埃索美拉唑治疗反流性食管炎临床比较研究

目的 比较埃索美拉唑与奥美拉唑治疗反流性食管炎(RE)的疗效.方法 随机将符合RE诊断标准的70例患者分为埃索美拉唑治疗组35例和奥美拉唑对照组35例.治疗8周后分别作出症状评价及胃镜评价.结果 治疗8周后,治疗组症状改善优于对照组,有显著性差异(P＜0.05);胃镜下疗效观察结果显示治疗组显著优于对照组(P＜0.05).结论 埃索美拉唑治疗RE的疗效明显优于奥美拉唑.     

中西医结合治疗HP相关性慢性胃炎的疗效分析

目的观察中西医结合治疗HP相关性慢性胃炎的疗效.方法将92例慢性胃炎患者随机分为两组,对照组用雷尼替丁0.15 g 阿莫西林1.0 g 甲硝唑0.4 g,治疗组在对照组治疗的基础上,再用自拟疏肝建中汤治疗;两组用药1个月为1疗程.结果治疗组和对照组治疗后症状改善总有效率分别为93.62%、91.11%,两组症状改善差异有显著性意义(P＜0.01),两组临床症状疗效差异无显著性(P＞0.05).两组治疗前后症状积分变化比较;治疗组和对照组用药后积分比较差异有显著性(P＜0.01、P＜0.05);治疗后与对照组比较差异有显著性(P＜0.05).胃镜检查总有效率比较:治疗组89.36%,对照组66.67%,与对照组比较有显著性差异(P＜0.05).HP清除率比较:治疗组91.49%,对照组71.11%,与对照组比较有显著性差异(P＜0.05).结论中西医结合治疗HP相关性慢性胃炎较单纯西药组疗效显著.     

藿砂口服液运脾止泻功效的临床研究

目的 研究藿砂口服液治疗泄泻的临床疗效和安全性.方法 将符合泄泻诊断标准的120例患者随机分为2组.治疗组63例,对照组57例,治疗组用藿砂口服液加补液治疗,对照组用藿香正气口服液加补液治疗,疗程3天.结果 治疗组治疗前后症状积分比较差异有高度显著性(P＜0.01),2组治疗后症状积分比较,腹泻积分差异有显著性(P＜0.05),其他症状积分比较差异无显著性(P＞0.05),2组临床疗效比较差异无显著性(P＞0.05).在试验过程中2组未见不良事件发生.结论 藿砂口服液对泄泻具有良好的疗效和安全性.     

中药联合CSⅡ强化治疗初发2型糖尿病(气阴两虚型)临床研究

目的:观察中药联合皮下胰岛素泵治疗初发2型糖尿病(气阴两虚型)对其证候积分及胰岛素抵抗的影响.方法:治疗组以中药联合皮下胰岛素泵治疗,对照组单予皮下胰岛素泵治疗.结果:治疗组患者治疗后临床症状体征有明显改善,有效率84.6%;对照组有效率74.9%.组间对比表明治疗组症状的改善明显优于对照组,有显著性差异(P＜0.05).治疗组患者治疗后空腹血糖、餐后2 h血糖均明显降低,与治疗前比较均有显著性差异(P＜0.01);与对照组比较亦有显著性差异(P＜0.05).治疗组FINS、ISI、HOMA-IR、HOMA-βcell较治疗前均有改善(P＜0.05～0.01),与对照组比较有显著差异(P＜0.05).结论:中药联合皮下胰岛素泵治疗初发2型糖尿病(气阴两虚型),可明显提高疗效,改善胰岛素抵抗.     

施氏温针灸合穴位贴敷治疗神经根型颈椎病的临床研究

目的 观察施氏温针灸配合穴位贴敷疗法对神经根型颈椎病患者的治疗效果,并评价该疗法的临床疗效.方法 将符合标准的60例患者随机分成治疗组、对照组各30例,治疗组采用施氏温针合穴位贴敷疗法治疗,对照组采用普通针刺合穴位贴敷治疗.记录治疗前后患者麦吉尔疼痛量表各项评分,并通过SPSS 19.0统计软件进行分析比较显著性.结果 ①治疗组愈显率为80％,与对照组53.3％比较(P＜0.05).②对疼痛评定指数(PRI)、视觉模拟评分(VAS)和现时疼痛强度(PPI)积分比较,2组治疗前后自身对照均有所降低(P＜0.01);2组治疗前后差值进行比较,疼痛评定指数(PRI)和现时疼痛强度(PPI)积分,治疗组较对照组明显降低,且差异有统计学意义(P＜0.01),而视觉模拟评分(VAS)治疗组较对照组降低,差异有统计学意义(P＜0.05).结论 施氏温针灸合穴位贴敷治疗神经根型颈椎病疗效可靠,并能明显缓解疼痛症状.     

小陷胸汤合四逆散治疗肝胃郁热型原发性胆汁反流性胃炎的临床观察

目的观察小陷胸汤合四逆散治疗肝胃郁热型胆汁反流性胃炎的临床疗效。方法采用简单随机、平行对照方法将132例原发性胆汁反流性胃炎患者随机分为4组：小陷胸汤合四逆散组、小陷胸汤组、四逆散组、对照组多潘立酮组,每组33例。疗程4周,随访4周。观察治疗前后各组的证候积分变化。结果小陷胸合四逆散组、四逆散组治疗及随访期间均与治疗前症状积分有显著性差异（P值均〈0.01）,且症状积分呈逐渐下降趋势。小陷胸汤组、多潘立酮组治疗及随访期间均与治疗前症状积分有显著性差异（P值均〈0.01）,但随访第2周与第4周之间无显著性差异（P=0.425）。小陷胸汤合四逆散、小陷胸汤、四逆散均能改善＂胃痛＂、＂腹胀＂、＂嗳气＂、＂泛酸＂、＂恶心＂、＂嘈杂＂、＂胸闷＂、＂胁痛＂、＂失眠＂、＂多梦＂等症状（P〈0.05）,与多潘立酮组相比,＂反酸＂、＂失眠＂症状改善更明显,而＂腹胀＂症状改善不及多潘立酮组。结论小陷胸汤合四逆散、小陷胸汤、四逆散均能显著改善胆汁反流性胃炎患者症状。治疗4周时小陷胸汤合四逆散治疗胆汁反流性胃炎疗效优于多潘立酮,小陷胸汤、四逆散疗效与多潘立酮疗效相当。小陷胸汤合四逆散、四逆散在4周随访期内症状持续改善,小陷胸汤、多潘立酮在4周随访期内症状复发。     

中西医结合治疗十二指肠溃疡70例

目的 观察奥美拉唑联合中药口服综合疗法治疗十二指肠溃疡的临床疗效.方法 采用随机数字表法将70例十二指肠溃疡患者分为治疗组和对照组,各35例.治疗组采用西药配合中药(柴胡、党参、茯苓、白术,1剂/d,早晚分服)综合疗法口服,对照组仅服用奥美拉唑胶囊(10 mg/d),观察治疗后第1,3个月患者主要症状积分、中医证候疗效及胃镜下疗效.结果 2组治疗后第1个月,主要症状上腹痛、嗳气、反酸、胸骨后烧灼感积分与治疗前比较,具有下降趋势(P＜0.05,P＜0.01),且治疗组优于对照组(P＜0.05);上腹胀积分仅治疗组治疗前后有统计学意义(P＜0.05).随访第3个月,2组上腹痛、嗳气分值与治疗前比较明显降低(P＜0.05,P＜0.01),且治疗组改善情况要优于对照组(P＜0.05).治疗组证候疗效总有效率为88.57％,对照组77.14％,2组比较,具有统计学意义(P＜0.05).治疗组胃镜下疗效总有效率为77.14％,对照组为60.00％,2组比较,具有统计学意义(P＜0.05).结论 奥美拉唑胶囊配合中药口服疗法可明显降低十二指肠溃疡的主要症状积分,提升中医证候疗效及改善胃镜下表现.     

雷贝拉唑联合莫沙必利治疗反流性食管炎疗效观察

目的 探讨雷贝拉唑联合莫沙必利治疗反流性食管炎的临床疗效.方法 64例反流性食管炎患者随机分成两组,治疗组34例和对照组30例.治疗组采用雷贝拉唑联合莫沙必利治疗,对照组采用雷尼替丁联合西沙必利治疗,观察比较两组的临床疗效.结果 治疗组的有效率为91.1%(31/34),明显高于对照组(70.0%),两组总有效率比较,差异有统计学意义(P＜0.05).两组的反酸、烧心、胸骨后灼痛的治疗前积分比较,差异无显著性,治疗后,两组的积分均显著低干治疗(P＜o.05),且治疗组积分与对照组比较,差异也有显著性(P＜0.05).结论 雷贝拉唑联合莫沙必利治疗反流性食管炎疗效好,能明显改善临床症状,值得临床推广和应用.     

饮食指导联合康复新液治疗糜烂性胃炎的临床研究

目的 观察饮食指导联合康复新液治疗糜烂性胃炎的临床疗效.方法 将90例患者随机分为观察组和对照组,分别予康复新液和雷贝拉唑肠溶胶囊治疗,药物疗程均为2周,试验组联合饮食指导,8周后复查胃镜.结果 两组治疗前差异无统计学意义(P＞0.05).治疗两周后,两组症状积分均降低(P＜0.05),两组差异无统计学意义(P＞0.05);6、8周后,观察组症状积分均明显低于对照组(均P＜ 0.05).两组治疗前黏膜损伤指数差异无统计学意义(P＞0.05).治疗后黏膜损伤指数分别为3.33+0.98和8.78±3.45,差异有统计学意义(P＜0.05).两组综合疗效差异有统计学意义(Z=2.779,P=0.005).结论 康复新液与雷贝拉唑肠溶胶囊治疗糜烂性胃炎疗效相当,联合饮食指导有利于糜烂性胃炎的治疗.     

血府逐瘀汤治疗慢性特发性荨麻疹(血瘀阻络型)临床观察

目的:观察血府逐瘀汤治疗慢性特发性荨麻疹(血瘀阻络型)的临床疗效.方法:120例病例随机分为两组,每组45例.对照组采用皿治林治疗,治疗组采用血府逐瘀汤加减治疗.结果:两组患者治疗后远期疗效、不良反应发生率比较有显著性差异(P＜0.01),两组患者治疗前后症状体征积分、免疫功能、红细胞参数比较有显著性差异(P＜0.01,P＜0.05),治疗组治疗后免疫功能、红细胞参数与对照组治疗后比较有显著性差异(尸P＜0.05).结论:血府逐瘀汤治疗慢性特发性荨麻疹(血瘀阻络型)临床疗效显著,值得在临床上进一步推广应用.     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

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.