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1.
Objective:To analyze the diagnostic consistency of Chinese medicine(CM) specialists in patients with cardiovascular disease and to study syndrome classification and identification based on the multi-label learning method.Methods:Using self-developed CM clinical scales to collect cases,inquiry information,complexity,tongue manifestation and pulse manifestation were assessed.The number of cases collected was 2,218.Firstly,each case was differentiated by two CM specialists according to the same diagnostic criteria.The consistency of the diagnosis based on Cohen’s Kappa coefficient was analyzed.Secondly,take the same diagnosis syndromes of two specialists as the results of the cases.According to injury information in the CM scale "yes" or "no" was assigned "1" or "0",and according to the syndrome type in each case "yes" or "no" was assigned "1" or "0".CM information data on cardiovascular disease cases were established.We studied CM syndrome classification and identification based on the relevant feature for each label(REAL) leaming method,and the diagnostic rate of the syndrome was studied using the REAL method when the number of features selected was 5,10,15,20,30,50,70,and 100,respectively.Results:The syndromes with good diagnostic consistency were Heart(Xin)-qi deficiency,Heart-yang deficiency,Heart-yin deficiency,phlegm,stagnation of blood and stagnation of qi.Syndromes with poor diagnostic consistency were heartblood deficiency and blood deficiency of Heart and Liver(Gan).The highest diagnostic rates using the REAL method were Heart-yang deficiency followed by Heart-qi deficiency.A different number of features,such as 5,10,15,20,30,40,50,70,and 100,respectively,were selected and the diagnostic accuracy based on five features showed the highest diagnostic accuracy.The top five features which had a strong correlation with the syndromes were in accordance with the CM theory.Conclnsions:CM syndrome differentiation is strongly subjective and it is difficult to obtain good diagnostic consistency.The REAL method fully considers the relationship between syndrome types and injury symptoms,and is suitable for the establishment of models for CM syndrome classification and identification.This method can probably provide the prerequisite for objectivity and standardization of CM differentiation.  相似文献   

2.
乌藤消银方治疗血瘀风燥型银屑病临床研究   总被引:2,自引:0,他引:2  
目的:观察乌藤消银方治疗血瘀风燥型银屑病的临床疗效及对血脂、血清脂蛋白的影响。方法:将63例血瘀风燥型银屑病患者按随机、单盲、对照临床设计分为中药组33例和对照组30例,中药组给予乌藤消银方治疗,对照组给予复方氨肽素片治疗,两组治疗8周后,观察两组患者的临床疗效、治疗前后银屑病皮损面积和严重程度指数(PASI)、皮肤病生活质量指数(DLQI)、中医证候评分、血脂(TG、CHOL、HDL-C、LDL-C)及LP(a)水平变化,并观察疗程结束后随访转归情况。结果:中药组有效率为66.67%,对照组有效率为60.00%,两组比较差异无统计学意义(P〉0.05),中药组复发率低于对照组;两组患者治疗后PASI积分均较治疗前下降(P〈0.01),两组间比较差异无统计学意义(P〉0.05);两组DLQI指数积分均较治疗前降低,中药组较对照组积分改善明显(P〈0.05);中药组治疗后血脂及LP(a)降低,尤以TG降低显著(P〈0.01);中药组可明显改善瘙痒、抑郁心烦及失眠等中医证候。结论:乌藤消银方治疗血瘀风燥型银屑病疗效显著,且能改善患者生活质量,复发率较低,其部分作用机制可能和调节血脂及LP(a)水平有关。  相似文献   

3.
刘旸  武玲华  杨丁 《当代医学》2022,28(4):24-27
目的探讨体外冲击波治疗膝关节髌内侧滑膜皱襞综合征的临床疗效。方法选取2018年3月至2020年1月本院收治的60例膝关节髌内侧滑膜皱襞综合征患者,按随机数字表法分为体外冲击波治疗组(ESWT组)和对照组,各30例。ESWT组采用体外冲击波治疗,对照组采用脉冲短波治疗,比较两组治疗前及治疗3周后Lysholm膝关节功能评分(LKSS)和VAS评分。结果治疗后,两组LKSS评分均高于治疗前,VAS评分均低于治疗前,且ESWT组LKS、VAS评分均优于对照组(P<0.05)。结论体外冲击波治疗膝关节髌内侧滑膜皱襞综合征疗效显著,值得临床推广应用。  相似文献   

4.
目的:探讨以证候为内容的冠心病中医疗效评价方法,并验证可靠性。方法:以100 mm刻度法及综合评价层次分析法(AHP)为数学工具,以"综合集成研讨厅"为研讨方式,共取57个中医症状量化值为底层指标,以11个基本证候为第二层次指标,以实证与虚证为第三层次指标,以证候总评分为顶层指标,初步构建了以证候为内容的冠心病层次分析综合疗效评价方法。并在临床上与心绞痛评分、西雅图心绞痛评分、生存质量(SF-36)等进行了相关性对比研究,对模型的可靠性进行了验证。结果:冠心病证候总评分与心绞痛评分、西雅图心绞痛评分、SF-36有显著的相关性。结论:构建的以证候为内容的冠心病中医综合疗效评价方法可评价冠心病的轻重程度。  相似文献   

5.
Objective  To lessen the occurrence of contrast-induced nephropathy (CIN), the preventive measures of CIN were reviewed.
Data sources  The data used in this review were from PubMed with relevant English articles and from Chinese Knowledge Information (CNKI) published from 1989 to 2009. The search terms were “contrast medium”, “contrast-induced nephropathy” and “prevention”. Articles involved in prevention of CIN were selected.
Study selection  CIN is the third most common cause of acute kidney injury and is associated with an unfavorable prognosis. The best treatment is prophylaxis because CIN can not be reversed or ameliorated.
Results  Thirty articles were included. Among various preventive measures, pericatheterization hydration is almost universally accepted as an appropriate and safe measure to prevent CIN, although there is no agreement as to composition, amount, and timing of hydration. Based on the use of concomitant nephrotoxic agents or high doses of contrast medium (CM) is one of risk factors for CIN, discontinuation of potentially nephrotoxic drugs 2–3 days before and after the procedure until renal function recover, and using the lowest possible dose of CM can decrease the risk of CIN. It is promising that removing the majority of CM from the coronary sinus, before it enters the systemic circulation, during coronary angiography can reduce the risk for CIN in animal studies and in limited clinical trials. Inconsistent data exist with respect to application of some vasodilators (endothelin antagonists and adenosine antagonists) and antioxidants (N-acetylcysteine and statins) in preventing CIN in high-risk patients, and new vasodilators and antioxidants continue to be tested.
Conclusions  Pericatheterization hydration, discontinuation of nephrotoxic drugs, and using the lowest possible dose of CM are effective measures to lessen the risk for CIN. Other prophylactic strategies and some drugs are promising, but further confirmation is required.
  相似文献   

6.
<正>Objective:To evaluate the clinical effects of Chinese medicine(CM) on acute myocardial infarction (AMI) with a prospective cohort study.Methods:A total of 334 AMI patients from January 2007 to March 2009 were consecutively enrolled,and were assigned to a treatment group(169 cases) treated with combined therapy(CM for at least one month and Western medicine) and a control group(165 cases) with Western medicine alone.Clinical data including age,gender,smoking,medical history,infarction area,heart functional classification,CM syndrome scores,blood-stasis syndrome score,primary end-point(death,nonfatal myocardial infarction,and revascularization) and secondary end-point(ischemic stroke,rehospitalization due to angina,heart failure and shock),were collected. CM syndrome scores,blood-stasis syndrome score,primary end-point and secondary end-point were collected during the 6-month follow-up.Kaplan-Meier method was used for the survival analysis.The multifactor analysis was analyzed by Cox proportional hazards regression.Results:At the end of 6-month the CM syndrome score and blood- stasis syndrome score in the treatment group were lower than those in the control group(P0.01),especially the symptoms of chest pain,spontaneous perspiration and insomnia.Rehospitalization rate due to angina during the 6-month follow-up in the treatment group(2.96%) was lower than that in the control group(7.88%,P0.05).Kaplan- Meier survival curve showed that event-free cumulated survival of rehospitalization due to angina during the 6-month follow-up in the treatment group was higher than that in the control group(Log rank 4.700,P=0.03).Cox regression analysis showed that heart dysfunction[hazard ratio(HR)=1.601,95%CI=1.084-2.364,P=0.018]and diabetes mellitus(HR=1.755,95%Cl=1.031-2.989,P=0.038) were hazard factors to end-point,whereas CM(HR 0.405,95% Cl=0.231-0.712,P=0.002),percutaneous coronary intervention(PCI,HR=0.352,95%CI=0.204-0.607,P0.001) and angiotensin converting enzyme(ACE) inhibitors(HR=0.541,95%Cl=0.313-0.936,P=0.028) were protective factors.Conclusions:CM therapy could decrease CM syndrome scores and blood-stasis syndrome score,reduce the rehospitalization rate during 6-month follow-up due to angina.Heart dysfunction and diabetes mellitus were hazard factors to end-point,whereas CM,PCI and ACE inhibitors were protective factors.  相似文献   

7.
目的:以病机证素为纲,探讨特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)的病机演变规律,为临床治疗提供新思路。方法:通过文献分析、专家咨询等确立IPF的病机证素辨识标准,收集40例IPF患者的病机证素,利用SPSS 19.0软件进行统计分析。结果:在IPF发生发展过程中,各病机证素错综复杂,胶结合和为患。在疾病的急性加重期痰、瘀、湿的比例出现最高,慢性持续期则为气虚、瘀、湿,而到了临床缓解期则变为瘀、气虚、阳虚。急性加重期,痰和中医证候总积分呈正相关,瘀和mMRC呼吸困难分级呈正相关,痰、瘀、气虚和胸部高分辨CT结果呈正相关;慢性持续期,风、寒、阳虚和中医证候总积分呈正相关;临床缓解期,寒、气虚和中医证候总积分呈正相关,瘀、阳虚和mMRC呼吸困难分级呈正相关。结论:IPF患者在不同疾病阶段病机类型亦不相同,瘀贯穿疾病发展过程始终,治疗应将病机证素和临证发展转归相统一,组方配伍中应注重化瘀通络药物的使用。  相似文献   

8.
目的对军队医院范围经济进行测定。方法收集3个地区57家军队医院2005~2007年的面板数据,建立基于面板数据的混合回归模型和时点固定效应模型,根据假设检验结果 ,择优选择成本函数模型,并依据范围经济概念,建立范围经济模型。应用计量经济学方法估计参数,计算医院范围经济。结果两模型假设检验结果认为,混合回归模型优于时点固定效应模型。本次测定的军队医院全部具有范围经济,医院规模越大,级别越高,范围经济性越显著。结论大规模的医院开发高度相关主营业务可实现更大的范围经济性。  相似文献   

9.
目的 观察天舒胶囊联合西比灵治疗血瘀型偏头痛的临床疗效。方法 选择诊断为偏头痛患者60例,按序号奇偶数分成治疗组30例、对照组30例,治疗组采用天舒胶囊联合西比灵胶囊,对照组仅采用西比灵胶囊,疗程为30 d,疗程结束后1个月比较患者偏头痛积分、疼痛指数、证候积分及生活质量指数等变化。结果 两组患者偏头痛积分、疼痛指数、证候积分及生活质量指数均有显著改善,治疗组优于对照组(P<0.05);两组患者偏头痛、疼痛、证候等疗效分布比较,差异均有统计学意义(P<0.05),治疗组优于对照组。结论 天舒胶囊联合西比灵能显著改善血瘀型偏头痛患者的偏头痛积分、疼痛指数、证候积分及生活质量指数。  相似文献   

10.
Objective:To explore the clinical effect and adverse reactions of Strychnos nux-vomica in bortezomib-induced peripheral neuropathy(BIPN)of patients with multiple myeloma(MM).Methods:A total of 19 MM patients with BIPN were enrolled and Nux Vomica Capsule(NVC,0.4 g,thrice daily)were orally administrated for 30 days.Comparative analysis on parameters between pre-and post-therapy,including peripheral neuropathy(PN)grade,neurotoxicity score,Chinese medicine(CM)syndrome score,total neuropathy score(TNS),coagulation function,and serum nerve growth factor(NGF)levels were conducted.The adverse events were monitored.Results:In BIPN of MM patients who received NVC,PN grade was lowered,neurotoxicity score was obviously decreased(P 0.01),and both CM syndrome score and TNS were remarkably decreased(P<0.01).After the therapy,activated partial thromboplastin time was prolonged(P<0.01)and fibrinogen was declined(P<0.05),showing improvement in the hypercoagulable state of patients.No significant difference of NGF recovery degrees was detected between pre-and post-therapy(P>0.05).No evident adverse reactions were observed during the course of treatment.Conclusion:Strychnos nux-vomica L.has significantly effect with a good safety in treatment of BIPN in MM patients.  相似文献   

11.

Objective

To observe the clinical efficacy and the change of airway responsiveness to Chinese medicine (CM) in treating cough variant asthma (CVA).

Methods

Ninety-four patients who had confirmed the diagnosis of CVA were selected and randomly assigned to the treatment group and the control group by the blocked randomization method. The ratio of the two groups was 2:1. The treatment group had 63 patients that were treated by CM, lost in 10 cases, 53 patients had finished the trial. The control group had 31 patients that were treated by montelukast tablets and theophylline, lost in 5 cases, 26 patients had finished the trial, two weeks as one therapeutic course. The syndrome efficacy, cough efficacy, symptom score and the airway responsiveness between two groups were observed.

Results

The comparison of the syndrome efficacy: the total effective rate of the treatment group was 90.57% and the control group was 76.92%, and the two groups were significantly different (P<0.05). The comparison of the cough efficacy: the total effective rate of the treatment group was 98.11% and the control group was 80.77%, and the two groups were also significantly different (P<0.05). Syndrome scoring and cough scoring were all significantly lowered, but the airway responsiveness was not significantly lowered.

Conclusions

The treatment of CM could ease the cough, improve the syndrome, and shows obvious advantages compared with the control group, which is worthy of extensive clinical application.  相似文献   

12.
固本祛风颗粒治疗变应性鼻炎虚证患者临床疗效观察   总被引:1,自引:0,他引:1  
目的:观察运用固本祛风颗粒治疗变应性鼻炎的临床效果。方法随机选取变应性鼻炎患者60例,口服固本祛风颗粒6个月。在治疗前、中、后分别对患者进行主观综合评价,并对患者的生活质量及临床症状进行评分。结果患者临床症状评分、主观综合评价、TNSS总分等各项指标均有不同程度降低,治疗前和治疗3个月,治疗3、6个月,治疗6、12个月之间的评分差异比较均有统计学意义(P<0.05)。相关分析显示TNSS评分同RQLQ总分之间呈正相关。结论使用固本祛风颗粒治疗变应性鼻炎虚证患者能使其临床症状和生活质量有明显提高。  相似文献   

13.
Background: Syndrome is one of the most important concepts in Chinese medicine(CM) theory. However, it was not well accounted in most of randomized controlled trials(RCTs). Objective: To determine whether CM syndrome differentiation affects the treatment results, functional constipation(FC) was selected as a target disease, and MaZiRenWan(麻子仁丸, MZRW), a classic CM formula commonly used for constipation with excessive heat syndrome, was selected for study. Methods: It is an 18-week prospective double-blinded, doubledummy RCT, including 2-week run-in, 8-week treatment and 8-week post treatment follow-up. A total of 120 FC patients diagnosed as excessive heat syndrome will be recruited from the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and the Baokang Affiliated Hospital of Tianjin University of Traditional Chinese Medicine. Patients will be randomly allocated into fixed MZRW(f_MZRW) granule group, modified MZRW(m_MZRW) granule group or bisacodyl group. For m_MZRW group, no more than two herbal granules can be added according to the syndrome differentiation for individual participants. The primary end point is the mean of complete spontaneous bowel movements(CSBMs) per week during the treatment period. Secondary end points include mean of CSBMs per week during follow-up, stool form, global symptom improvement, constipation and constipation-related symptoms assessment, CM syndrome change, and reported adverse events. Discussion: This trial is designed to evaluate the effectiveness of these three interventions for FC patients with the CM syndrome of excessive heat, and to determine the change of CM syndrome and the progress of disease during the treatment course. The results are important to explore whether syndrome differentiation is important for the therapeutic effect of a formula on a disease.  相似文献   

14.

Objective

To identify key symptoms of two major syndromes in chronic hepatitis B (CHB), which can be the clinical evidence for Chinese medicine (CM) doctors to make decisions.

Methods

Standardization scales on diagnosis for CHB in CM were designed including physical symptoms, tongue and pulse appearance. The total of 695 CHB cases with dampness-heat (DH) syndrome or Pi (Spleen) deficiency (SD) syndrome were collected for feature selection and modeling, another 275 CHB patients were collected in different locations for validation. Key symptoms were selected based on modified information gain (IG), and 5 classifiers were applied to assist with models training and validation. Classification accuracy and area under receiver operating characteristic curves (AUC) were evaluated.

Results

(1) Thirteen DH syndrome key symptoms and 13 SD syndrome key symptoms were selected from original 125 symptoms; (2) The key symptoms could achieve similar or better diagnostic accuracy than the original total symptoms; (3) In the validation phase, the key symptoms could identify syndromes effectively, especially in DH syndrome, which average prediction accuracy on 5 classifiers could achieve 0.864 with the average AUC 0.772.

Conclusion

The selected key symptoms could be simple DH and SD syndromes diagnostic elements applied in clinical directly. (Registration N0.: ChiCTR-DCC-10000759)
  相似文献   

15.
  目的  观察子午流注结合五行音乐疗法治疗心脾两虚型失眠的临床疗效。  方法  选取浙江省立同德医院2019年6月—2020年6月收治的心脾两虚型失眠患者72例,根据随机数字表法随机分为观察组和对照组,每组36例。对照组仅采用五行音乐干预,观察组给予子午流注结合五行音乐干预方法。比较2组患者治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)量表的各项评分和相关心脾两虚型失眠的中医证候评分,并比较2组患者的临床疗效。  结果  治疗前,2组在主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能、安眠药物及PSQI总分等评分方面比较差异无统计学意义(均P>0.05);治疗后,2组患者上述指标均有所改善,观察组患者在睡眠质量各方面评分和PSQI总分均明显低于对照组患者(均P < 0.01)。治疗前,2组中医证候评分差异无统计学意义(t=0.191,P>0.05);治疗后,2组中医证候评分均有所改善,观察组较对照组明显降低(t=26.886, P < 0.01)。观察组临床治疗总有效率显著高于对照组(χ2=8.692,P < 0.01)。  结论  子午流注结合五行音乐疗法能明显改善心脾两虚型失眠患者的临床症状,提高临床治疗效果,值得在临床上推广和使用。   相似文献   

16.
目的通过研究气虚血瘀型中风先兆患者中医临床症状积分与中风发病的相关性,探讨气虚血瘀型中风先兆症状积分,预测中风发病的可能性。方法选取62例气虚血瘀型中风先兆证患者为研究对象,以12个月后中风发病与否为终点,记录患者性别、年龄、烟酒史、家族史、体重指数、危险因素干预依从性和中医临床症状积分,研究中风先兆发为中风的主要影响因素。结果体重指数、危险因素干预依从性、中医临床症状积分与中风先兆发为中风有相关性(P〈0.05)。通过Logistic回归分析显示,中医临床症状和危险因素干预依从性是中风先兆发为中风的独立因素。结论中风先兆12个月后发为中风的独立危险因素包括中医临床症状积分和危险因素干预依从性。  相似文献   

17.
[目的] 观察交泰丸合用盐酸氟西汀治疗抑郁症心肾不交证的临床疗效。[方法] 选择符合纳入标准患者80例,随机分成对照组(40例)和治疗组(40例),共服药8周,观察汉密尔顿抑郁量表(HAMD)总分、HAMD因子评分及HAMD减分率、中医证候量表积分和中医证候量表有效率的情况,以评价其临床疗效。[结果] 交泰丸合用盐酸氟西汀治疗4周和治疗8周均可明显减少轻中度抑郁症患者的HAMD评分、HAMD因子评分和中医证候量表积分,与治疗前比较具有统计学差异,疗效以8周最佳(P<0.05或P<0.01);HAMD因子评分中迟滞评分治疗4周和治疗8周时治疗组明显低于对照组(P<0.05);交泰丸合用盐酸氟西汀治疗8周后,轻中度抑郁症患者HAMD减分率和中医证候量表有效率明显优于单用盐酸氟西汀,总有效率优于单用盐酸氟西汀。[结论] 交泰丸合用盐酸氟西汀可以缓解抑郁状态,改善中医症状体征,并且增强盐酸氟西汀抗抑郁的远期临床疗效。  相似文献   

18.
Objective: To summarize and elucidate the characteristics and evolvement of Chinese medicine(CM) patterns reflecting the physical and mental conditions of participants in the Mars 500 long-term closed environment. Methods: The DS01-T Digital TCM Four-Diagnostic Instrument and CM Inquiring Diagnostic Questionnaire were used to collect information from 6 participants in the Mars 500 International Joint Research Project, through diagnostic methods of observation, palpation and inquiry according to CM theory. During the 520 days of the experiment, data collection was performed 37 times; a total of over 400 digital images of tongues and facial complexion and over 20,000 data were collected. These data were then analyzed by a team of experts in CM, statistics, and data mining. Results: The CM pattern evolvement of participants in the long-term closed environment followed some common trends. Qi deficiency was the main CM pattern observed, with individual features depending on constitutional differences [manifested in varying degrees of accompanying patterns of Gan (Liver) qi stagnation, Pi (Spleen) deficiency, dampness encumbering, or yin deficiency]. Conclusion: The research has verified the effectiveness of CM syndrome differentiation based on the four diagnostic methods, which should serve as a solid foundation for observation, monitoring, and intervention in regard to the health conditions of astronauts in long-term space flights in the future.  相似文献   

19.
目的 探讨慢性前列腺炎伴抑郁症的中医证候分布特点. 方法 选取符合病例诊断标准的110例患者进行临床证候调查,根据其临床表现,结合中医证候诊断标准, 辨证分析确定其证型;将数据进行统计学处理,分析研究对象各中医证型、证候要素分布的特点.结果 110例患者共计12种证候,包含病位类证素6个,病性类证素11个.实性证候要素中以肝郁、气滞为基本要素,虚性证候要素中以肾虚、脾虚为主,各证候要素按出现频率高低依次为:肝郁>气滞>湿热>肾虚>痰湿>脾虚>血瘀>心虚>气虚>阴虚>阳虚. 结论 慢性前列腺炎伴抑郁症患者中医证候分布具有一定特征性,早期多以实证为主,后期为虚实夹杂证,肾虚肝郁、痰湿瘀阻是其基本病机,为指导临床辨证论治提供了一定的理论依据.  相似文献   

20.
目的 分析支气管哮喘非急性发作期内金匮肾气丸汤联合穴位敷贴的临床治疗价值。方法 选取2019年9月至2021年10月南阳油田总医院的76例支气管哮喘非急性发作期病例,根据治疗方法分为对照组与观察组,各38例。对照组在常规西医药治疗同时用金匮肾气丸汤治疗,观察组在对照组的基础上联合穴位敷贴治疗。观察两组疗效、肺功能参数以及中医证候积分等指标。结果 治疗后,观察组总有效率(97.37%)高于对照组(84.21%),差异有统计学意义(P<0.05);观察组肺功能参数中的第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、第1秒用力呼气容积与用力肺活量比值(forced expiratory volume in the first second/forced vital capacity,FEV1/FVC)、呼气峰值流速(peak expiratory flow,PEF)上升幅度均高于对照组,差异有统计学意义(P<0.05);观察组中医证候评分及总积分降幅大于对照组,差异有统计学意义(P<0.05)。结论 金匮肾气丸汤联合穴位敷贴治疗非急性发作期内的支气管哮喘疗效显著,有利于改善患者的肺功能和临床症状。  相似文献   

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