奥美拉唑及吗丁啉加中药降逆汤治疗反流性食管炎临床对比观察

[目的]观察奥美拉唑及吗丁啉加中药降逆汤治疗反流性食管炎的疗效及对胃动素、胃泌素的影响.[方法]将120例患者随机分成中药治疗组(降逆汤,n=40),西药治疗组(奥美拉唑及吗丁啉,n=40)和中西医结合治疗组(奥美拉唑及吗丁啉加中药降逆汤,n=40),疗程4周,观察治疗前后症状、胃镜检查,并测定血清胃动素及胃泌素的含量变化.[结果]中西医结合组的疗效(有效率97.5%)明显高于单用中药组(75%)或单用西药组(80%);患者的血清胃动素[(182.6±43.9)pg/mL]与胃泌素[(99.2±31.7)pg/mL]水平明显低于正常对照组[(326.6±58.4)pg/mL,(163.1±28.7)pg/mL];3种疗法都能升高血清胃动素与胃泌素水平,而以中西医结合组的作用最好,胃动素与胃泌素平均升高110.9pg/mL和37.7 pg/mL,优于单用中药组(27.6 pg/mL和17.5 pg/mL)或单用西药组(74.6 pg/mL和21.7 pg/mL).[结论]奥美拉唑及吗丁啉和中药降逆汤是治疗反流性食管炎的有效药物,中西医结合疗法可进一步提高对反流性食管炎的疗效,促进胃肠道的动力.     

吗丁啉、奥美拉唑联合中药降逆汤治疗反流性食管炎80例临床分析

目的 观察吗丁啉、奥美拉唑联合中药降逆汤治疗反流性食管炎的临床效果.方法 选择80例反流性食管炎患者为研究对象,随机均分为对照组和观察组(n=40),对照组采用西药吗丁啉+奥美拉唑治疗,观察组在对照组的基础上加用中药降逆汤加减治疗.比较2组治疗效果,治疗前后血清胃动素、胃泌素变化情况.结果 观察组治疗总有效率达97.5%,显著高于对照组的总有效率77.5%,观察组治疗后血清胃动素(298.4±30.2)pg/mL、胃泌素(136.1±40.2)pg/mL显著高于对照组(205.7±38.4)pg/mL(、114.2±30.5)pg/mL,差异均有统计学意义(P<0.05).结论 中西医结合治疗反流性食管炎临床效果显著,值得推广应用.     

采用奥美拉唑及吗丁啉联合中药降逆汤治疗反流性食管炎的临床疗效分析

目的：探究采用奥美拉唑及吗丁啉联合中药降逆汤治疗反流性食管炎的临床疗效。方法选取82例反流性食管炎患者,将其随机分成观察组和对照组,各41例。观察组通过奥美拉唑、吗丁啉、中药降逆汤治疗,对照组采取吗丁啉和奥美拉唑治疗,对比2组患者的治疗效果、治疗前、后血清胃动素和胃泌素情况。结果观察组的治疗总有效率为97.56%,对照组的治疗总有效率为80.49%,差异有统计学意义（P<0.05）。对照组治疗后患者血清胃动素(205.6±38.3)低于观察组（298.5±30.3）,胃泌素（124.1±30.4）低于（138.9±30.3）,2组比较差异均有统计学意义（P<0.05）。结论反流性食管炎通过奥美拉唑、吗丁啉、中药降逆汤治疗,临床效果较佳,值得临床方面应用和推广。     

消痞汤对功能性消化不良患者胃泌素及胃电图的影响

目的:探讨中药消痞汤治疗功能性消化不良(FD)的作用机制。方法:用消痞汤治疗FD112例,并与口服吗丁啉片剂88例进行比较,观察两组治疗前后胃电图、血清胃泌素的变化情况。结果:消痞汤能显著增高胃电幅值(P<0.05),降低血清胃泌素水平(P<0.01),其作用与吗丁啉相仿(P>0.05)。结论:消痞汤能有效治疗FD,可能与其改善胃动力,调节胃肠激素分泌有关。     

和胃理气方对功能性消化不良肝郁模型大鼠胃动素、P物质的影响

目的探讨功能性消化不良（FD）的发病机制以及和胃理气方对FD肝郁模型大鼠的作用。方法将48只Wistar大鼠随机分为生理盐水组、模型组、和胃理气方高、中、低剂量组和吗丁啉组,每组8只。除生理盐水组外,其余各组均采用＂夹尾激怒法＂制作肝郁型FD大鼠模型。造模后,生理盐水组与模型组灌服等体积生理盐水;和胃理气方高、中、低剂量组分别灌服不同剂量的和胃理气方药液,吗丁啉组灌服已配制的吗丁啉混悬液。观察各组大鼠血浆胃动素（MTL）、P物质（SP）的变化情况。结果经中药和胃理气方及西药吗丁啉治疗的模型大鼠血浆中MTL、SP的含量增高,且和胃理气方高剂量组血浆SP与吗丁啉组比较有显著性差异（P〈0.05）。结论和胃理气方能增高模型大鼠血浆中MTL、SP的含量,可能是其治疗FD的作用机制之一。     

二金汤对实验性功能性消化不良大鼠胃排空和胃肠激素的影响

目的 :观察二金汤对大鼠胃排空和胃肠激素的影响 ,探讨其可能的作用机制。方法 :采用不规则进食加稀酸喂养制作大鼠功能性消化不良 (FD)模型 ,并随机分成大、小剂量二金汤、吗丁啉、生理盐水、模型组共 5组 ,连续给药 2 8d后 ,放免法检测血浆胃动素和血清胃泌素含量 ;以酚红法观察胃排空。结果 :与正常组相比 ,模型组胃排空和血浆胃动素含量显著降低 (P <0 .0 5 ) ;大剂量二金汤组与吗丁啉组比模型组显著升高 (P <0 .0 5 ) ;各组血清胃泌素含量无差异 (P >0 .0 5 )。结论 :二金汤具有促进内源性胃动素释放和胃排空作用 ,可能是其治疗功能性消化不良的机制之一。     

止酸方治疗反流性食管炎及其对血清胃动素的影响

目的：观察止酸方治疗反流性食管炎（RE）的临床疗效及胃镜下疗效,并观测治疗组与对照组治疗后血清胃动素水平。方法：将100例RE患者随机分为止酸方治疗组与西药对照组。治疗组50例口服止酸方汤剂,对照组50例口服雷尼替丁和吗丁啉,两组以4周为1个疗程,1个疗程后观察疗效;在治疗前后测血清胃动素含量并在治疗后进行组间比较。结果：临床疗效总有效率：治疗组98.00%,对照组84.00%,两组比较差异有显著性（P〈0.05）;胃镜疗效总有效率：治疗组96.00%,对照组82.00%,两组比较差异有显著性（P〈0.05）;胃动素比较：治疗组与对照组均有升高,但治疗后治疗组与对照组比较差异有显著性（P〈0.05）。结论：止酸方治疗RE疗效确切,其作用机制可能与升高血清胃动素有密切关系。     

金龙汤治疗功能性消化不良53例疗效观察

目的 探讨金龙汤治疗功能性消化不良的临床效果。方法 采用症状积分法,观察比较金龙汤组与吗叮啉组的临床疗效,同时检测服用金龙汤前、后血清胃泌素和血浆胃动素的变化。结果 金龙汤症状改善和临床总有效率均优于吗丁啉组（Ｐ〈０．０１）。金龙汤组服药后血浆胃动素水平较服药前显著升高（Ｐ〈０．０１）。而血清胃泌素水平变化不明显（Ｐ〉０．０５）。结论 金龙汤是治疗功能性消化不良的有效方剂,疗效优于临床常用西药吗丁     

HP相关良性胃病患者血清胃泌素和胃动素的检测及意义

目的探讨血清胃泌素和胃动素的释放与幽门螺杆菌(HP)相关性胃炎及消化性溃疡的关系。方法采用放射免疫计数仪对268例HP阳性、183例HP阴性及150例HP清除后良性胃病患者血中的胃动素和胃泌素水平进行检测。结果HP阳性的慢性浅表性胃炎(CSG)、胃溃疡(GU)、十二指肠球部溃疡(DU)患者的血清胃泌素和胃动素水平:DU>GU>CSG(P<0.01)。HP阳性患者血清胃泌素水平较HP阴性患者高(P<0.05或0.01),而胃动素水平恰好相反(P<0.01)。HP清除后病人血清胃动素水平升高、胃泌素水平下降(P<0.01)。结论HP感染可引起血清胃泌素水平升高、胃动素水平降低。     

五磨饮治疗脾虚气滞型功能性消化不良的机制研究

目的研究五磨饮治疗脾虚气滞型功能性消化不良的机制。方法选取广州中医药大学附属清远中医院2013年2~12月收治的脾虚气滞型功能性消化不良患者120例,按就诊先后顺序分为治疗组和对照组,各60例,治疗组给予五磨饮中药配方颗粒,对照组给予多潘立酮治疗,两组疗程均为4周。观察临床疗效,检测患者胃动素及胃泌素含量。结果治疗组和对照组总有效率分别为93.3%和83.3%,差异有统计学意义（P〈0.05）;治疗组患者血浆胃动素[（376.5±92.8）pg/mL]和胃泌素[（58.8±13.9）pg/mL]含量显著升高（P〈0.05）;对照组患者血浆胃动素[（356.7±85.4）pg/mL]含量显著升高（P〈0.05）,有升高血清胃泌素[（48.7±12.4）pg/mL]含量的趋势,但差异无统计学意义（P〉0.05）。结论五磨饮能够有效治疗脾虚气滞型功能性消化不良,促进胃动素和胃泌素分泌可能是其作用机制之一。     

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.