目的 探究芒针透刺躯干肌联合穴位敷贴对中风后平衡障碍的治疗效果.方法 选取我院2020年1月-2021年12月收治的中风后平衡障碍患者60例,随机分为观察组和对照组,各30例,对照组采用西医常规治疗联合穴位敷贴,观察组采用西医常规治疗和芒针透刺躯干肌联合穴位敷贴,持续4 w,评价治疗前、治疗后2 w和治疗后4 w 2组患者Berg评分(BBS)、Fugl-Meyer评分及Barthel指数,平衡测试仪检测质心轨迹面积和长度差异,比较2种疗法疗效及安全性.结果 治疗后,2组患者BBS、Fugl-Meyer评分和Barthel指数均随治疗时间延长而提高(P<0.05),质心轨迹面积和长度均随治疗时间延长而降低(P<0.05),组内不同时间点比较差异有统计学意义(P<0.05),治疗后2 w和治疗后4 w,观察组均优于对照组(P<0.05);观察组患者临床有效率为86.66％,高于对照组的63.33％(P<0.05),治疗期间2组患者不良事件发生率无统计学意义(P>0.05).结论 芒针透刺躯干肌联合穴位敷贴可改善患者中风后平衡障碍,增强患者运动能力,效果优于单独使用穴位敷贴,且具有安全性高的优点.

目的 观察补中益气汤加减联合针刺治疗后循环缺血性孤立性眩晕患者的临床疗效.方法 选取本院于2020 年4 月至2022 年 4 月收治的60 例后循环缺血性孤立性眩晕患者为研究对象,随机分为对照组(30 例)和观察组(30 例),对照组予以穴位针灸治疗,观察组在对照组的基础上予以补中益气汤加减治疗.比较治疗后患者的临床疗效、中医证候(头晕目眩、神疲乏力、耳鸣耳聋)评分,检测患者血清中神经元特异性烯醇化酶(neuron-specific enolase,NSE)、S100B蛋白(S100 calcium-binding protein B,S-100B)、髓鞘碱性蛋白(myelin basic protein,MBP)、神经肽Y(neuropeptide Y,NPY)、同型半胱氨酸(homocysteine,HCY)和D-二聚体(D-dimer,D-D)含量,记录治疗期间的不良反应情况.结果 观察组治疗 2 周后总有效率为 93.33%,明显高于对照组70.00%(P<0.05);观察组中医证候评分、NSE、S-100B、MBP、NPY、Hcy和D-D水平低于对照组(P<0.05);治疗期间,两组未出现明显不良反应.结论 补中益气汤加减联合穴位针灸治疗后循环缺血性孤立性眩晕患者,能有效减轻症状,改善神经功能和内皮细胞功能,降低血液黏度,安全性好,具有一定临床价值.

目的 观察补阳还五汤加减联合针刺治疗缺血性脑卒中后肢体运动功能障碍的疗效.方法 将64例患者随机分为对照组和治疗组,观察过程中每组均脱落2例,每组最终完成病例数均为30例.在西医基础治疗的同时,治疗组采用补阳还五汤加减联合针刺疗法,对照组采用针刺疗法,每日1次,每周6次,所有患者均接受28 d的治疗.采用中医证候积分评定患者中医证候疗效,Fugl-Meyer运动功能评分量表(Fugl-Meyer motor function assessment,FMA)评估患者运动功能,Berg平衡量表(Berg balance scale,BBS)评估患者平衡功能,改良Barthel指数(modified Barthel index,MBI)评估患者日常生活能力,并进行临床疗效评价.结果 与治疗前比较,两组患者治疗后中医证候积分显著降低(P<0.05),治疗组中医证候积分降低程度显著大于对照组(P<0.05).与治疗前比较,两组患者治疗后FMA评分、BBS评分、MBI评分均显著升高(P<0.05),且治疗组FMA评分、BBS评分、MBI评分升高程度更显著(P<0.05).治疗组临床疗效显著优于对照组(P<0.05).结论 在针刺治疗基础上联用补阳还五汤加减内服可提高缺血性脑卒中后肢体运动功能障碍的疗效.

早发性卵巢功能不全(POI)近年来的发病趋势呈逐年上升且年轻化状态,患者的卵巢功能减退,其生殖功能及内分泌功能处于较低的水平,是导致不孕、月经不调的重要因素.患者往往承担着身心双重痛苦,严重影响生活质量及幸福指数.益经汤为傅氏治疗"年未老经水断"名方,有不少医家将其应用于治疗卵巢功能减退,发现其确能提高血清雌激素水平,改善卵巢功能.现就其方中各味方药入手,从药学性味及现代药理来剖析其治疗早发性卵巢功能不全的机制,为临床用药提供理论依据.

目的 观察天突芒针弯刺联合康复训练对中风后吞咽障碍病人吞咽功能的影响 方法 选取中风后吞咽障碍病人60例,分为治疗组、对照组各30例.治疗组在康复训练的基础上联合天突芒针弯刺,对照组单纯采用康复训练,两组均治疗4周.入组前及治疗后进行洼田氏饮水试验(WST)、标准吞咽功能评定量表(SSA)、改良曼恩吞咽能力评估量表(MMASA)评定.结果 两组病人治疗后WST分级、SSA积分、MMASA评分比较,差异有统计学意义(P<0.05),且治疗后治疗组WST分级、SSA积分、MMSA评分均优于对照组,差异有统计学意义(P<0.05);治疗组总有效率为93.33％,对照组总有效率为73.33％,两组比较差异有统计学意义(P<0.05).两组病人均未出现明显的不良反应.结论 天突芒针弯刺联合康复训练对中风后吞咽障碍病人疗效更佳.

目的:分析中医及中西医结合方案治疗IgA肾病的疗效。方法:回顾性分析2005年～2011年间收治的150例IgA肾病患者的临床资料,并分为中药及中西医结合两组,对相关临床指标、疗效及病理类型进行分析。结果:从基线比较中西医结合组在尿蛋白及病理类型上较中药组为重,两组治疗前后的血肌酐、肾小球滤过率(GFR)、24h尿蛋白、尿红细胞及中药组治疗前后的尿素氮有明显改善,差异有统计学意义(P均<0.05);但两组治疗起始时肌酐正常与升高患者总缓解率的组间差异并无统计学意义(P>0.05);按病理划分,两组中局灶节段增生、系膜增生及系膜增生伴硬化三组治疗前后的24h尿蛋白明显下降,中西医结合组局灶增生伴硬化与FSGS组的24h尿蛋白也明显下降,差异有统计学意义(P均<0.05)。结论:本研究表明中医及中西医结合方案对IgA肾病均有一定疗效,均能改善疾病相关临床指标,单纯中药治疗亦可改善部分病理类型患者的24h尿蛋白。但由于中西医结合组尿蛋白基线水平更高,病理类型更重,提示中西医结合方案适用于较重的IgA肾病,而单纯中医方案则适用于相对较轻的IgA肾病。

Objective:To investigate the distribution pattern of TCM syndrome in patients with IgA nephropathy and its relationship with the main clinical indexes to improve the accuracy of TCM diagnosis of the disease and supply possible evidences to researching the normalization of its TCM syndrome.Methods:According to the pertinent literature and the findings of the Delphi method to determine the common syndromes of the disease and work out the questionnaire.209 cases collected by questionnaire in patients with case history of IgA nephropathy data, clinical symptoms of TCM, Clinical inspection reports etc,frequency analysis, factor analysis, cluster analysis multivariate statistical methods was adopted to determine the classification of IgA nephropathy in TCM syndromes, analysis of variance,and non-Parameter test methods w as conducted to analyze the relationship between different clinical indexes and the above syndromes.In order to determine the classification of IgA nephropathy in TCM syndromes and analyze the relationship between different clinical indexes and the above syndromes, we collected case history, clinical symptoms of TCM and Clinical inspection reports by questionnaire and apply statistical methods.Results:IgA nephropathy syndromes are divided into liver-kidney yin deficiency Syndrome, qi-yin deficiency Syndrome, Spleen-Kidney Yang deficiency and blood stagnation Syndrome, Lung-Spleen Qi Deficiency and Damp-Heat Syndrome. In the 209 patients, the proportion of qi-yin dificiency was 33%, followed by Lung-Spleen Qi Deficiency and Damp-Heat Syndrome 30%, Spleen-Kidney Yang deficiency and blood stagnation Syndrome 25%, liver-kidney yin deficiency Syndrome 12 %.The level of 24h urinary protein was higher in Spleen-Kidney Yang deficiency and blood stagnation Syndrome than in qi-yin deficiency Syndrome and Lung-Spleen Qi Deficiency and Damp-Heat Syndrome (P0.01);and the levels of serum creatinine in Spleen-Kidney Yang deficiency blood stagnation Syndrome was highest of the four syndromes(P0.01), and that level in Lung-Spleen Qi Deficiency and Damp-Heat Syndrome was higher than qi-yin deficiency Syndrome; The level of hemoglobin in Lung-Spleen Qi Deficiency and Damp-Heat Syndrome was higher than that of Spleen-Kidney Yang deficiency and blood stagnation Syndrome(P0.05);there are differences in the distribution of the four syndromes in gender(P0.05)and different stages of CKD (P0.001).Conclusion:IgA nephropathy syndromes can be divided into four types:liver-kidney yin deficiency Syndrome, qi-yin deficiency Syndrome, Spleen-Kidney Yang deficiency and blood stagnation Syndrome, Lung-Spleen Qi Deficiency and Damp-Heat Syndrome. Since there are certain regularity in the relevant indexes and distribution of the four syndromes.

Objective:To summarize and analyze the therapeutic effect of Yiqi Huoxue Huashi Project for patients with idiopathic membranous nephropathy(IMN),and to observe the factor that influence the therapeutic effect.Methods:Two hundred and thirty four IMN patients were treated with Yiqi Huoxue Huashi Project.Clinical data including the common informations,course of disease,laboratory examination and follow-up office visit of IMN patients were collected and analyzed.Results:The rate of complete remission was 42.31%. The total effective rate was 76.07%. The total effective rates at year 1,2,3 and more than 4-year were 72.22%,74.48%,75.47% and 78.38%,respectively.The total effective rate of using Chinese medicine,combination of Chinese medicine and Western medicine and Chinese medicine after withdrawl of various western drugs showed no effectives was 80.31%,77.53%,70.89%.The renal survival rates of three years’,five years’ and ten years’were 99%,95% and 80% respectively.Univariate analysis showed that age,smoking,hypertension,serum creatinine,blood urea nitrogen,albumin,24 hours’urinary protein were the influence factors of remission.Multiple analysis showed four important influencing factors,which were age,smoking,follow time and albumin.Conclusion:The treatment of Yiqi Huoxue Huashi Project had good curative effect in evidence,even consolidated and low recurrence rate.The project was effective to protect renal function,and prolong renal survival time.The important factors that influenced curative effect were age,smoking,follow-up time and albumin level.

原发性局灶节段性肾小球硬化(focal segmental glomeru-losclerosis,FSGS)是一组具有类似病理特征的症候群,为儿童及成人多种肾脏疾病持续进展至终未期肾病最多见的病理改变,也是肾移植后复发的最常见原因.

肾癌又称肾细胞腺癌,起源于肾小管的上皮细胞,可发生在肾实质的任何部位,是肾脏最常见的实质肿瘤.肾细胞癌占全部成人恶性肿瘤的3%,在男性生殖系肿瘤中居膀胱癌之后,占肾肿瘤80%～90%,近年来发病有增高趋势.邓跃毅教授,近年接诊肾癌术后患者日渐增多,经中药调理后肾功能有显著改善.现将收集整理的肾癌患者资料报告如下.