IgA肾病中医辨证分型与病理类型的相关性分析

目的:探讨IgA肾病中医辨证分型与西医病理类型之间的关系。方法:对113例住院期间肾穿刺诊断为IgA肾病的患者进行中医辨证分型,分析二者的相关性。结果:IgA肾病肾虚湿瘀证最为常见,多表现为系膜增生性肾炎,并可出现局灶性节段性肾小球硬化和新月体性肾炎,病理损害程度较重;其次为脾虚湿热证,主要表现为系膜增生性肾炎和轻微病变;热结咽喉证则与肾小球轻微病变关系最为密切。结论:IgA肾病中医证型及病机演变与西医病理类型和病理损害程度具有较高的相关一致性。

中医男科学术经验述略

“根之茂者其实遂,膏之沃者其光晔”。笔者认为,中医是一门理论性很强的学科,其基础理论是中医之根;中医又是一门实践性很强的学科,在临证中可以汲取丰富的营养。笔者认为中医应理论与临床并重,更应注重医教研著全面发展。尝谓:“为医者,临床乃第一生命”;“为医者,不可一...

138例药物性肝损伤患者影响预后的因素分析

目的探讨影响药物性肝损伤（DILI）预后的因素。方法 2008年7月至2014年7月在我院住院期间发生DILI患者69例,采用Logistic回归分析影响预后的各个因素。结果本组患者发病年龄主要在50-59岁,女性患者多于男性,肝细胞型占78.3%;各年龄段患者临床类型无显著性差异（P〉0.05）;76.1%DILI患者预后良好,未愈者占23.9%;中药引发的DILI占43.5%,且预后较其他种类药引起者差;患者在住院期间恢复还是未愈与患者性别、年龄、用药至发病时间或是否合并慢性疾病无显著性相关（P〉0.05）,而与临床类型、是否有过敏史、发病时是否出现免疫特性临床表现有显著性相关（P〈0.05）;初始发病时血清总胆红素、总胆汁酸和碱性磷酸酶水平是预测预后的较好指标（P〈0.05）。结论 DILI患者预后主要取决于用药种类和个体体质差异,初始发病时肝功能指标对预后有一定的预测意义。

加减清营汤对大鼠体液免疫及血液流变学的影响

目的 观察加减清营汤对大鼠体液免疫及血液流变学的影响。方法 采用免疫比浊法测定血清中IgG、IgM、IgA和C4、C3 值 ,同时测定血浆黏度和血小板聚集率。结果 该方能够明显提高大鼠的补体C4的含量 (P <0 .0 1)以及补体C3的含量 (P <0 .0 5 ) ;2 0 0 %加减清营汤能够降低IgG和IgA的含量 (P <0 .0 5 ) ,提高补体C4的含量 (P <0 .0 5 )。加减清营汤对大鼠全血黏度无明显影响 (P >0 .0 5 ) ,但能降低大鼠血浆黏度 (P <0 .0 5 ) ;在对血小板聚集率的影响方面 ,加减清营汤能抑制血小板的最大聚集率 (P <0 .0 5 ) ,2 0 0 %加减清营汤能显著抑制血小板的最大聚集率 (P <0 .0 1)和 5min聚集率 (P<0 .0 5 )。结论 加减清营汤其作用强度与复方丹参相似。

加温加湿CO_(2)在预防人工气胸胸腔镜下食管癌切除手术患者术中低体温中的应用效果

目的:观察加温加湿CO_(2)在人工气胸胸腔镜下食管癌切除手术中维持患者术中体温、预防患者术中低体温的效果。方法:选取人工气胸胸腔镜下食管癌切除手术患者69例作为研究对象,将注入加温加湿CO_(2)的35例设为试验组;将注入未加温加湿CO_(2)的34例设为对照组。观察两组患者不同时间点的核心体温、术中低体温发生率、寒战发生率及苏醒时间。结果:两组患者的年龄、身高、体重、性别、ASA分级、建立人工气胸时长、手术总时长、出入量的差异均无统计学意义(P>0.05)。两组患者在手术开始前和建立人工气胸后30 min的核心体温差异无统计学意义(P>0.05);而两组患者在建立人工气胸后60 min、撤除气胸时、撤除气胸后30 min及手术结束时的核心体温差异具有统计学意义(P<0.05);两组患者的核心体温均随手术时间的推进而逐步下降,但试验组的下降幅度低于对照组。试验组患者术后寒战发生率低于对照组,但差异无统计学意义(P>0.05);试验组患者术中低体温发生率低于对照组,苏醒时间短于对照组,且差异均有统计学意义(P<0.05)。结论:在胸腔镜下食管癌根治手术中运用加温加湿CO_(2)建立人工气胸有利于维持患者术中体温,减少术中体温的下降幅度,还可以降低术中低体温的发生率,缩短术后苏醒时间。

经颅多普勒超声检测MCA与OA在原发性高血压病中的脑血流储备研究

目的运用经颅多普勒超声对高血压病患者大脑中动脉(MCA)和眼动脉(OA)血流储备及血管反应性研究,探讨其检查结果及临床意义。方法门诊随机抽取20例原发性高血压病患者40只眼及同时期体检健康20例正常对照组40只眼,运用经颅多普勒超声检查2组患者MCA及OA的平均血流速度(Vm)、屏气后的平均血流速度(Vm’)、搏动指数(PI)、屏气后的搏动指数(PI’)和屏气指数(BHI)的参数进行对比分析。结果高血压组与对照组比较:OA的平均血流速度(Vm)、屏气后的平均血流速度(Vm’)、搏动指数(PI)、屏气指数(BHI)与对照组比较均有统计学意义(P<0.05);MCA的搏动指数(PI)、屏气后的搏动指数(PI’)与对照组比较均有统计学意义(P<0.05)。结论通过对高血压患者MCA、OA的脑血管反应性检测,可以为高血压病患者早期及时提供防治依据。

针刺对多发性肌炎免疫调整作用的实验研究

本实验运用家兔肌匀浆为抗原免疫豚鼠制成与人类多发性肌炎（ＰＭ）类似的实验性自身变态反应性肌炎（ＥＡＭ）动物模型，以模型动物的肌电图、肌酶谱及肌肉病理作为分析指标，通过针刺“足三里”、“血海”，连续８周，结果表明：针刺组与对照组比较，免疫注射８周时，针刺组豚鼠肌电图的时限及波幅均值明显高于对照组（Ｐ均＜０．０５）；肌酶显著低于对照组（Ｐ均＜０．０５）；肌肉病理病变程度明显轻于对照组。提示针刺对ＰＭ患者的免疫机制具有一定的良性调整作用。

养血清脑颗粒治疗椎基底动脉供血不足的临床研究

目的观察养血清脑颗粒治疗椎基底动脉供血不足的疗效。方法90名椎基底动脉供血不足患者随机分为治疗组和对照组,并在治疗后经经颅多普勒(TCD)检测。结果治疗前后临床症状及血流速度均有显著差异(P<0.01)。结论养血清脑颗粒对治疗椎基底动脉供血不足疗效确切。

Development and evaluation of Panax notoginseng saponins contained in an in situ pHtriggered gelling system for sustained ocular posterior segment drug delivery

Objective:This study aimed to lay the foundation for the research on Panax notoginseng saponins(PNS)in pH-sensitive in situ gel and the development and improvement of related preparations.Methods:We used Carbopol■940,a commonly used pH-sensitive polymer,and the thickener hydroxypropyl methylcellulose(HPMC E4M)as an ophthalmic gel matrix to prepare an ophthalmic in situ gel of PNS.In addition,formula optimization was performed by assessing gelling capability with the results of in vitro release studies.In vitro(corneal permeation,rheological,and stability)and in vivo(ocular irritation and preliminary pharmacokinetics in the vitreous)studies were also performed.Results:The results demonstrated that the in situ gelling systems containing PNS showed a sustained release of the drug,making it an ideal ocular delivery system for improving posterior ocular bioavailability.Conclusions:This study lays the foundation for the research of PNS contained in an in situ pH-triggered gel as well as the development and improvement of related preparations.It concurrently traditional Chinese medicine with a contemporary in situ gelling approach to provide new directions for the treatment of posterior ocular diseases such as diabetic retinopathy.

富碘中药治疗甲亢的研究进展

近年来,甲状腺功能亢进症(甲亢)的发病人群越来越年轻化。此病的发生与环境因素及遗传因素密切相关。碘是合成甲状腺激素的重要原料。多项循证医学研究表明,用碘剂治疗甲亢的效果较好,且安全性较高。本文主要是对用富碘中药治疗甲亢的研究进展进行综述。

Research Progress on Molecular Mechanism of Moxibustion in the Treatment of Ankylosing Spondylitis

As an important part of traditional Chinese medicine (TCM) nursing technology, moxibustion plays a unique role in improving the symptoms of ankylosing spondylitis (AS). The research on the mechanism of moxibustion intervention in AS mainly focuses on anti-inflammatory effects, immune regulation, bone metabolism regulation, intestinal flora regulation, and so on. Molecular medicine is of great significance to further clarify the mechanism of moxibustion intervention in AS. However, there are still some problems in the research on the molecular mechanism of moxibustion intervention in AS: the existing biomedical research methods only explore from a specific field and lack the exploration of moxibustion-targeted molecules based on biomedical network. In the future, the molecular network effect of moxibustion on AS can be discussed comprehensively and systematically with the help of omics technology and the construction of biological information interaction network between omics. The effect of moxibustion on upstream osteogenic transcription factors and related signaling pathways such as WNT, β-catenin, and BMP/Smads is not yet clear. Future research can focus on the relevant signal targets of bone reconstruction and clarify the mechanism of moxibustion against the new bone formation. In addition, there is a lack of research on the molecular mechanism of moxibustion in the treatment of AS from the perspective of metabolites. It is necessary to further explore the mechanism of moxibustion in the treatment of AS with the help of metabonomics technology.

温阳通络法联合甲钴胺治疗痛性糖尿病周围神经病变疗效研究

目的 观察温阳通络法联合甲钴胺治疗痛性糖尿病周围神经病变(PDPN)的疗效。方法 将我院120例PDPN患者随机分成观察组与对照组各60例。对照组给予甲钴胺治疗,观察组给予甲钴胺联合温阳通络法治疗,治疗8周后,比较两组临床疗效、Toronto临床评分与视觉模拟评分法(VAS)评分、空腹血糖(FPG)、2 h口服葡萄糖耐量试验(2hPG)、糖化血红蛋白(HbA1c)水平、运动神经传导速度(MCV)、感觉神经传导速度(SCV)、白细胞计数(WBC)、血红蛋白(Hb)、丙氨酸氨基转移酶(ALT)、血肌酐(Cr)水平。结果 治疗后,观察组总有效率高于对照组(P <0.05)。两组Toronto临床评分、VAS评分、FPG、2hPG、HbA1c低于治疗前,MCV、SCV高于治疗前;观察组Toronto临床评分和VAS评分、FPG、2hPG、HbA1c低于对照组,观察组MCV、SCV高于对照组(P<0.05)。治疗前后两组WBC、Hb、ALT、Cr水平接近,差异无统计学意义(P>0.05)。结论 温阳通络法联合甲钴胺治疗PDPN患者,能改善周围神经病变和血糖水平,降低疼痛程度,增加周围神经传导速度,不影响肝肾功能、血常规,疗效显著。

Wrist–ankle acupuncture combined with pinching along the spine for children allergic rhinitis: A randomized controlled trial

Objective:To investigate the clinical effect of wrist–ankle acupuncture combined with pinching along the spine on allergic rhinitis(AR)in children.Methods:A total of 65 children with AR were collected from February 2017 through to December 2018 and they were randomly divided into a combined treatment group with wrist–ankle acupuncture,pinching along the spine and western medication(combined treatment group,32 cases)and a western medication group(33 cases).In the western medication group,loratadine was prescribed for oral administration.In the combined treatment group,on the base of the medication as the western medication group,the wrist–ankle acupuncture was adopted in combination with pinching along the spine.Before and after treatment,the symptoms and physical signs were scored and the clinical effect was observed in the children of the two groups.Results:After the treatment and in the follow-up,the scores of the symptoms and physical signs in the combined treatment group were lower than those of the western medication group,indicating a statistical significance(all P<0.05).The total effective rate was 93.7%in the combined treatment group,which was higher than 63.63%in the western medication group,indicating a statistical significance(P<0.05).Conclusion:The combined treatment of wrist–ankle acupuncture combined with pinching along the spine and loratadine effectively relieves the clinical symptoms and the physical signs in AR children.The clinical effect of this combined treatment is better than the simple use of loratadine.

Experimental research progress on the effect of moxibustion on liver and its influence factors

Through retrieving the relevant experimental researches from Pubmed,CNKI,Wanfang and VIP databases,it is discovered that the effects of moxibustion on liver are mainly reflected in the following three aspects,namely,maintaining the normal functions of liver,promoting the repair of liver injury and delaying liver aging.By further analysis and in view of experiments,the factors influencing these effects may include stimulation site,stimulation intensity and heat source.The effects of moxibustion on liver and its influencing factors are explored and discovered in the perspective of experimental researches and these discoveries have been verified in clinical practice correspondingly.Based on the current study situation,moxibustion therapy is still limited in clinical studies on liver disorders as compared with the experimental researches.Hence,the deep exploration of moxibustion on its specific biological effect and mechanism and the excavation of moxibustion on its clinical application are likely to be the coming emphasis of the basic research and clinical practice for moxibustion.

Case for abdominal migraine in child patient treated by acupuncture

A girl patient,seven years old,complaining intermittent periumbilical pain accompanied with headache and vomiting for almost one year.Acupuncture was adopted in treatment.Acupoints were Bǎihui(百会GV20),Yintang(印堂EX-HN3),Zhongwan(中脘CV12),Tàiyáng(太阳EX-HN5),Wangu(完骨GB12),Hegu(合谷LI4),Tianshū(天枢ST25),Zusānli(足三里ST36),Sānyinjiao(三阴交SP6)and TAichong(太冲LR3),electroacupuncture,warming needling moxibustion and infrared irradiation were applied.Acupuncture and moxibustion were given once every two days and 10 treatments were as one course.After one course of treatment,the child patient narrated that the attack frequency of headache and abdominal pain was reduced,the severity alleviated and the persistent duration shortened.After two courses of treatment,abdominal pain never occurred and the child patient was recovered and had a normal life and school activity.The disease was not recurred in one-year follow-up.