Objective To observe the therapeutic effect of Shegan Mahuang Decoction combined with acupoint application in treating the post-infection cough.Methods One hundred and twenty patients with post-infection cough were equally randomized into treatment group and control group.The treatment group was given Shegan Mahuang Decoction combined with acupoint application,and the control group was treated with Ketotifen and Chinese herbal medicine particles placebo,the treatment lasting 7 days.The changes of main symptoms were observed before treatment,3 and 7 days after treatment,and then the therapeutic effect in both groups was evaluated.Results(1)The cure rate of the treatment group was 25.0% and the total efficiency was 93.3%.In the control group,the cure rate was 11.6% and the total efficiency was 80.0%.The differences of cure rate and total efficiency were significant between the two groups(P0.05).(2)The differences of total scores of symptoms such as cough,expectoration,and itching in the throat were insignificant between the two groups before treatment(P﹥0.05).After treatment for 3 and 7 days,the total scores of symptoms were decreased obviously in both groups(P0.05 or P0.01 compared with those before treatment).On treatment day 7,the decrease of score of all symptoms except for itching in throat in the treatment group was superior to that in the control group(P0.05).(3)Time for cough relief was shorter in the treatment group than that in the control group(P0.05).(4)Adverse reaction was not found in the two groups.Conclusion Shegan Mahuang Decoction combined with acupoint application is effective and safe in treating the post-infection cough,and has better effect on relieving the symptoms of cough and expectoration than Ketotifen.

<正>甄梦初(1909-1990年),广东省中医院名老中医,当代岭南名医,行医五十余载,誉享省港,虽已与世长辞,但其学术思想及临床经验对后来者仍具有很大价值,尤其是他对于疑难杂症的见解和治验更是不可多得的宝藏。甄老长居岭南之地,浏览涉猎中医学各门派著作,其理论以《内经》、

【Objective】 To observe the therapeutic effect of herbal medicine mainly with the actions of clearing lung and removing phlegm on type Ⅱ respiratory failure patients with acute exacerbation of chronic obstructive pulmonary diseases receiving positive-pressure noninvasive ventilation.【Methods】Forty one patients were randomized into groups A(n=21) and B(n=20).The two groups received routine western medicine and bi-level positive-pressure noninvasive ventilation.Group A received decoction of herbal medicines(mainly composed of Culmus Phragmitis,Semen Coicis,Semen Benincasea,Pericarpium Trichosanthis,Radix Scutellariae,Semen Armeniacae,Fructus Aurantii Immaturus,etc.) additionally.The changes of blood gas parameters and noninvasive ventilation time in patients with respiratory machine removed were compared after treatment.【Results】Oxygen partial pressure(PaO2) and pH value increased,and carbon dioxide partial pressure(PaCO2) decreased in the two groups(P0.05 or P0.01 compared with those before treatment),the above changes were obvious in group A(P0.05 or P0.01 compared with group B).The noninvasive ventilation time was shortened in group A as compared with group B(P0.05).【Conclusion】Herbal medicine mainly with the actions of clearing lung and removing phlegm combined with noninvasive ventilation by respiratory machine can improve the ventilation of type Ⅱ respiratory failure patients with acute exacerbation of chronic obstructive pulmonary diseases,and shorten the noninvasive ventilation time.

目的:观察参附注射液在慢支肺气肿合并肺心病休克中的应用效果。方法:对在广东省中医院二沙岛分院急诊科就诊的71例慢支肺气肿肺心病合并休克的患者,随机分为2组。两组均予抗感染、氧疗、抗休克、纠正水电解质紊乱等常规治疗,治疗组在此基础上加用参附注射液。观察两组患者治疗后的生命体征、血氧饱和度及血气分析的变化。观察患者的转归,是否在24h内行气管插管,在24h及1周内的死亡率及血压纠正情况。结果:联用参附针组患者临床疗效和血压回升,较对照组有明显优势。结论:参附注射液在慢支肺气肿合并肺心病休克救治中,具有抗休克抗缺氧作用,可提高救治效果。

The summary of managing experience through tested ones for phaseⅠclinical drug trials, presented specific characteristics providing as preliminary clinical pharmacologic basis and evaluation test of safety for human beings.The testing designs have to be considered with best advantage and least risk for the tested ones and furthermore with complete regulation of informed consent and responsibility.The comprehensive factors in selecting trial volunteers should include establishment of the clinical file especially involving the adverse events.

Objective To study the change of serum matrix metalloproteinase in patients of chronic congestive heart failure(CHF)with Liquichip.Methods MMP-3 and MMP-9 were measured in sera of 15 cases of CHF patients and 15 normal controls with Luminex liquichip.Results Serum MMP-3 and MMP-9 in patients of CHF were significantly higher than normal control(P<0.05).Conclusion The concentrations of serum MMP-3 and MMP-9 in patients of CHF is higher and is associated with ventricular remodeling.

目的观察中药克感汤治疗外感高热的临床疗效.方法采用克感汤加减治疗外感高热患者60例,并与西药青霉素和病毒唑治疗60例进行随机对照比较,观察每例患者在服药期内临床疗效、外感高热的开始退热及完全退热时间.结果治疗组临床总有效率(93%)高于对照组(69%)(P＜0.01),开始退热时间和完全退热时间早于对照组(P＜0.05或0.01).结论克感汤加减治疗外感高热有较好的临床疗效.

目的探讨严重急性呼吸综合征(SARS)出院患者康复治疗前后相关实验室检查结果的变化.方法对79例出院后的SARS患者辨证分型后给予口服中药进行康复治疗4周,用药前后抽血测白细胞计数、淋巴细胞计数、谷丙转氨酶、血清免疫球蛋白IgA亚类(IgA)、T细胞亚群抗原标志CD4+(CD4+),构建数据库,采用t检验进行分析.结果SARS出院患者在用药后白细胞计数、淋巴细胞计数略低于治疗前,但均在正常范围内,谷丙转氨酶、IgA及CD4+均较治疗前略有升高,但除IgA升高差异具有显著性(P<0.01)外,其余各项差异均无显著性(P>0.05).结论SARS患者免疫功能的升高可能与中医药干预作用有关,但亦不能排除为患者自身机体恢复的过程.

目的:通过临床实验,观察珠贝定喘丸和金喉健气雾剂对支气管哮喘急性发作期患者的临床疗效.方法:将具有支气管哮喘典型临床表现并为急性发作期的患者42例随机分为两组,治疗组服用珠贝定喘丸并金喉健气雾剂雾化吸入,同时寒哮方选射干麻黄汤合小青龙汤加减,热哮方选清肺定喘汤;对照组予以西医常规治疗.结果:两组疾病疗效、证候疗效比较,差异无显著性(P均＞0.05);两组患者治疗前证候积分无显著性差异(P＞0.05),治疗后证候积分较治疗前显著降低(P＜0.05),治疗后组间比较无显著性差异(P＞0.05);患者血清EOS变化两组患者治疗前无显著性差异(P＞0.05),治疗后均有显著性降低(P＜0.05),且对照组更为显著.结论:中医药对支气管哮喘患者症状改善有较明显的作用,能有效降低患者血清EOS水平,从而抑制炎性介质的释放,减轻气道高反应状态.

外感高热是临床常见的一种急症,以发热、恶寒,或伴口渴、脉浮数等为主要临床表现.我科运用克感汤治疗外感高热62例,疗效满意,现报道如下.

2000年10月～2003年10月,我院急诊科应用葛花配合西医治疗急性酒精中毒42例,疗效满意,现报告如下.

目的了解恶性肿瘤患者的血液流变性和微循环变化.方法对100例恶性肿瘤患者及50例健康人血液流变学指标、血小板计数、血小板聚集率及甲襞微循环指标进行比较.结果恶性肿瘤患者全血粘度、血浆粘度、血浆纤维蛋白原、血沉、红细胞聚集指数、血小板计数、血小板聚集率及甲襞微循环加权积分值(形态积分值、流态积分值、管周积分值及总积分值)等均显著高于健康人(P<0.01或P<0.05).结论恶性肿瘤患者存在血液高粘、高凝、高聚状态及微循环障碍.

癌痛在肿瘤病人中十分常见.据世界卫生组织(WHO)估计,肿瘤患者中至少有1/3存在着不同程度的疼痛,晚期患者则高达60%～90%,25%患者在疼痛中死亡,每天世界上有350万人遭受癌痛的折磨[1].目前止痛药仍是控制癌痛的主要手段,但长期使用易产生耐药、成瘾以及出现镇静、恶心呕吐、便秘、呼吸抑制、精神错乱、尿潴留等副作用.而中医药治疗癌痛较之西医治疗具有副作用小、若有效则维持镇痛的时间长、且可以针对原发病本身进行治疗的优点.鉴于此,我们于2000年1月～2001年1月采用中药辨证论治治疗癌痛54例,取得了满意的效果.现报告如下.

癌痛在肿瘤病人中十分常见.据世界卫生组织(WHO)估计,肿瘤患者中至少有1/3存在着不同程度的疼痛,晚期患者则高达60%～90%,25%患者在疼痛中死亡,每天世界上有350万人遭受癌痛的折磨.[1]目前止痛药仍是控制癌痛的主要手段,但长期使用易产生耐药、成瘾以及出现镇静、恶心呕吐、便秘、呼吸抑制、精神错乱、尿潴留等副作用.而中医药治疗癌痛较之西医治疗具有副作用小、若有效则维持镇痛的时间长、且可以针对原发病本身进行治疗的优点.鉴于此,我们于2000年1月-2001年1月采用中药辨证论治治疗癌痛54例,取效满意.

目的:为探讨二黄三草漱口液对肿瘤并发口腔真菌感染的疗效.方法:对40例患者进行分组治疗,以咽拭纸试验和毒副反应作为观察指标.结果:治疗组总有效率为90%,对照组总有效率为85%,两组总有效率比较,经统计学处理无显著性差异(P＞0.05).治疗组中有2例出现恶心、腹痛、腹泻、胃肠胀气、食欲不振等消化道反应,未出现皮疹、肝肾功能损害的病例;对照组中有16例出现消化道反应,2例出现皮疹,4例出现肝肾功能损害.结论:二黄三草漱口液治疗肿瘤合并口腔真菌感染的疗效比口服氟康唑要好,且毒副反应小.