Cytokine release syndrome triggered by programmed death 1 blockade(sintilimab)therapy in a psoriasis patient:A case report

BACKGROUND In recent years,immune checkpoint inhibitors(ICIs)have demonstrated remarkable efficacy across diverse malignancies.Notably,in patients with advanced gastric cancer,the use of programmed death 1(PD-1)blockade has significantly prolonged overall survival,marking a pivotal advancement comparable to the impact of Herceptin over the past two decades.While the therapeutic benefits of ICIs are evident,the increasing use of immunotherapy has led to an increase in immune-related adverse events.CASE SUMMARY This article presents the case of a patient with advanced gastric cancer and chronic plaque psoriasis.Following sintilimab therapy,the patient developed severe rashes accompanied by cytokine release syndrome(CRS).Fortunately,effective management was achieved through the administration of glucocorticoid,tocilizumab,and acitretin,which resulted in favorable outcomes.CONCLUSION Glucocorticoid and tocilizumab therapy was effective in managing CRS after PD-1 blockade therapy for gastric cancer in a patient with chronic plaque psoriasis.

Effect of the Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia

Objective: To investigate the effect of Chinese medicine prescription-Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia and its influence on the immune function. Methods: A total of 48 Wistar rats were randomly divided into the normal control group, the damp-heat syndrome model group, the Haoqinqingdan decoction group (high, medium and low dose group) and the ribavirin group. The body temperature and weight of rats in each group were recorded after modeling. After treatment for 6 d, the concentration of T lymphocyte subgroup (CD3+ CD4+ , CD3+ CD8+ ) was determined by flow cytometry. The OD value of IFN毭/IL-4 was detected by double-antibody sandwich ELISA method, and its concentration was acquired through conversion. Results: After modeling, the temperature and weight of rats in each modeling group showed the increasing trend ( P<0.01). From the second day of treatment, there was significant difference in the body mass between groups, and the rat weight of the control group was higher than in the modeling group ( P<0.05 or 0.01). With the advances of treatment, only the temperature in the medium and high dose Haoqinqingdan decoction groups declined significantly ( P<0.05). After treatment, the CD4+ /CD8+ ratio of the damp-heat syndrome model group decreased more significantly compared with the control group. Elevated CD3+ CD8+ percentages and declined CD4+ /CD8+ ratios can be observed in the low dose group and ribavirin group ( P<0.05). Moreover, the CD3+ CD4+ percentage of ribavirin group was lower than in the control group ( P<0.05). After treatment, the IFN-毭 and IFN-毭/ IL-4 levels in the peripheral blood of rats in the dampheat syndrome group were obviously higher than in the control group ( P<0.05). Conclusions: Compared with ribavirin, the high dose Haoqinqingdan decoction can improve the ratio of T lymphocyte subgroup and Th1/Th2 cell balance more effectively.

Clinicopathological features and expression of regulatory mechanism of the Wnt signaling pathway in colorectal sessile serrated adenomas/polyps with different syndrome types

BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can also develop into CRCs through the serrated pathway.Sessile serrated adenomas/polyps(SSAs/Ps),a type of serrated polyps,are easily misdiagnosed during endoscopy.AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types.METHODS From January 2021 to December 2021,patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital,affiliated with Shanghai University of Traditional Chinese Medicine.Thirty cases each of large intestine damp-heat(Da-Chang-Shi-Re,DCSR)syndrome and spleen-stomach weakness(Pi-Wei-Xu-Ruo)syndrome were reported.Baseline comparison of the general data,typical tongue coating,colonoscopy findings,and hematoxylin and eosin findings was performed in each group.The expression of the Wnt pathway-related proteins,namelyβ-catenin,adenomatous polyposis coli,and mutated in colorectal cancer,were analyzed using immunohistochemistry.RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types(P=0.001).The other aspects did not differ between the two groups.The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups,which was manifested asβ-catenin protein translocation into the nucleus.However,SSAs/Ps patients with DCSR syndrome had more nucleation,higherβ-catenin expression,and negative regulatory factor(adenomatous polyposis coli and mutated in colorectal cancer)expression(P<0.0001)than SSA/P patients with Pi-Wei-Xu-Ruo syndrome.In addition,the SSA/P size was linearly correlated with the related protein expression.CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis.A high-quality colonoscopic diagnosis was essential.The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.

The role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease

Objective:To explore the role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease(DKD).Methods:A total of 183 patients with DKD were divided into 3 groups:the early DKD group,established DKD group,and advanced DKD group.All patients were classified according to traditional Chinese medicine(TCM)syndrome type,and clinical indexes were collected for statistical analysis.Results:A total of 183 DKD patients were included in this study.Fibroblast growth factor 23(FGF23),chitinase-3-like protein 1(CHI3L1),endocan,tumor necrosis factor receptor 1(TNFR1),secretory leukocyte protease inhibitor(SLPI),and vascular endothelial growth factor A(VEGF-A)were increased in advanced DKD.FGF23,CHI3L1,endocan,SLPI,and TNFR1 showed a negative correlation with estimated glomerular filtration rate(eGFR),while they had a positive correlation with 24 h urine protein.After adjusting for age,gender,diabetes duration,body mass index(BMI),hemoglobin,glucose,uric acid,24 h urine protein,cholesterol,triglyceride,low-density lipoprotein,and hemoglobin A1c(HbA1c),the multiple regression analysis showed that FGF23,endocan,TNFR1,and SLPI significantly correlated with eGFR.Conclusions:FGF23,endocan,TNFR1,and SLPI are elevated in advanced DKD compared with early stage,and they may take part in the pathogenesis and progression of DKD.Our study provides useful biomarkers for predicting the appearance of damp-heat syndrome,including FGF23,endocan,TNFR1,and SLPI.

Efficacy of Pidan Jianqing decoction in treatment of type 2 diabetes with spleen deficiency and damp-heat syndrome

Introduction:This study aimed to assess the clinical efficacy of Pidan Jianqing decoction in the treatment of type 2 diabetes.Methods:A total of 72 patients with type 2 diabetes differentiated as spleen deficiency with damp-heat syndrome were randomly assigned to a treatment group(n=35)or control group(n=32).Patients in the control group received diet and exercise guidance and medication in the form of 0.5 g metformin hydrochloride tablets,while patients in the treatment group received Pidan Jianqing decoction in addition to the treatment given to the control group.Efficacy was evaluated after 8 weeks of treatment.Results:Efficacy was 91.4%in the treatment group versus 68.8%in the control group,which was a statistically significant difference(P<0.05).Significant group differences were also noted in the number of patients with improvement in symptoms such as dry mouth and polydipsia,frequency of urination and polyuria,abdominal distention and loss of appetite,fatigue and weakness,and sticky stools(all P<0.05),with greater improvement in the treatment group compared to the control group.The fasting blood glucose(FBG)and 2 h postprandial blood glucose levels significantly improved in both groups after treatment(P<0.05);however,there was no significant difference in glycated hemoglobin levels before and after treatment in both groups.Conclusion:Pidan Jianqing decoction can lower blood glucose levels and improve symptoms in patients with type 2 diabetes.

经筋推拿联合穴位熏蒸治疗肩周炎(寒湿痹阻证)临床观察

目的观察经筋推拿结合穴位熏蒸治疗肩周炎(寒湿痹阻证)的临床疗效。方法将60例患者用随机数字表法分为对照组(常规推拿结合穴位熏蒸)与观察组(对照组基础上加经筋手法)各30例,对比两组诊疗前后的视觉模拟疼痛量表(VAS)评分,前屈、后伸、内旋、外展4个维度的肩关节活动角度(ROM)变化以及两组临床疗效。结果观察组临床总有效率为90.00%,显著高于对照组的83.33%(P<0.05);两组治疗后VAS评分比较,观察组显著低于对照组(P<0.05);两组治疗后ROM比较,观察组的前屈、后伸、内旋、外展的数值均大于对照组(P<0.05)。结论经筋推拿结合穴位熏蒸治疗肩周炎(寒湿痹阻证)临床疗效确切,可以有效缓解疼痛,显著扩大肩关节的活动角度和改善肩部功能状态。

部分神经肌肉阻滞在急性呼吸窘迫综合征肺与膈肌保护性通气中的应用

肺与膈肌保护性通气,是对急性呼吸窘迫综合征患者实施正压机械通气过程中需要遵守的基本原则。为了避免强烈的自主呼吸驱动导致的跨肺压增加和膈肌过载性损伤,神经肌肉阻滞被推荐用于中重度急性呼吸窘迫综合征的早期治疗阶段,但会引起以膈肌废用性萎缩为特征的膈肌功能障碍。部分神经肌肉阻滞通过滴定式调节神经肌肉阻滞剂的药物剂量,可以在保留膈肌活性的同时将呼吸驱动的强度控制在安全范围内,是一种可行的肺与膈肌保护性通气策略。本综述旨在对相关领域的研究现状进行总结,以期对目前的临床实践提供指导,并为未来的相关研究方向提供思路。

牵正散合活血通络汤治疗脑梗死恢复期风痰瘀阻证患者疗效及神经功能缺损的影响

目的:探讨牵正散合活血通络汤对治疗脑梗死恢复期风痰瘀阻证患者疗效及神经功能缺损的影响。方法:选取2022年5月~2023年4月在我院就诊的脑梗死恢复期的患者106例,采用随机数字表法将患者分成对照组和观察组,各53例。对照组给予常规西药治疗,观察组在对照组的基础上采用牵正散合活血通络汤治疗,两组均持续治疗12周。比较两组中医症候积分、临床疗效、神经功能缺损情况和日常生活能力[美国国立卫生院卒中量表(NIHSS)和改良Barthel指数(MBI)量表]、血液流变学参数及安全性。结果:治疗后,2组主症、次症及总分较治疗前降低,观察组更低(P<0.05)。观察组临床总有效率高于对照组(88.68%vs.71.70%,P<0.05)。治疗后,两组NIHSS评分降低,MBI评分升高(P<0.05),与对照组相比,观察组NIHSS评分更低,MBI评分则更高(P<0.05)。与治疗前相比,治疗后2组低切全血黏度、红细胞比容及纤维蛋白原水平均下降(P<0.05),观察组上述血液流变学参数较对照组均下降(P<0.05)。两组不良反应总发生率比较(对照组7.55%vs.观察组1.89%),差异无统计学意义(P>0.05)。结论:脑梗死恢复期风痰瘀阻证患者运用牵正散合活血通络汤治疗可缓解临床症状,提高疗效,促进神经功能修复,提升日常生活能力,改善血液流变学,且不增加不良反应。

葛根二陈汤结合针刺对痰湿阻滞型精神分裂症患者的疗效分析

目的:观察葛根二陈汤结合针刺对痰湿阻滞型精神分裂症患者的疗效。方法:选择2021年2月—2023年2月于福清市第八医院就诊的精神分裂症患者82例,采用随机数字表法分为对照组(n=41)与联合组(n=41)。两组均给予奥氮平口服治疗,对照组另给予针刺治疗,联合组在对照组基础上给予葛根二陈汤口服治疗。观察两组临床疗效、精神症状、中医症候积分、认知功能与不良反应。结果:治疗后,联合组阳性和阴性精神症状评定量表(PANSS)各项评分均较对照组低,差异均有统计学意义(P<0.05);联合组治疗总有效率较对照组高,差异有统计学意义(P<0.05);治疗后,联合组主症与次症积分均低于对照组,差异均有统计学意义(P<0.05);治疗后,联合组威斯康星卡片分类测验(WCST)中正确应答数(RC)、完成分类数(CC)与正确应答百分比(RCP)均高于对照组,非持续性错误(NRPE)、持续性错误数(RPE)、持续性错误的百分数(RPEP)均低于对照组,差异均有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:葛根二陈汤结合针刺应用于痰湿阻滞型精神分裂症治疗中可以改善患者精神症状,提高认知功能,疗效确切,安全性较高。

续命汤化裁方治疗脑梗死(风痰瘀阻证)的疗效及对脑血流动力学指标的影响

目的观察续命汤化裁方治疗脑梗死(风痰瘀阻证)的疗效及对脑血流动力学指标的影响。方法将脑梗死患者80例按随机数字表法分为对照组与治疗组各40例。对照组根据指南进行常规治疗;治疗组在对照组的基础上给予续命汤化裁方内服。两组均治疗2周。比较美国国立卫生院神经功能缺损量表(NIHSS)评分、生活能力Barthel指数评分、风痰瘀阻证症状评分、疗效以及脑血流动力学指标。结果治疗后,两组的NIHSS评分明显降低,Barthel指数评分显著上升,治疗组上述指标评分改善更为显著(P<0.01);治疗后,两组风痰瘀阻证症状评分明显降低,治疗组降低更为明显(P<0.01);治疗组总有效率为92.50%,明显高于对照组的72.50%(P<0.05);治疗后,两组双侧大脑中动脉的平均血流流速(Vm)明显升高,血管阻力指数(RI)显著降低,治疗组以上指标较对照组改善更为明显(P<0.01)。结论在西医常规干预措施基础上,运用续命汤化裁方治疗脑梗死(风痰瘀阻证)的疗效更优,能够更有效地改善患者的神经功能缺损、生活质量以及脑血流动力学指标。

通瘀煎治疗冠心病稳定型心绞痛急性发作(心血瘀阻证)的疗效观察

目的观察通瘀煎治疗稳定型心绞痛(SAP)急性发作(心血瘀阻证)患者的疗效。方法筛选SAP急性发作(心血瘀阻证)患者102例,用随机数字表法分为两组。对照组以指南为参考标准采取西医常规干预措施,治疗组在对照组的基础上加用通瘀煎内服。两组均治疗2周。比较两组心绞痛发作和硝酸甘油用量、心血瘀阻证症状评分、心功能指标、临床疗效。结果治疗后,两组心绞痛发作频率、持续时间以及硝酸甘油用量显著减少,且治疗组以上3项指标均明显少于对照组(P<0.01);治疗后,两组心血瘀阻证证候评分明显降低,且治疗组显著低于对照组(P<0.01);治疗后,两组心功能指标左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)明显降低,左室射血分数(LVEF)显著增加,且治疗组以上心功能指标改善显著优于对照组(P<0.01);治疗组的总有效率(90.20%)明显高于对照组(72.55%)(P<0.05)。结论于西医常规干预措施的基础上,加用通瘀煎治疗SAP急性发作(心血瘀阻证)患者的疗效更优,能缓解心绞痛发作,改善中医证候和心功能。

基于“阳化气,阴成形”理论辨治阴虚湿阻证

阴虚湿阻证是病性虚实夹杂的一类证型,在代谢性疾病、呼吸系统疾病、疲劳综合征、亚健康状态等临床辨证中均为多见。临床上阴虚与湿邪停滞的矛盾病理状态容易并存,又因湿邪缠绵难除,阴虚正亏难复,辨证、治疗皆属不易。从《黄帝内经》“阳化气,阴成形”理论角度分析,阴血津液亏虚、阳化气不足、阴成形太过是阴虚湿阻证形成的关键,本着“治病必求于本”,辨治时当虚实兼顾、邪正并调,助阳化湿不伤阴、滋阴养形不助湿,使阴津复、气得化、湿浊除,方可达到《伤寒论》“津液自和”的思想。该文着眼于阴虚湿阻证这一津液类病证,对其因、机、症、治展开探讨,以期启发临床实践,并为从“津液自和”论治感染新冠后疲劳综合征提供思路。

Logistic Regression Analysis of Damp-Heat and Cold Damp Impeding Syndrome of Rheumatoid Arthritis:A Perspective in Chinese Medicine

Objective： To investigate a method for quantitative differential diagnosis of damp-heat and cold-damp impeding syndrome of rheumatoid arthritis （RA） in Chinese medicine （CM）. Methods： Laboratory parameters were collected from 306 patients with RA. The clinical symptoms and laboratory parameters were compared between patients with these two syndromes （158 with RA of damp-heat impeding syndrome, and 148 with RA of cold-damp impeding syndrome）, and a regression equation was established to facilitate discrimination of the two RA syndromes. Results： There were significant differences in disease activity score in 28 joints [DAS28 （4）], erythrocyte sedimentation rate （ESR）, white blood cell count （WBC）, C-reactive protein （CRP）, platelet count （PLT）, albumin （ALB） and globulin （GLB） between the two syndrome of RA （P〈0.05）. Logistic regression analysis showed that the parameters ESR, WBC, CRP, joint pyrexia, joint cold, thirst, sweating, aversion to wind and cold, and cold extremities were statistically useful to discriminate damp-heat from cold-damp impeding syndrome. The regression equation was as follows： P=1/{1＋exp[-（3.0-0.021X1-0.196X2-0.163X3- 1.559X4＋1.504X5-0.927X6-1.039X7＋1.070X8＋1.330X9）]}. The independent variables X1-X9 were ESR, WBC, CRP, hot joint, cold joint, thirst, sweating, aversion to wind and cold, and cold limbs. A P value 〉 0.5 signified cold-damp impeding syndrome, and a P value 〈 0.5 signified damp-heat impeding syndrome. The accuracy was 90.2%. Conclusion： The regression equation may be useful for discriminating damp-heat from cold-damp impeding syndrome of RA.

NFKB1基因多态性与冠心病(心血瘀阻证)及炎症因子的相关性研究

目的 探讨NFKB1启动子区-94ins/del ATTG(rs28362491)与冠心病(心血瘀阻证)及炎症因子的关系。方法 选取冠心病患者173例,根据中医辨证分型,分为心血瘀阻证69例和非心血瘀阻证104例,同期非冠心病患者107例为对照组。采用聚合酶链反应-限制性片段长度多态性技术分析NFKB1-rs28362491基因多态性,检测肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平。结果 冠心病(心血瘀阻证)NFKB1基因多态性位点DD基因型及D等位频率明显高于冠心病非心血瘀阻证及对照组(P <0.05);冠心病(心血瘀阻证)患者血清TNF-α、IL-6、IL-8水平明显高于冠心病非心血瘀阻证及对照组(P <0.05);DD基因型组TNF-α、IL-6、IL-8水平均高于ID和II基因型组(P <0.05)。结论 NFKB1-rs28362491基因多态性与冠心病(心血瘀阻证)有关联,DD基因型可能干预TNF-α、IL-6、IL-8水平成为冠心病(心血瘀阻证)易感性遗传因素。

Objective Tongue Inspection on 142 Liver Cancer Patients with Damp-Heat Syndrome

Objective： To establish the diagnosis evidence of objective tongue inspection for liver cancer （LC） patients with damp-heat syndrome （DHS） by dynamically observing their tongue figures using modern tongue image analytic apparatus, and to explore the effect of intervention on the tongue figures. Methods： Tongue figures were collected from 142 LC patients with DHS by tongue image analytic apparatus. Red （R）, green （G） and blue （B） values were analyzed. The r and g values were calculated requesting r=R/（R＋G＋B）, g=G/（R＋G＋B）, and b=l-r-g, and scored in combination with Chinese medical symptoms scale. The tongue figure and correlated scores were collected from 59 of them 3 days after transcatheter arterial chemoembolization intervention. Results： The range of objective tongue inspection of LC patients with DHS was as follows： as for tongue fur, 0.360〈r〈0.402 and 0.280〈g〈0.322; as for tongue proper, 0.404〈r〈0.470 and 0.243〈g〈0.301. The tongue figures and the average scores of quality of life, DHS, poor appetite, aggravated pain, decreased sleep quality and aggravated fever were obviously changed in the 59 LC patients with DHS after intervention, showing statistical difference when compared with before intervention （P〈0.05 or P〈0.01）. Conclusion： The range of objective tongue inspection of LC patients with DHS could be known by collecting and analyzing objective indicator of tongue figures, thus laying foundation for further studies with analysis of correlation between intervention and Chinese medicine based on tongue figures.

后路针刀治疗前斜角肌综合征的临床疗效研究

目的:研究后路针刀治疗前斜角肌综合征的临床疗效。方法:将100例前斜角肌综合征患者随机分成3组,按针刀、针灸、封闭3种治疗方法分别进行治疗,分别于患者治疗结束后1周、1个月、3个月时进行随访,将患者按疗效分成4级:治愈、显效、有效和无效,治疗组分别与对照组(针灸组和封闭组)比较疗效优良率和有效率,根据统计分析结果评定后路针刀治疗前斜角肌综合征的临床疗效及意义。结果:治疗结束后1周时,针刀组疗效明显优于针灸组,封闭组和针刀组疗效同样有效。治疗结束后1个月、3个月时,针刀组疗效明显优于针灸组和封闭组,封闭组的疗效不断减退。结论:后路针刀是治疗前斜角肌综合征的有效治疗方法。

肋间神经阻滞治疗285例开胸手术后疼痛综合征的回顾性分析

目的回顾性分析肋间神经阻滞治疗开胸手术后疼痛综合征(PTPS)的效果,并探讨影响疗效的相关因素。方法 选择完成5次肋间神经阻滞治疗的PTPS患者285例,采用疼痛缓解程度评分法,以总疼痛缓解总百分率50%为界分为治疗有效(A)组和治疗无效(B)组,记录两组患者的性别、年龄、术前有无胸背部疼痛、手术部位、术后放化疗、术后情绪、治疗前疼痛持续时间、治疗前疼痛视觉模拟评分(VAS评分)等,分析上述因素与疗效的相关性。结果 治疗后患者总疼痛缓解总百分率>50%者占29.5%(84/285)。两组间年龄、术前有胸背痛、手术取右侧胸部切口、治疗后行化疗、治疗前疼痛VAS评分的差异均无统计学意义(P值均>0.05)。A组治疗后接受胸部放疗和术后情绪低落者的构成比均显著低于B组(P值均<0.05),治疗前疼痛持续时间亦显著短于B组(P<0.05)。性别、手术部位、术后接受胸部放疗、术后情绪低落、治疗前疼痛持续时间与治疗后疼痛缓解程度的总相关性为76.4%,其中治疗前疼痛持续时间的相关性为69.7%。治疗前疼痛持续时间与治疗后疼痛缓解程度呈负相关(r=-0.635,P<0.05)。结论 PTPS的病因主要为直接或间接的肋间神经损伤,影响其疗效的因素涉及整个围术期,早期治疗是提高疗效的关键。

湖南地区类风湿关节炎中医证型与临床检测指标关系研究

目的探索湖南地区类风湿关节炎(Rheumatoid arthritis,RA)中医证型与临床检测指标的关系,为RA临床辨证论治提供参考依据。方法采集2015年1月-2016年5月于湖南中医药大学第一附属医院风湿科就诊且确诊为RA病历资料299例。采用Epidata 3.1建立数据库,并采用SPSS 22.0软件进行数据处理,分析RA中医证型与类风湿因子、血沉、C反应蛋白、肝功能等临床检测指标关系。结果血沉:湿热痹阻证血沉表达水平与肝肾阴虚证比较,差异有统计学意义(P=0.021)。类风湿因子:各证型间的类风湿因子表达水平比较,差异无统计学意义(P>0.05)。C反应蛋白:湿热痹阻证表达水平与寒湿痹阻证比较,差异具有统计学意义(P=0.022)。肝功能:RA各证型球蛋白平均表达量均高于正常值,白球比均低于正常值,但各证型间比较,差异无统计学意义(P>0.05)。结论 RA中医证型与临床检测指标存在一定关系,血沉是潜在的湿热痹阻证与肝肾阴虚证辨证指标,C反应蛋白是潜在的湿热痹阻证与寒湿痹阻证辨证指标,但其临床检验效能尚有待于进一步研究。

大面积艾绒温灸对寒湿痹阻型腰椎间盘突出症下肢麻木的影响

目的探讨大面积艾绒温灸对寒湿痹阻型腰椎间盘突出症下肢麻木患者的影响。方法分析四川省眉山市中医医院2017年7月～2018年3月收治的100例寒湿痹阻型腰椎间盘突出症下肢麻木患者的临床资料,依据治疗方式不同分为对照组(常规针刺)和观察组(大面积艾绒温灸),各50例。观察两组患者治疗前后视觉模拟评分(VAS)、日本骨科协会评估治疗分数(JOA)、腰椎活动度情况,比较两组患者的临床效果、满意度和3个月内复发率情况。结果两组患者治疗前VAS评分、JOA评分、腰椎活动度比较,差异均无统计学意义(P> 0.05)。治疗后两组VAS评分低于治疗前,JOA评分、腰椎活动度高于治疗前,且观察组治疗后VAS评分低于对照组,JOA评分、腰椎活动度高于对照组,差异有统计学意义(P <0.05)。观察组临床治疗总有效率、满意度高于对照组,3个月内复发率低于对照组,差异有统计学意义(P <0.05)。结论大面积艾绒温灸应用于寒湿痹阻型腰椎间盘突出症下肢麻木患者可以减轻疼痛,提高预后恢复和疗效,降低复发率,值得临床推广应用。

醒脑静治疗中风中脏腑的临床疗效观察

目的探析中风中脏腑患者应用醒脑静治疗的临床效果。方法将我院48例2015年1月~2018年12月收治的中风中脏腑患者根据辨证分型分成两组,甲组(痰火瘀闭证,n=24)和乙组(痰浊瘀闭证,n=24),两组患者均给予醒脑静注射液静脉滴注治疗,比较分析两组临床疗效、治疗前后主要症状评分、神经功能缺损程度评分。结果甲组总有效率为95.83%,明显比乙组(75.00%)高,差异有统计学意义(P <0.05)。两组治疗后神识欠清、牙关紧闭、口噤不开、肢体强痉症状评分与治疗前比较,差异有统计学意义(P <0.05),且甲组各症状评分均显著低于乙组,差异有统计学意义(P <0.05)。两组治疗后神经功能缺损程度评分明显低于治疗前,差异有统计学意义(P <0.05),且甲组评分显著低于乙组,差异有统计学意义(P <0.05)。结论中风中脏腑患者应用醒脑静注射液治疗的临床效果十分确切,尤其是对于痰火瘀闭证患者来说,能够进一步缓解患者临床症状,减轻患者神经功能缺损程度,值得临床深入研究与推广应用。