct NCV that was decreased by diabetes, and improve the hemorheology index.Puerarin was also relatively safe clinically. However,since the articles included in the study were not high-quality, more studies should be conducted to strengthen their findings.

Comparison of clinical effectiveness of acupuncture and a Western drug on allergic rhinitis:study protocol for a randomized controlled trial

OBJECTIVE： To compare the efficacy of an acu- puncture regimen for persistent allergic rhinitis （PER）, aimed at improving a patient＇s mind or Shen in Traditional Chinese Medicine, to that of a sec- ond-generation H-receptor antagonist, cetirizine hydrochloride. METHODS： This multicenter, randomized, con- trolled clinical trial on PER will be conducted at three institutions in China. The total study period will be 9 weeks. After a 1-week preparatory screen- ing period, 240 eligible participants with PER willbe randomized to receive acupuncture or pharma- cotherapy （1： 1） for 4 weeks with a 4-week fol- low-up. The primary outcome will be changes in 7-day average total nasal symptom score. Second- ary outcome measures include rhinoconjunctivitis quality of life questionnaire score and total non-na- sal symptom score. RESULTS： The presence and seriousness of psycho- logical and emotional impairments should be con- sidered in therapeutic programs for allergic rhinitis. No clinical trial for treating allergic rhinitis via acu- puncture regulation of psychological and emotion- al activities has been reported. CONCLUSION： The findings of the trial will allow us to determine the effects of the mind （Shen）-regula- tion treatment approach. We will also be able to confirm if the effects of acupuncture are equivalent to those of the conventional drug cetirizine hydro- chloride.

Characteristics and Advantages of Traditional Chinese Medicine in the Treatment of Acute Myocardial Infarction

Objective: To obtain epidemiological data on Traditional Chinese Medicine (TCM) therapeutic status of acute myocardial infarction (AMI) and to determine TCM characteristics and advantages to improve the level of TCM prevention and treatment of AMI. Methods: Clinical epidemiology methods were used to register and survey the TCM therapeutic status of hospitalized AMI patients. In 2001, the Chinese Association of Integrative Medicine surveyed the therapeutic status of 3308 AMI patients hospitalized in 30 hospitals in Beijing and Shanghai from 2000-2001. The Beijing Collaborative Study Group on Therapeutic Status of Acute Myocardial Infarction (the Study Group) then conducted a 10-year-long register survey on hospitalized AMI patients in Third-grade A-Level TCM hospitals in Beijing. After 2002, the Study Group further surveyed the treatment conditions of AMI-hospitalized patients in 10 Second-grade A-Level TCM hospitals. The therapeutic status in 8 Third-grade A-Level Western medicine hospitals was surveyed in 2001 and 2005 as a control. In 2008, in cooperation with the China Association of Chinese Medicine, the Study Group further performed a survey at 26 Third-grade A-Level TCM hospitals nation-wide. Approximately 5000 cases were investigated to obtain authoritative data on the therapeutic status of AMI patients in TCM hospitals in China. Results: We found that Chinese herbal intravenous preparations may be beneficial in reducing the mortality of AMI. Major complications of AMI, such as heart failure and arrhythmia, were significantly less during the 10-year survey period. The mortality of hospitalized AMI patients showed a decline. TCM treatment was helpful for AMI patients in improving their quality of life. Ten-year dynamic monitoring showed that the ability to perform reperfusion and to use drugs appropriately, as well as an effort to carry out the Clinical Guidelines has made great progress in TCM hospitals. However, TCM hospitals still have some problems in treating AMI, including a lack of standardized TCM syndrome diagnosis, the need for syndrome differentiation and treatment standardization, and clinical skills in reperfusion and standardized drug treatment still need to be further improved. Compared with AMI patients in Western medicine hospitals during the same period, those in TCM hospitals had the following characteristics: they were admitted to hospital later; they were older when they had a heart attack; there were more females, they had more problems in their medical history, and they had more concomitant illnesses and complications. Therefore, the demographic baseline data were significantly different between AMI patients in TCM hospitals and those in Western medicine hospitals. This indicated that patients in TCM hospitals were more critical than those in Western medicine hospitals. Conclusions: TCM has special advantages in treating AMI. TCM hospitals are making continuous progress in standardized treatment of AMI, but further improvement is still required. AMI patients in TCM hospitals have some special characteristics, and their condition may be more critical. Further clinical research on TCM treatment of AMI is required.

A case of Galen vein thrombosis occurring after bilateral acetabular fractures in the Tibet plateau - what can we learn？

Hypoxia leads to increased red blood cells and blood viscosity at high altitude while moderate trauma increases coagulation in blood. Under the above-mentioned conditions, venous sinus thrombosis is more likely to occur. A patient suffering bilateral acetabular fractures together with the gradual disturbance of consciousness was admitted to our hospital. Though computed tomography arteriogram （CTA） of the brain displayed normal blood vessels; bilateral thalamus and brainstem infarction were found on head computed tomography （CT} and Galen vein thrombosis on cerebral computed tomography venography （CTV）. Dehydration and tracheotomy were immediately conducted with antiplatelet, anticoagulant and neurotrophic medicine administered to the patient. After three days＇ treatment, the patient＇s con- sciousness gradually improved and eventually became clear enough to leave the hospital. On follow-up, no dysfunction was documented.