补泻手法辨证治疗腰背痛临床观察

根据中医基本理论,将120例腰背痛患者分为虚证和实证两大类,并分组进行疗效对比手法治疗。观察组60例,辩证施治,补虚泻实;对照组60例,平补平泻,不辩证施治。结果显示观察组痊愈率明显高于对照组,疗程也较对照组短(虚证P<0.05,实证P<0.01)。表明手法的补泻作用是客观存在的,且具有一定的临床应用价值。     

脾虚和肾虚雌性大鼠生育能力的实验观察

为系统观察脾虚和肾虚雌性ＳＤ大鼠的生育能力，将大鼠随机分为：脾虚组、脾虚复健组、肾虚组、肾虚复健组、正常组。脾虚组和肾虚组分别按常规方法用利血平和羟基脲制成脾虚模型和肾虚模型。虚证动物模型出现与人类相似的症状：动情周期紊乱，甚至消失；生殖器官萎缩；血清卵泡刺激素（ＦＳＨ）、雌二醇（Ｅ２）水平下降；子宫腺体数目减少，卵巢次级和成熟卵泡数减少，生育能力下降。而肾虚大鼠上述变化更显著。用四群子喂饲脾虚模     

复方珍珠口服液的临床研究

复方珍珠口服液由珍珠、黄精、枸杞子、何首乌、熟地黄等多种补益中药材组成,提取制备而成的口服液,经临床144例验证表明,该口服液具有滋补肝肾、养血活颜、延缓衰老的功能。对肝肾两虚、头晕眼花、健忘、夜尿、病后体弱,高胆固醇、高血压症有较好的疗效;其中治疗肾虚证总有效率为95.83％,治疗高血压症总有效率为80.9％,治疗高胆固醇总有效率为71.47％。     

益肾通淋汤防治草酸钙肾结石的实验研究

本文观察了益肾通淋汤对大鼠实验性草酸钙结石的防治实验。结果表明,实验组在草酸钙晶体数和聚体数、肾小管扩张数,肾钙含量等方面均少于对照组(P<0.05或P<0.01);同时观察了实验大鼠肾脏的一般组织学改变,可见对照组肾小管上皮细胞浊肿变性,甚至细胞崩解、细胞碎片,胞核和刷状堟PAS阳性物质脱落于管腔内,有的与结石晶体粘附,肾小管明显扩张,而实验组未见明显的组织学损害。因而认为益肾通淋汤可能是通过抑制草酸钙结晶的析出和聚集,改善肾组织细胞的代谢和功能,减少细胞器脱落成为结石核心和基质物质以及加速尿液排泄,促进微结石排出的途径而起到防治尿结石作用的。     

不同证候的注意缺陷多动障碍患儿多巴胺D2受体基因携带情况检测

注意缺陷多动障碍（ａｔｔｅｎｔｉｏｎｄｅｆｉｃｉｔｈｙｐｅｒｃａｔｉｖｉｔｙｄｉｓｏｎｒｄｒ,ＡＤＨＤ）是常见的儿童行为障碍,目前病因尚未明确,国外近年由于分子生物学方法的介入,发现多巴胺Ｄ２受体ＴａｑＩＡ１等位基因与本病相关,通过对广州市城镇学龄儿童多巴胺Ｄ２受体基因ＴａｑＩＡ多态性的检测,支持Ａ１等位基因与本病的关系（Ｐ＝０．００６５２０）并发现病该基因与中医辨证的“肾虚肝亢”证候关系更为密切     

强的松豚鼠肾虚模型的听力观察

为了解肾虚与听力的关系,利用糖皮质激素模拟“肾虚”动物模型,应用耳廓反射（ＰＲ）阈及听性脑干反应（ＡＢＲ）监测“肾虚”模型豚鼠的听力变化,初步发现：“肾阴虚”及“肾阳虚”实验豚鼠均出现了听力下降现象,但“肾阴虚”的听力下降以６ｋＨｚ为明显,而“肾阳虚”的听力下降以２ｋＨｚ为明显,且“肾阳虚”时２～８ｋＨｚ听力下降的程度均比“肾阴虚”严重,动物听力下降的程度与其全身“虚弱”症状的程度一致。以上结果为探讨“肾开窍于耳”的实质提供了新的实验资料。     

中药脑栓康治疗急性缺血性中风气虚血瘀证的临床试验

为客观评价益气活血化瘀复方脑栓康（ 由黄芪、水蛭、葛根等中药组成） 治疗急性缺血性中风（ 脑血栓形成） 气虚血瘀证的临床疗效, 采用随机双盲对照临床试验, 将１１１ 例急性缺血性中风（ 脑血栓形成）气虚血瘀证患者随机分为两组。试验组５６ 例接受脑栓康和基础治疗, 安慰剂组５５ 例接受安慰剂和基础治疗。基础治疗包括西药脱水药（ 甘露醇和／ 或速尿） 、支持疗法, 不用抗凝及扩血管药。疗程为４ 周。结果：①试验组和安慰剂组显著进步分别为２４ ．０８％ 、５．７７ ％ , 进步分别为７２ ．２２ ％ 、８８ ．４６％ , 无效分别为３ ．７０ ％ 、５ ．７７％ , 总有效率分别为９６ ．３０ ％ 、９４．２３ ％ 。两组总疗效差异有显著性（ Ｐ＜ ０ ．０５） ; 两组预期治疗（ｉｎｔｅｎｔｉｏｎ－ｔｏ－ｔｒｅａｔ） 的组间比较, 总疗效差异也有显著性（ Ｐ＜ ０ ．０５） , 提示试验组疗效优于安慰剂组。②试验组对急性缺血性中风气虚血瘀证症状的改善比安慰剂组好（ Ｐ＜ ０ ．０１） 。③未发现脑栓康的不良反应。结果表明： 脑栓康是一种治疗急性缺血性中风（ 脑血栓形成） 气虚血瘀证的安全、有效的药物, 值得进一步研究和开发     

Kidney Stones: A Fetal Origins Hypothesis

Kidney stones are common, with a multifactorial etiology involving dietary, environmental, and genetic factors. In addition, patients with nephrolithiasis are at greater risk of hypertension, diabetes mellitus, metabolic syndrome, and osteoporosis, although the basis for this is not fully understood. All of these renal stone–associated conditions have also been linked with adverse early‐life events, including low–birth weight, and it has been suggested that this developmental effect is due to excess exposure to maternal glucocorticoids in utero. This is proposed to result in long‐term increased hypothalamic‐pituitary‐axis activation; there are mechanisms through which this effect could also promote urinary lithogenic potential. We therefore hypothesize that the association between renal stone disease and hypertension, diabetes mellitus, metabolic syndrome, and osteoporosis may be related by a common pathway of programming in early life, which, if validated, would implicate the developmental origins hypothesis in the etiology of nephrolithiasis. © 2013 American Society for Bone and Mineral Research.     

健脾补肾中药对恶性骨肿瘤化疗后骨髓抑制患者外周血象的影响

目的:观察健脾补肾中药对恶性骨肿瘤化疗后骨髓抑制患者外周血象的影响。方法:将符合要求的60例恶性骨肿瘤化疗后骨髓抑制患者随机分为2组,每组30例。联合治疗组采用健脾补肾中药口服联合重组人粒细胞集落刺激因子皮下注射治疗,单纯西药组采用重组人粒细胞集落刺激因子皮下注射治疗;均连续治疗7 d为1个疗程,共治疗1个疗程。比较2组患者治疗前后外周血液中白细胞计数、血红蛋白含量及血小板计数,并评估白细胞、血红蛋白及血小板抑制程度。治疗结束1周后,评价患者临床症状改善情况及生活质量。结果:①白细胞计数。治疗前2组患者的白细胞计数比较,差异无统计学意义[(3.28±0.64)×10⁹个·L^-1,(3.19±0.76)×10⁹个·L^-1,t=0.566,P=0.576];治疗结束1周后,2组患者的白细胞计数均高于治疗前(t=-6.606,P=0.000;t=-3.583,P=0.000),且联合治疗组患者的白细胞计数高于单纯西药组[(8.68±1.75)×10⁹个·L^-1,(4.63±1.20)×10⁹个·L^-1,t=10.954,P=0.000]。②血红蛋白含量。治疗前2组患者的血红蛋白含量比较,差异无统计学意义[(112.47±10.05)g·L^-1,(108.63±9.67)g·L^-1,t=-1.941,P=0.062];治疗结束1周后,2组患者的血红蛋白含量均高于治疗前(t=-11.750,P=0.000;t=-5.695,P=0.000),且联合治疗组患者的血红蛋白含量高于单纯西药组[(140.83±17.36)g·L^-1,(126.87±15.56)g·L^-1,t=4.331,P=0.000]。③血小板计数。治疗前2组患者的血小板计数比较,差异无统计学意义[(121.10±23.51)×10⁹个·L^-1,(126.90±30.52)×10⁹个·L^-1,t=-1.250,P=0.221];治疗结束1周后,2组患者的血小板计数均高于治疗前(t=-12.528,P=0.000;t=-5.846,P=0.000),且联合治疗组患者的血小板计数高于单纯西药组[(224.23±60.28)×10⁹个·L^-1,(187.70±55.89)×10⁹个·L^-1,t=2.741,P=0.010]。④白细胞抑制程度。治疗结束1周后,联合治疗组0度9例、Ⅰ度11例、Ⅱ度7例、Ⅲ度3例,单纯西药组0度4例、Ⅰ度7例、Ⅱ度8例、Ⅲ度6例、Ⅳ度5例;联合治疗组患者的白细胞抑制程度优于单纯西药组(Z=-2.717,P=0.007)。⑤血红蛋白抑制程度。治疗结束1周后,联合治疗组0度8例、Ⅰ度10例、Ⅱ度12例,单纯西药组0度3例、Ⅰ度10例、Ⅱ度6例、Ⅲ度6例、Ⅳ度5例;联合治疗组患者的血红蛋白抑制程度优于单纯西药组(Z=-2.547,P=0.011)。⑥血小板抑制程度。治疗结束1周后,联合治疗组0度11例、Ⅰ度13例、Ⅱ度4例、Ⅲ度2例,单纯西药组0度8例、Ⅰ度7例、Ⅱ度8例、Ⅲ度4例、Ⅳ度3例;联合治疗组患者的血小板抑制程度优于单纯西药组(Z=-2.009,P=0.045)。⑦临床症状改善情况。治疗结束1周后,联合治疗组显著改善13例、部分改善14例、无效3例,单纯西药组显著改善7例、部分改善12例、无效11例;联合治疗组患者的临床症状改善情况优于单纯西药组(Z=-2.363,P=0.018)。⑧生活质量。治疗结束1周后,联合治疗组改善16例、稳定10例、降低4例,单纯西药组改善9例、稳定8例、降低13例;联合治疗组患者的生活质量高于单纯西药组(Z=-2.430,P=0.015)。⑨其他。治疗过程中,单纯西药组6例应用促红细胞生成素、3例输注血小板,联合治疗组无1例采取上述措施。结论:对于恶性骨肿瘤化疗后骨髓抑制患者,在采用重组人粒细胞集落刺激因子皮下注射治疗的基础上,应用健脾补肾中药口服治疗,可以增加外周血液中白细胞计数、血红蛋白含量及血小板计数,减轻骨髓抑制程度,有利于改善临床症状、提高生活质量,其疗效优于单纯采用重组人粒细胞集落刺激因子皮下注射治疗。     

Comparison of Fracture Prediction Tools in Individuals Without and With Early Chronic Kidney Disease: A Population-Based Analysis of CARTaGENE

Whether fracture prediction tools developed for the management of osteoporosis can be used in chronic kidney disease (CKD) is poorly known. We aimed to compare the performance of fracture prediction tools in non-CKD and CKD. We analyzed CARTaGENE, a population-based survey of 40-year-old to 69-year-old individuals recruited between 2009 and 2010. Renal function was assessed using baseline creatinine and categorized according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines (non-CKD, stage 2, stage 3). Individuals without creatinine measurements or with advanced CKD (stage 4 or 5; prevalence <0.25%) were excluded. Predicted 5-year fracture probabilities (using Fracture Risk Assessment Tool [FRAX], QFracture, and Garvan) were computed at baseline. Fracture incidence (major fracture [MOF] or any fracture) was evaluated in administrative databases from recruitment to March 2016. Discrimination (hazard ratios [HRs] per standard deviation [SD] increase in Cox models; c-statistics) and calibration (standardized incidence ratios [SIRs] before and after recalibration) were assessed in each CKD strata. We included 19,393 individuals (9522 non-CKD; 9114 stage 2; 757 stage 3). A total of 830 patients had any fracture during follow-up, including 352 MOF. FRAX (HR = 1.89 [1.63–2.20] non-CKD; 1.64 [1.41–1.91] stage 2; 1.76 [1.10–2.82] stage 3) and QFracture (HR = 1.90 [1.62–2.22] non-CKD; 1.57 [1.35–1.82] stage 2; 1.86 [1.19–2.91] stage 3) discriminated MOF similarly in non-CKD and CKD. In contrast, the discrimination of Garvan for any fracture tended to be lower in CKD stage 3 compared to non-CKD and CKD stage 2 (HR = 1.36 [1.22–1.52] non-CKD; 1.34 [1.20–1.50] stage 2; 1.11 [0.79–1.55] stage 3). Before recalibration, FRAX globally overestimated fracture risk while QFracture and Garvan globally underestimated fracture risk. After recalibration, FRAX and QFracture were adequately calibrated for MOF in all CKD strata whereas Garvan tended to underestimate any fracture risk in CKD stage 3 (SIR = 1.31 [0.95–1.81]). In conclusion, the discrimination and calibration of FRAX and QFracture is similar in non-CKD and CKD. Garvan may have a lower discrimination in CKD stage 3 and underestimate fracture risk in these patients. © 2020 American Society for Bone and Mineral Research.