甲状腺结节临证以肝郁、脾郁者多见,胡宗德教授在甲状腺结节的临床诊疗中,结合《黄帝内经》"五郁之治""结者散之""以平为期"等理论,提出了甲状腺结节"木郁达之,土郁夺之,结者散之,以平为期"的中医治疗理念,在临床治疗中取得了良好疗效.

目的:观察中药穴位贴敷联合空气波压力治疗仪防治胃癌术后深静脉血栓形成的临床疗效.方法:选取胃癌患者80例,采用随机数字表法分为对照组和观察组,每组40例.对照组给予常规术后康复锻炼及预防治疗,观察组在对照组治疗的基础上给予中药穴位贴敷联合空气波压力治疗仪治疗.观察两组患者治疗后深静脉血栓发生率、下肢静脉血流速度,以及凝血状态和血小板功能变化情况.结果:对照组下肢肿胀、疼痛发生率20.00％、深静脉血栓发生率为15.00％,观察组下肢肿胀、疼痛发生率为5.00％、深静脉血栓发生率为2.50％,观察组下肢肿胀、疼痛发生率及深静脉血栓发生率低于对照组,差异有统计学意义(P＜0.05);观察组手术后7 d活化部分凝血活酶时间(activated partial thrombo-plastin time,APTT)、凝血酶原时间(prothrombin time,PT)水平高于对照组,差异有统计学意义(P＜0.05);观察组手术后7 d血小板最大聚集率和D-二聚体水平低于对照组,差异有统计学意义(P＜0.05);观察组手术后7 d血液黏度和纤维蛋白原水平低于对照组,差异有统计学意义(P＜0.05);观察组手术后7 d股静脉、胭静脉血流速度高于对照组,差异有统计学意义(P＜0.05).结论:中药穴位贴敷联合空气波压力治疗仪可提高胃癌患者手术后深静脉血栓的防治效果,降低血栓发生率,改善患者胃肠功能障碍、凝血状态及血小板功能,提高下肢静脉的血流速度.

Objective:To observe the clinical effect of Yiqi Yangjing recipe combined with sticking therapy on lung cancer pleural effusion.Methods:From December 2017 to August 2019, 68 patients with advanced lung cancer and pleural effusion in Pudong New Area Hospital of Traditional Chinese Medicine were selected and randomly divided into two groups by random number table method, with 34 cases in each group.The control group was given furosemide orally on the basis of routine nutritional support treatment, and the treatment group was given Yiqi Yangjing prescription orally and traditional Chinese medicine sticking therapy on the basis of the control group.Both two groups were treated for 6 weeks.The changes of pleural fluid volume and quality of life scores were observed and compared between the two groups.Results:The total effective rate in the treatment group was 70.5%(24/34), which in the control group was 47.1%(16/34), the difference was statistically significant between the two groups(χ 2=3.886, P<0.05). The total effective rate of TCM syndrome integral was 64.7%(22/34) in the treatment group, and 35.3%(12/34) in the control group, the difference was statistically significant between the two groups(χ 2=5.800, P<0.05). After treatment, the overall quality of life score of the treatment group(55.74±5.15)points, which was higher than that of the control group[(51.91±5.20)points]( t=56.130, P<0.05). Conclusion:Yiqi Yangjing recipe combined with traditional Chinese medicine sticking therapy can effectively improve the clinical efficacy of lung cancer hydrothorax, improve the quality of life of patients.

在所有原发性支气管肺癌中, 非小细胞肺癌(non-small cell lung cancer, NSCLC)占 80％～85％[1].2010 年美国研究发现,年龄超过 60 岁的老人死亡原因排在第二的是肺癌,随着年龄的增长,肺癌发病率也越来越高,其中,年龄小于 39 岁非小细胞肺癌的发病率为 0.03％, 年龄≥70 岁肺癌的发病率高达 5.56％[2]. 中国肺癌的发病率和病死率均居恶性肿瘤第一位. 其发病率随年龄增长呈上升趋势,发病年龄高峰为 70～75 岁[3]. 老年 NSCLC 患者体质较差,基础疾病较重,在制定西医治疗方案时面临较大的挑战, 因此中医药综合治疗是老年NSCLC 重要治疗方式之一.

Objective To observe the clinical efficacy of Shugan Liqi Tianjing Decoction in the treatment of adverse reactions caused by breast cancer postoperative endocrine therapy.Methods 62 patients with adverse reactions caused by breast cancer postoperative endocrine therapy were randomly divided into the treatment group and control group,31 cases in each group.The control group was only treated with conventional endocrine therapy,while the treatment group was trcated with Shugan Liqi Tianjing Decoction based on the treatment for the control group,with a course of two months.The Kupperman improved score,endometrial thickness,parameters of blood lipid and bone mineral density(BMD) were observed and compared.Results ①For the comparison of the difference of Kupperman improved score before and after treatment,the difference in the treatment group was obviously greater than that in the control group (P ＜0.05).②For the comparison of the difference of endometrial thickness before and after treatment,the difference in the treatment group was obviously lower than that in the control group (P ＜0.05).③After treatment,there was statistically significant difterence on the triacylglycerol level between the two groups(P ＜0.05).④After treatment,the BMD levels of L2-L4 and femoral neck in the treatment group was obviously higher than those in the control group(P ＜0.05).Conclusion Shugan Liqi Tianjing Decoction can significantly relieve the adverse reactions caused by breast cancer postoperative endocrine therapy,and improve the life quality of patients and prognosis.