Treatment of 140 cerebral palsied children with a combined method based on traditional Chinese medicine(TCM)and western medicine

Objective:To observe and evaluate a method that is effective and practical for treatment of cerebral palsied(CP)children in China.Method:The patient's age and disease type and individual specific conditions were considered in choosingtherapy methods accordingly:Chinese herbs,acupuncture,auricnlar seed pressure,point finger pressing,massage,orthopedichand manipulation,physiotherapy,occupational therapy,language therapy,etc.Meanwhile we created a new CP treatment modelthat combines hospitalized treatment with family therapy.Results:The majority of CP patients improved greatly in motor andsocial adaptation capacities after treatment.Wilcoxon paired rank sum test analysis showed that there were significant differencesbetween the data before and after treatment(P<0.01).Conclusion:This combined therapy method,based on traditional Chinesemedicine and western medicine plus family supplemental therapy,is an effective and practical treatment strategy for CP children inChina.

Therapy of acute severe pancreatitis awaits further improvement

ＴｈｅｒａｐｙｏｆａｃｕｔｅｓｅｖｅｒｅｐａｎｃｒｅａｔｉｔｉｓａｗａｉｔｓｆｕｒｔｈｅｒｉｍｐｒｏｖｅｍｅｎｔＷＵＸｉａｎＺｈｏｎｇＳｕｂｊｅｃｔｈｅａｄｉｎｇｓｐａｎｃｒｅａｔｉｔｉｓ／ｔｈｅｒａｐｙ；ｐａｎｃｒｅａｔｉｔｉｓ／ｄｒｕｇｔｈｅｒ...

Progress on the Pathogenesis and Treatment of OCD, AD and Depression

Background: Obsessive-compulsive, anxiety disorder, and depression are the most common negative emotions. The incidence rate is high and spread across all age groups. With the rapid development of the world economy and the increasing competition in social life, the incidence rate has also increased rapidly, more and more young suffer from these three kinds of mental illnesses. Many studies have been carried out to investigate the pathogenesis and therapeutic method. It is necessary to summarize the progress for references to further research and treatment. Method: Based on a series of literature, the studies on the pathogenesis and therapeutic method of the three kinds of illnesses are summarized and analyzed. The points and results either of West medicine (WM) or traditional Chinese medicine (TCM) are collected and compared to find the best tendency of study and the best therapeutic method. Results: Obsessive-compulsive disorder, anxiety disorder and depression are common in recent years and severely affect people’s lives. In view of WM. These three kinds of illnesses are all related to the changes or damage of part of brain and nervous system. While TCM thinks that they are due to Qi stagnation or deficiency of heart Yin. Many methods of treatment have been presented and used clinically, but the effect is limited. Conclusion: The most promising and effective methods are those combining WM and TCM.

One Case of Diabetes Nephropathy Stage V, Combined Valvular Disease, Total Heart Failure with Diabetes Foot Gangrene

The patient was found to have 4+urine sugar by physical examination 14 years ago and was treated with oral hypoglycemic drugs. Insulin was injected intramuscularly nine years ago. Two and a half years ago, it was found that the color of the thumb, index and middle toe of the left foot became black. He went to a third-class hospital in Beijing and was diagnosed as “diabetes foot”. He was treated with “balloon dilation of lower limb blood vessels of diabetes foot”. Half a year ago, the third toe on the right side was broken and treated in the hospital again. “Popliteal artery stent implantation” was given for the diagnosis of “double kidney insufficiency, diabetes foot, left heart failure, combined heart valve disease”, “Hemofiltration therapy” and anti-inflammatory, amino acid supplementation, kidney function protection, anticoagulation, anemia correction and other treatments. Later, he went to our hospital and was diagnosed by the TCM diagnosis: category of consumptive disease, toe or finger gangrene (syndrome/pattern of qi and yin deficiency). Western medicine diagnosed: stage V of diabetes nephropathy, type II diabetes foot gangrene, combined with heart valve disease, hypoalbuminemia, double kidney cyst, moderate anemia, pleural effusion, hyperkalemia, pulmonary infection, and total heart failure. The patient was treated by the Qi-acupuncture therapy of TCM in combination with Chinese and Western medicine Medical treatment made the patient significantly better and discharged.

扶正消癌Ⅰ号方联合OFL方案治疗中晚期胃癌的临床观察

目的:观察扶正消癌Ⅰ号方对OFL方案治疗中晚期胃癌的减毒增效作用。方法:将60例患者随机分为2组各30例,对照组单纯采用OFL方案化疗,治疗组在对照组治疗的基础上给予扶正消癌Ⅰ号方。治疗3周为1疗程,治疗3疗程后评价近期疗效、毒副反应、生活质量和中医辨证分型疗效。结果:近期疗效治疗组为50.00%,对照组为43.33%,2组近期疗效比较,差异无显著性意义(P>0.05);毒性反应发生率、生活质量改善情况、中医辨证分型疗效2组分别比较,差异均有显著性意义(P<0.05)。结论:扶正消癌Ⅰ号方联合OFL方案治疗中晚期胃癌能显著降低毒副反应发生率,提高患者生活质量,显著改善中医临床症状,具有肯定的减毒增效作用。

Therapeutic effect of Zijin capsule in liver fibrosis in rats

AIM To confirm the therapeutic effect of Zijin capsule on liver fibrosis in rat model. METHODS Model group: bovine serum albumin (BSA) Freund′s incomplete adjuvant 0 5ml was injected subdermally at d 1, d 15 , d 22 , d 29 and d 36 for primary sensitization. Seven days after the fifth injection, BSA antibody in the serum was detected by double agar diffusion method. Normal saline of 0 4ml was injected through cauda vein to BSA antibody positive rat twice a week for fifteen times. Traditional Chinese medicine (TCM) decoction group and Zijin capsule group: In the attack injection period, Chinese medicinal decoction or Zijin capsule was given ig, the others were the same as in the model group. NS was used in the control group. The collagen content of rat liver was determined by Bergman′s method and expressed as ±s . The liver pathological changes were divided into four grades and expressed as the avarage of the total rank sum. RESULTS The collagen content (mg/g) of the liver in the control group (7 2±1 9) was significantly lower than that in the other groups; it was higher in the model group (31 7±16 6) than that in the two therapeutic groups; and lower in Zijin capsule group (9 7±2 8) than that in the TCM decoction group (11 5±5 3). The pathological changes were more aggravated in the model group (37 4) than those in the two therapeutic groups; and more severe in the TCM decoction group (30.2) than in the Zijin capsule group (22.9) CONCLUSION The therapeutic effect of Zijin capsule on the model was confirmed.

王文萍从痰瘀论治肺癌经验

王文萍教授认为,肺癌病机为痰瘀互结,临证以活血化瘀、调畅气机为主,软坚散结、化痰祛瘀为辅,方用血府逐瘀汤合二陈汤化裁治疗肺癌,同时注重对患者进行心理疏导,减轻其精神压力,以达到标本兼治的目的。本文从病因病机、治法治则、遣方用药总结王文萍教授治疗肺癌的临证经验,并附验案一则,以期较为全面地分析王文萍从痰瘀论治肺癌的学术思想。

儿童腺样体肥大中医病因病机及治疗进展探讨

腺样体肥大(adenoid hypertrophy,AH)是常见的儿童五官科疾病,多因过敏、反复感染等导致,久而失治可导致睡眠呼吸障碍、生长发育等问题。阐明AH的病因病机对提高中医临证辨治至关重要。该文系统总结近年来AH相关中医研究,在古代医家脾虚、痰湿、风热论治的基础上,将其病因病机进一步总结为脏腑虚损兼夹外邪、肺脾肾不足、痰湿阻窍、痰瘀互结等;总体而言,以虚为本、痰瘀为标。治疗上,以补虚泻实为主,或分期而治,或运脾补肺、清热化痰,化痰散瘀通窍贯穿始终,配合推拿、中药雾化、灼烙、熏鼻、雷火灸、点刺刮痧等特色外治,以期综合调理本虚标实之机。通过系统综述AH相关中医病因病机及治疗现状,旨在加深中医治疗AH的认识与思考,为AH的中医综合治疗提供理论依据。

Clinical Observation on the Combined Use of Acupuncture and Herbal Medicine for Treatment of Chloasma

Objective:To observe the clinical effects of the combined use of acupuncture and herbal medicine for treatment of chloasma.Methods:Totally 60 patients were randomly divided into a treatment group of 30 cases,treated by acupuncture and herbal medicine,and a control group of 30 cases,administered Vitamin C and Vitamin E.The clinical effects were observed.Results:The total effective rate of the treatment group is 93.3%better than that of the control group(76.7%) ,the difference was significant(P<0.01) .Conclusion:Combined use of acupuncture and herbal medicine may yield definite therapeutic effects in treating chloasma patients.

谭新华运用角药治疗男性下尿路症状的经验

谭新华教授运用角药治疗男性下尿路症状经验丰富,临床疗效显著,其所用角药类型可划分为补益类与祛邪类,分别有3种首选角药组合。补益类:针对脾肾气虚证,首选黄芪-人参-白术组合;针对肾阴亏虚证,首选熟地黄-女贞子-墨旱莲组合;针对肾阳不足证或下焦虚寒证,首选山药-益智仁-乌药组合。祛邪类:针对肝气郁滞证,首选柴胡-白芍-川楝子组合;针对气血瘀滞证,首选怀牛膝-桃仁-莪术组合;针对下焦湿热证型,首选车前子-萹蓄-瞿麦组合。从角药配伍角度分析谭新华教授治疗男性下尿路症状,并于文末附医案1则加以说明,以期进一步传承和发扬其学术思想,为临床提供参考。

中医药治疗非哺乳期乳腺炎

非哺乳期乳腺炎是一组发生在女性非哺乳期的良性炎症性疾病。该病病因不明,易漏诊、误诊,目前临床尚无统一有效的治疗方案,仍属乳腺疑难杂症,因其易反复发作、迁延不愈,也被称之为“不死的癌症”,对患者身心健康造成了极大的影响。西医以手术为主,药物为辅,但疗效不一,且复发率高,易致乳房畸形。近年来中医药治疗该病疗效显著,通过内治、外治及内外合治等手段发挥其优势。现将相关文献进行梳理,以期为临床治疗提供一定参考。

中药湿敷联合内服治疗急性踝关节扭伤临床研究

目的探究外敷平乐消肿止痛膏联合内服平乐解毒饮治疗急性踝关节扭伤的临床效果。方法选取2019年6月—2023年6月河南省洛阳正骨医院急诊科诊治的急性踝关节扭伤(I度和II度)的患者100例,分为试验组和对照组,各50例。在POLICE原则的基础治疗上,对照组予吲哚美辛巴布贴膏;试验组予外敷平乐消肿止痛膏联合内服平乐解毒饮,观察2组临床疗效、VAS评分、肿胀值、AOFAS评分的变化。结果治疗后,试验组临床总有效率优于对照组(P<0.05);治疗第1周和第2周,试验组VAS评分和肿胀值小于对照组(P<0.05);治疗第2周,试验组AOFAS评分优于对照组(P<0.05)。结论外敷平乐消肿止痛膏联合内服平乐解毒饮治疗急性踝关节扭伤有显著疗效,能很好缓解疼痛和肿胀程度,有效恢复患肢的功能。

中医药治疗慢性疲劳综合征研究进展

中医药治疗慢性疲劳综合征的方法主要包括中医内治法、中医外治法和联合治疗。目前,中医药治疗CFS的研究仍存在以下问题:(1)临床病例样本量过少,缺乏对患者治疗后期的随访,影响研究的可信度;(2)诊断缺乏明确的诊断标志物作为金标准;(3)治疗效果评判多采用量表评分,缺乏统一客观的疗效判定标准;(4)现研究主要从免疫、炎症、氧化损伤等角度进行机理探究,相关机理仍尚未明确。在今后的研究中,应增加病例观察数量,重视回顾性研究,提高随访率,统一诊断和疗效判定标准,加强对相关机制的研究,以期阐明药物及外治法的作用机理,丰富循证医学依据,推动中医药在治疗CFS领域的应用和发展。

参术冠心方治疗冠心病稳定型心绞痛临床研究

【目的】观察参术冠心方治疗冠心病稳定型心绞痛的疗效。【方法】采用多中心、随机、双盲、安慰剂对照的临床研究方法,共纳入病例120例,随机分为试验组和对照组。2组均给予相同的西医标准治疗,试验组同时给予参术冠心方中药复方颗粒剂,对照组给予参术冠心方安慰剂,2组疗程均为90 d。观察各时点的心绞痛发作情况、中医证候计分、西雅图心绞痛量表评分的变化情况。【结果】(1)完成随访114例,其中试验组55例,对照组59例。(2)心绞痛发作情况比较:治疗后第30、60、90天3个时点试验组心绞痛发作次数的改善作用优于对照组,差异均有统计学意义(P<0.05);治疗后第30、60天2个时点试验组的心绞痛发作持续时间的改善作用优于对照组,差异均有统计学意义(P<0.05);试验组第30天硝酸甘油的使用总量少于对照组,差异有统计学意义(P<0.05)。试验组治疗后第30、90天诱发心绞痛的体力活动程度的改善作用优于对照组,差异有统计学意义(P<0.05);试验组治疗后第30、60、90天3个时点心绞痛疼痛程度的改善作用优于对照组,差异均有统计学意义(P<0.01)。(3)试验组治疗后各时点中医证候计分和西雅图心绞痛量表各维度积分的改善均优于对照组,差异均有统计学意义(P<0.05)。【结论】参术冠心方能改善冠心病稳定型心绞痛患者的心绞痛症状,改善中医证候计分,提高患者的日常活动耐量。

帕金森病抑郁中西医结合诊断与治疗专家共识(2021年版)

抑郁是帕金森病最常见的非运动症状,帕金森病抑郁发病机制尚未完全阐明。为规范疾病诊断体系并提高临床疗效,通过组织全国7个省、直辖市中医和西医领域相关专家进行多次讨论和修改,共同制定《帕金森病抑郁中西医结合诊断与治疗专家共识(2021年版)》(以下简称共识)。共识中西医并重,参考帕金森病、抑郁症等相关诊断标准制定帕金森病抑郁西医诊断、评估量表和西医治疗的专家共识;同时参考中医颤证、郁证等相关中医诊断标准制定帕金森病抑郁中医辨证诊断体系和辨证论治的专家共识,并针对疾病早期和进展期采取不同的中西医结合治疗方法,有确切的临床优势且安全性较高,可供临床医师参考应用。

中西医结合治疗190例老年胰腺癌的预后分析

目的通过临床回顾性研究对以清胰化积方为主的中西医综合治疗老年胰腺癌进行疗效评估,探讨可行性治疗模式。方法采用Kaplan-Meier方法计算生存期,Log-rank检验进行组间比较,并通过应用Cox比例风险模型对2002年1月至2008年12月期间接受中西医结合治疗的190例老年胰腺癌患者进行多因素分析。结果本组190例老年胰腺癌患者:1年生存率28.42%;3年生存率6.32%;5年生存率2.11%。中位生存期为7.1个月。其中清胰化积组102例,中位生存期8.7个月;非清胰化积方88例,中位生存期4.7个月,差异有统计学意义(P<0.05)。KPS评分<80、CA19-9≥500 U/ml、消瘦(体重在6个月内减轻≥10%)、肝转移、手术方式、全身化疗和清胰化积中药是影响该治疗模式预后的独立影响因子。结论根治手术、全身化疗和清胰化积中药是老年胰腺癌长期生存保护因素。老年胰腺癌Ⅲ期患者可化疗结合清胰化积方中药治疗,Ⅳ期老年胰腺癌患者则应以中药及最佳对症支持治疗为主。

虚实辨证推拿治疗小儿急性非细菌感染性腹泻的临床对照研究

【目的】观察虚实辨证推拿治疗小儿急性非感染性腹泻的临床疗效。【方法】将113例小儿急性非感染性腹泻患儿随机分为试验A组37例、试验B组38例及对照组38例。3组均给予基础治疗(包括喂养指导、预防脱水及纠正脱水),试验A组在基础治疗的同时给予内服固定处方中药汤剂,试验B组在A组的基础上配合虚证推拿法或实证推拿法,对照组在基础治疗的同时口服思密达。3组均以3 d为1个疗程,疗程结束后观察临床疗效。【结果】全分析集(full analysis set,FAS)和符合方案集(per protocol set,PPT)的分析结果一致,3组的疗效基本相当,组间比较差异均无统计学意义(P﹥0.05)。治疗期间3组病例均未见明显不良反应。【结论】基础治疗是治疗小儿急性非细菌感染性腹泻的关键,中药辨证施治能起到与思密达基本相同的作用,而虚实辨证推拿治疗并不能显著提高中药辨证治疗的疗效。

中西医结合治疗HBV相关慢加急性肝衰竭合并肝性脑病的效果分析

目的探讨中西医结合治疗HBV相关慢加急性肝衰竭(ACLF)合并肝性脑病(HE)患者8周病死率情况,分析影响其预后的独立危险因素。方法选取2012年1月-2015年2月18家医院收治的HBV-ACLF患者,采用随机对照设计分为试验组和对照组,分别给予中西医结合治疗和单纯西医综合治疗,纳入所有0周合并HE的患者125例。观察2组8周病死率情况。计量资料2组间比较采用t检验或Mann-Whitney U检验,计数资料2组间比较采用χ2检验,生存分析采用Kaplan-Meier方法及logrank检验,危险因素分析采用Cox比例风险回归模型。结果试验组及对照组8周病死率分别为27.5%、50.0%(χ~2=5.630,P=0.018),8周内中位生存时间分别为41.2 d、28.4 d,累积生存概率分别为60.4%、32.5%(χ~2=6.187,P=0.013);Cox回归分析结果显示与对照组相比,试验组是HBV-ACLF合并HE患者预后的保护因素[风险比(HR)=0.424,P=0.018,95%可信区间(95%CI):0.208~0.864],高TBil(HR=1.063,P=0.042,95%CI:1.002~1.128)、低PTA(HR=0.942,P=0.044,95%CI:0.890~0.998)、ACLF分期晚期(HR=2.737,P=0.009,95%CI:1.287~5.818)、合并消化道出血(HR=5.291,P=0.003,95%CI:1.736~16.126)是8周死亡的独立危险因素。结论中医药治疗可显著降低HBV-ACLF合并HE患者的8周病死率,提高8周生存概率,延长生存时间。TBil、PTA、疾病分期、消化道出血是该组患者的独立预后影响因素。

中西医结合治疗激素性股骨头坏死的实验研究

目的 探讨中西医结合治疗激素性股骨头坏死的作用机制。方法 将 40只兔子随机分为对照组、模型组、中药组、介入组和综合组。于治疗后 8周 ,分别进行血液流变学、血脂、股骨头空骨陷窝数测定及观察。结果 中药组和介入组动物血浆和全血粘度、红细胞聚集指数、总胆固醇、甘油三脂和股骨头空骨陷窝率均明显低于模型组 (P <0 0 5)。综合组与模型组比较 ,全血高、中切粘度、红细胞聚集指数和甘油三脂明显降低 ,有显著差异 (P <0 0 1 ) ,与中药组和介入组比较亦有差异 (P <0 0 5) ,全血低切粘度、血浆粘度、总胆固醇降低 ,与模型组比较仍有差异 (P <0 0 5) ,空骨陷窝率较模型组显著降低 (P <0 0 1 )。结论 中药组、介入组和综合组治疗股骨头缺血性坏死 ,均可以降低血脂 ,改善血液循环 ,促进坏死骨修复和新生骨再生 。