This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relev...This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: "ascites", "liver fibrosis", "cirrhosis", "chronic hepatitis", "chronic liver disease", "decompensated cirrhosis", "hepatic encephalopathy", "hypertransaminasemia", "liver transplantation" and "portal hypertension". Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology, Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications. Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis.展开更多
Objective The objective of this study was to analyze the status of the clinical application of Yufeng Ningxin(YFNX)preparations and systematically evaluate their efficacy and safety in the treatment of cardiovascular ...Objective The objective of this study was to analyze the status of the clinical application of Yufeng Ningxin(YFNX)preparations and systematically evaluate their efficacy and safety in the treatment of cardiovascular and cerebrovascular diseases.Methods Through searching databases of China National Knowledge Infrastructure,Wanfang,SinoMed,VIP,PubMed,Embase,and the Cochrane Library,the literature of clinical research on YFNX preparations in treating malignant tumors of cardiovascular and cerebrovascular diseases from the establishment of the databases to February 2021 was collected.The clinical randomized controlled trials and case-control studies of cardiovascular and cerebrovascular diseases treated with these preparations were analyzed.Two reviewers independently screened literature,extracted data,and assessed the risk of bias in the included studies,and meta analysis was performed by using ReMan 5.3 software to analyze the eficacy and safety of YFNX preparations in the treatment of cardiovascular and cerebrovascular diseases.Results A total of 29 clinical studies were finally included.The dosage forms were dropping plls,tablets,capsules,and granules.The preparations were used for the treatment of coronary heart disease,hypertension,neuropathic headache,etc.This study systematically evaluated the efficacy and safety of YFNX preparations in the treatment of coronary heart disease,hypertension,and nervous headache.A total of 1,162 cases were included in 13 studies,582 cases of the YFNX preparation group and 580 cases of the Western medicine group.The results of meta-analysis showed that the clinical efficacy of YFNX preparations combined with the Western medicine group in the treatment of coronary heart disease and hypertension,improving electrocardiogram and reducing the frequency and duration of angina attacks,was better than that of the simple Western medicine group,and the difference was statistically significant.Conclusion YFNX preparations are effective for coronary heart disease,hypertension,and neuropathic headache,and the adverse reactions are few.展开更多
Objective To explore the remote efficacy and safety of consciousness-restoring resuscitation （Xingnao Kaiqiao, short for XNKQ） acupuncture on cerebral infarction at recovery phase. Methods Two hundred and thirty-fou...Objective To explore the remote efficacy and safety of consciousness-restoring resuscitation （Xingnao Kaiqiao, short for XNKQ） acupuncture on cerebral infarction at recovery phase. Methods Two hundred and thirty-four cases of cerebral infarction at recovery phase were randomized into XNKQ group and routine acupuncture group （routine group） in light of SAS code. One hundred and sixteen cases in the XNKQ group were treated with XNKQ acupuncture （once a day, totally 4 weeks） and routine treatment with western medicine. One hundred and eighteen cases in the routine group received routine acupuncture and routine treatment with western medicine. Follow-up lasted 6 months. Primary indexes： the situations of survival, treatment and recurrence at the end of follow-up. Secondary indexes： assessment of nerve functions at the end of follow-up and rate of adverse events during acupunc- ture. Results In 6 months follow-up, the mortality was 0.86% and rate of continuous treatment was 36.21% in the XNKQ group and they were 1.69% and 36.44% respectively in the routine group. The differences did not present statistical significance between the two groups （X^2 = 0.29, P=0.59; X^2 = 0.32, P = 0.57）. Concerning to the decrease of recurrence rate and improvement of nerve functions, the out-comes in the XNKQ group were superior to those in the routine group （P〈0.01）. Severe adverse events did not happen in the two groups. Conclusion XNKQ acupuncture is safe therapy and its remote efficacy is superior to that of routine acupuncture in the decrease of recurrence rate and improvement of nerve functions.展开更多
文摘This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: "ascites", "liver fibrosis", "cirrhosis", "chronic hepatitis", "chronic liver disease", "decompensated cirrhosis", "hepatic encephalopathy", "hypertransaminasemia", "liver transplantation" and "portal hypertension". Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology, Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications. Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis.
基金supported by Tianjin Municipal Education Commission Scientifc Research Program(2021KJ170).
文摘Objective The objective of this study was to analyze the status of the clinical application of Yufeng Ningxin(YFNX)preparations and systematically evaluate their efficacy and safety in the treatment of cardiovascular and cerebrovascular diseases.Methods Through searching databases of China National Knowledge Infrastructure,Wanfang,SinoMed,VIP,PubMed,Embase,and the Cochrane Library,the literature of clinical research on YFNX preparations in treating malignant tumors of cardiovascular and cerebrovascular diseases from the establishment of the databases to February 2021 was collected.The clinical randomized controlled trials and case-control studies of cardiovascular and cerebrovascular diseases treated with these preparations were analyzed.Two reviewers independently screened literature,extracted data,and assessed the risk of bias in the included studies,and meta analysis was performed by using ReMan 5.3 software to analyze the eficacy and safety of YFNX preparations in the treatment of cardiovascular and cerebrovascular diseases.Results A total of 29 clinical studies were finally included.The dosage forms were dropping plls,tablets,capsules,and granules.The preparations were used for the treatment of coronary heart disease,hypertension,neuropathic headache,etc.This study systematically evaluated the efficacy and safety of YFNX preparations in the treatment of coronary heart disease,hypertension,and nervous headache.A total of 1,162 cases were included in 13 studies,582 cases of the YFNX preparation group and 580 cases of the Western medicine group.The results of meta-analysis showed that the clinical efficacy of YFNX preparations combined with the Western medicine group in the treatment of coronary heart disease and hypertension,improving electrocardiogram and reducing the frequency and duration of angina attacks,was better than that of the simple Western medicine group,and the difference was statistically significant.Conclusion YFNX preparations are effective for coronary heart disease,hypertension,and neuropathic headache,and the adverse reactions are few.
基金Supported by National 973 Project of China (2006CB504504)Tianjin Municipal Key Technologies Research Program(05YFGDSF02300)
文摘Objective To explore the remote efficacy and safety of consciousness-restoring resuscitation （Xingnao Kaiqiao, short for XNKQ） acupuncture on cerebral infarction at recovery phase. Methods Two hundred and thirty-four cases of cerebral infarction at recovery phase were randomized into XNKQ group and routine acupuncture group （routine group） in light of SAS code. One hundred and sixteen cases in the XNKQ group were treated with XNKQ acupuncture （once a day, totally 4 weeks） and routine treatment with western medicine. One hundred and eighteen cases in the routine group received routine acupuncture and routine treatment with western medicine. Follow-up lasted 6 months. Primary indexes： the situations of survival, treatment and recurrence at the end of follow-up. Secondary indexes： assessment of nerve functions at the end of follow-up and rate of adverse events during acupunc- ture. Results In 6 months follow-up, the mortality was 0.86% and rate of continuous treatment was 36.21% in the XNKQ group and they were 1.69% and 36.44% respectively in the routine group. The differences did not present statistical significance between the two groups （X^2 = 0.29, P=0.59; X^2 = 0.32, P = 0.57）. Concerning to the decrease of recurrence rate and improvement of nerve functions, the out-comes in the XNKQ group were superior to those in the routine group （P〈0.01）. Severe adverse events did not happen in the two groups. Conclusion XNKQ acupuncture is safe therapy and its remote efficacy is superior to that of routine acupuncture in the decrease of recurrence rate and improvement of nerve functions.
