鼠神经生长因子联合加味七味白术散治疗T2DM周围神经病变

【摘要】 目的 探讨在鼠神经生长因子（NGF）的基础上给予加味七味白术散治疗2型糖尿病（T2DM）合并糖尿病周围神经病变（DPN）的临床疗效，并评估患者的神经功能与神经传导速度。 方法 选取2017年6月~2019年9月我院收治的100例T2DM合并DPN的患者为研究对象，按照入组先后顺序分为对照组与观察组，两组各50例。对照组给予营养神经与控制血糖的基础性治疗，观察组在营养神经与控制血糖的基础上给予七味白术散治疗。所有的患者进行连续8周的治疗，在正中神经与腓总神经评估感觉（SNCV）及其运动（MNCV）神经传导速度，并采用多伦多临床评分系统（TCSS）评估神经功能，评估临床症状的恢复情况，最后记录临床疗效。同时测定所有患者的空腹血糖（FBG）、餐后2小时血糖（2 h PBG）的变化情况，血脂［低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）］的变化情况。 结果 对照组的治疗总有效率（81.25%）低于观察组（97.73%） (P＜0.05)；两组患者治疗后2 h PBG、FBG、TG、LDL-C、TC均低于治疗前 (P＜0.05)，而HDL-C较治疗前升高 (P＜0.05)，以上血糖血脂治疗后两组患者之间比较差异无统计学意义（P＞0.05）；治疗后，两组患者正中神经及其腓总神经的MNCV与SNCV均高于治疗前 (P＜0.05)，且观察组高于对照组 (P＜0.05)；治疗后两组患者TCSS评分及临床症状评分均较治疗前降低 (P＜0.05)，且观察组低于对照组 (P＜0.05)。 结论 在鼠神经生长因子的基础上给予加味七味白术散治疗能很好改善2型糖尿病合并糖尿病周围神经病变患者的临床症状、神经功能，提高临床疗效，可在临床推广应用。     

益气活血祛湿法治疗糖尿病周围神经病变临床探讨

目的：探究益气活血祛湿法治疗糖尿病周围神经病变（DPN）的临床疗效。方法选择该院的98例糖尿病周围神经病变患者,随机分为观察组和对照组各49例。在积极控制患者血糖水平的基础上观察组给予益气活血祛湿法治疗,对照组给予西药常规治疗。对两组患者治疗前后神经传导速度进行观察比较;评价两组患者治疗后的临床疗效。结果治疗后两组患者腓总神经和正中神经的MNCV及SNCV均优于治疗前,差异具有统计学意义（P〈0.05）;观察组治疗后腓总神经和正中神经的MNCV及SNCV和对照组治疗后进行组间比较,优于对照组,差异具有统计学意义（P〈0.05）;治疗后经评价,观察组总有效率为89.80%,对照组总有效率为77.55%,观察组总有效率优于对照组,差异具有统计学意义（P＜0.05）。结论益气活血祛湿法治疗DPN能显著改善患者神经功能,提高临床疗效,加快患者恢复,可临床推广使用。     

脑心通联合氢溴酸高乌甲素治疗糖尿病周围神经病变效果观察

目的 探讨脑心通联合氢溴酸高乌甲素治疗糖尿病周围神经病变(DPN)的临床效果.方法 将88例DNP患者随机分为对照组和治疗组,各44例.对照组进行常规治疗;观察组应用脑心通联合氢溴酸高乌甲素治疗.2周为1个疗程,治疗1个疗程后观察两组治疗效果及治疗前后神经传导.结果 观察组治疗总有效明显高于对照组(P＜0.05),观察组治疗后正中神经和腓总神经运动及感觉传导速度均高于对照组(均P＜0.05),治疗组治疗后疼痛评分低于对照组(P＜0.05).结论 脑心通联合氢溴酸高乌甲素治疗DPN临床效果好,能够明显改善周围神经病变,并可缓解患者急性疼痛.     

甲钴胺联合前列地尔治疗糖尿病周围神经病变疗效观察

目的：探讨甲钴胺联合前列地尔治疗糖尿病周围神经病变（DPN）的临床疗效。方法将96例DPN患者随机均分为观察组和对照组（n=48）,对照组给予甲钴胺治疗,观察组给予甲钴胺联合前列地尔治疗,观察2组患者治疗疗效。结果观察组患者治疗后感觉传导速度及运动传导速度均优于对照组（P＜0.05）;观察组治疗总有效率为93.75%,高于对照组的72.92%（P＜0.05）。结论甲钴胺联合前列地尔治疗DPN可提高治疗疗效。     

鼠神经生长因子联合α-硫辛酸治疗糖尿病周围神经病变的疗效分析

目的观察鼠神经生长因子联合α-硫辛酸对糖尿病周围神经病变（diabeticperipheralneuropathy,DPN）的临床疗效。方法86例DPN患者随机分为观察组（n=44）和对照组（n=42）,观察组给予肌肉注射鼠神经生长因子联合静脉滴注α-硫辛酸治疗,对照组给予静脉滴注仪一硫辛酸治疗,疗程3周,观察分析两组治疗前后临床疗效及对正中神经及腓总神经传导速度的影响。结果观察组临床疗效总有效率81．82％,对照组总有效率69．05％,两组间相比差异有统计学意义（P〈0．05）;两组治疗后的正中神经、腓总神经的传导速度均较治疗前有显著改善（P〈0．05）,但观察组明显优于对照组（P〈0．05）,且治疗过程中未发现有明显副作用。结论鼠神经生长因子联合α-硫辛酸对DPN的疗效优于单用α-硫辛酸,是一种理想的治疗方案。     

弥可保合黄芪桂枝五物汤治疗糖尿病周围神经病变

目的：观察弥可保合加味黄芪桂枝五物汤治疗糖尿病周围神经病变（DPN）的疗效。方法：44例DPN患者随机均分为两组，两组原控制血糖方案不变，治疗组口服弥可保合加味黄芪桂枝五物汤，对照组口服弥可保，疗程均为8周，于治疗前后进行临床症候疗效评价、空腹和餐后2小时血糖测定、肌电图检测。结果：治疗组肌电图（EMG）与治疗前比较差异均有显著性意义（P＜0．05），与对照组比较，差异也有显著性意义（P＜0．05）。结论：加味黄芪桂枝五物汤治疗糖尿病周围神经病变，能改善神经传导速率，还可能促进血糖下降。     

糖通饮治疗糖尿病周围神经病变29例

目的观察糖通饮治疗糖尿病周围神经病变（DPN）的临床疗效,验证导师治疗DPN的学术观点,寻找治疗DPN临床有效方法。方法将符合诊断标准的DPN患者57例,按就诊顺序随机分为治疗组29例和对照组27例,在糖尿病基础治疗上,治疗组予糖通饮、对照组予甲钴胺口服治疗。观察2组患者临床症状、神经传导速度及血脂、血糖等指标。结果治疗组多伦多神经病变评分（TCSS）减少优于对照组（P<0.05）;治疗组腓运动神经、感觉神经传导速度改善均优于对照组（P<0.05）;治疗组总胆固醇、甘油三脂显著下降,优于对照组（P<0.01或P<0.05）。结论糖通饮可明显改善DPN患者的临床症状体征、神经传导速度,降低血脂,总体疗效优于对照组,是治疗DPN的有效组方。     

α-硫辛酸联合甲钴胺注射液治疗糖尿病周围神经病变临床价值分析

目的探讨α-硫辛酸联合甲钴胺注射液治疗糖尿病周围神经病变临床疗效。方法选择我院2007年9月～2009年11月收治的糖尿病周围神经病变患者86例,随机分为观察组和对照组,每组各43例,分别给予α-硫辛酸联合甲钴胺注射液和甲钴胺注射液治疗,疗程为2周,对两组患者治疗前后症状和神经传导速度测定进行比较。结果治疗2周后两组肌电图显示正中神经、腓总神经、胫神经的运动神经传导速度（MCV）和感觉神经传导速度（SCV）均显著高于治疗前（P〈0.05）,且观察组在治疗后MCV和SCV传导速度均好于对照组（P〈0.05）。观察组显效17例,有效24例,无效2例,总有效率达95.3%,显著高于对照组60.5%（P〈0.01）。结论α-硫辛酸联合甲钴胺治疗糖尿病周围神经病变,效果显著,安全可靠,值得临床推广。     

α-硫辛酸与甲钴胺治疗2型糖尿病周围神经病变的效果对比

目的对比分析α-硫辛酸与甲钴胺治疗2型糖尿病周围神经病变(DPN)的临床效果。方法选取鹤壁市人民医院收治的70例2型糖尿病合并DPN患者,按随机数表法分为研究组和对照组,各35例。给予研究组常规治疗+α-硫辛酸治疗,给予对照组常规治疗+甲钴胺治疗,对比观察两组患者治疗前后的神经感觉传导速度(SCV),并评价其临床效果。结果治疗前,两组正中神经、尺神经和腓肠神经的感觉传导速度比较,差异无统计学意义(P均>0.05);治疗后,观察组正中神经、尺神经和腓肠神经的SCV均高于对照组,差异有统计学意义(P均<0.05)。研究组的治疗总有效率高于对照组(94.3%比77.1%),差异有统计学意义(P<0.05)。结论α-硫辛酸治疗2型糖尿病合并DPN效果显著,能提高患者SCV。     

血塞通联合甲钴胺治疗糖尿病周围神经病变52例

目的探讨血塞通注射液联合甲钴胺注射液治疗糖尿病周围神经病变（DPN）的临床疗效。方法将2007年3月—2011年4月我院收治的102例DPN患者随机分为2组,治疗组52例,在常规控制血糖的基础上用血塞通注射液联合甲钴胺注射液治疗,对照组50例采用甲钴胺注射液治疗,疗程均为4周。观察2组总有效率及神经传导速度改善情况。结果治疗组总有效率为84.6%,对照组为62.0%,2组比较差异有统计学意义（P〈0.05）;治疗组神经传导速度改善明显优于对照组（P〈0.05）。结论血塞通注射液联合甲钴胺注射液治疗糖尿病周围神经病变疗效显著,是较为理想的治疗方案。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…