Objective To evaluate the effect of otilonium bromide combined with probiotics on the patients of diarrhea-predominant irritable bowel syndrome(IBS-D)with small intestinal bacterial overgrowth(SIBO).Changes of orocecal transit time(OCTT)after SIBO negative conversion were observed.Methods Sixty patients diagnosed IBS-D with SIBO-positive were randomly divided into otilonium bromide group(n=30)and otilonium bromide and probiotics group(n=30),the treatment course was four weeks,the scores of main symptom,SIBO and OCTT were measured before and after the treatment.The negative rate of SIBO,changes of OCTT and the effect on main symptoms were observed.Results The negative rate of SIBO in the experimental group was higher than that in control group after the treatment,73.7%(22/30)vs 46.7%(14/30)(P 0.05).The scores of main symptom,SIBO and OCTT between two groups showed no significant difference(P 0.05).The scores of main symptom were improved and OCTT was shortened in two groups after the treatment(P0.05or0.01),but the scores of main symptom in the experimental group were decreased more than those of control group,OCTT was shorter than that of control group(P 0.05).Conclusion The treatment of otilonium bromide and probiotics can make SIBO negative,shorten OCTT,and the method may well improve the main symptoms in IBS-D.

目的：观察中西医结合方法治疗糖尿病足的疗效及价值。方法将57例糖尿病足病患者随机分为2组，治疗组予中西医结合治疗，对照组予单纯西医治疗，比较2组达到临床治愈时间及费用。结果治疗组愈合的时间明显短于对照组（P＜0．05），总治疗费用明显少于对照组（P＜0．05）。结论中西医结合治疗糖尿病足疗效显著，费用更低。

Objective To study the efficacy of combined therapy of Jinghuaweikang capsule and Itopride hydrochloride dispersible tablets for functional dyspepsia .Methods One hundred and fifty eight patients with func-tional dyspepsia were randomly grouped into experimental group ( n=79 ) and the control group ( n=79 ) .The pa-tients in the experimental group were given 2 capsule of Jinghuaweikang capsule ,3 times a day in addition to Itopride Hydrochloride Tablets 50 mg,3 times per day for four weeks .The patients in the control group were only given Itopride Hydrochloride Tablets 3 times a day for 4 weeks.The therapeutic efficacy and side effects were compared between the two groups by chi square test .Results The total effective rate in the experimental group (92.41%) was superior to that in the control group (60.76%,P<0.05).No severe side-effects were found in the both groups .Conclusion Jinghuaweikang capsules combined with Itopride hydrochloride dispersible tablets can more significantly improve gen -eral efficacy and symptoms in patients with functional dyspepsia than single use of motility medicine Itopride hydro -chloride dispersible tablets .

Objective To observe Yiji capsule for patients with diarrhea-predominant irritable bowel syndrome and change of interleukin-1β and interleukin-13.Methods 90 Patients with diarrhea-predominant irritable bowel syndrome were randomly divided into two groups.45 cases in the control group were treated by live combined bacillus subtilis and enterococcus faecium enteric-coated capsules treatment(500 mg,three times a day) for 4 weeks.Patients in treatment group(n= 45) were treated by Yiji capsule(3 capsule,three times a day) and live combined bacillus subtilis and enterococcus faecium enteric-coated capsules(500 mg,three times a day) for 4 weeks.The efficacy and the change of symptom score,IL-1β and IL-13 before and after treatment were observed in two groups.Results The symptoms score including diarrhea,abdominal pain and bloating rated after treatment was decreased as compared with that before treatment in two groups(P<0.05).The total effective rate in the treatment group(86.7%) was obviously higher than that in the control group(64.4%,P<0.05).The level of IL-1βafter treatment were obviously lower than that before treatment in two groups(P<0.05).The level of IL-13 after treatment were obviously higher in two groups(P<0.05).The improvement of treatment group was more than that of control group after treatment(P<0.05).Conclusion Yiji capsule can improve clinical symptoms and the curative effect,regulate the expression of IL-1βand IL-13 in patients diarrhea-predominant irritable bowel syndrome.

功能性消化不良(functional dyspepsia,FD)是临床上最为常见的消化系统疾病之一,30%人群在一生中均出现过消化不良的症状[1].FD的发病率约为30%～50%[2],其病因十分复杂,与胃肠动力障碍、内脏感知异常、胃酸分泌异常及消化不良等有关,其中胃肠动力障碍是FD的重要病因[3].促动力药物(依托必利)是治疗功能性消化不良的主要药物,但由于FD的发病机制是多因素的,单纯促动力治疗效果并不佳.针对不同机制的多药联合应用治疗FD从理论上分析应具有更好的疗效.我们采用依托必利联合复方阿嗪米特治疗FD,并与单用依托必利治疗进行比较,旨在评价该治疗方法治疗FD的临床疗效和应用的安全性.

Objective To study the efficacy and safety of combined therapy of Yiji Capsule and sodium cromoglycate for diarrhea-predominant irritable bowel syndrome.Methods 90 patients with diarrhea-predominant irritable bowel syndrome were randomly divided into two groups.Patients in control group(n=45) were treated by Sodium cromoglycate.45 cases in treatment group were treated by combined therapy of Yiji capsule and sodium cromoglycate.The therapeutic course was four weeks in two groups.Results The symptom score after treatment was decreased as compared with that before treatment in two groups(P<0.05).The decrease in treatment group was more obvious than that in control group(P<0.05).The total effective rate in treatment group(80.0%) was higher than that in control group(57.8%,P<0.05).Conclusion Combined therapy of Yiji Capsule and sodium cromoglycate can more significantly improve efficacy and symptoms in patients with diarrhea-predominant irritable bowel syndrome than that of single use of motility medicine Yiji Capsule.

目的 观察改良仙方活命饮对糖尿病足溃疡愈合的效果.方法 107例糖尿病足病患者随机分为治疗组53例及对照组54例,2组均控制血糖达标,对照组仅给予换药,治疗组给予口服方剂以改良仙方活命饮为主方进行加减,观察2组达到临床观察终点时需要的时间及截肢率.结果治疗组达到治疗终点的患者平均治疗时间短于对照组,截肢率低于对照组,差异有统计学意义(P<0.05).结论 应用中西医结合的方法用治疗糖尿病足溃疡疗效好、效价比高.

糖尿病足属中医学消渴、脱疽范畴,是糖尿病下肢神经、血管病变的结果.糖尿病足造成截肢者比非糖尿病患者高5～10倍[1].在美国每年有近200万糖尿病患者罹患糖尿病足,大约每年花费2亿美元在糖尿病足的医疗护理上[2].2004-07-2011 -06,我们在西药常规治疗基础上采用应用改良仙方活命饮治疗糖尿病足溃疡合并感染60例,并与单纯西医常规治疗60例对照观察,结果如下.

Objective To observe the therapeutic effect of diarrhea-predominant irritable bowel syndrome treated by combination of Berberine and lived combined B.Subtilis and E.Faecium enteric-coated capsules(Medilac-s).Methods 80 cases of diarrhea-predominant irritable bowel syndrome were randomly divided into two groups.40 patients were in each group.Patients in treatment group were treated by combination of Berberine(300 mg,thrice a day) and Medilac-s(2 pills,thrice a day).40 cases in control group were treated by Berberine(300 mg,thrice a day).The course was three weeks in two groups.Results The total effective rate in treatment group(90%) was higher than that in control group(72.5%,P0.05).Conclusion Combination of Berberine and Medilac-s is safe,effective and inexpensive on the treatment of diarrhea-predominant irritable bowel syndrome.

目的 观察糖耐量低减合并高脂血症患者血清脂联素(ADPN)水平的变化特点.方法 检测糖耐量低减合并高脂血症者(IGT-HLP)等四组的脂联素、血脂、0 h、2 h的血糖(PG)、胰岛素(Ins),并计算胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)和腰臀比(WHR).结果 IGT-HLP患者的ADPN显著低于其他三组,ADPN与BMI、WHR、PG、三酰甘油(TG)、2 h Ins、HOMA-IR呈负相关.结论 在IGT-HLP患者中ADPN水平明显降低,并与PG、TG、2 hIns、HOMA-IR存在负相关.

Objective To observe the therapeutic effect of diarrhea-predominant irritable bowel syndrome treated by combination of Berberine and Flupentixol and Melitracen tablets.Methods 120 patients with diarrhea-predominant irritable bowel syndrome were randomly divided into two groups.60 cases in control group were treated by Berberine(300 mg,thrice a day).60 patients in treatment group were treated by combination of Berberine(300 mg,thrice a day) and Flupentixol and Melitracen tablets(a pills,twice a day).The effect and side effect were observed after a course(12 weeks).Results The total effective rate in treatment group(95.0%) was higher than that in control group(75.0%,P0.05).The tolerance and safety of medicine in two groups was good.There was no obvious side effect.Conclusion The effect of combination of Berberine and Flupentixol and Melitracen tablets was definite on diarrhea-predominant irritable bowel syndrome.

目的观察黄连素对腹泻型肠易激综合征(IBS)的治疗效果。方法将迁安地区消化科门诊腹泻型肠易激综合征患者随机分为2组,治疗组60例,给予黄连素0.3g/次,3次/d,对照组60例,给予匹维溴胺50mg/次,3次/d,两组患者治疗3周,观察临床效果。结果治疗组总有效率75%,对照组总有效率78.3%,两组比较差异无统计学意义。结论黄连素能有效缓解腹泻型IBS患者症状,且价格低廉,无明显不良反应,可作为治疗腹泻型IBS一线药物。

Objective To judge the effect of plasma exchange (PE) to the patients with severe hepatopath of nonage according to evaluating the change of the liver function of reserve with 13C-methacetin breath test. Methods There are two groups: the case group and the control group. Each group has 30 patients. The patients in the case group were treated by PE. All the patients received 13C-methacetin breath test at before or one week after treatment. MVmax40, CUM40 and CUM120 were present. At the same time, clinical symptoms, glutamate-pyruvate transaminase (ALT), total bilirubin (TBiL) and prethrombin active (PTA) were observed. Results MVmax40, CUM40, CUM120 and PTA were higher, ALT and TBiL were lower in the case group after treatment (t=4.679, 4.752, 5.048, 5.413, 6.208, 7.413, P=0.000,P<0.01). After a week, MVmax40, CUM40, CUM120 and PTA were higher, ALT and TBiL were lower in the case group than that in the control group (t=2.260, 2.247, 2.476, 4.017, 3.250, 3.658, P<0.05). The total effective rates in the case group and the control group were 83.3 % (25/30) and 43.3 % (13/30),which are significant different(χ2 10.335,P<0.01). Conclusion PE can im-prove the liver reservation functionin the severe hepatopath of nonage.

血浆置换是目前治疗重型肝炎、肝衰竭的一种常用方法,近年来,我院采用血浆置换治疗48例不同期重型肝炎,取得不同临床效果,报告如下.

目的:探寻治疗颅脑损伤后遗症行之有效的方法,最大限度提高患者生存质量。方法:总结96例应用中药逐瘀醒脑汤治疗后疗效分析,并从血液流变学、凝血常规方面说明其药物作用机理。结果:用药1~3个月后全血黏度、全血低切相对指数逐渐下降,血浆凝血酶原时间、活化部分凝血酶时间逐渐延长,与对照组比较差异有显著性意义,P<0.05;与对照组比较临床症状改善,治疗组总有效率亦大于对照组,P<0.05。结论:中药治疗颅脑损伤后遗症有其独特作用,并被现代临床检验相佐证,其作用机理,能明显改善预后,提高患者生存质量,缩短病程,减少后遗症,值得推广。

目的:探讨颅脑损伤后遗症期血液黏度及凝血功能变化规律,以利临床寻找有效的治疗方法。方法:监测患者入院时、2周、1个月、3个月、0.5 a血流变学及凝血功能测定值,分析其变化规律。结果:全血比黏度、全血低切指数、红细胞聚集指数随病程延长逐渐增加,提示高粘血症,红细胞聚集倾向;血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)逐渐缩短,亦提示高凝状态。结论:血液高凝状态是制约颅脑损伤后遗症恢复与改善的较重要因素之一。

目的 探讨糖尿病足溃疡经济有效的治疗方法.方法 对62例糖尿病足溃疡合并感染患者,随机分为中西医结合治疗组(治疗组)及单纯西医治疗组(对照组),比较达到临床观察终点时需要的时间、费用以及截肢率.结果 两组患者达到观察终点的时间、费用、截肢率比较差异均具有统计学意义(P＜0.05),对照组明显高于治疗组.结论 应用中西医结合治疗糖尿病足溃疡合并感染具有较好的疗效及较高效价比.

假尿嘧啶核苷是tRNA降解的最终产物,机体不再重新利用而从尿中排泄.因在肿瘤患者体内异常增高,被作为肿瘤标志物用于肿瘤的早期诊断、鉴别诊断、肿瘤进展与复发的监测、疗效和预后的判断.

目的:探讨Cyclin Dl、DNA倍体和假尿嘧核苷与胃癌生物学行为的关系,进一步认识三者在胃癌发生、发展及转移过程中的作用与意义.方法:应用流式细胞技术(FCM)以及高效液相色谱(HPLC)分析,对46例胃癌患者、56例慢性胃炎患者(浅表性20例,萎缩性16例,萎缩+不典型增生20例)及30例正常对照者胃粘膜和癌组织中Cyclin Dl的表达、DNA倍体与含量以及血尿和冒粘膜组织中假尿嘧啶核苷(PU)水平变化,进行定量分析,同时进行细胞形态学研究,并追踪随访监测观察.结果胃癌组Cyclin Dl阳性表达率、DNA异倍体率、DNA及PU含量显著高于其他各组(P＜0.001);不典型增生组Cyclin Dl阳性表达率、DNA异倍体率也明显高于正常对照及浅表性胃炎组(P＜0.01);胃癌患者血、尿中PU水平显著高于其他各组(P＜0.001);Cyelin Dl过度表达与胃癌的临床病理特征无关(P＞0.05);DNA异倍体率、DNA含量与胃癌分化程度及Lauren's分型有关(P＜0.05),但与有无淋巴结转移和TNM分期无关(P＞0.05);PU值与胃癌的分化程度、TNM分期、淋巴转移有关,但与Lauren's分型无关.Cyclin Dl过度表达与DNA倍体和含量、PU水平呈正相关.结论:Cyclin Dl表达、DNA异倍体与PU量变不仅参与了胃癌的发生、发展过程,而且影响胃癌的生物学行为及其预后.

目的:通过定量检测胃癌患者发生、发展过程中血清、尿及胃粘膜组织假尿嘧啶核苷(PU)的含量变化,探讨其与胃癌生物学行为的关系方法:选取132例胃镜活检组织标本,其中浅表性胃炎20例,慢性萎缩性胃炎16例,不典型增生20例,胃癌46例;30例正常胃粘膜作为对照组采用高效液相色谱法定量分析研究对象的血、尿及组织中假尿嘧啶核苷水平变化.结果:胃癌患者血清、尿及组织中PU分别是4.96±2.72(μmol/ml)、17.01±4.53(nmol/μmol肌酐)、7 90±3 16(μmol/ml),均显著高于其他各组(P＜0.001);不典型增生组上述各值虽有增高,但无统计学差异.PU值与胃癌的分化程度、TNM分期、淋巴转移有关,而与Lauren's分型无关.结论:胃癌组假尿嘧啶核苷含量明显高于其他组且与其生物学行为相关,并且胃粘膜不典型增生开始增高,因此可作为胃癌早期诊断及判断预后的重要指标。