术后胃瘫是消化道肿瘤术后并发症之一,临床表现以早饱、恶心、呕吐、腹胀、肠鸣音减弱或消失等胃排空障碍为主要症状.消化道肿瘤术后胃瘫(postsurgical gastroparesis syndrome,PGS)一旦发生,严重影响患者后续治疗及预后,增加其身心痛苦及家庭经济负担.笔者采用针刺联合穴位贴敷治疗PGS,现报道如下.

目的 研究脐疗联合艾灸对老年胃潴留患者的临床疗效及功能状态的影响.方法 选取2019年2月—2020年1月就诊于北京中医药大学东方医院老年病科的40例胃潴留患者,按照随机数宇表法将其分为对照组和治疗组,各20例.两组均接受促胃肠动力药物,治疗组在此基础上接受脐疗联合艾灸治疗,疗程14 d.比较两组临床疗效、中医证候评分、世界卫生组织残疾评定量表Ⅱ评分.结果 治疗组有效率高于对照组,差异有统计学意义(P<0.05).治疗后,治疗组脘腹痞满、纳差而饱、大便溏软、泛吐清水、嗳气不爽、头晕乏力评分均低于治疗前,对照组脘腹痞满、纳差而饱、泛吐清水评分均低于治疗前,治疗组脘腹痞满、纳差而饱、泛吐清水、嗳气不爽、头晕乏力评分均低于对照组,大便溏软评分高于对照组,差异有统计学意义(P<0.05).治疗后,两组理解与交流、生活自理、与人相处、社会参与评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05).治疗组治疗后生活活动评分低于治疗前,差异有统计学意义(P<0.05).结论 脐疗联合艾灸对老年胃潴留患者有确切的临床疗效,可明显改善患者的中医证候,并在一定程度上改善功能状态,且安全性良好.

目的:探究封髓丹联合DIA方案对骨肉瘤病人外周血T细胞亚群及血清肿瘤特异性生长因子(TS-GF)、巨噬细胞移动因子(MIF)表达的影响.方法:选取2010-01～2018-01期间我院40例骨肉瘤病人,按照随机数字表法分组,各20例.对照组予以DIA化疗方案,于此基础上,观察组予以DIA化疗方案联合封髓丹治疗.统计两组治疗总有效率、不良反应发生率,并对比治疗前、疗程结束后外周血T细胞(CD3+、CD4+、CD4+/CD8+)、血清TSGF、MIF水平,对比生存质量及治疗后12mo、15mo、18mo生存率.结果:观察组治疗总有效率、生存率相比,无明显差异(P>0.05);观察组CD3+、CD4+、CD4+/CD8+较对照组高(P<0.05);观察组疗程结束后血清TSGF、MIF水平较对照组低(P<0.05);两组III～IV级不良反应,无明显差异(P>0.05),观察组I～II级不良反应发生率较对照组低(P<0.05);观察组治疗后6mo KPS评分较对照组高(P<0.05);两组治疗后12mo、15mo、18mo生存率对比,无明显差异(P>0.05).结论:封髓丹联合DIA方案治疗骨肉瘤病人,保证治疗效果及生存率同时,可显著降低血清TSGF、MIF水平,有效调节外周血T细胞亚群水平,改善生存质量.

目的:观察针刺联合穴位贴敷治疗消化道恶性肿瘤术后胃瘫综合征的临床疗效.方法:选取85例消化道恶性肿瘤术后胃瘫综合征的患者,随机分为西医治疗组24例,穴位贴敷组29例,针刺联合穴位贴敷组32例,西医治疗组给予营养支持及对症治疗;穴位贴敷组在西医治疗组基础上采用自拟胃瘫外敷方加味穴位贴敷,每日1次;针刺联合穴位贴敷组在穴位贴敷组治疗基础上加用普通针刺治疗,针刺主穴选取足三里、三阴交、太冲、内关穴,每日1次,共治疗14 d.观察治疗后3组患者临床疗效、恢复经口进食时间及不良反应发生情况.结果:治疗后西医治疗组有效率为41.67％,穴位贴敷组有效率为68.97％,针刺联合穴位贴敷组有效率为90.60％,3组有效率两两比较,差异均有统计学意义(P＜0.05).分层统计发现,3组发生率较高的胃癌、胰腺癌、十二指肠癌患者,西医治疗组有效率为40.00％,穴位贴敷组有效率为66.67％,针刺联合穴位贴敷组有效率为96.43％,3组有效率比较,差异均有统计学意义(P＜0.05).3组患者恢复经口进食时间分别为西医治疗组(10.80±3.16)d,穴位贴敷组(7.10±4.41)d,针刺联合穴位贴敷组(6.69±2.70)d,穴位贴敷组、针刺联合穴位贴敷组与西医治疗组患者恢复经口进食时间比较,差异有统计学意义(P＜0.05),但穴位贴敷组与针刺联合穴位贴敷组比较,差异无统计学意义(P＞0.05).所有患者均未出现皮肤不良反应及针刺相关不良反应.结论:针刺联合穴位贴敷治疗消化道恶性肿瘤术后胃瘫综合征疗效确切,无明显不良反应.

Objective:To investigate Chinese medicine combined with cryoablation in treatment of unresectable sarcoma.Methods:44 patients were divided into two groups according to different treatment methods.The control group including 18 patients was treated with Chinese medicine only.The observation group including 26 patients was treated with Chinese medicine combined with cryoablation.We evaluated recent efficacy after 4 weeks;progression-free survival and overall survival and recorded adverse reactions.Results:The disease control rate of the observation group was significantly better than the control group(P ＜ 0.05).The median progression-free survival in the observation group was 2 months and the control group was 0 month.The median overall survival in the observation group was 8 months and the control group was 5 months.There was no statistically significant difference between the two groups (P ＞ 0.05).The adverse reactions of two groups was mild and eased by observed or symptomatic treatment.Conclusion:The cryoablation in the treatment of unresectable sarcoma can increase the disease control rate and extend progressionfree survival and overall survival.The patients are well tolerated.

Objective To study the characteristic, diagnosis and treatment method, prognosis and out-come of multiple primary malignant neoplasms ( MPMNs) in 53 cases, thus to understand MPMNs better and to guide clinic. Methods 53 patients with MPMNs from September, 2013 to February, 2016 were involved in this study. All the data in Dongfang Hospital, Beijing University of Chinese Medicine were collected to conduct retrospective analysis. Results There were 49 cases with duplex primary malignant neoplasms(DPMNs), 3 cases with triple primary malignant neoplasms,1 case with quadruple primary malignant neoplasms. There were 111 malignant neoplasms lesions in 53 MPMNs patients, including 33 located in alimentary system, 29 in respiratory system, 20 in head and neck, 11 in mammary gland, 9 in urinary system, 6 in gynecology system and 3 in brain,hematological system. The survival time of the 53 patients ranged from 2 to 360 months. With a median survival time of 60 months, 1 year, 3 year and 5 year cumulative survival rate in 53 patients were 84. 4%,65. 5% and 49. 2%. Conclusion Among MPMNs, the high-incidence age ranged from 60~79 and DPMNs occurred more often. The common lo-cations of MPMNs were alimentary system, respiratory system,and head and neck. 53 MPMNs patients had unbalanced physique, and both phlegm-damp and blood stasis occurred most. Treatment methods had an effect on survival time. Chemotherapy during first primary malignant neoplasmsis was a independ-ent risk factor to the survival time in MPMNs,which showed statistical difference(P<0. 05).

Objective To investigate the efficacy and safety of cinobufagin injection on hematuria patients due to bladder cancer.Methods 28 cases were divided into treatment group (n =12)and control group (n =16).The patients in control group were treated with regular medicine of hemocoagulase (2 Unit, intravenous drip,three times a day)and hematopoietic materials such as Vitamin 12,folic acid,and chalybeate.In addition to the therapy for the control group,the patients in the treatment group were bladder intravesically instillated with cinobufagin injection.Then a retrospective study was carried out by comparing the effects of hemostasis,alleviating anemia,TCM patterns,urethral pain,Karnofsky Perform-ance Status (KPS),and adverse effect between the two groups.Results After treatment,66.60 % of patients in the treatment group showed urinary red blood cells counts decreasing more than 50%,while only 31.25 % patients in the control group did;58.33 % of patients in treatment group showed blood HGB level increasing more than 20 g/L,while 25.00 % patients in the control group;the doses of analgesic drug decreased by more than 50% were 62.50% in the treatment group,higher than 10.00 %in the control group;KPS in the treatment group was significantly higher than that in the control group(P<0.05).After symptomatic supportive treatment,the adverse effects including mild gastrointestinal reac-tion,pain,and fever could be relieved.Conclusion The treatment of combined bladder intravesical in-stillation of cinobufagin injection with intravenous drip of hemocoagulase would alleviate hematuria due to bladder cancer,attenuate urethral pain and improve the patients'life quality.It can be one of options for treatment for hematuria patients with bladder cancer.

目的:研究二陈汤对非小细胞肺癌(NSCLC)痰证患者生活质量的影响.方法:采用前瞻性临床研究方法,收集东方医院肿瘤科门诊与住院晚期NSCLC痰证患者40例给予二陈汤口服2周,对治疗前后生活质量进行比较.结果:QLQ-C30和QLQ-LCl3量表评分显示,治疗后的整体评分高于治疗前,治疗前的躯体功能、角色功能、消化道症状、呼吸道症状、其他症状评分高于治疗后,认知功能评分高于治疗后.结论:二陈汤可显著提高NSCLC痰证患者的生活质量.

目的:探究多西他赛联合泼尼松治疗激素难治性前列腺癌(HRPC)的临床效果.方法:选取从2013年2月至2015年2月在我院接受治疗的HRPC患者72例.对患者在治疗前与治疗后的血清前列腺特异抗原(PSA)、骨痛NRS评分变化进行对比分析,并且对治疗后产生的毒副反应进行评价.结果:在所有参与研究的患者中,有4例(5.6％)失访,8例(11.1％)退出治疗.在可进行疗效评价的60例患者中,PSA至正常水平有16例(26.7％);有效24例(40.0％);稳定12例(20.0％);无效8例(13.3％).骨痛NRS评分降低28例(77.8％);骨痛NRS评分无改变4例(11.1％);骨痛NRS评分升高4例(11.1％).在治疗后68例患者产生了毒副作用,骨髓抑制(Ⅰ～Ⅱ级)20例(29.4％);骨髓抑制(Ⅲ～Ⅳ级)12例(17.6％);静脉炎12例(17.6％);口腔炎8例(11.8％);脱发36例(52.9％);轻度乏力16例(23.5％);甲床改变20例(29.4％);胃肠道反应24例(35.3％).结论:在治疗激素难治性前列腺癌时,采用多西他赛联合泼尼松的方法效果良好,毒副作用小,应在临床中推广使用.

目的:探讨桔梗半夏汤在术后胃瘫临床治疗中的应用及体会。方法:对11例术后胃瘫患者在调整静脉营养、胃肠减压等保守治疗策略的同时给予口服桔梗半夏汤治疗,随访并总结疗效。结果:11例患者均在3周内恢复进食,平均12.5d,且6个月追访均无复发,疗效满意。结论:半夏桔梗汤治疗术后胃瘫疗效确切,无明显不良反应。

Objective: To explore the curative effect and adverse actions of ultrasonic conductance transmission technology combined with external treatment of Zhentong Formula in treating yin syndrome of cancer pain. Methods: The patients with cancer pain( n = 120) were randomly divided into two groups. Patients in treatment group received ultrasonic conductance transmission technology combined with external treatment of Zhentong Formula,while the control group gave patients ultrasonic conductance transmission technology combined with external treatment of placebo for 7 days. The analgesic effect,initial time,and adverse actions of the treatment were observed in both groups. Results: The total effective rate of relieving cancer pain of treatment group was 86. 7%,and that of control group was 33. 3%,which showed significant difference( P < 0. 05). NRS scores of treatment group before and after treatment were significantly different( P < 0. 05),but there was no significant difference of NRS scores in control group before and after treatment. The effective time of treatment group started on day two on average with mild side effects and good dependence. Conclusion: Ultrasonic conductance transmission technology combined with external treatment of Zhen Tong Formula has a good curative effect on treating a variety of cancer pain with quick effect and slight adverse actions.

Objective To observe the curative effect and safety of Huachansu Injection poured into thorax and abdomen in the treatment of malignant hydrothorax and ascite, and discuss the mechanism initially. Methods The patients with malignant hydrothorax and ascite (n=30) were chosen and given the perfusion treatment in thorax and abdomen three times a week (250 mL normal saline and 40 mL Huachansu Injection) after draining pleuroperitoneal fluid. One therapeutic course was two weeks. After one therapeutic course, the review on curative effect was conducted according to quantity of pleuroperitoneal fluid, tumor marker (TM), RBC count and symptoms. Results The total effective rate was 46.67%. The red color became lighter in 75.00% (12/16) patients with bloody hydrothorax and ascite by naked eye. The levels of TM and RBC count decreased significantly in the most of patients. Conclusion The perfusion treatment of Huachansu Injection has certain curative effect on malignant hydrothorax and ascite diagnosed as syndrome of dampness heat toxin.

<正>超声电导药物透射技术,是一种新型强力透皮给药技术,超声电导结合中药外用治疗癌性疼痛有研究价值,取得了一定的临床效果,现总结如下。1临床资料2011年1月至2012年9月间,在我院肿瘤科住院患者90人,均为临床确诊的中晚期癌症患者,其中男性51例,女性39例;年龄最大的82岁,最小的26岁,平均年龄63岁。其中疼痛程度为重度疼痛的46人,中度疼痛37人,轻度疼痛7人。疼痛部位分布为腹部疼痛为27人,脊柱疼痛为21人,胸部疼痛为17人,肋骨疼痛为12人,四肢疼痛为11人,髂骨疼痛为2人。入选病例均为经病理学证实为恶性

<正>我国是肝癌大国,肝癌占我国恶性肿瘤死亡的第3位,且其发病率及死亡率一直呈上升趋势,故探索有效的中西医结合方法治疗肝癌有重大的临床意义。总结近10年来我科运用中药鳖甲煎丸化裁配合西医微创治疗原发性肝癌38例,现总结如下。1一般资料1.1临床资料病例共38例,男性28例,女性10例;最高年龄

孙一奎是温补学派的代表人物之一,其提出“命门动气”的理论,对中医学发展有重要的影响.著有《赤水玄珠》、《医旨绪余》、《孙氏医案》等书.针对不同病机所导致的痰证,均拟定了一套与之相应的治疗方法.从脾湿、阴虚火动、食积、气郁等方面简要介绍其治疗痰证的经验.

目的:观察以多种中医外治法联合治疗阴证癌性疼痛的疗效。方法:对60例阴证的癌痛患者予以外敷、艾灸以及中药超声离子导入的中医外治法治疗疼痛局部,7d为1个疗程,治疗前后以数字分级法观察患者的疼痛评分,对比治疗前后疼痛评分的变化,判断多种中医外治法综合治疗癌性疼痛的临床疗效。结果:完全缓解(CR)4例,明显缓解(PR)30例,轻度缓解(MR)19例。无效(NR)7例,总有效率88.33%。结论:以多种中医外治法结合治疗癌性疼痛证属阴证者,疗效显著,副作用轻微,可作为癌性疼痛有效的治疗方法。

<正>癌性疼痛是肿瘤患者常见的并发症。据世界卫生组织(WHO)数据统计,全世界每年约有400万癌症患者遭受疼痛的折磨,其中50%患者有中等乃至剧烈程度的疼痛,30%的患者有剧烈乃至难以忍受的疼痛。药物治疗是临床镇痛治疗的重要手段之一。

目的:观察温阳行气膏外敷阿是穴对骨转移癌疼痛的临床疗效。方法:选择骨转移癌40例,随机分为温阳行气膏敷贴治疗组20例和布桂嗪片30mg口服对照组20例治疗1周。结果:治疗组总有效率为92.5%,在疼痛完全缓解率、持续止痛时间方面优于对照组(P<0.05),提示温阳行气膏对骨转移癌具有较好的止痛功效。

恶性肿瘤是复杂险恶的疾病,给患者带来极大痛苦,甚至危及患者生命.对于恶性肿瘤防治的重视程度逐年提高,治疗技术手段愈加丰富,其中中医外治法在临床中应用越来越广泛.

<正>0引言为探索晚期胰头癌的治疗新方法,我们采用局部靶动脉灌注化疗联合华蟾素泵入方法治疗晚期胰头癌病例30例,现报告如下。1资料与方法1.1临床资料收集2005年9月至2008年8月我科收治的30