目的:采用Meta分析方法评价大柴胡汤治疗2型糖尿病的临床疗效.方法:在PubMed、Medline、EMBase、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、重庆维普中文科技期刊数据库、万方数据库中查找大柴胡汤治疗2型糖尿病的随机对照试验研究.2位研究人员独立进行筛选,提取数据,评估方法质量,数据分析采用RevMan 5.3软件进行.结果:共纳入13项随机对照试验,1141例患者.Meta结果显示,与西药常规疗法治疗的对照组相比,加用大柴胡汤的试验组在降低空腹血糖、餐后2 h血糖、糖化血红蛋白、身体质量指数、体质量等方面优于对照组,所纳入的研究中有2篇文章报道了不良反应,但均未进行干预治疗.结论:与标准治疗相比,大柴胡汤联合降糖药物治疗2型糖尿病在改善血糖、糖化血红蛋白以及体质量参数方面效果更佳,然而由于样本量小,审查的试验方法学质量欠佳,有必要进行高质量的循证医学研究.
Objective:To observe the effect of spleen-and-kidney-tonifying and blood-circulating therapy on reducing or even removing the oxidative stress and inflammatory factors of patients with diabetic nephropathy for the purpose of preventing pro-tein oxidation damage. Methods:A total of 60 diabetic patients were selected with diabetic nephropathy who received inpatient and outpatient services from the Nephropathy Department of Clifford Hospital between September 2013 and September 2014, and they were divided into the following groups according to the globally-accepted diagnostic criteria( Mogensen′s staging criteria) and their serum creatinine level:early diabetic nephropathy group ( DN1 group) 22 cases: UAER sustained 20~200 μg/min; clinical diabetic ne-phropathy group (DN2 group) 18 cases: UAER >200 μg/min; end -stage diabetic nephropathy group (DN3 group) 20 cases:UAER >200 μg/min and Cr>445 μmol/L. All patients in the DN1, DN2, and DN3 groups received Chinese herbal treatments to invigorate the spleen and kidney and to promote blood circulation. Routine treatments were applied to the patients and the levels of their AOPP, AGE, SOD, hsCRP and IL-6 were examined before and after the treatment. Results:With the development of DN, the levels of serum AOPP, AGE, hsCRP and IL-6 increased (P<0. 05), and the activity of SOD decreased (P<0. 05). AOPP and SOD were significantly negative correlated. After the treatment, in terms of the total effect of traditional Chinese medicine for clinical symptoms, a significant therapeutic effect was shown in these three groups with regard to spleen and kidney tonification and blood cir-culation promotion. The effective rate for DN1 was 54. 55%, and the total effective rate was 95. 45%;the effective rate for DN2 was 38. 89%, and the total effective rate was 88. 89%;the effective rate for DN3 was 40. 00%, and the total effective rate was 85. 00%. The patients’ UAERs in these three groups were all reduced. For all the three groups, the levels of serum AOPP, AGE, hsCRP and IL-6, and UAER decreased significantly four weeks after the treatment (P<0. 01). The level of SOD was significantly higher than that before the treatment (P<0. 05). Conclusion:Spleen-and-kidney-tonifying and blood-circulating therapy is of great signifi-cance for reducing oxidative stress and inhibiting inflammation in clinical practice.
Objective: To observe and assess the therapeutic effect of fistulotomy with the basal layer suture in treatment of low simple anal fistula. Methods: Eighty cases with low simple anal fistula were divided into 2 groups. The study group (40 cases) received the treatment of fistulotomy with the basal layer suture and the control group (40 cases) received the traditional treatment of fistulotomy. The cure rate, length of the healing time, size of the scar was observed. Results: The groups had no difference in the rate of curing(P>0.05). The study group had significantly shorter wound healing time and smaller size of scars compared with the control group (P<0.05). Conclusion: It is suggested that the fistulotomy with the basal layer suture is a reasonable method for the treatment of low simple anal fistula. It could not only cure anal fistula but also shorten wound healing time and prevent anus deforming.
