盐酸西布曲明治疗肥胖症的疗效观察

目前肥胖发病率迅速增加 ,无论是发达国家 ,还是发展中国家 ,据估计全球约有 3亿人患有肥胖症。在我国 ,随着人民生活水平的提高 ,生活方式的改变 ,肥胖的发生率逐步升高 ,在城市超重及肥胖人数从 1982年的 9.7% ,上升到 1992年的14 .9% ,2 0 0 2年将达到 2 5 %。肥胖症本身及与之相关的 2型糖尿病、高血压、高血脂和心脑血管疾病严重影响人们的生活质量并缩短寿命。对肥胖症的治疗 ,主要包括控制饮食 ,加强运动治疗。在饮食和运动治疗效果不佳时需应用药物治疗。盐酸西布曲明 (商品名 :可秀 )是一种 5 羟色胺和去甲肾上腺素的再摄取抑制剂…     

针刺对单纯性肥胖症远期疗效观察

目的：观察针刺治疗单纯性肥胖症的远期疗效，为进一步研究其作用机理提供临床依据。方法：98例单纯性肥胖症患者分为胃肠实热（63例）、脾虚湿阻（24例）、肝郁气滞（5例）和肾气不足（6例）等4型，视不同证型施以相应补泻手法减肥。结果：98例患者均接受1个疗程的治疗。经3年随访，总有效率88.8％。结论：单纯性肥胖症患者的辩证分型不同、合并症各异，但只要按照中医辩证治疗，均可获得良好疗效。     

学龄前儿童单纯性肥胖症的调查分析

随着我国国民经济的发展，居民生活条件的提高，小儿肥胖症的发病率不断增高。研究资料已经发现小儿肥胖症与成人肥胖症、冠心病、高血压、糖尿病等有一定关系。为了探求本地儿童单纯肥胖症的发病情况，找出相关因素，我们对市区内部分幼儿园的2.5～6岁儿童进行了调查分析，现报告如下。     

单纯性肥胖症对儿童健康的损害

目的：分析单纯性肥胖症对儿童健康的损害。资料来源：应用计算机检索medline 2000—01／2006—12与儿童单纯肥胖症相关的文章，检索词为“children，obesity”，限定文章语言种类为英文。同期检索中国期刊全文数据库与儿童单纯肥胖症相关的文章，检索词为“儿童，单纯性肥胖”，限定文章语言种类为中文。资料选择：对资料进行初筛，选取针对性强的文章。同一领域的文献则选择近期发表或权威杂志的文章。然后，对筛选出的文献查找全文。排除标准：①综述文献。②重复的同一研究。资料提炼：共收集到180篇与儿童单纯肥胖症相关的文章，入选22篇，其中5篇关于肥胖症血流变学临床实验研究，5篇关于肥胖相关性肾病的研究，7篇通过临床调查肥胖儿童睡眠状况流行病学研究，另外5篇文献观察肥胖儿童的精神卫生问题。资料综合：单纯性肥胖多由于进食过多，摄入的能量超过消耗量。它与成人的一些慢性病，如冠心病、高血压、糖尿病等有一定关联，近年来还发现其对小儿血流变学、肾脏、睡眠状况等产生一定影响，使儿童健康造成严重损害。结论：单纯性肥胖症严重地影响着儿童的身心健康，不仅导致儿童血脂代谢异常、心血管系统异常、胰岛素抵抗等损害，而且在其他方面也存在明显的影响。     

单纯性肥胖症对儿童健康的损害

目的:分析单纯性肥胖症对儿童健康的损害。资料来源:应用计算机检索medline2000-01/2006-12与儿童单纯肥胖症相关的文章,检索词为“children,obesity”,限定文章语言种类为英文。同期检索中国期刊全文数据库与儿童单纯肥胖症相关的文章,检索词为“儿童,单纯性肥胖”,限定文章语言种类为中文。资料选择:对资料进行初筛,选取针对性强的文章。同一领域的文献则选择近期发表或权威杂志的文章。然后,对筛选出的文献查找全文。排除标准:①综述文献。②重复的同一研究。资料提炼:共收集到180篇与儿童单纯肥胖症相关的文章,入选22篇,其中5篇关于肥胖症血流变学临床实验研究,5篇关于肥胖相关性肾病的研究,7篇通过临床调查肥胖儿童睡眠状况流行病学研究,另外5篇文献观察肥胖儿童的精神卫生问题。资料综合:单纯性肥胖多由于进食过多,摄入的能量超过消耗量。它与成人的一些慢性病,如冠心病、高血压、糖尿病等有一定关联,近年来还发现其对小儿血流变学、肾脏、睡眠状况等产生一定影响,使儿童健康造成严重损害。结论:单纯性肥胖症严重地影响着儿童的身心健康,不仅导致儿童血脂代谢异常、心血管系统异常、胰岛素抵抗等损害,而且在其他方面也存在明显的影响。     

电针治疗单纯性肥胖症93例疗效观察

目的:确证电针治疗单纯性肥胖症的疗效.方法:123例患者随机分为2组,试验组93例采用电针加耳压疗法,对照组30例采用多功能神经肌肉治疗仪减肥处方治疗,10次为1个疗程,治疗2个疗程.结果:2组间治愈率、显效率、有效率比较,差异均有极显著意义(P＜0.05或0.01).结论:电针加耳压治疗单纯性肥胖症,优于多功能神经肌肉治疗仪减肥处方.     

针灸治疗单纯性肥胖症并发经前期紧张综合征的疗效分析

目的：观察针灸疗法对女性肥胖症及肥胖并发经前期紧张综合征患者的干预效果。方法：选择1998-01／2002-12在南京中医药大学门诊部就诊的肥胖症及肥胖并发经前期紧张综合征的女性患者90例，分为单纯肥胖组和伴经前期紧张综合征组，每组45例，均自愿参加观察。依据中医辨证施治基本理论，两组均采用耳体针结合的针灸疗法。耳穴埋藏揿针或王不留行籽，胶布固定，每日自行按压3次，每次每穴按压一两分钟，3d更换1次，两耳交替治疗。针灸体穴隔日1次，每次留针30min。耳体针同时进行，以3个月为1个疗程，治疗1个疗程。治疗前及治疗3个月后比较两组患者的临床病证指数和疗效。临床病证指数得分越高表明病情越严重，总分最高为46．49。疗效判断值=[（疗前临床病证指数-疗后临床病证指数）／疗前临床病证指数]。显效：疗效判断值≥2／3；有效：1／3≤疗效判断值〈2／3；无效：疗效判断值〈1／3。结果：纳入肥胖症患者90例，全部进入结果分析，无脱落。①两组患者治疗3个月后的疗效比较：单纯肥胖组患者的总有效率显著高于伴经前期紧张综合征组【97％，87％（X^2=-25．71，P〈0．01）】。②两组患者治疗前及治疗3个月后临床病证指数比较：单纯肥胖组及伴经前期紧张综合征组患者治疗3个月后均显著低于治疗前[4．47&;#177;5．75，17.64&;#177;5．88；9．28&;#177;8．53，28．24&;#177;9．51（t=10．70，9．98，P〈0．01）1。结论：针灸疗法对单纯肥胖症及肥胖伴经前期紧张综合征患者均具有良好的干预效果，表明针灸疗法同时具有减肥和改善经前期紧张综合征病证的作用。     

针灸治疗单纯性肥胖症并发经前期紧张综合征的疗效分析

目的观察针灸疗法对女性肥胖症及肥胖并发经前期紧张综合征患者的干预效果。方法选择1998-01/2002-12在南京中医药大学门诊部就诊的肥胖症及肥胖并发经前期紧张综合征的女性患者90例,分为单纯肥胖组和伴经前期紧张综合征组,每组45例,均自愿参加观察。依据中医辨证施治基本理论,两组均采用耳体针结合的针灸疗法。耳穴埋藏揿针或王不留行籽,胶布固定,每日自行按压3次,每次每穴按压一两分钟,3d更换1次,两耳交替治疗。针灸体穴隔日1次,每次留针30m in。耳体针同时进行,以3个月为1个疗程,治疗1个疗程。治疗前及治疗3个月后比较两组患者的临床病证指数和疗效。临床病证指数得分越高表明病情越严重,总分最高为46.49。疗效判断值=[(疗前临床病证指数-疗后临床病证指数)/疗前临床病证指数]。显效疗效判断值≥2/3;有效1/3≤疗效判断值<2/3;无效疗效判断值<1/3。结果纳入肥胖症患者90例,全部进入结果分析,无脱落。①两组患者治疗3个月后的疗效比较单纯肥胖组患者的总有效率显著高于伴经前期紧张综合征组[97%,87%(χ2=25.71,P<0.01)]。②两组患者治疗前及治疗3个月后临床病证指数比较单纯肥胖组及伴经前期紧张综合征组患者治疗3个月后均显著低于治疗前[4.47±5.75,17.64±5.88;9.28±8.53,28.24±9.51(t=10.70,9.98,P<0.01)]。结论针灸疗法对单纯肥胖症及肥胖伴经前期紧张综合征患者均具有良好的干预效果,表明针灸疗法同时具有减肥和改善经前期紧张综合征病证的作用。     

护理干预对单纯性肥胖症儿童的影响

目的 探讨护理干预对儿童单纯性肥胖症(CSO)的治疗效果.方法 随机抽取门诊55例确诊为CSO的患儿进行有效的护理干预,并对治疗前后的疗效进行分析.结果 经统计学处理,结果显示有差异(P＜0.05).结论 对CSO患儿施行护理干预具有重要意义,可有效达到减肥的效果,以利于儿童健康成长.     

Use of sibutramine an inhibitor of the reuptake of serotonin and noradrenaline, in the treatment of binge eating disorder: A placebo-controlled study

Binge-eating disorder, which is characterized by repeated episodes of uncontrolled eating, is common in obese patients and is often accompanied by comorbid psychiatric disorders, especially depression. In previous studies, selective serotonin reuptake inhibitors have demonstrated efficacy in reducing the frequency of binge eating and addressing comorbid psychiatric disorders, but they have not shown the ability to promote weight loss. Sibutramine, a new serotonin and norepinephrine reuptake inhibitor, has been shown in short- and long-term studies to be effective in promoting and maintaining weight loss in obese patients who have binge-eating disorder. In this randomized, double-blind, placebo-controlled study, the efficacy, safety, and tolerability of sibutramine were evaluated in the treatment of binge-eating disorder in obese patients. Twenty patients were randomly assigned in equal numbers to receive either sibutramine 10 mg/day or placebo for 12 weeks. Assessments were made at baseline and every 2 weeks throughout the study. Binge frequency, defined as the number of days during the previous week that included binge-eating episodes, was the primary outcome measure. By the end of the study, the binge frequency among patients given sibutramine was significantly lower than that among those given placebo. The main adverse events in the sibutramine group were dry mouth and constipation. The findings suggest sibutramine is an effective medication in the treatment of binge-eating disorders and is well tolerated. In addition, it addresses the 3 main goals in the treatment of binge-eating disorder: reducing the frequency of binge eating, promoting and maintaining weight loss, and treating the comorbid psychiatric conditions.     

Safety and efficacy of sibutramine in overweight Hispanic patients with hypertension

This 6-month randomized study evaluated the safety and efficacy of sibutramine in 57 overweight Hispanic patients with hypertension. Following a 2-week washout to confirm the diagnosis of hypertension, antihypertensive medication was adjusted to achieve a blood pressure less than 140/90 mm Hg before institution of either sibutramine 10 mg or placebo once a day. A body mass index in excess of 27 kg/m² was required for entry. At study end, weight had changed from 75.4±9.6 to 70.0±9.5 kg in the sibutramine group and from 77.9±9.0 to 74.5±9.4 kg in the placebo group. In the sibutramine group, systolic blood pressure was 127.8±5.8 mm Hg after stabilization and 125.2±8.5 mm Hg after completion of the trial; respective values for diastolic blood pressure were 82.4±3.7 and 81.5±4.6 mm Hg. With placebo, blood pressure dropped from 129.0±7.1/80.9±4.9 mm Hg to 122.8±9.7/80.3±5.4 mm Hg at the same timepoints. In the sibutramine group, 14 patients reported 21 adverse events, most frequently headache (n=5), constipation (n=4), and dry mouth (n=4). In the placebo group, 13 patients had 20 adverse events. Sibutramine is safe and effective in overweight Hispanic patients with hypertension, but monitoring of blood pressure and titration of antihypertensive medication are necessary.     

Use of sibutramine in obese hispanic adolescents

A study on the treatment of obese adolescents with the use of sibutramine in private practice is presented. Patients consisted of 24 boys and 43 girls with obesity (body mass index [BMI] < 85th percentile sex-specific BMI for age and sex) ranging from 12 to 18 years of age. Patients were given sibutramine 10 mg per day for 6 months. With the last observation carried forward adjustment, after 6 months of treatment, patients’ average weight changed from 91.6±19.7 kg to 81.9±19.0 kg (P > .001), that is, 89.5±7.3% of initial weight. The most frequently reported adverse events included increased blood pressure and pulse rate (n=7), constipation (n=8), dry mouth (n=4), and constipation and dry mouth (n=3). Sibutramine may be considered effective for the treatment of obese adolescents, with a level of safety similar to that observed in adult patients.     

西布曲明治疗肥胖高脂血症性脂肪性肝炎的实验性研究

目的:探讨减肥药西布曲明对肥胖高脂血症性脂肪性肝炎大鼠的作用。方法:40只SD大鼠持续10周高脂饮食后随机分为2组。模型组(n=20)恢复正常饮食;西布曲明组(n=20)恢复正常饮食,同时给予西布曲明2mg/(kg·d)。另设20只普通饮食大鼠作正常对照。4周后处死,分别测定血清肝功能、甘油三酯(TG)、胆固醇(TC)、游离脂肪酸(FFA),血浆脂蛋白脂酶(LPL)、肝脂酶(HL),血清及肝组织丙二醛(MDA)、肿瘤坏死因子α(TNFα);观察肝脏病理变化。结果:与对照组比较,模型组血脂、ALT、AST,血清及肝组织MDA,TNFα明显升高,血浆LPL、HL明显下降,病理学检查示明显脂肪性肝炎;与模型组比较,西布曲明组血脂紊乱明显改善,血清ALT、血清及肝组织MDA明显降低,血清AST有下降趋势,血浆LPL、HL明显升高,病理学检查接近正常,但TNFα下降不明显。结论:西布曲明可通过减轻脂质过氧化促进肥胖高脂血症性脂肪肝性肝炎的痊愈。     

Double-blind study of naproxen vs placebo in the treatment of acute migraine attacks

Naproxen was compared with placebo in a double-blind, crossover trial in classic and common migraine. The trial was terminated at a fixed date; 37 patients had entered, 5 of whom were excluded. Naproxen was given as 750 mg at the first symptom of the attack, a total of 1250 mg per 24 h was allowed. Patients were followed for six attacks or three months in each phase, whichever came first. The severity of the headache was significantly less with naproxen in the first 2 h of the attack (p = 0.047), whereas there was no difference when the whole attack was considered. Significantly more patients preferred naproxen (p = 0.042). Side effects occurred in five patients, causing withdrawal of one patient while on naproxen.     

复方丹参注射液、蝮蛇抗栓酶及等容血液稀释对血液流变学影响的对比研究

观察静滴复方丹参注射液，蝮蛇抗栓酶及等容血液稀释对血液流变学的影响，结果表明：复方丹参注射液具有明显降低全血粘度、血浆粘度及改善红细胞变形性作用，安全且使用方便，无不良反应；蝮蛇抗栓酶具有明显抗凝、降纤、降粘、溶栓作用，但有出血反应等副作用。等容血液稀释法快速有效降低Ｈｃｔ、全血粘度，改善血液浓粘凝聚状态，本法安全、方便、见效快。     

The use of placebo in clinical nursing research

Aims. This paper reviews placebo and placebo effects and their measurement and application to nursing. Ethical and methodological issues are also discussed. Implications for nursing and recommendations for future study are offered. Background. Placebos have been used for decades in clinical trials but discussion about conceptual, methodological and ethical issues has been comparatively scarce. Conclusion. It is concluded that true placebo effects are difficult to measure and control and the use of credible placebo is sometimes impractical in clinical nursing research. This leads to the increased use of usual care as a control by researchers. However, more information should be reported in studies that use this approach, including the specification of usual care, its monitoring and patient adherence. Relevance to clinical practice. Where its use is considered ethical, safe and feasible, a placebo arm should be included in studies of efficacy to distinguish between active and inactive treatment.     

不同电化学发光免疫分析仪测定结果的可比性分析

目的：探讨罗氏E601和E411两系统间相同项目的检测结果是否具有可比性,以确保不同仪器在检测相同项目时检测结果的准确性和一致性。方法按照美国临床实验室标准化委员会（NCCLS）EP9-A2文件要求,以E601电化学发光免疫分析仪为比对仪器,E411为实验仪器,促甲状腺激素（TSH）为比对项目进行比对分析。以美国临床实验室修正法规（CLIA′88）规定的室间质量评价允许误差范围的1/2TEa为标准,对两系统间的预期偏倚进行评估。结果两检测系统在医学决定水平处的预期偏倚在允许范围内,临床可以接受。结论临床实验室内同一检测项目同时在两套或以上系统检测时应进行比对和偏倚评估,以确保检测结果具有可比性。