[[目的]]介绍陈华教授继承浙派中医儿科学术特色,临床运用滋阴清热法异病同治小儿乳蛾、便秘、积滞、胃脘痛、鼻衄、抽动障碍等疾病的经验.[[方法]]通过跟师学习,收集和分析陈华教授运用滋阴清热法治疗疾病之医案,研究浙派中医儿科学术特色,结合陈华教授临证所谈所述以及笔者对中医儿科学术的思考,在充分认识人群体质特点及疾病共性的基础上,总结分析陈华教授运用滋阴清热法治疗儿科多种疾病的临床经验,并列举典型医案.[[结果]]陈华教授继承浙派中医儿科学术特色,认为浙江地区儿童常见阴虚火旺体质,常发热病,病机多为阴虚火旺、本虚标实,治疗上重视滋阴清热,同时根据不同的疾病特点灵活运用,以滋阴清热、疏风解表法治疗乳蛾;滋阴清热、润肠通便法治疗便秘;滋阴清热、消食导滞法治疗积滞;滋阴清热、疏肝理气法治疗胃脘痛;滋阴清热、凉血止血法治疗鼻衄;滋阴清热、平肝熄风法治疗抽动障碍.[[结论]]陈华教授继承了浙派中医儿科"因人因地制宜,擅长滋阴清热"的特色,重视儿童阴虚火旺之体质、本虚标实之病机,通过辨证论治,灵活运用滋阴清热法,改善患儿体质,控制疾病发展,临床疗效显著,其经验值得总结推广.

目的 评价益骨汤治疗老年性骨质疏松症(senile osteoporosis,SOP)的临床疗效和安全性.方法 采用多中心随机对照的临床设计方案,从2015年1月至2016年12月的住院患者中,选取214例患有SOP的患者,按照治疗方案随机分为治疗组和对照组.对照组105例,其中男性43例,女性62例,年龄(77.1±6.6)岁,运用基础治疗(元素钙600 mg、维生素D 125 U,每日1次,连续服用;福善美70 mg/片,每周1次,连续服用3个月;结合运动疗法).治疗组109例,其中男性52例,女性57例,年龄(76.5±7.1)岁,在对照组的治疗方案基础上再加服益骨汤.两组患者均以3个月为一个疗程,随访期为6个月.治疗后,采用视觉模拟评分法(visual analogue scale,VAS)评分、腰椎骨密度(bone mineral density,BMD)、骨折风险评估(fracture risk assessment,FRAX)、中医证候评分以及骨代谢指标(碱性磷酸酶ALP和血浆抗酒石酸酸性磷酸酶TRAP5b)评定两组临床疗效.结果 214例患者获得随访,治疗后SOP患者VAS评分、BMD、FRAX、中医证候评分和骨代谢指标(ALP、TRAP5b)较治疗前均有明显改善,差异有统计学意义(P<0.05),且经治疗后,治疗组改善程度较对照组明显,VAS评分及中医证候评分比较差异有统计学意义(P<0.01).观察组总有效率82.6％高于对照组68.6％,对比差异具有统计学意义(P<0.05).结论 在常规抗SOP的同时口服中药益骨汤,可以提高BMD,促进骨形成,在缓解SOP患者疼痛程度及综合活动功能方面,优势更加明显,具有较好的临床疗效和安全性.

目的:观察手法复位联合3D打印外固定支具治疗单纯性胸腰椎骨折的疗效.方法:选取胸腰椎骨折患者60例,随机分为A组、B组和C组,每组20例.A组给予手法复位联合3D打印外固定支具治疗,B组给予切开复位椎弓根螺钉内固定治疗,C组给予手法复位治疗.观察各组患者椎体前缘压缩度(anterior vertebral body compression,AVBC)、脊柱后凸角(Cobb角)、腰部疼痛视觉模拟评分(visual analogue score,VAS)变化情况.结果:三组患者治疗后AVBC、Cobb角、VAS评分均较治疗前明显改善,差异有统计学意义(P＜0.05);三组治疗后3个月时恢复的AVBC值及Cobb角均有不同程度的丢失,C组治疗后3个月AVBC丢失值高于A组、B组,差异有统计学意义(P＜0.05);A组、C组治疗后1周VAS评分低于B组,差异有统计学意义(P＜0.05).结论:镇痛下手法复位在单纯压缩性骨折的治疗过程中可以恢复伤椎高度、矫正脊柱后凸畸形,3D打印外固定支具可以精准定位伤椎,通过局部力学作用达到维持脊柱过伸、保持伤椎高度、缩短卧床时间的作用.

Respiratory syncytial virus (RSV) infection can deteriorate asthma by inducing persistent airway inflammation. Increasing evidence elucidated that pyroptosis plays a pivotal role in asthma. Conciliatory anti-allergic decoction (CAD) exhibits an anti-inflammatory effect in ovalbumin (OVA)-induced asthma; however, the effects and mechanisms of CAD in RSV-infected asthmatic mice have not yet been elucidated. The RSV-infected asthmatic mice model and lipopolysaccharide (LPS)-induced 16HBE cell pyroptosis model were established, respectively. Pulmonary function, ELISA, and histopathologic analysis were performed to assess the airway inflammation and remodeling in mice with CAD treatment. Furthermore, ultra-performance liquid chromatography-quadrupole time-of-flight/mass spectrometry (UPLC-Q-TOF/MS) was conducted to identify the chemical compounds of high-dose CAD (30 g/kg). Cell viability and apoptosis of 16HBE cells were assessed by CCK-8 and flow cytometry assays, respectively. Finally, the expression levels of apoptosis-, pyroptosis-, and TLR3/NLRP3/NF-κB/IRF3 signaling-related genes were measured with qRT-PCR or western blotting, respectively. Pulmonary function tests showed that CAD significantly ameliorated respiratory dysfunction, airway hyperresponsiveness, inflammation cell recruitment in BALF, pulmonary inflammation, collagen deposition, and cell death in lung tissues. CAD significantly decreased the content of TNF-α, IL-13, IL-4, IL-1β and IL-5 in the bronchoalveolar lavage fluid (BALF), IL-17, IL-6, and OVA-specific IgE in serum and increased serum IFN-γ in asthma mice. The results of UPLC-Q-TOF/MS showed that high-dose CAD had 88 kinds of chemical components. In vitro, CAD-contained serum significantly suppressed LPS-induced 16HBE cell apoptosis. Additionally, CAD and CAD-contained serum attenuated the up-regulated expressions of Bax, Cleaved caspase-3, NLRP3, ASC, Cleaved caspase-1, GSDMD-N, IL-18, IL-1β, TLR3, p-P65, p-IκBα, and IRF3 but increased Bcl-1 and GSDMD levels in the asthma mice and LPS-induced 16HBE cells, respectively. These results illustrated that CAD may have a potential role in improving airway inflammation and pyroptosis through inhibition of the TLR3/NLRP3/NF-κB/IRF3 signaling pathway.

目的 探讨不同刮痧方法干预腰椎间盘突出症(lumbar disc herniation,LDH)的效果.方法 2017年7月至2018年6月,便利抽样法选取扬州市某医院骨伤科门诊就诊的非急症期LDH患者90例,随机分为循经刮痧组、穴位刮痧组及循经加穴位刮痧组各30例.刮拭三个疗程后,比较三组日本骨科学会下腰痛评估表评分(Japanese orthopaedic association,JOA)、视觉模拟疼痛评分(visual analogue scale,VAS)及血清白介素1-beta(interleukin 1-beta,IL-1β)、血清白介素10(interleukin 10,IL-10)含量.结果 与干预前相比,干预后三组患者的JOA评分以及血清IL-10含量均上升,VAS评分以及血清IL-1β含量均下降,差异均有统计学意义(均P<0.01).干预后,循经加穴位刮痧组JOA评分、VAS评分以及血清IL-1β、IL-10含量的改善情况均优于循经刮痧组和穴位刮痧组,差异均有统计学意义(均P<0.01);循经刮痧组和穴位刮痧组JOA评分、VAS评分及血清IL-1β、IL-10含量比较,差异均无统计学意义(均P>0.05).结论 刮痧干预LDH疗效确切,具有抗炎、镇痛作用,经穴结合刮痧干预LDH比单纯循经或穴位刮痧效果好,该方法虽然刮拭部位较多,但疗效更优,值得推广.

[目的]介绍陈华教授分期辨治小儿感染后咳嗽的经验.[方法]通过随师临诊,整理感染后咳嗽医案,熟读浙派中医儿科学术特色相关文献,结合笔者对中医学术的思考,在确定小儿感染后咳嗽分期的基础上,探究陈师基于不同分期辨治小儿感染后咳嗽的临床经验,并列举医案以验证.[结果]陈师主张分"风邪束肺""肺热壅盛""正虚邪恋"三期辨治小儿感染后咳嗽,其中"正虚邪恋"期又以"脾虚痰湿""阴虚内热"证为多见,分别采用疏风宣肺、清肃肺热、健脾化痰或滋阴清热法治疗,充分体现了浙派中医儿科"善用风药、巧用和法、健运脾胃、滋阴清热"的学术特色.所列案例为小儿感染后咳嗽的典型医案,风邪束肺期疏风宣肺,肺热壅盛期清肃肺热,正虚邪恋期养阴清热或健脾化痰,疗效确切.[结论]陈师通过分期辨治小儿感染后咳嗽,灵活运用浙派中医儿科学术特色,可有效减轻咳嗽症状、改善患儿体质、减少反复发作,疗效显著,值得推广.

Objective:To observe the clinical effect of scraping therapy on lumbar disc herniation (LDH) with different syndromes.Methods:Using the convenient sampling method, a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects. Among them, there were 11 cases of qi stagnation and blood stasis syndrome, 8 cases of damp-heat obstruction syndrome, 7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome. Du meridian, the bladder meridian of Foot Taiyang, as well as Jiaji (EX-B2) in pathological or painful sections, Ashi point, Shenshu (BL 23) , and Weizhong (BL 40) were mainly scraped. The treatment interval is 2~5 days (the marks of scrapping fade) , twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment. Japanese Orthopaedic Association (JOA) Score, Visual Analogue Scale (VAS) , serum interleukin-1 β (IL-1β) and interleukin-10 (IL-10) were compared before and after scraping.Results:Compared with those before scraping, the JOA score increased, the VAS decreased, the serum IL-1β content decreased and the serum IL-10 content increased after scraping, and the differences were sttaistically significant ( P<0.01) . Among them, the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome, damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . Conclusions:The curative effect of scraping in the treatment of LDH is definite, and the curative effect is better for excessive syndromes.

目的:基于数据挖掘技术,探讨俞景茂教授诊治小儿反复呼吸道感染的规律.方法:收集俞景茂教授诊治小儿反复呼吸道感染的门诊病案,运用Microsoft Excel和SPSS Clementine软件,进行治法、方剂的分布频数、频率的分析,并运用关联规则对治法和方剂关联性,以及药物之间的关联性进行统计分析.结果:俞师诊治小儿反复呼吸道感染非急性感染期主要从肺脾两脏论治,较常见的证候是气阴两虚证和少阳不和证,并分别常以四君子汤加味和小柴胡汤加减治疗,同时注重疏风活血法的运用.结论:数据挖掘法的应用对于挖掘名老中医临床经验具有重要价值.

回顾近10年来中医外治法治疗小儿遗尿的临床研究,认为中医外治法治疗小儿遗尿有方便使用、依从性好、复发率低、改善伴随症状等优势,但其在治疗标准及疗效评估方面尚无统一标准,部分外治方法的安全性有待评价.

[目的]总结浙派中医儿科重视脾胃学术思想的历史源流,以及在脾胃学术思想基础上的临证运用特色.[方法]通过对浙派中医儿科史料、相关中医古籍的仔细研读,并参阅现代浙派中医儿科名医的论文、论著,结合笔者对中医经典及中医学术的思考,总结、概括浙派中医儿科脾胃学术思想的历史源流及浙派中医儿科名医的临证运用特色.[结果]浙派中医儿科继承了《黄帝内经》《伤寒杂病论》及钱乙、朱丹溪、叶天士重视脾胃的学术思想.经研究提炼,浙派中医儿科重视脾胃学术思想在儿科临证运用的四大特色可归纳为:调补脾胃忌呆滞,临证用药宜轻灵,四旁诸疾治中洲,重视饮食有节制.[结论]浙派中医儿科重视脾胃学术思想的临证运用特色对儿科临床具有较强的指导意义,对充实浙派中医儿科学术内涵起到了积极作用.

[目的]总结浙派中医儿科在传承中医经典理论的基础上,运用"和法"治疗儿科疾病的临床运用特色及经验.[方法]运用史料考证、古籍研读、文献分析的方法,从"和法"的历史沿革、学术特点及临证治案三个方面,分析浙派中医儿科对"和法"的传承、创新及临床运用特色.[结果]浙派中医儿科在张仲景、张景岳等历代医家影响下,结合浙江地域气候、社会特点,以及小儿稚阴稚阳、易寒易热、传变迅速等生理病理特点,进一步发展了"和法"在儿科的应用范围,具体形成了强调分期论治,善用和解表里;重视寒热错杂,擅长调和脏腑;辨别体质强弱,注重调整阴阳三个方面的学术特色.[结论]浙派中医儿科巧用"和法"治疗小儿多种疾病,学术特色鲜明,完善了中医儿科的治法,对中医儿科临床具有重要的实践指导意义,是浙派中医儿科学术体系的重要组成部分.

反复呼吸道感染(recurrent respiratory tract infections,RRTI)是儿科的常见病、多发病,指1年以内发生上、下呼吸道感染的次数频繁,超出了一定范围[1],具有反复发作、迁延日久的特点,可形成恶性循环,影响小儿生长发育.机体免疫功能紊乱是引起儿童RRTI的高危因素[2].肠道微生态在免疫反应中对呼吸道传染病的抵抗起到一定作用[3],肠道微生态失衡可改变宿主免疫状态,导致抵抗力下降而引起RRTI,这与中医"肺与大肠相表里"关系密切.研究证实,中医药通过健脾治疗RRTI疗效显著,对肠道菌群亦有调节作用.因此,本文基于肠道微生态探讨健脾治疗RRTI的作用机制,以期为科学研究及临床应用提供参考.

BACKGROUND:Asthma is a complex inflammatory disorder that plagues a large number of people. Schisandrin B is an active ingredient of the traditional Chinese herbal medicine Schisandra with various proven physiological activities such as anti-inflammatory and antioxidant activities. In this study, we explored the anti-inflammatory and antioxidant effects and provided the mechanistic insights into the activity of schisandrin B in a mouse model of ovalbumin- (OVA-) induced allergic asthma.METHODS:Male BALB/c mice were sensitized and challenged with OVA to induce asthma and treated with various doses (15 mg/kg, 30 mg/kg, and 60 mg/kg) of SCH to alleviate the features of allergic asthma, airway hyperresponsiveness, inflammatory response, OVA-specific immunoglobulin (Ig)E level, and pathological injury.RESULTS:Schisandrin B significantly attenuated the airway hyperresponsiveness induced by OVA. Moreover, schisandrin B administration suppressed inflammatory responses, reduced the level of IgE, and attenuated pathological injury. Mechanistically, schisandrin B treatment promoted the activation of nuclear erythroid 2-related factor 2 (Nrf2), but suppressed the stimulation of the NF-κB pathway caused by OVA.CONCLUSION:Taken together, our study suggests that schisandrin B attenuates the features of asthmatic lungs by inhibiting the NF-κB pathway and activating the Nrf2 signaling pathway.

目的 探讨益骨汤防治骨质疏松的物质基础及其靶标,阐明益骨汤防治骨质疏松症的潜在靶点和作用机制.方法 通过TCMSP等数据库筛选益骨汤组分中的活性成分及其作用靶点.通过OMIM、GeneCards等数据库预测益骨汤治疗骨质疏松症的相关靶点,构建"药物-成分-靶点-疾病"网络.利用Cytoscape软件构建益骨汤组分治疗骨质疏松症的成分作用靶点网络,采用STRING数据库构建PPI网络,利用通过生物学信息注释数据库分析靶点的GO富集和KEGG信号通路.结果 共纳入益骨汤6味中药相关的有效活性成分159个,589个药物靶标,按照君臣佐使配对,其中334个靶点有相互作用关系;蛋白互作分析提示INS、AKT1、IL6、MAPK3、VEGFA等为蛋白互作网络中的核心靶点;靶标富集结果显示3 148个GO术语被显著富集(均P＜0.05);PI3K-Akt信号通路、MAPK信号通路、cGMP-PKG信号通路、Wnt信号通路、破骨细胞分化等175个信号通路被显著富集(均P＜0.05).结论 中药复方君臣佐使配伍可以转换为靶标相互作用的化合物形式,阐明益骨汤的物质基础及配伍机制.益骨汤组分靶标和通路不仅具有调节成骨细胞和破骨细胞功能的双重作用,还通过影响和干预骨微循环境,体现补肾健脾活血法治疗骨质疏松的物质基础,符合骨质疏松的病理生理机制.

[目的]追溯浙派中医儿科源流,梳理古今传承脉络,总结浙派中医儿科学术特色与传承发展.[方法]通过史料考证、文献分析、实地调查、名家走访等方法,从探究古今医家儿科学术思想的传承脉络,并结合浙江地域特点,归纳总结浙派中医儿科的学术特色,并探讨其传承方式及发展模式.[结果]浙派中医儿科受钱乙、金元各家尤其是朱丹溪学术的影响,同时结合浙江湿热地理环境因素特点,通过家传以及师带徒的传统方式和院校教育、名中医工作室建设等现代传承模式,形成了"因人因地制宜,擅长滋阴清热;重视后天之本,强调健运脾胃;详辨虚实夹杂,巧用和解之法;注重风邪为病,善用祛风之药"的临床诊疗学术特色.[结论]浙派中医儿科的四大学术特色,为流派学术思想的凝练及流派优势的发挥创造了良好条件.在传统师带徒方式的基础上结合院校教育并开展名医工作室建设的传承模式,更有利于浙派中医儿科的学术传承与创新发展.

目的 观察针刺四缝穴联合异功散加减治疗脾胃气虚型小儿厌食症的效果.方法 2018年5月至2019年9月浙江中医药大学滨江门诊部收治的脾胃气虚型厌食症患儿72例,随机分为对照组与观察组各36例.两组均予异功散加减口服,每日1剂,水煎服,早晚各1次,每次约100mL.观察组在此基础上予针刺四缝穴治疗,每周1次.两组均治疗3周后评判疗效,并比较治疗前后中医证候积分.结果 观察组治疗显效率(22.2％)高于对照组(2.8％),治疗后食量、每餐进食时间、腹胀、口渴喜饮积分明显低于对照组,差异均有统计学意义(P<0.05).结论 针刺四缝穴可明显提高厌食症患儿的食量,有效改善其中医证候.

[目的]介绍陈华教授继承浙派中医儿科学术特色治疗小儿腺样体肥大的临床经验.[方法]通过跟师学习、研究浙派中医儿科学术特色及整理医案,总结分析陈师治疗小儿腺样体肥大的临床经验,并列举医案以验证.[结果]陈师继承浙派中医儿科学术特色,认为小儿腺样体肥大的病因在于虚、痰、瘀,病机为肺脾两虚、痰瘀互结,将病程分为感染期、迁延期、恢复期三期,于分期治疗中"巧用和法、健运脾胃、养阴固本",并将化痰散瘀法贯穿治疗的全程.所列案例为小儿腺样体肥大的典型案例,于感染期疏风清肺,迁延期扶正祛邪,恢复期健脾养阴,兼以化痰散瘀,疗效确切.[结论]陈师从腺样体肥大肺脾两虚、痰瘀互结的基本病机出发,通过分期治疗,灵活运用浙派中医儿科学术特色,改善患儿临床症状,缩小腺样体,疗效显著,值得推广.

Objective:To analyze the predictive value of enhanced MRI in the outcome of prolapsed and sequestrated lumbar disc herniation through a retrospective analysis.Methods:A retrospective analysis of the data of 64 patients with prolapsed and sequestrated lumbar disc herniation from January 2015 to December 2018, including 38 males and 26 females; age 35.72±12.44 years (range, 22-64 years) ; 43 cases of prolapsed type, 21 cases of sequestrated type. Conservative treatment was the first choice for all patients, in case of surgical indications during the treatment, percutaneous endoscopic lumbar discectomy or fenestration discectomy will be performed. Enhanced MRI was performed at the first and last inspections, the volume of the protrusion, the thickness of rim enhancement (Tr), and the extent of rim enhancement (Er) were measured and calculated at the same time. According to the ring around the protrusion, the size of the rim-enhancement area was divided into type I-III; then compared the relationship between the rim-enhancement signal differentiation and the resorption rate of protrusions, and the correlation between Tr, Er values and the resorption rate of protrusions during the initial inspection.Results:Among the 64 patients, 42 patients completed conservative treatment, and 22 received surgical treatment. According to the rim-enhancement signal differentiation, 23 cases were treated conservatively for type I, 3 cases were treated by surgery; 16 cases were treated for type II conservatively, 7 cases were treated by surgery; 3 cases were treated for type III conservatively, and 12 cases were treated by surgery. All patients were followed up for 12 to 34 months. Among 42 conservatively treated patients, The volume of the protrusion before treatment was 2 645.67±690.86 mm 3, and the volume of the protrusion after treatment was 842.76±573.35 mm 3. The volume of protrusions before and after treatment was statistical significance ( t=11.897, P<0.001), Tr was 1.38±0.83 mm, and Er was 73.08%±34.39%, the resorption rate of protrusions was 65.10%±24.50%, and 39 cases (92.86%, 39/42) reached the standard for protrusion resorption (resorption rate ≥30%); 23 cases of type I , the resorption rate was 76.54%±18.62%; 16 cases of type II had an resorption rate of 56.81%±21.44%; 3 cases of type III had an resorption rate of 21.58%±12.19%. The resorption rate of type III were compared by single factor analysis of variance, and the difference was statistically significant ( F=12.885, P<0.001); 32 cases of both type I and II (82.05%, 32/39) had significant resorption (resorption rate ≥50%), and no case of type Ⅲ had significant resorption, comparing with type I and II, the difference was statistically significant ( P=0.010); Tr was positively correlated with resorption rate ( r=0.569, P<0.001), Er was positively correlated with resorption rate ( r=0.677, P<0.001). Conclusion:Under close clinical observation, parts of the prolapsed or sequestrated lumbar disc herniations can be conservatively treated, and the herniated disc can be resorption in many people and the clinical symptoms were alleviated. Rim-enhancement signal differentiation by enhanced MR has a better predictive value for the outcome of the herniation, type I is more prone to resorption, preferred conservative treatment, type Ⅲ is not easy to resorption, preferred surgery treatment, and the higher thickness of rim enhancement, the greater extend the rim-enhancement, the more prone to resorption phenomenon.

目的 探讨肺通气功能(包括阻塞性及限制性通气功能障碍)与动脉硬化的相关性,探讨以踝臂脉搏波传导速度(ba-PWV)评估的动脉硬化与肺通气功能的相关性.方法 在2018年1月至8月我院健康体检中自报未患有脑卒中、心肌梗死、肺心病及恶性肿瘤等重大慢性疾病的相对健康人群6 403名,收集既往史如吸烟史、高血压史、糖尿病史,血生化、血超敏C反应蛋白(hs-CRP),血流动力学指标如收缩压、舒张压、ba-PWV,身体测量指标如身高、体重、腰围,以及肺通气功能指标.评估ba-PWV与肺通气功能之间的关系.结果 参照入选标准及排除标准后,共2433名纳入统计,其中男916名,女1 517名.ba-PWV与年龄、吸烟指数、腰围、收缩压、舒张压、甘油三酯、胆固醇、低密度脂蛋白、hs-CRP、糖化血红蛋白呈正相关,与身高、用力肺活量(FVC)占预计值百分比(FVC％pred)、第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1％pred)、1秒率(F EV1/FVC)、最大呼气中段流量(MMEF)占预计值百分比(MMEF％pred)呈负相关.ba-PWV与体重、体重指数、FVC、MMEF、γ-谷氨酰转肽酶、高密度脂蛋白、肌酐、尿酸无显著相关性.经调整上述有意义的参数后,FVC％pred和FEV1％pred与ba-PWV呈负相关(P＜0.05),而FEV1/FVC及MMEF％pred与ba-PWV无明显相关性.结论 FEV1/FVC与动脉硬化指标ba-PWV无相关性,但FVC％pred和FEV1％pred与ba-PWV呈负相关.在临床上,肺通气功能受损患者需长期随访了解有无动脉硬化,而动脉硬化患者亦需要长期随访来尽早发现是否存在肺通气功能受损.

目的 通过比较在胸腰椎骨折中单纯行经皮椎弓根螺钉内固定术与配合吴门医派手法整复后行经皮椎弓根螺钉内固定术的临床疗效,探讨手法整复在治疗胸腰椎骨折中的作用.方法 选取在2017年10月至2018年9月由我院脊柱外科收住的胸腰椎骨折病患者40例,分为手法整复配合椎弓根螺钉内固定组(治疗组)和单纯经皮椎弓根螺钉内固定组(对照组).观察并比较两组患者治疗前后椎体高度比、手术时间、术中出血量、术前腹胀改善情况、脊柱后凸角度及腰痛VAS评分的变化.结果 两组患者手术时间、术中出血量、术前腹胀改善情况、腰痛VAS评分均有统计学意义(P<0.05),但治疗前后椎体高度比、脊柱后凸角度无统计学意义(P>0.05).结论 两种治疗方法 总体疗效相近,但术前先行手法整复具有缩短手术时长、减少术中出血量、改善术前腹胀情况、降低患者腰痛评分等优点.