冠心病合并2型糖尿病中医辨证论治研究进展

阐述了冠心病合并2型糖尿病的病因病机,总结了中医辨证论治的治疗进展,认为中医辨证论治该病有独特的优势,并提出了以后的研究方向.     

慢性收缩性心力衰竭患者跨壁复极离散度分析

目的观察慢性收缩性心力衰竭患者的体表心电图T波峰-末间期(Tp-Te)及QT间期离散度,用以评估慢性收缩性心力衰竭患者的预后。方法测量和比较50例慢性收缩性心力衰竭患者、50例健康人体表心电图上Tp-Te及QT间期离散度并进行分析。结果心力衰竭组患者Tp-Te较健康对照组显著增加(P0.05);心力衰竭组患者QT间期离散度也较健康对照组显著增加(P0.05)。结论慢性收缩性心力衰竭患者跨壁复极离散度明显增加,12导联体表心电图Tp-Te及QT间期离散度可以预测慢性收缩性心力衰竭患者的预后。     

下生殖道感染与子宫颈细胞学异常的相关性研究

Objective?To study the association between abnormal cervical cytology and bacterial vaginosis (BV), vulvovaginal candidiasis(VVC), trichomonas vaginitis(TV), high-risk human papillomavirus(HR-HPV) infection in women attending cervical cancer screening. Methods?The study recruited 3 300 women aged 21 to 64 years of age who participated in cervical cancer screening. Demographic information was collected. Cervical exfoliated cell specimens were collected for liquid-based cytological diagnosis and HR-HPV detection. Reproductive tract secretions specimens were collected for molecular vaginitis diagnostics from women who were diagnosed with negative for intraepithelial lesion or malignancy(NILM) and all HR-HPV positive or ≥atypical squamous cells of undetermined significance(ASC-US). The Logistic multivariate model was used to analyze the risk factors of abnormal cervical cytology. Results?645 women were included in the study, including 408 NILM, 182 ASC-US, 23 low-grade squamous intraepithelial lesion (LSIL), and 32 high-grade squamous intraepithelial lesions (HSIL). The positive rate of HR-HPV (14.7%, 39.0%, 78.3% and 87.5%) increased with the severity of cytology (P<0.001). The prevalence of BV in different cytological diagnosis (34.1%, 49.5%, 60.9% and 43.8%) were significantly different (P<0.001), and the prevalence of BV in ASC-US were significantly higher than that in women with NILM (P<0.05). The prevalence of VVC in different cytological diagnosis (14.2%, 4.9%, 8.7% and 3.1%) was significantly different (P<0.01), and the ASC-US group was significantly lower than the NILM group (P<0.001). There was also a significant difference in the distribution of the prevalence of TV (2.5%, 9.3%, 4.3%, and 6.3%, P<0.01). The prevalence of TV in women with abnormal cytology was higher than that in women with normal cytology(P<0.05). The Logistic analysis showed that HR-HPV infection, BV, TV, VVC, lower level of education, and postmenopause were related to abnormal cervical cytology. Conclusion?HR-HPV infection is the determinant of abnormal cervical cytology. BV, TV, VVC, lower level of education, postmenopause, etc. may associate with abnormal cervical cytology.     

葶苈大枣泻肺汤合决渎汤治疗心力衰竭阳虚水泛证临床研究

目的:探究葶苈大枣泻肺汤合决渎汤在心力衰竭阳虚水泛证中的临床疗效。方法:将86例慢性心力衰竭患按照随机数字表法分为观察组和对照组,各43例,对照组采用左西孟坦治疗,观察组予葶苈大枣泻肺汤合决渎汤治疗。治疗2周后,比较两组的中医症候评分、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、N-脑钠肽前体(NT-proBNP)、高敏心肌肌钙蛋白(hsTn)T、血管紧张素Ⅱ(AgnⅡ)、同型半胱氨酸(Hcy)、疗效及不良反应。结果:治疗后,两组主症积分、次症积分均降低,观察组低于对照组(P<0.05);两组LVEF均升高,观察组高于对照组(P<0.05);两组LVESD及LVEDD均降低,观察组低于对照组(P<0.05);两组NT-proBNP、hsTnT、AgnⅡ、Hcy均降低,观察组低于对照组(P<0.05)。观察组临床疗效优于对照组(P<0.05)。两组治疗期间均未出现严重不良反应。结论:葶苈大枣泻肺汤合决渎汤治疗阳虚水泛证心力衰竭,有助于促进患者心功能的恢复,临床疗效优越且安全性较好。     

健脾益阴法改善IGT人群早期相胰岛β细胞分泌功能损害的临床研究

目的:观察健脾益阴法为主的中医药干预对改善IGT患者早期相胰岛细胞分泌功能的临床效果。方法:入选70例新诊断的IGT患者,随机分为治疗组和对照组,在生活干预的基础上,治疗组加用健脾益阴方,45d为1个疗程,共观察2个疗程,分别比较2组在血糖及HOMA-β、HOMA-IR、MBCI、△I30/△G30等临床指标。结果:2组的各项指标均较治疗前有明显的改善,治疗组在血糖、△I30/△G30、HOMA-IR等方面较对照组改善更为明显。结论:以健脾益阴方为主的中医药干预IGT,可以获得生活干预以外的收益。