Study of Interference Treatment by Xuesaitong (血塞通) Soft Capsuleon Patients of Nephrosis Syndrome with Qi Deficiency and Blood Stasisduring Dose Reducing Stage of Corticosteroid

Objective: To observe the effect of Xuesaitong (血塞通, XST) soft capsule in interference treatment on patients of nephrosis syndrome (NS) during corticosteroid (CS) dose reducing stage. Methods: Seventy-one NS patients applying prednisone and initiating dose reducing stage were randomized into trial group and control group. On the basis of conventional prednisone dose reduction of both groups, the trial group was given additionally XST, and the treatment course ended with the reduction to maintenance dose. In the course of observation, those who did not comply with the criteria of observation were excluded. Before and after the dose reduction, TCM syndrome scoring, 24 hrs urinary protein amount, blood β2-microglobulin (β2-MG), urinary β2-MG, blood fibrinogen (Fbg), plasma prothrombin time (PT), blood lipid, etc. were observed. Results: The trial group of XST could obviously lower their urinary protein amount and blood lipid level (P<0.05 or P<0.01), markedly improve the blood coagulation parameters (P<0.01), improve the TCM syndrome and CS induced adverse reaction (P<0.05 or P<0.01), also obviously reduced the recurrence rate of NS (P<0.05). Conclusion: XST could obviously improve the clinical symptoms and renal impairment parameters in NS patients during CS dose reduction stage, improve the CS induced adverse reaction and prevent the recurrence of NS.

A Clinical Study on the Treat ment of Chronic Pelvic Inflammation of Qi-stagnation with Blood Stasis Syndrome by Penyanqing Capsule (盆炎清胶囊)

Objective： To observe the clinical efficacy of Penyanqing Capsule （盆炎清胶囊, PYQC） in treating pelvic inflammation of Qi-stagnation with blood stasis syndrome. Methods： The randomized, single blinded, parallel positive drug controlled method was adopted, with 82 patients assigned into two groups by envelop method. The 42 patients in the treated group received PYQC 3 times a day, 4 capsules each time taken orally; the 40 patients in the control group were given orally Fuyankang tablets （妇炎康片, FYKT） 3 times a day, 6 tablets each time. The therapeutic course for both groups was 2 months, and 2 courses of treatment were given successively to observe the comprehensive effect, changes of symptoms and signs before and after treatment. The effects of PYQC on hemorrheological character in part of the patients and on the pathogenetic chlamydia and mycoplasma were also observed. Results： The total effective rate in the treated group was 83.3%, which was insignificantly different from that in the control group （77.5%, P〉0.05）. However, PYQC could significantly lower the hemorrheologic indexes in patients and showed definite influence on the pathogenetic chlamydia and mycoplasma. Conclusion： PYQC has good therapeutic effect in treating chronic pelvic inflammation of Qi-stagnation with blood stasis syndrome, and showed definite effect on chlamydia and mycoplasma.

Serum proteomic approach in patients with Qi deficiency and blood stasis syndrome in coronary heart disease:to explore therapeutic mechanism of Yiqi Huoxue decoction

OBJECTIVE To explore the curative effect and mechanism of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.METHODS The patients with coronary heart disease of Qi deficiency and blood stasis syndrome were treated with Yiqi Huoxue decoction for 3 months,and the changes of cardiac function were observed.61 serum samples(including 29 cases of disease group and 32 cases of Yiqi Huoxue expression group)were analyzed by non labeled proteomics.The disease group was used as the control group,and the protein with expression level difference of more than 1.2 folds(P<0.05)was screened.The molecular function,biological pathway and protein interaction of the different proteins were analyzed by bioinformatics,so as to identify the molecular and biological pathway of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.RESULTS Clinical treatment found that Yiqi Huoxue decoction can improve TCM syndrome score and left ventricular ejection fraction,regulate blood glucose and blood lipid levels,prolong thrombin time,and improve heart function.The results of proteomic quantitative analysis showed that there were 69 proteins with different expression levels in the disease group.Bioinformatics analysis results showed that Yiqi Huoxue decoction may regulate ApoA1,alpha-2 and other proteins to act on HDL assembly,platelet degradation,PI3K Akt signaling pathway,and then play a therapeutic role in coronary heart disease with Qi deficiency and blood stasis syndrome.CONCLUSION Yiqi Huoxue decoction can effectively improved the heart function decline caused by Qi deficiency and blood stasis syndrome of coronary heart disease.It mainly act on energy metabolism and platelet activation pathway by activating HDL assembly and platelet degradation signal pathway proteins.This study can provide reference for the follow-up treatment mechanism of Qi deficiency and blood stasis syndrome of coronary heart disease.

Study on the relationship between syndrome characteristics degree and inflammatory factor and negative emotional scale in"double heart disease"patients with Qi stagnation blood stasis and heart gallbladder heat stagnation

Objective:To Discuss the correlation between Hypersensitivity C-reactive Protein(Hs-CRP),Total Cholesterol(TC),Triglyceride(TG),negative emotion scale and TCM syndrome scores in“Double Heart Disease”patients with Qi stagnation blood stasis and heart gallbladder heat stagnation.Method:Fifty-two patients in Western Medicine Diagnosis of Double Heart Disease,in TCM syndrome identified as Qi stagnation blood stasis Heart gallbladder heat stagnation syndrome,detects it Hs-CRP,TC,TG levels by ELISA,use TCM Syndromes Scale to evaluate TCM Syndrome,use the Pittsburgh Sleep Quality Index(PSQI)and Self-rating symptom scale(SCL-90)to assess anxiety and sleep levels,analyze the correlation between TCM syndrome scores and Hs-CRP,TC,TG level,PSQI index,SCL-90 index.Result:There was a significant positive correlation between Hs-CRP,TG level and TCM Syndrome scores(P<0.05);TC level was postively correlated with TCM Syndrome scores,but there was no statistical significance(P>0.05);There was a significant positive correlation between PSQI index,SCL-90 index and TCM Syndrome scores(P<0.05).Conclusion:In“Double Heart Disease”patients with Qi stagnation blood stasis and heart gallbladder heat stagnation,there have characteristic syndrome changes in terms of inflammatory factor level,blood lipid level and negative emotion score;Which the above indexes can reflect the severity of TCM syndromes to a certain extent and provide the basis for the effective intervention treatment of TCM.

Pharmacological effects of Paeoniflorin and Albiflorin on IL-3, GM-CSF, IL-6 and TNF-α in the rats of syndrome of stagnation of liver qi and blood deficiency

目的：观察芍药苷（PF）、芍药内酯苷（AF）对血虚肝郁证候模型大鼠外周血细胞、脏器指数、造血细胞因子的影响,探讨白芍养血柔肝功效的物质基础及作用机制.方法：将SD雄性大鼠,根据体质量随机分组,每组12只.除空白组外,其余均采用放射线辐照结合慢性束缚应激复制血虚肝郁证候模型.观察大鼠体质量、脏器指数,并监测外周全血中白细胞（WBC）、红细胞（RBC）、血红蛋白（HGB）的数量,分离血清用放射免疫法（RIA）检测大鼠白细胞介素-3（IL-3）、粒细胞-巨噬细胞集落刺激因子（GM-CSF）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）的含量.结果：与模型组比较,PF30mg·kg^-1组和AF30mg·kg^-1组体质量、脾脏指数、白细胞数量明显增加（P〈0.05、P〈0.01）.RIA结果显示,PF30mg·kg^-1组和AF30mg·kg^-1组均可增加该组IL-3含量（P〈0.05、P〈0.05）和减少该组TNF-α含量（P〈0.05、P〈0.05）.结论：芍药苷、芍药内酯苷通对骨髓造血系统和免疫系统的调节作用,发挥对血虚肝郁大鼠的补血作用,提示二者均为白芍养血柔肝功效的主要有效成分.

Plasma L-ENK, AVP, ANP and serum gastrin in patients with syndrome of Liver-Qi-stagnation

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Metabonomics analysis of the urine of rats with Qi deficiency and blood stasis syndrome based on NMR techniques

Metabonomics analysis of the urine of rats with Qi deficiency and blood stasis syndrome has been performed by comparison with those of normal rats based on NMR techniques. The relative contents of formate,creatinine,2-oxoglutarate(2-OG) ,citrate,taurine,trimethylamine-N-oxide(TMAO) ,succinate and hippurate in the urine of the rats with Qi deficiency and blood stasis syndrome have been changed. These results have provided evidence for understanding the mechanism and the therapy of Qi defi-ciency and blood stasis syndrome.

Evaluation of the Therapeutic Effect of Contrast-Enhanced Ultrasound on Different Types of Knee Osteoarthritis in the Elderly

Objective: To evaluate the curative effect of the Traditional Chinese Medicine (TCM) external therapy on knee osteoarthritis patients with different TCM constitutions using musculoskeletal ultrasonography and contrast-enhanced ultrasonography, and to explore the application value of contrast-enhanced ultrasonography in knee joint diseases. Methods: A total of 57 patients diagnosed with knee osteoarthritis in Shaanxi University of Traditional Chinese Medicine from December 2019 to May 2021 were collected, and they were divided into qi stagnation and blood stasis type group (23 cases) and cold-dampness obstruction type group (34 cases) according to the traditional Chinese medicine method. All patients were given acupuncture combined with TCM fumigation and washing. All patients underwent musculoskeletal ultrasonography and contrast-enhanced ultrasonography before and after treatment, observed and recorded relevant data, and compared the treatment effects between the two groups. Results: 85.96% (49/57) of knee osteoarthritis (KOA) patients had suprapatellar bursa effusion, 42.1% (24/57) had iliotibial band bursae effusion, some of which had poor sound transmission, and thickened synovium was seen in most effusions, 33.33% (19/57) had osteophyte formation. Compared with before treatment, the depth of suprapatellar sac effusion in the Qi stagnation and blood stasis type group decreased after treatment (P Conclusion: Musculoskeletal contrast-enhanced ultrasonography was used to quantitatively evaluate the efficacy of TCM external therapy on KOA for different TCM constitutions. Dynamic observation of synovial lesions of knee osteoarthritis provides a valuable imaging method for evaluating the efficacy of traditional Chinese medicine.

平衡火罐干预对气滞血瘀型原发性痛经患者的效果

目的探讨平衡火罐干预气滞血瘀型原发性痛经患者的临床效果。方法选取2020年1月—2021年12月河南中医药大学第一附属医院诊治的原发性痛经气滞血瘀证患者64例为研究对象,根据就诊顺序以及患者意愿将其分为观察组和对照组,每组32例。对照组患者给予常规痛经的健康指导,观察组在对照组基础上给予平衡火罐干预。比较2组患者治疗前后视觉模拟评分法(VAS)评分、痛经症状评分、血清前列腺素E_(2)(PGE_(2))、雌二醇(E_(2))、月经来潮时间、月经周期、月经量以及疗效。结果2组患者第1、2、3次月经来潮时VAS评分与干预前比较,差异有统计学意义(P<0.05);观察组第1、2、3次月经来潮时VAS评分低于对照组,差异有统计学意义(P<0.05)。2组患者第1、2、3次月经来潮时痛经症状评分与干预前比较,差异有统计学意义(P<0.05);观察组第1、2、3次月经来潮时痛经症状评分低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。2组患者第1、2、3次月经来潮时PGE_(2)、E_(2)水平与干预前比较,差异有统计学意义(P<0.05);2组第1、2、3次月经来潮时PGE_(2)、E_(2)水平比较,差异有统计学意义(P<0.05)。2组患者月经周期、月经持续时间、月经量比较,差异无统计学意义(P>0.05)。结论平衡火罐干预气滞血瘀型原发性痛经的效果较好,安全性较高.

三七活骨丸联合体外冲击波对气滞血瘀型早期股骨头缺血性坏死患者的影响

目的 观察三七活骨丸联合体外冲击波(ESW)对气滞血瘀型早期股骨头缺血性坏死的影响。方法 选取2021年4月至2022年10月黑龙江中医药大学附属第二医院收诊的72例气滞血瘀型早期股骨头缺血性坏死患者,采用随机数字表法将其分为对照组和观察组,各36例。对照组采用ESW治疗,观察组在对照组的基础上口服三七活骨丸,两组均治疗4周。观察治疗前及治疗2、4周后两组视觉模拟评分法(VAS)评分、髋关节Harris评分、中医证候评分,并进行疗效评价。比较两组治疗前后血清白细胞介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)、骨保护素(OPG)水平。结果 对照组有4例患者在治疗期间服用其他药物,故剔除。观察组临床疗效优于对照组(P<0.05)。两组治疗2、4周后VAS、中医证候评分均低于治疗前,髋关节Harris评分高于治疗前,两组治疗4周后VAS、中医证候评分均低于治疗2周后,髋关节Harris评分高于治疗2周后(P<0.05)。治疗2、4周后,观察组髋关节Harris评分高于同期对照组,中医证候评分低于同期对照组(P<0.05)。治疗4周后,观察组VAS评分低于同期对照组(P<0.05)。治疗4周后,两组血清IL-1、IL-6、TNF-α水平低于治疗前,血清OPG水平高于治疗前,且观察组血清IL-1、IL-6、TNF-α水平低于对照组,血清OPG水平高于对照组(P<0.05)。结论 三七活骨丸联合ESW对于改善气滞血瘀型早期股骨头缺血性坏死患者的症状疗效良好,适合临床应用。

调经止痛丸对子宫内膜异位症气滞血瘀证患者腹腔镜术后CA125的影响

目的观察调经止痛丸对子宫内膜异位症(endometriosis,EMS)气滞血瘀证患者腹腔镜术后临床症状及癌胚抗原125(carcinoembryonic antigen 125,CA125)的影响。方法选取河北省沧州中西医结合医院120例接受腹腔镜手术治疗的EMS气滞血瘀证患者,随机分为对照组和观察组,各60例。对照组术后予以常规西药进行治疗,观察组在对照组基础上服用调经止痛丸,连续治疗6个月。比较两组临床疗效、中医证候积分、血清CA125、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及不良反应。结果观察组总有效率96.67%,高于对照组85.00%(P<0.05);观察组治疗后中医证候积分及CA125、TNF-α水平显著低于对照组(P<0.01);两组患者不良反应发生率差异无统计学意义(P>0.05)。结论调经止痛丸可有效减轻EMS气滞血瘀证患者腹腔镜术后临床症状,改善TNF-α及CA125水平。

瘀滞型肩关节周围炎中医优化方案筛选研究

目的基于随机对照试验进行中医临床治疗优化方案的筛选研究,明确中医治疗瘀滞型肩关节周围炎的最佳临床方案。方法选取2020年6月-2021年12月在长春中医药大学附属医院门诊就诊的瘀滞型肩关节周围炎患者99例,随机分为A、B、C组,3组常规进行推拿及功能锻炼治疗,在此基础上A组联合药物疗法,B组联合针灸疗法,C组联合药物疗法及针灸疗法,疗程2周,于治疗后1周、2周及3个月对患者进行随访。以视觉模拟标尺评分(visual analogue scale,VAS评分)、Constant-Murley肩关节评分量表、肩关节活动范围、红细胞沉降率(erythrocyte sedimentation rate,ESR)及生化指标评价疗效和安全性。结果共92例患者完成研究。相较于本组治疗前,3组在治疗后1周、2周及3个月VAS评分、Constant-Murley肩关节评分、肩关节活动范围有显著改善(P<0.05),完成治疗后ESR有显著改善(P<0.05),肝肾生化指标无统计学意义(P>0.05)。3组组间比较,治疗后1周疗效无统计学意义(P>0.05),C组2周后及3个月效果明显优于A、B组(P<0.05)。完成治疗后的ESR及肝肾生化指标水平无统计学意义(P>0.05)。3组均未发现严重不良事件,不良反应发生率3组比较,差异无统计学意义(P>0.05)。结论针刺、中药内服及外用等疗法对于瘀滞型肩关节周围炎患者的疼痛和活动受限具有显著疗效,能明显地提高患者的生活质量,综合应用中医治疗手段2周后的中远期疗效明显优于单一手段。

NFAT3在充血性心力衰竭气虚血瘀证患者舌苔液中的表达及意义

目的研究活化T细胞核因子3(nuclear factor of activated T-cells 3,NFAT3)在充血性心力衰竭(congestive heart failure,CHF)气虚血瘀证患者舌苔液中的表达及与临床指标相关性,初步拟定该证候的诊断界值。方法收集CHF气虚血瘀证患者及健康对照者各30例,酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测舌苔液中NFAT3的含量。结果NFAT3在CHF气虚血瘀证患者舌苔液的含量为(481.40±103.00)pg/mL,明显高于健康对照者舌苔液的含量[(237.90±156.50)pg/mL](P<0.01);且随着美国纽约心脏协会(New York Heart Association,NYHA)心功能分级的增加,CHF气虚血瘀证患者舌苔液中NFAT3含量不断升高(P<0.01);CHF气虚血瘀证患者舌苔液NFAT3与NYHA心功能分级呈正相关性(r=0.927,P<0.01),与B型脑钠肽(brain natriuretic peptide,BNP)(r=0.806,P<0.01)呈正相关性,与左室射血分数(left ventricular ejection fraction,LVEF)呈负相关性(r=-0.739,P<0.01)。绘制受试者操作特性曲线(receive operating characteristic,ROC)初步拟定舌苔液清中NFAT3诊断CHF气滞血瘀证的界值为363.37 pg/mL,曲线下面积为0.91。结论NFAT3能够反映CHF病情轻重程度,可为CHF气虚血瘀证提供客观化、量化的参考和依据。

坚骨胶囊对气滞血瘀型肘关节骨关节炎的影响

目的 探讨坚骨胶囊治疗气滞血瘀型肘关节骨关节炎的临床效果。方法 选择2018年1月至2021年6月河北省沧州中西医结合医院收治的气滞血瘀型肘关节骨关节炎患者90例,按照随机数字表法将其分成两组,每组45例。观察组采用坚骨胶囊联合玻璃酸钠治疗,对照组单用玻璃酸钠治疗,两组连续治疗5周。比较两组临床疗效,比较治疗前后Mayo肘关节功能评分(MEPS)、患侧肘关节关节活动度(ROM)、视觉模拟评分法(VAS)评分,以及关节滑液中基质金属蛋白酶-3(MMP-3)、白细胞介素-1β(IL-1β)、软骨寡聚基质蛋白(COMP)、转化生长因子-β_(1)(TGF-β_(1))水平。比较两组不良反应发生情况。结果 观察组临床疗效优于对照组(P<0.05)。治疗后,两组MEPS评分、肘关节ROM高于治疗前,VAS评分低于治疗前,且观察组MEPS评分、肘关节ROM高于对照组,VAS评分低于对照组(P<0.05)。治疗后,两组关节滑液中MMP-3、IL-1β、COMP水平低于治疗前,关节滑液中TGF-β_(1)水平高于治疗前,且观察组关节滑液中MMP-3、IL-1β、COMP水平低于对照组,关节滑液中TGF-β_(1)水平高于对照组(P<0.05)。两组治疗过程中均无明显不良反应发生。结论 联合坚骨胶囊治疗能更有效地调控气滞血瘀型肘关节骨关节炎患者关节滑液中MMP-3、IL-1β、COMP和TGF-β_(1)的表达水平,促进关节软骨修复。

气阴两虚夹瘀型2型糖尿病患者外周血LncRNA TUG 1与血管病变标志因子的相关性

目的分析气阴两虚夹瘀型2型糖尿病患者外周血长链非编码RNA牛磺酸调节基因1(long non-coding RNA taurine regulatory gene 1,LncRNA TUG1)与血管病变因子的相关性。方法随机选取该院内分泌科住院的气阴两虚夹瘀型2型糖尿病患者50例作为观察组,另选取46例健康体检者作为健康对照组。检测餐后2 h血糖(2-hour postprandial blood glucose,2 h PG)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、内皮素(endothelin,ET)、一氧化氮(nitric oxide,NO)水平及LncRNA TUG1表达;经Pearson线性相关分析,血清LncRNA TUG1与ET、NO、HbA1c、血糖指标的相关性。结果与健康对照组比较,气阴两虚夹瘀型2型糖尿病患者LncRNA TUG1、HbA1c、FPG、2 h PG、ET水平明显升高(P<0.01),NO水平明显降低(P<0.01),差异具有统计学意义。Pearson相关性分析显示,LncRNA TUG1与NO水平呈显著负相关(P<0.01);与ET、HbA1c、FPG、2 h PG水平呈显著正相关(P<0.01)。结论气阴两虚夹瘀型2型糖尿病患者外周血LncRNA TUG1高表达,与HbA1c、ET、血糖呈正相关,与NO水平呈负相关,与血管病变标志因子关系密切,存在一定的相关性,可作为潜在预测指标。

益心泰颗粒对慢性心衰(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α的影响

目的观察益心泰颗粒对慢性心力衰竭(CHF)(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α的影响。方法采用丙硫氧嘧啶灌胃及阿霉素腹腔注射复制CHF(心气虚兼血瘀水停证)模型大鼠,将造模成功大鼠分为模型组与益心泰低、中、高剂量组和曲美他嗪组;另设正常对照组。灌胃4周后观察心肌组织病理结构,检测LVEF、血清NT-proBNP及心肌组织FFA、ATP/AMP、LAC、pAMPK、AMPK、PGC-1α水平。结果与模型组比较,益心泰颗粒低、中、高剂量组及曲美他嗪组LVEF、心肌组织ATP/AMP值、心肌组织p-AMPK、AMPK、PGC-1α相对灰度值均明显升高(P<0.05或P<0.01),血清NT-proBNP及心肌组织FFA、LAC明显降低(P<0.05或P<0.01)。结论益心泰颗粒能促进慢性心力衰竭(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α表达,改善心肌能量代谢。

基于气滞血瘀理论探讨五虎口服液治疗急性软组织损伤的疗效

目的基于气滞血瘀理论探讨五虎口服液治疗急性软组织损伤的疗效。方法选取2020年9月—2022年9月于我院就诊的130例急性软组织损伤(ASTI)患者作为研究对象,通过随机数字表法分为研究组(65例)和对照组(65例),对照组给予吲哚美辛巴布膏治疗,研究组在对照组基础上给予五虎口服液治疗。并建立五虎口服液治疗ASTI的效益与风险多准则决策分析模型。采用RevMan5.3软件合并数据,得出各效益指标和风险指标效应值,采用Hiview3软件计算出研究组和对照组的效益值、风险值和效益-风险总值,改变效益-风险中一级指标的权重来评价模型的灵敏度。结果治疗后,研究组患者在压痛、瘀斑、肿胀、功能障碍、VAS评分、疼痛缓解时间、肿胀缓解时间、不良反应、临床疗效、功能障碍缓解时间方面改善显著优于对照组(均P<0.05);且IL-6、TNF-α水平均显著低于对照组(P<0.05),其余指标比较差异无统计学意义(P>0.05);研究组和对照组的效益值分别为66和50,风险值分别为71和83,效益-风险总值分别为67、57。研究组的效益-风险总值最高。无论效益-风险的相对权重如何改变,模型评价结果均保持不变,表明该模型稳定型良好。结论基于气滞血瘀理论下,五虎口服液治疗ASTI获益高于风险,可降低不良反应的发生率,能够为临床合理用药提供依据。

黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者ICU获得性衰弱的疗效

目的观察黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者重症监护病房(intensive care unit,ICU)获得性衰弱的效果。方法将66例重症骨创伤ICU获得性衰弱患者,按照随机数字表法分为对照组33例和观察组33例。对照组给予功能锻炼,观察组在此基础上联合黄芪桂枝五物汤加减联合针刺,连续治疗2周。比较两组的临床疗效、机械通气时间、ICU住院天数、日常生活活动能力Barthel指数(BI)评分、APACHEⅡ评分、肌力状态(MRC)评分。结果观察组的有效率90.91%(30/33),高于对照组的有效率69.70%(23/33)(P<0.05);观察组机械通气天数、住ICU时间明显短于对照组(P<0.05);治疗14d,观察组患者的BI等级优于对照组(P<0.05);治疗3d、治疗5d、治疗7d的观察组的APACHEⅡ评分明显低于对照组,肌力状态MRC评分明显高于对照组(P<0.05)。结论黄芪桂枝五物汤加减联合针刺治疗能明显缩短重症骨创伤ICU获得性衰弱患者的机械通气时间、ICU住院天数,提高日常活动能力,改善肢体肌力,更利于促进疾病康复。

长蛇灸联合熏洗包熏蒸治疗气滞血瘀型腰椎间盘突出症对患者疼痛介质及炎症因子的影响

目的:探讨长蛇灸联合熏洗包熏蒸在腰椎间盘突出症(气滞血瘀型)患者治疗中的应用价值,观察其对炎症因子、疼痛介质水平的影响。方法:将2019年6月—2020年12月因腰椎间盘突出症于南昌市洪都中医院就诊且中医证型属于气滞血瘀型的90例患者纳入研究,用随机数字表法将患者分为对照组、观察A组、观察B组,各30例。对照组予硬膜外封闭治疗,观察A组予硬膜外封闭治疗+熏洗包熏蒸治疗治疗,观察B组予硬膜外封闭治疗+熏洗包熏蒸+长蛇灸治疗。治疗2周后比较临床效果。结果:治疗后,三组血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP)、白介素-1β(interleukin-1,IL-1β)、血清前列腺素E2(prostaglandin E2,PGE2)、5-羟色胺(5-hydroxytryptamine,5-HT)水平均较治疗前降低,观察B组均低于观察A组、对照组,观察A组上述指标水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后三组视觉模拟评分法(visual analogue scale,VAS)评分均降低,日本骨科协会(Japanese orthopaedic association,JOA)评分及血清β-内啡肽(β-endorphin,β-EP)均较治疗前升高,观察B组VAS评分数值水平低于观察A组、对照组,JOA评分及β-EP数值水平则均高于观察A组及对照组,观察A组VAS评分水平低于对照组,JOA评分及β-EP数值则均更高,差异均有统计学意义(P<0.05)。结论:对于腰椎间盘突出症(气滞血瘀型)患者而言采用长蛇灸联合熏洗包熏蒸可减轻炎症反应,降低疼痛介质,改善临床症状及腰椎功能,安全性高,有助于临床效果提高。

Summary of 32 Patients with Cardiac Syndrome X Treated by TCM Therapy of Regulating Qi Relieving Chest Stuffiness and Promoting Blood Circulation

Objective： To evaluate the clinical effect of Liqi Kuanxiong Huoxue method （宽胸活血,LKH, traditional Chinese medicine, TCM therapeutic method for regulating qi, relieving chest stuffiness and promoting blood circulation） in treating patients with cardiac syndrome X （CSX）. Methods： The prospective, non-randomized controlled study was conducted on 51 selected patients with CSX, who were non-randomly assigned to 2 groups, the treated group treated with LKH in addition to the conventional treatment （32 patients）, and the control group treated with conventional treatment （19 patients） like nitrate, diltiazem hydrochloride, etc. The treatment course was 14 days. The changes of such symptoms as angina pectoris, TCM syndrome and indexes of treadmill exercise test before and after treatment were observed. Results： After treatment, such symptoms as chest pain and stuffy feeling and palpitation in the treated group were improved more than those in the control group （P〈0.05）; the total effective rate on angina pectoris and TCM syndrome in the treated group was better than that in the control group （P〈0.05）. The treadmill exercise test showed that the maximal metabolic equivalent （Max MET）, the time of angina onset and ST segment depression by 0.1 mV were obviously improved after treatment in both groups, but the improvement in the treated group was better than that in the control group respectively （P〈0.05）. Conclusion： The LKH method could reduce the frequency of angina attacks and improve the clinical condition of patients with CSX.