Recent Situation of Acupuncture and Moxibustion in the Treatment of Stomach Pain with Deficiency and Cold of Spleen and Stomach

Stomachache is one of the most common diseases of digestive system, among which stomach pain of deficiency cold of spleen and stomach is the most common. Acupuncture and moxibustion therapy as an external treatment of traditional Chinese medicine for relieving stomach pain due to deficiency of spleen and stomach, has the advantages of convenient operation, small adverse reactions and remarkable curative effect, which is easy for patients to accept. In this paper, acupuncture and moxibustion therapy such as moxibustion and warm acupuncture therapy for stomach pain of spleen and stomach deficiency cold type is summarized to provide evidence-based basis for clinical treatment of stomach pain of spleen and stomach deficiency cold type.

Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes

Diabetes mellitus(DM)is still one of the most common diseases worldwide,and its prevalence is still increasing globally.According to the American and European recommendations,metformin is considered a first-line oral hypoglycemic drug for controlling type 2 DM(T2DM)patients.Metformin is the ninth most often prescribed drug in the world,and at least 120 million diabetic people are estimated to receive the drug.In the last 20 years,there has been increasing evidence of vitamin B12 deficiency among metformin-treated diabetic patients.Many studies have reported that vitamin B12 deficiency is related to the malabsorption of vitamin B12 among metformin-treated T2DM patients.Vitamin B12 deficiency may have a very bad complication for the T2DM patient.In this review,we will focus on the effect of metformin on the absorption of vitamin B12 and on its proposed mechanisms in hindering vitamin B12 absorption.In addition,the review will describe the clinical outcomes of vitamin B12 deficiency in metformintreated T2DM.

Association of Vitamin D Deficiency with Diabetic Retinopathy in Young People with Type 1 Diabetes Mellitus

Background: Diabetic retinopathy is among the most common diabetic complications, and is one of the leading causes of blindness in the world. Recent studies have linked vitamin D to the pathogenesis of diabetes and there is growing evidence that vitamin D can interfere with the mechanisms involved in diabetes and its complications. Despite improvements in treatment, diabetic retinopathy remains a significant complication of type 1 diabetes mellitus. Identification of early treatable predictors of diabetic retinopathy such as vitamin D deficiency, may allow more aggressive management of those at high risk. Purpose: To assess the association of vitamin D deficiency with diabetic retinopathy in young people with type 1 diabetes mellitus. Design: Observational study with case control design. Method: 60 young people with type 1 diabetes aged between 11 to 24 years were included in this study. Among them, 30-young people have diabetic retinopathy and 30-young people do not have diabetic retinopathy. Purposive sampling technique was applied as per inclusion criteria. Statistical analysis of the results was done by using computer-based software, SPSS version 26. P value of less than 0.05 was considered as statistically significant. Results: Vitamin D deficiency was present in 83% of the young people with diabetic retinopathy and in 53% without diabetic retinopathy. The mean vitamin D level in young people with and without diabetic retinopathy was 17.38 ± 3.77 ng/ml and 20.15 ± 5.06 ng/ml respectively and the difference was statistically significant (p = 0.019). Vitamin D deficiency was increased with the severity of diabetic retinopathy. Univariate and multivariate logistic regression showed vitamin D deficiency was independently associated with diabetic retinopathy with a crude odds ratio of 5.69 with a p value of 0.008 and adjusted odds ratio of 16.08 with a p value of 0.002 respectively. Conclusion: Result of the study revealed that vitamin D deficiency was strongly associated with diabetic retinopathy in young people with type 1 diabetes mellitus.

Clinical effects of a traditional Chinese medicine nursing programme to intervene in gastric pain of the spleen and stomach with Qi deficiency

BACKGROUND Gastroparesis is a common digestive disorder characterized by delayed gastric emptying,which can lead to symptoms such as nausea,vomiting,abdominal pain,and poor appetite.Traditional Chinese medicine(TCM)has been used for centuries to treat gastrointestinal disorders,including gastroparesis.TCM theory suggests that spleen and stomach qi deficiency syndrome is one of the main pathogenic factors in gastroparesis.Nursing care plays an important role in the treatment of gastroparesis,and TCM nursing interventions have shown promising results in improving patient outcomes.However,there is limited research on the clinical effectiveness of TCM nursing interventions for gastroparesis with spleen stomach deficiency syndrome.This study aimed to evaluate the clinical effect of TCM nursing intervention in the treatment of gastroparesis with spleen stomach deficiency syndrome and to compare it with routine nursing interventions.AIM To analyze the clinical effect of traditional Chinese medicine nursing intervention in the treatment of gastric paraplegia with spleen stomach deficiency syndrome.METHODS From January 2020 to July 2021,80 patients with gastroparesis of spleen stomach qi deficiency type diagnosed in our hospital were selected for the study.The 80 patients were randomly divided into a control group and an experimental group,with 40 cases in each group.During the treatment period,the control group received routine nursing interventions,while the experimental group received traditional Chinese medicine nursing procedures.Compare the nursing effects of the two groups and observe the changes in traditional Chinese medicine symptom scores,pain levels,and sleep quality before and after treatment.RESULTS After treatment,comparing the treatment effects of the two groups,the total effective rate of the experimental group was significantly higher than that of the control group,with statistical significance(P<0.05).There was no statistically significant difference in the TCM symptom score,visual analogue scale(VAS)score,and Pittsburgh sleep quality index(PSQI)score between the two groups before treatment(P>0.05).However,after treatment,the TCM syndrome scores,VAS scores,and PSQI scores of the experimental group were significantly lower than those of the control group,with a statistically significant difference(P<0.05).CONCLUSION In the clinical nursing intervention of patients with mild gastroparesis due to spleen and stomach qi deficiency,the traditional Chinese medicine nursing plan has good clinical application value and nursing effect,and has a good effect on improving patients’pain and sleep quality.

Efficacy of integrative medicine in deficiency of both qi and yin in the rat model of type 2 diabetes

Objective:To establish a rat model of type 2 diabetes(T2DM)manifesting the Chinese medicine syndrome pattern of both qi and yin deficiency for evaluating the efficacy of a Chinese herbal formula(CHF),integrative medicine(IM),and pioglitazone(PIO)on T2DM indicators in the animal model.Methods:The rat model was induced by a high-fat diet(HFD)and streptozotocin(STZ,30 mg/kg).CHF(3.4 g/kg),PIO(2.7 mg/kg),and IM(3.4 g CHF+2.7 mg PIO)were administered to rats once daily for 14 days.Related laboratory parameters were observed.Results:Diabetic rats showed unsmooth fur,alopecia,reduced activity,huddling,somnolence,depression,pale or reddened tongue,damp/dark red tail,and high levels of water and food intake,urine volume,and stool weight,but weakened grip strength.Low levels of serum SOD,Nat-Kt-ATPase,cAMP/cGMP,and a high level of iNOS were observed.Hyperglycemia,hyperinsulinemia,insulin resistance,high levels of serum glucagon/IDE and pancreatic amylin,and low serum and pancreatic SS levels were evident as well.Conclusions:A rat model of T2DM with both qi and yin deficiency was successfully replicated.CHF appeared to be more efficacious than IM and PIO in the rat model of qi and yin deficiency pattern of T2DM,though IM and PIO were each found to have their merits and drawbacks in attenuating T2DM indicators in the rat model.

Comparative evaluation in treating qi-yin deficiency and phlegm stasis syndrome of type 2 diabetes mellitus in a rat model

Objective:To compare the efficacy of traditional Chinese medicine (TCM),western medicine and integrative medicine in treating type 2 diabetes mellitus (T2DM) in a rat model.Methods:The T2DM rat model was established with a high-fat diet (HFD) for 35 days and a single injection of streptozotocin (STZ,30 mg/kg).The T2DM-induced rats were divided into three groups,and treated with Yiqi Yangyin Huatan (YQYYHT) granules (3.84 g/kg per day),pioglitazone (1.35 mg/kg per day) or YQYYHT granules + pioglitazone (3.84 g/kg per day+1.35 mg/kg per day) respectively for 14 days.Clinical features and behavioral changes,as well as T2DM indicators,were recorded to evaluate therapeutics effects in each treatment group.Results:The T2DM rat model expressed insulin resistance (IR),with features similar to qi-yin deficiency and phlegm stasis syndrome,including decreased cyclic adenosine monophosphate/cyclic guanosine monophosphate (cAMP/cGMP) ratio,decreased levels of Na+-K+-ATPase,superoxide dismutase (SOD) and high density lipoprotein-cholesterol (HDL-C),and increased levels of serum triglyceride (TG),total cholesterol (TC) and low density lipoprotein (LDL-C).All three treatment groups showed significant decreases in fasting blood glucose (FBG) and fasting insulin (Fins),and improvement of TCM syndrome to different degrees.Importantly,YQYYHT improved the most of the indicators of T2DM,followed by integrative medicine and pioglitazone alone.Conclusion:Compared with western medicine or integrative medicine,prescription of TCM based on syndrome differentiation may offer more advantages in the prevention and treatment of T2DM.

Exploration and Study of Jianpi Qushi Powder Combined with Standard Anti HP Quadruple Therapy in the Treatment of HP Infectious Gastritis of Spleen Deficiency and Dampness Stagnation Type

Objective: To explore the therapeutic effect of traditional Chinese medicine Jianpi Qushi powder combined with standard anti-HP quadruple therapy in the treatment of HP infectious gastritis with spleen deficiency and dampness stagnation. Methods: From January 2020 to December 2021, 223 patients with laboratory-confirmed HP infection who were admitted to the Outpatient and Inpatient Department of Internal Medicine in our hospital were selected as the research objects and randomly divided into two groups. 101 patients in the control group were given standard anti HP quadruple therapy;122 cases in the treatment group were given traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy. The two groups were rechecked carbon breath test after the designed course of treatment, and the curative effects of the two groups were compared. Results: 113 cases in the treatment group were cured by traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy, and the cure rate was 92.62%. 84 cases in the control group were cured by standard anti HP quadruple therapy, and the cure rate was 83.17%, χ2 = 4.7955, P = 0.0285, the difference was statistically significant (P < 0.05). Conclusion: Traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy in the treatment of HP infectious gastritis with spleen deficiency and dampness stagnation is one of the best treatment schemes for HP infection. The results of this study achieve the best clinical treatment effect, and provide a more valuable and reliable method for the treatment of gastropathy in clinical internal medicine, which is worthy of popularization and application.

Effect of Huangqi Xiaoke Recipe combined with alprostadil on qi and yin deficiency type diabetic nephropathy and its effect on vascular endothelium and oxidative stress

Objective: To observe the clinical efficacy of Huangqi Xiaoke Decoction combined with alprostadil on qi and yin deficiency type diabetic nephropathy (DN) and its effect on vascular endothelium and oxidative stress. Methods: A total of 72 patients with qi and yin deficiency type DN who were admitted to the diabetes specialist ward and outpatient department of Baoan District Hospital of Shenzhen from January 2017 to July 2018 were enrolled. The patients were divided into the control group and the observation group according to the random number method. 36 cases in each group. Both groups were treated with conventional treatments such as hypoglycemic, hypotensive, lipid-lowering and anti-platelet aggregation. The control group was treated with alprostadil on the basis of conventional treatment. The observation group was given orally on the basis of the control group. Both groups were treated once a day for a total of 4 weeks. Compare the clinical syndrome scores and clinical efficacy of the two groups before and after treatment;fasting blood glucose (FPG), glycosylated hemoglobin (HbA1C), blood lipids (TC, TG, LDL, HDL), serum creatinine (SCr), blood urea nitrogen (BUN Endothelin-1 (ET-1), nitric oxide (NO), von Willebrand factor (vWF);glutathione peroxidase (GSH-Px), superoxide disproportionation The level of enzyme (SOD), malondialdehyde (MDA). Results:The total effective rate of TCM syndromes in observation group was 94.44%, which was significantly different from 72.22% in the control group. The scores of TCM syndromes in the observation group were significantly lower than those in the control group;Compared with the control group, the HDL-C of the observation group did not change much, there was no statistical difference;FBG, HbA1C, SCr, BUN, TC, TG, LDL-C, ET-1, vWF, MDA Significantly decreased, NO, GSH-Px, SOD increased significantly, with significant difference. Conclusion: Huangqi Xiaoke Decoction combined with alprostadil in the treatment of qi and yin deficiency type DN has significant curative effect, which can not only lower blood sugar, regulate blood lipids, improve renal function and clinical symptoms, but also inhibit oxidative stress and protect endothelial function.

Collection of Professor Lihong Zhu's Experience in Treating Postpartum Hypogalactia of Blood Deficiency and Liver Depression Type

Professor Lihong Zhu proposed the syndrome type of"blood deficiency and liver depression"in the clinical treatment of postpartum hypogalactia,and discussed its main etiology and pathogenesis as Yin blood deficiency and liver Qi stagnation,with blood deficiency as the basis and liver depression as the standard.She self-made"Shugan Shengru prescription/5*which was added and subtracted with symptoms,with remarkable clinical effect,and widened the thinking of diagnosis and treatment of postpartum hypogalactia.

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.

Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind

To date,metformin remains the first-line oral glucose-lowering drug used for the treatment of type 2 diabetes thanks to its well-established long-term safety and efficacy profile.Indeed,metformin is the most widely used oral insulinsensitizing agent,being prescribed to more than 100 million people worldwide,including patients with prediabetes,insulin resistance,and polycystic ovary syndrome.However,over the last decades several observational studies and meta-analyses have reported a significant association between long-term metformin therapy and an increased prevalence of vitamin B12 deficiency.Of note,evidence suggests that long-term and high-dose metformin therapy impairs vitamin B12 status.Vitamin B12(also referred to as cobalamin)is a water-soluble vitamin that is mainly obtained from animal-sourced foods.At the cellular level,vitamin B12 acts as a cofactor for enzymes that play a critical role in DNA synthesis and neuroprotection.Thus,vitamin B12 deficiency can lead to a number of clinical consequences that include hematologic abnormalities(e.g.,megaloblastic anemia and formation of hypersegmented neutrophils),progressive axonal demyelination and peripheral neuropathy.Nevertheless,no definite guidelines are currently available for vitamin B12 deficiency screening in patients on metformin therapy,and vitamin B12 deficiency remains frequently unrecognized in such individuals.Therefore,in this“field of vision”article we propose a list of criteria for a cost-effective vitamin B12 deficiency screening in metformin-treated patients,which could serve as a practical guide for identifying individuals at high risk for this condition.Moreover,we discuss additional relevant topics related to this field,including:(1)The lack of consensus about the exact definition of vitamin B12 deficiency;(2)The definition of reliable biomarkers of vitamin B12 status;(3)Causes of vitamin B12 deficiency other than metformin therapy that should be identified promptly in metformin-treated patients for a proper differential diagnosis;and(4)Potential pathophysiological mechanisms underlying metformin-induced vitamin B12 deficiency.Finally,we briefly review basic concepts related to vitamin B12 supplementation for the treatment of vitamin B12 deficiency,particularly when this condition is induced by metformin.

Diabetic Cardiovascular Risk and Carnitine Deficiency <br/>—Carnitine Deficiency in Clinical Diabetes Mellitus

Background: Type 1 diabetes mellitus increases the risk of coronary heart disease. The Pittsburgh IDDM morbidity and mortality study reported greater than 10 fold coronary heart disease mortality compared with US national data?[1]. Adults with diabetes have heart disease death rates 2 to 4 times higher than adults without diabetes [2]. Diabetic cardiomyopathy explains much of this survival difference and carnitine deficiency is a cause of cardiomyopathy. Research Design and Methods: Adult subjects (40) with type 1 diabetes mellitus were seen for a routine annual visit having no clinical complaints. Fasting serum samples were collected for annual chemistries and the measurement of carnitine. Results: The mean total (40.8 ± 8.8) [40 - 80 nmol/ml] and free (32.9 ± 7.9) [30 - 60 nmol/ml] carnitine levels for this group included 43% low total and 28% low free carnitine. The mean esterified/free (E/F) carnitine ratio (0.25 ± 0.09) for this group was elevated indicating carnitine insufficiency. Conclusions: Fatty acids are the primary energy source for diabetic heart muscle, and carnitine is essential for intracellular fatty acid transport and ATP production. Therefore, mild carnitine deficiency can compromise fatty acid energy production in a failing heart. Carnitine deficiency in subjects at high risk for cardiovascular failure is a possible unrecognized reason for the 4 fold increased death rate in patients with type 1 diabetes. Supplementation with oral carnitine could reduce that increased risk of heart failure, in patients with type 1 diabetes. Intravenous carnitine may be life saving when managing acute cardiac failure in patients with diabetes mellitus. Normal carnitine levels in patients with type 1 diabetes may provide a biochemical environment that prevents the long recognized idiopathic heart failure that occurs in insulin requiring diabetics as first reported in the 1974 Framingham Study.

Research Progress of Jianpi Qushi Powder Combined with Standard Anti Hp Quadruple Therapy in the Treatment of Hp Infectious Gastritis with Spleen Deficiency and Dampness Stagnation

Stomach Helicobacter pylori infection is one of the common gastric diseases. Helicobacter pylori infectious gastritis of spleen deficiency and dampness stagnation is a relatively intractable chronic disease. In recent years, traditional Chinese medicine methods have emerged one after another in the treatment of gastric Helicobacter pylori infection. By collecting references, the author reviewed the clinical characteristics of gastric Helicobacter pylori infection and the new progress of traditional Chinese medicine treatment.

腺苷脱氨酶2缺乏症临床特征与基因型分析

目的总结3例腺苷脱氨酶2(ADA 2)缺乏症患儿的临床特征及基因型特点,提高对该病的认识。方法回顾性分析3例ADA2缺乏症患儿的临床特点并利用全外显子测序进行遗传学分析。利用试剂盒测定患儿血浆中ADA2酶的活性。总结该病的临床及基因型特征。结果本组3例患儿均存在ADA2基因变异,例1以反复发热、皮疹、惊厥为主要临床表现,合并脑卒中,伴炎症指标明显升高,ADA2基因存在复合杂合变异:c.139G>T和c.484T>C突变。例2以反复发热、皮疹为主要临床表现,病程中合并消化道穿孔、脑卒中,炎症指标明显升高。WES检测发现ADA2基因存在c.916C>T及c.1069G>A复合杂合突变。例3以反复发热、咳嗽为主要临床表现,合并心肌炎,伴免疫功能明显下降;WES检测发现患者ADA2基因存在c.849T>G纯合突变。血浆ADA2酶活性测定发现例1和2酶活性显著降低。结论ADA2缺乏症国内罕见,临床特征多变,掌握其临床特征及基因特点,有助于提高诊断水平。

基于文献挖掘和网络药理学探析阴虚型免疫性血小板减少症用药规律与作用机制

目的利用数据挖掘技术及网络药理学探讨中药治疗阴虚型免疫性血小板减少症用药规律与潜在作用机制。方法运用中国知网、万方数据库检索中药治疗阴虚型免疫性血小板减少症相关文献,通过中医传承辅助平台V2.5软件分析组方规律,确定常用药对;运用中药系统药理学数据库与分析平台(TCMSP)、本草组鉴数据库、GeneCards数据库获取关键基因和主要靶点信息,利用STRING数据库构建交集靶点蛋白相互作用网络,采用Cytoscape 3.7.1软件中的CytoHubba和MCODE插件筛选出关键靶点信息,采用METASCAPE数据库基因本体(GO)功能富集分析和京都基因与基因组百科全书(KEGG)通路富集分析。结果共筛选得到129篇有效文献,共计130个中药处方,通过关联规则筛选出“生地黄—牡丹皮—旱莲草”为最佳中药复方,HSP90AA1、STAT3、VEGFA、MAPK3等为关键靶点,槲皮素、山柰酚、金合欢素与木犀草素等为主要有效成分,其主要作用机制可能是调控癌症通路、Th17细胞分化及核转录因子κB(NF-κB)信号通路等。结论治疗阴虚型免疫性血小板减少症应抓住止血、凉血、行血三要素,初步揭示常用复方“生地黄—牡丹皮—旱莲草”通过多成分—多靶点—多通路发挥治疗作用,为今后研究提供理论依据。

基于糖代谢和胰岛素抵抗评估益气养阴法治疗气阴两虚型2型糖尿病的疗效

目的分析益气养阴法治疗气阴两虚型2型糖尿病对患者糖代谢和胰岛素抵抗评估的影响。方法南京中医药大学附属南京市中西医结合医院2019年6月—2022年3月收治的90例气阴两虚型2型糖尿病患者随机分为胰岛素泵治疗组(45例)和益气养阴治疗组(45例)。益气养阴治疗组采用胰岛素泵强化治疗联合益气养阴法进行治疗,胰岛素泵治疗组单独进行胰岛素泵强化治疗,两组均治疗2周。统计两组治疗2周后的临床疗效及治疗期间不良反应发生情况,比较两组治疗前和治疗2周后中医证候积分、糖代谢情况、胰岛素抵抗情况。结果治疗2周后,益气养阴治疗组总有效率为91.11%(41/45),高于胰岛素泵治疗组[73.33%(33/45),P<0.05]。治疗2周后与治疗前比较,两组口燥咽干、倦怠乏力、失眠、自汗盗汗、五心烦热、气短懒言评分及血清空腹血糖(fasting blood glucose,FPG)、餐后2 h血糖(postprandial 2-hour blood glucose,2 h PG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、空腹胰岛素(fasting insulin,FINS)水平、胰岛素抵抗指数(Homa-IR)降低,益气养阴治疗组低于胰岛素泵治疗组(P<0.05),两组胰岛素敏感指数(insulin sensitivity index,ISI)、胰岛功能指数(Homa-islet)升高,益气养阴治疗组高于胰岛素泵治疗组(P<0.05)。治疗期间,益气养阴治疗组总不良反应发生率与胰岛素泵治疗组比较,差异无统计学意义(P>0.05)。结论气阴两虚型2型糖尿病患者采用益气养阴法进行治疗,可有效改善患者中医证候、糖代谢,降低患者机体胰岛素抵抗程度,具有较好的治疗效果。

加减黄芪健脾汤治疗脾胃虚弱型慢性结肠炎反复发作性腹泻的临床研究

目的探讨加减黄芪健脾汤治疗脾胃虚弱型慢性结肠炎反复发作性腹泻的临床效果。方法选取2020年12月至2022年8月在大连市中心医院中医内科接受治疗的60例慢性结肠炎患者作为研究对象,采用随机数字表法将其分为治疗组和对照组,每组各30例。治疗组给予加减黄芪健脾汤治疗,对照组给予枯草杆菌二联活菌肠溶胶囊治疗。分别于治疗前及治疗后2、4、8周记录血中T淋巴细胞亚群(CD3^(+)、CD4^(+))的水平及中医症状积分,并比较两组的临床疗效和停药1个月后复发率。结果治疗组患者治疗后2、4、8周的血中T淋巴细胞亚群(CD3^(+)、CD4^(+))水平高于对照组,差异有统计学意义(P<0.05);治疗组患者治疗后2、4、8周的临床症状总积分低于对照组,差异有统计学意义(P<0.05);治疗组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗组患者停药1个月后的复发率低于对照组,差异有统计学意义(P<0.05)。结论加减黄芪健脾汤治疗脾胃虚弱型慢性结肠炎反复发作性腹泻具有显著疗效,能改善患者的临床症状,还可以提高患者的免疫功能。

补肾活血方治疗肾虚血瘀型卵巢储备功能下降患者的临床疗效观察

目的观察补肾活血方对肾虚血瘀型卵巢储备功能下降(DOR)患者的治疗效果。方法选取北京妇产医院中医科2021年1月至2022年12月就诊的180例诊断为DOR的肾虚血瘀型患者作为研究对象,采用计算机随机分组法分为雌二醇片/雌二醇地屈孕酮片组(西药组)、补肾活血方组(中药组)和补肾活血方联合雌二醇片/雌二醇地屈孕酮片组(联合组),各60例。观察三组治疗前后卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、抗米勒管激素(AMH)、窦卵泡数(AFC)、卵巢体积、卵巢动脉和子宫动脉阻力指数(RI)、子宫内膜厚度的变化,比较三组中医证候评分及疗效。结果11例患者(4例来自西药组,3例来自中药组,4例来自联合组)退出研究。6个月后,三组FSH和LH均显著降低,E_(2)和AMH升高(P<0.05);西药组和联合组较中药组FSH降低更显著,E_(2)升高更显著(P<0.01)。治疗后,中药组和联合组卵巢体积增加(P<0.05),AFC显著增加(P<0.01),卵巢动脉RI显著降低(P<0.01);西药组卵巢体积增加不显著(P>0.05),AFC显著增加(P<0.05),卵巢动脉RI显著降低(P<0.05);三组子宫动脉RI均无显著改善(P>0.05)。三组子宫内膜厚度均显著增加(P<0.05),西药组和联合组较中药组增加更显著(P<0.01)。与治疗前相比,三组治疗后中医证候评分均显著降低(P<0.05),且中药组和联合组中医证候评分降低的程度大于西药组(P<0.05)。西药组总有效率为71.43%,中药组为82.46%,联合组为85.96%;联合组的疗效优于西药组(P<0.05)。结论补肾活血方能够通过平衡激素水平、促进排卵和修复子宫内膜对DOR患者产生良好的治疗效果,联合应用雌二醇片/雌二醇地屈孕酮片可能是治疗DOR的一种行之有效的治疗策略。

红光照射联合去腐生新膏治疗气虚血瘀型臁疮的临床效果

目的:观察应用红光照射治疗联合去腐生新膏外用治疗气虚血瘀型臁疮的临床疗效。方法:选取64例臁疮患者,中医证属气虚血瘀型,采用随机数字表法分为试验组和对照组,每组32例。两组入院后均行清创治疗,清创后两组均采用红光照射治疗,其中试验组配合外用去腐生新膏,对照组配合外用重组人碱性成纤维生长因子凝胶。比较治疗后两组患肢临床疗效(疼痛、肿胀、溃疡面积、溃疡深度、创面愈合率、愈合时间)、创面愈合相关因素[创面细菌阳性率、患肢经皮氧分压(tcpO_(2))、皮肤不良反应率]、血清炎症及相关细胞因子[C反应蛋白(CRP)、白细胞介素(IL-6)、血管内皮生长因子(VEGF)]。结果:治疗后两组临床疗效指标(疼痛、肿胀、溃疡面积、溃疡深度、创面愈合率、愈合时间)及tcpO_(2)、CRP、IL-6、VEGF指标均较前改善。试验组治疗7 d后疼痛、肿胀缓解情况均优于对照组(P <0.05);治疗14 d后肿胀、CRP较对照组改善(P <0.05),溃疡面积、溃疡深度、tcpO_(2)、IL-6、VEGF较对照组明显改善(P <0.01)。治疗后,两组创面细菌培养阳性率及皮肤不良反应率无明显差异(P>0.05)。结论:红光照射联合去腐生新膏治疗气虚血瘀型臁疮临床疗效显著,其能改善创面炎症,促进血管新生、改善微循环,且不增加创面不良反应发生率。

温阳通督药物罐治疗肾虚督寒型强直性脊柱炎疗效观察

目的:观察温阳通督药物罐对肾虚督寒型强直性脊柱炎的临床疗效。方法:将174例肾虚督寒型强直性脊柱炎患者随机分为试验组(药物罐治疗,55例)、对照一组(玻璃火罐治疗,57例)和对照二组(水煮拇指罐治疗,56例),均给予基础治疗,观察各组Bath强直性脊柱炎疾病活动指数(the bath ankylosing spondylitis disease activity index,BASDAI)、Bath强直性脊柱炎功能指数(the bath ankylosing spondylitis functional index,BASFI)、证候积分及红细胞沉降率(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)水平的变化情况,以及临床疗效和安全性。结果:治疗后,各组BASDAI、BASFI评分及证候积分均较治疗前降低,试验组降低更明显(P<0.05);各组ESR、CRP值均较治疗前降低(P<0.05),但组间比较差异无统计学意义(P>0.05);试验组、对照一组、对照二组总有效率分别为92.73%(51/55)、82.45%(47/57)、71.43%(40/56),试验组高于另外两组(P<0.05);治疗期间各组均未发生明显不良反应。结论:温阳通督药物罐能改善肾虚督寒型强直性脊柱炎患者临床症状,降低炎性指标水平,且不良反应少。