目的:探讨康达心口服液对缺血性心肌病患者血清人可溶性生长刺激表达基因蛋白2(sST2)水平的影响.方法:收集在福建中医药大学附属人民医院就诊的阳虚水泛型缺血性心肌病患者60例,按随机数字表法分为对照组和观察组各30例,对照组参照《稳定性冠心病诊断与治疗指南2018》和《中国心力衰竭诊断和治疗指南2018》推荐的治疗方案治疗,观察组在对照组基础上加用康达心口服液治疗,两组观察期均为4周,两组治疗前、后分别进行心脏彩超、6分钟步行试验,检测sST2、N末端B型利钠肽原(NT-proBNP)等指标.结果:两组患者治疗前各观察指标无统计学差异(P均＞0.05),用药4周后观察组与对照组比较sST2、NT-proBNP下降,LVEF、6分钟步行试验评级提高,差异有统计学意义(P均＜0.05).结论:联合使用康达心口服液能在优化治疗基础上进一步降低阳虚水泛型缺血性心肌病患者sST2,起到抑制心肌纤维化作用,治疗效果好.

目的:观察化痰活血方对痰瘀互结型冠状动脉慢血流(CSF)患者相关炎症因子、运动平板试验指标以及中医证候的影响.方法:纳入2019年8月-2020年7月在福建中医药大学附属人民医院心血管科住院符合诊断的患者88例,随机分为对照组、中药组各44例,对照组给予西药治疗,中药组在对照组基础上加用化痰活血方,治疗周期为8周,对比治疗前后两组炎症因子、运动平板试验指标以及中医证候积分的变化.结果:治疗后2组炎症因子TNF-α、IL-6均较前明显下降(P＜0.05),中药组下降优于对照组(P＜0.05);治疗后2组运动平板试验指标均较治疗前改善(P＜0.05),中药组明显优于对照组(P＜0.05);治疗后两组患者中医证候积分均较治疗前明显下降(P＜0.05),中药组明显优于对照组(P＜0.01).结论:化痰活血方联合西药治疗能够降低CSF相关炎症因子水平,提高患者运动平板实验阈值,改善中医证候.

目的 探讨高血压病患者盐摄入量与中医证型以及心、肾靶器官损害程度的相关性.方法 纳入符合诊断的高血压病患者148例,填写问卷调查,采集临床资料,进行中医辨证分型.通过24小时尿钠排泄量估算每日盐摄入量,测定尿微量白蛋白(MAU)水平,同时应用心脏彩超测定左心室重量指数(LVMI),进行相关性分析.结果 ①盐摄入量越多,血压分级越高.高血压3级组患者盐摄入量明显高于高血压1级组(P<0.05).②根据盐摄入量分组,高盐组与中盐组SBP、LVMI、MAU明显高于低盐组(P<0.05),高盐组SBP、LVMI、MAU明显高于中盐组(P<0.05).③高血压中医证型中痰湿壅盛组比例较高;高血压病各中医证型患者盐摄入量比较:肝火亢盛证

目的 观察康达心口服液治疗慢性心力衰竭阳虚血瘀证患者临床疗效及对心功能和运动耐量的影响.方法 选取80例慢性心力衰竭阳虚血瘀证患者,按随机数字表法分成对照组和观察组,对照组按照指南使用ACEI、β受体阻滞剂、利尿剂等西药常规治疗,观察组在对照组治疗方案的基础上加用康达心口服液治疗.8周后比较两组中医证候积分、治疗前后血清N末端B型脑钠肽前体(NT-proBNP)、可溶性生长刺激表达基因2蛋白(sST2).治疗前后进行心肺运动试验(CPET),比较无氧阈值(AT)、峰值摄氧量(peakVO2)的变化.结果 观察组与对照组治疗后NT-proBNP、sST2均较治疗前显著下降(P<0.01),观察组比对照组下降显著(P<0.05).对照组与观察组治疗后AT和peakVO2均较治疗前升高(P<0.05),观察组比对照组升高显著(P<0.05).在中医证候疗效方面,观察组较对照组改善显著(P<0.05).结论 康达心口服液能进一步改善慢性心力衰竭阳虚血瘀证患者的中医临床证候及其心功能和运动耐量.

目的 观察康达心口服液对阳气亏虚血瘀型慢性心力衰竭患者心肺运动试验的影响.方法 收集阳气亏虚血瘀型慢性心力衰竭急性加重期患者65例,按随机数字表法分为对照组和康达心组,出院后病情稳定2～4周.对照组给予西药治疗,康达心组在对照组用药基础上加用康达心口服液治疗,两组均治疗12周,两组在纳入观察前1天及12周末分别进行明尼苏达心力衰竭生活质量评分(minnesota living with heart failure questionnaire,MLHFQ)、N末端B型利钠肽原(N teminal pro brain natriuretic peptide,NT-proBNP)测定以及心肺运动试验(cardiopulmonary exercise testing,CPET),记录峰值摄氧量(peak VO2)、无氧阈值(anaerobic threshold,AT)、峰值氧脉搏(VO2/HR)、二氧化碳通气当量最低值(VE/VCO2最低值)、二氧化碳通气当量斜率(VE/VCO2 slope)指标.结果 两组治疗前各观察指标无统计学差异(P>0.05);两组治疗后对比治疗前MLHFQ、NT-proBNP及CPET各参数均有显著改善,差异有统计学意义(P<0.05);治疗后康达心组较对照组MLHFQ、NT-proBNP下降,差异有统计学意义(P<0.05),peakVO2、AT、VO2/HR升高,VE/VCO2、VE/VCO2 slope下降,差异有统计学意义(P<0.05).结论 联合使用康达心口服液治疗阳气亏虚血瘀型慢性心力衰竭,能明显提高患者运动耐量、改善心肺功能,提高生活质量.

目的:观察双清消斑饮对痰瘀互结型稳定性心绞痛患者心肺运动试验结果及生活质量的影响.方法:收集2020年1-6月在福建中医药大学附属人民医院就诊的痰瘀互结型稳定性心绞痛患者70例,按随机数字表法分为对照组和治疗组,各35例.对照组参照2018年《稳定性冠心病诊断与治疗指南》推荐的药物治疗方案治疗,治疗组在对照组基础上加用双清消斑饮治疗,两组观察期均为3个月,两组患者治疗前后分别进行心肺运动试验(cardiopulmonary exercise testing,CPET),记录峰值摄氧量(peak VO2)、无氧阈值(AT)、峰值氧脉搏(VO2/HR)、二氧化碳通气当量最低值(VE/VCO2最低值)、二氧化碳通气当量斜率(VE/VCO2斜率)等指标;采用SAQ、SF-36量表在治疗前后分别对两组患者进行调查.结果:两组治疗前心肺运动试验各观察指标比较差异无统计学意义(P>0.05);治疗后两组peak VO2、AT、VO2/HR均升高,且治疗组高于对照组(P<0.05);两组VE/VCO2最低值、VE/VCO2斜率均下降,且治疗组低于对照组(P<0.05);治疗组SAQ、SF-36评分高于对照组(P<0.05).结论:联合使用双清消斑饮能进一步改善痰瘀互结型稳定性心绞痛患者心肺功能及生活质量,治疗效果好.

目的 观察双清消斑饮对痰瘀互结型高血压伴糖尿病患者微量白蛋白尿(MAU)的影响. 方法 收集在福建中医药大学附属人民医院就诊的痰瘀互结型高血压伴糖尿病患者82例,按随机数字表法分为对照组和治疗组各41例,对照组参照2010年《中国高血压防治指南》《中国2型糖尿病防治指南(2017年版)》推荐的治疗方案治疗,治疗组在对照组治疗基础上加服双清消斑饮,疗程均为8周,比较2组治疗前后尿白蛋白与肌酐比值(UACR)、24 h尿白蛋白水平. 结果 治疗后2组UACR及24 h尿白蛋白均明显降低,治疗组UACR及24 h尿白蛋白下降较对照组明显(P＜0.05). 结论 联合使用双清消斑饮可明显降低痰瘀互结型高血压伴糖尿病患者MAU水平,从而减轻肾脏靶器官的损害.

目的 探讨胸痹中医辨证与冠状动脉病变程度的关系,为胸痹的中医辨证施治提供一定的参考依据.方法 对冠心病患者进行中医本虚标实辨证分型,分为标实证组及本虚证组,并进行冠状动脉造影,分析胸痹中医辨证与冠状动脉病变程度的关系.结果 冠心病组患者各标实证组、各本虚证组Gensini评分比较有差异(P＜0.05).结论 冠心病患者随着冠状动脉病变支数增多,狭窄程度加重,病变渐趋复杂,由气入血,由实到虚,虚实夹杂.

Objective To further optimize TCM norms on chronic heart failure , to provide a practical basis for the treatment of chronic heart failure, in order to explore the reform of health system to adapt to changes in the pattern of medical care , and to avoid wasting limited medical information .Method The standard management for clinical pathways base on TCM was carried out , to assess the effectiveness of clinical pathway for patients with chronic heart failure ( CHF ) , including medical efficiency , expenses and quality , as well as the partition of traditional Chinese medicine , and to optimize the process of diagnosis and treatment of TCM for patients of CHF , give suggestions for the reform of health system in the medical treatment pay model .Furthermore, hope to reduce the waste of the limited medical resources .Result Two groups in the average hospital days , Western medicine cost , Chinese herbal medicine fees , inspection fees and clinical effect were significantly different . Conclusions Implementation of TCM clinical pathway in patients with CHF could significantly shorten the hospitalization time , decreased the cost of hospitalization , ensured the medical quality , and enhanced patient satisfaction .

目的 探讨术中冰冻切片对甲状腺病变的诊断价值及误诊原因.方法 回顾性分析670例甲状腺病变术中冰冻切片诊断结果,并与石蜡切片比较,分析甲状腺冰冻切片病理形态特征及误诊和延迟诊断情况.结果 670例甲状腺冰冻切片病例中,确诊647例(准确率96.58％),误诊15例(误诊率2.24％),延迟诊断8例(延迟率1.19％);误诊病例中假阳性1例(0.15％),假阴性14例(2.09％).结论 直径小于0.2 cm的微小癌和不确定包膜侵犯的滤泡性肿瘤是甲状腺冰冻切片的主要诊断陷阱,准确取材、精心制片及熟练掌握冰冻切片甲状腺病变形态特征可提高冰冻切片诊断准确率并降低误诊率.

Objective To explore the application value of Liquid based cytology combine with sediment embedding biopsy and immunohistochemical detection in the diagnosis of hydrothorax.MethodsTo detecte liquid based cytology of 368 cases of hydrothorax and we found that 65 cases were malignant or suspicious malignant,and we further diagnosis and trace their organization sources by the means of sediment embedding biopsy combined with immunohistochemical staining.Results By the method of liquid based cytology ,we found that 49 cases (75.38%) were positive and 16 cases were suspicious positive . On the other hand ,by the method of sediment embedding biopsy conbined with immunohistochemical detection , 61 cases were positive,with the positive rate of 93.85%,and the difference was statistically significant (p < 0.05). Immunohistochemical markers results Confirmed that 41 cases of patients were lung adenocarcinoma, 2 cases were lung squamous carcinoma,1case was pulmonary neuroendocrine carcinoma, 2 cases were malignant mesothelioma, 9 cases were gastrointestinal carcinoma, 2 cases were breast cancer ,1 case was bile duct carcinoma , 3 cases were ovarian cancer and 4 cases were reactive mesothelium hyperplasia.Conclusion By using Liquid based cytology combined with sediment embedding biopsy and immunohistochemical detection can improve the accuracy of hydrothorax cytology diagnosis and positive detection rate,and be of great clinical application value in estimate the source of tumor cell tissue.