中医体质类型与原发性肝癌预后的相关性

目的 探讨中医体质类型与原发性肝癌预后的相关性.方法 采用标准化的9种中医体质分类量表对151例原发性肝癌患者进行中医体质辨识,对所有患者进行随访以了解患者生存期,用Kaplan-Meier法计算患者的总体生存期和中位生存期,采用Log-rank检验进行亚组分析.结果 中位生存期最长的是体质类型为平和质的患者;最短的是气虚质.4种主要体质类型的平均生存期和中位生存期如下:平和质的中位生存期为13.3个月;气虚质为3.7个月;阳虚质和湿热质分别为6.1个月和10.2个月.4种体质生存期之间的差异无统计学意义(P >0.05).将平和质和气虚质的中位生存期进行单因素对比,结果 示,两者之间的差异存在统计学差异(P<0.05).结论 中医体质与生存期有一定的相关性.气虚质是4种主要体质中预后最差的一种,其中位生存期为3.7个月.     

影响急性肾损伤患者预后的驱动因素调查及干预策略

目的 分析影响急性肾损伤患者预后的驱动因素及相应的干预策略,为后续诊治措施的制定、实施提供依据。方法 回顾性分析安庆市第一人民医院2021年5月至2023年5月收治的133例急性肾损伤患者的临床资料,根据出院后28 d生存情况进行分组,113例生存患者作为生存组,20例死亡患者作为死亡组。统计两组患者的临床基线资料,对其进行单因素分析,以急性肾损伤患者是否发生预后不良情况(死亡)作为因变量,将单因素分析结果中差异有统计学意义的指标作为自变量,通过多因素Logistic回归分析分析急性肾损伤患者预后的影响因素。结果 单因素分析结果显示,死亡组患者年龄≥60岁、存在冠心病、应用血管活性药物、存在脓毒血症的患者占比均高于生存组,死亡组患者血清血肌酐(Cr)、血尿素氮(BUN)水平均高于生存组(均P<0.05);两组患者性别、糖尿病、高血压、急性肾损伤不同分期、高尿酸血症患者占比及外周血血红蛋白(Hb)、血小板计数(PLT),血清白蛋白(Alb)、丙氨酸氨基转移酶(ALT)、总胆红素(TBiL)水平经比较,差异均无统计学意义(均P>0.05);多因素Logistic回归分析结果显示...     

Treatment of advanced non-small cell lung cancer with extracorporeal high frequency thermotherapy combined with Chinese medicine

Objective： To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy （EHFT） combined with Chinese medicine （CM） in the treatment of patients with advanced non-small cell lung cancer. Methods： The study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM （the treatment group）, the other only with CM （the control group）. The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3-4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate （DCR） and time to progression （TTP）. Secondary endpoints were overall survival time and 1-year survival rate. Results： Sixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease （28.8%）, while the DCR of the control group was 63.3%, and 11 had progression of disease （36.7%）; there was a significant statistical difference （P0.05）, suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time （MST） of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP （P0.05）, but no difference on MST or 1-year survival rate. Conclusion： EHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.     

原发性肝癌的中医体质调查分析

目的 探讨原发性肝癌患者的中医体质分布情况.方法采用标准化的9种中医体质分类量表对151例原发性肝癌患者进行中医体质辨识.结果 患者的体质类型分布为:平和质37人(24.5%),气虚质36人(23.8%),阳虚质25人(16.6%),湿热质21人(13.9%),气郁质14人(9.3%),瘀血质10人(6.6%),特禀质4人(2.6%),阴虚质2人(1.3%),痰湿质2人(1.3%).结论 肝癌患者的偏颇体质主要以气虚质、阳虚质和湿热质3种体质为主.体质类型存在性别差异,男性以气虚、阳虚和湿热质为主,而女性以阳虚质为主.     

萸地补肾养肝方对肝硬化合并肝肾综合征患者肝肾功能的保护作用

目的 探讨萸地补肾养肝方对肝硬化合并肝肾综合征患者肝肾功能的保护作用。方法 将81例肝硬化合并肝肾综合征患者分为研究组41例和对照组40例。对照组38例(脱落2例)患者进行常规西医治疗。研究组38例(脱落3例)在对照组基础上,给予萸地补肾养肝方。比较两组治疗3周的总有效率和尿量改变。评估两组的中医证候评分。检测治疗前后患者的主要肝肾功能指标的水平。运用血浆渗透压评分评估患者的预后。运用终末期肝病模型评分(model for end-stage liver disease, MELD)评估患者的病情程度。经彩色多普勒仪测定患者治疗前后肾主动脉主干、叶间动脉、肾窦内段动脉的血管阻力指数(resistance index, RI)。结果 研究组患者治疗3周的总有效率为94.74%,明显高于对照组的78.95%(P<0.05),治疗后两组的24小时尿量明显高于治疗前,且研究组的24小时尿量明显高于对照组(P<0.05)。两组治疗后的中医证候评分显著下降,研究组下降程度高于对照组(P<0.05)。两组治疗后的总胆红素(total bilirubin, TB)、谷草转氨酶(asp...     

中医体质类型与原发性肝癌TNM分期及Okuda分期的相关性

目的探讨中医体质类型与原发性肝癌TNM分期及Okuda分期的相关性。方法采用标准化的9种中医体质分类量表对151例原发性肝癌患者进行中医体质辨识,并就体质类型与肝癌TNM分期及Okuda分期进行Crosstabs相关性分析。结果Ⅰ期(T1N0M0)患者的偏颇体质主要以气虚质、淤血质、湿热质和阳虚质为主;Ⅱ期(T2N0M0)以平和质为主,偏颇体质阳虚质最多,其次是气虚质和阴虚质;ⅢA期(T3N0M0)以气虚质和湿热质为主,余偏颇体质分别是阳虚质、气郁质和淤血质;ⅢB期(T4N0M0)亦以平和质为主,偏颇体质主要是气虚质和阳虚质,其次是淤血质;ⅢC期(TXN1M0)偏颇体质以气虚质居多,其次是阳虚质、气郁质,痰湿质、湿热质和特禀质;Ⅳ期(TXNXM1)以阳虚质为主,余偏颇体质按由多至少的顺序依次是气虚质、气郁质、特禀质和痰湿质。Okuda分期Ⅰ期患者偏颇体质以湿热质、气郁质、气虚质和阳虚质为主,其次是淤血质和阴虚质;Ⅱ期以气虚、阳虚和湿热质为主,淤血质和气郁质次之;Ⅲ期以气虚质和阳虚质为主,其次是痰湿质和湿热质。结论体质类型与西医TNM分期及Okuda分期有一定的相关性,TNMⅠ、Ⅱ期患者以气虚质和阳虚质居多,ⅢA期以气虚质和湿热质为主,ⅢB期以上患者以阳虚质、气虚质为主。Okuda分期Ⅰ期、Ⅱ期以气虚、阳虚和湿热质为主;Ⅲ期以气虚质和阳虚质为主。