目的 观察加味黄芪桂枝五物汤治疗糖尿病周围神经病变(DPN)疗效.方法 将我院118例DPN患者随机分为治疗组与对照组各59例.对照组给予硫辛酸治疗,治疗组在对照组治疗基础上联合应用加味黄芪桂枝五物汤治疗.比较两组总有效率、治疗前后血浆黏度和血小板聚集率及血糖水平、中医证候、犹他神经症状(UENS)、疼痛视觉模拟法(VAS)、踝肱指数(ABI)、震动感觉阈值(VPT)、正中神经、腓总神经潜伏期和波幅.结果 治疗后,治疗组总有效率高于对照组(P＜0.05);两组血浆黏度、血小板聚集率、血糖水平、中医证候、UENS、VAS、VPT、正中神经、腓总神经潜伏期均低于治疗前,治疗组血浆黏度、血小板聚集率、血糖水平、中医证候、UENS、VAS、VPT、正中神经、腓总神经潜伏期均低于对照组(P＜0.05);两组ABI、正中神经、腓总神经波幅高于治疗前,治疗组ABI、正中神经、腓总神经波幅均均高于对照组(P＜0.05).结论 加味黄芪桂枝五物汤能较好地改善DPN患者中医证候、肌电图和血液循环,降低神经痛和血糖,疗效优于仅用西药的效果.

Objective: To explore the effect of traditional Chinese medicine characteristic nursing on improving neurological function and quality of life in patients with cerebral infarction. Methods: 70 patients with cerebral infarction admitted to our hospital from January 2021 to August 2022 were selected and divided into 2 groups by random number table method: control group (n =35) routine nursing, observation group (n =35) traditional Chinese medicine nursing, to evaluate the nursing effect of the two groups. Results: After intervention, the self-care ability of patients in observation group was better than control group, and the recovery of neurological function was better than control group. Life quality score of observation group was higher than control group, the difference was statistically significant (P ＜0.05). Conclusion: Traditional Chinese medicine nursing can enhance the effect of rehabilitation and improve the quality of life of patients.

Objective: To study the effect of comprehensive nursing intervention on blood glucose in patients with gestational diabetes mellitus. Methods: Sixty patients with gestational diabetes admitted to the Department of Internal Medicine of Integrated Chinese and Western Medicine of our hospital from January 2021 to October 2022 were selected and divided into control group (30 cases, routine nursing intervention) and observation group (30 cases, comprehensive nursing intervention). Results: Under comprehensive nursing intervention, 2h blood glucose after breakfast, lunch and dinner was lower than that of conventional nursing intervention, scores of knowledge of medication, exercise and diet were higher than that of conventional nursing intervention, scores of symptom management and common management were higher than that of conventional nursing intervention, and the total incidence of premature delivery, macrobaby, intrauterine distress and neonatal asphyxia were lower than that of conventional nursing intervention. The difference was significant (P ＜0.05). Conclusion: Comprehensive nursing intervention has a positive effect on the blood sugar of patients with gestational diabetes mellitus, so comprehensive nursing intervention is more valuable to popularize.

目的 观察血府逐瘀汤联合阿托伐他汀治疗2型糖尿病(T2DM)下肢血管病变临床疗效.方法 将我院80例T2DM下肢血管病变患者随机分为观察组与对照组各40例两组.对照组患者采用阿托伐他汀治疗.观察组患者采用血府逐瘀汤+阿托伐他汀治疗.比较两组患者临床疗效、空腹血糖(FPG)、2h餐后血糖(2hPG)、糖化血红蛋白％(HbA1c％)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)值及踝肱指数,足背温度.结果 治疗后,观察组总有效率显著高于对照组(P＜0.05);两组患者FPG、2hPG、HbA1c％值降低,观察组患者FPG、2hPG、HbA1c％值低于对照组(P＜0.05);两组患者TG、LDL值降低,HDL值升高,观察组患者TG、LDL值低于对照组,HDL值高于对照组(P＜0.05);两组患者踝肱指数、足背温度升高,观察组患者踝肱指数,足背温度高于对照组(P＜0.05).结论 血府逐瘀汤联合阿托伐他汀显著降低T2DM下肢血管病变患者血糖、血脂,提高下肢血管血流量,改善血管功能,疗效较仅使用阿托伐他汀显著.

目的:临床观察黄芪桂枝五物汤加减对2型糖尿病(T2DM)大血管病变患者内皮细胞因子(ET-1)、血管内皮生长因子(VEGF)的影响,从细胞水平探讨黄芪桂枝五物汤加减保护血管内皮功能从而防治及延缓2型糖尿病大血管病变的机理.方法:符合条件的60例2型糖尿病合并大血管病变的患者被随机分为治疗组合对照组,每组均为30例,均予以口服西药常规降糖治疗,治疗组同时予以加味黄芪五物汤治疗;两组疗程均为12周.治疗前后分别计算两组患者总有效率,检测其ET-1、VEGF水平.结果:临床观察表明,经加味黄芪桂枝五物汤治疗12周后对照组有效率为56.7％,治疗组总有效率为80.0％,治疗组疗效优于对照组(P＜0.05),加味黄芪桂枝五物汤组治疗后ET-1、VEGF较治疗前均有所降低(P＜0.05),与对照组相比各项指标均有显著性差异(P＜0.05).结论:加味黄芪桂枝五物汤可改善2型糖尿病大血管病变机体血管内皮细胞功能,延缓大血管病变,提示其机制可能与辅助降糖降低ET-1、VEGF水平,保护血管内皮细胞等有关.

目的:观察全生白术散治疗羊水过多的疗效.方法:选取2019年1月-2020年12月在安徽省妇幼保健院中医妇科门诊诊治的60例脾虚型羊水过多32周后孕妇为研究对象,随机分为对照组和研究组,每组均30例.对照组给予常规西医治疗,研究组在常规西医治疗基础上给予全生白术散中药治疗,分别治疗两周后,观察两组孕妇的宫高、体重、症状积分、腹围、羊水指数,以及两组孕妇分娩方式和母婴并发症发生的情况.结果:两组治疗后在症状积分方面,治疗组积分明显低于对照组(P＜0.05);在疗效方面,治疗组治愈率和总有效率分别为33.3％和96.7％;对照组治愈率和总有效率分别为6.67％和73.3％,治疗组疗效明显优于对照组(P＜0.05);治疗组在宫高、体重、腹围下降程度上明显优于对照组(P＜0.05);母婴并发症发生率及剖宫产率治疗组明显低于对照组(P＜0.05).结论:全生白术散治疗孕32周后脾虚型羊水过多患者疗效显著,值得临床推广.

目的 运用对比超声增强技术(contrast-enhanced ultrasound,CEUS)评估颈动脉低回声斑块新生血管强化分级与急性前循环责任病灶侧脑梗死的关系.方法 对60例急性前循环脑梗死患者双侧颈动脉低回声斑块行CEUS,根据斑块造影增强程度分为Ⅰ ～Ⅳ级,并检测所有斑块的厚度.结果 与非责任病灶侧相比,前循环责任病灶侧脑梗死检出低回声斑块53例(88.3％),经CEUS检测,责任病灶侧低回声斑块Ⅲ级增强患者比率明显高于Ⅰ级和Ⅱ级(χ2分别为5.588,3.565,P<0.05),但与Ⅳ级比较差异无统计学意义(χ2=0.005,P=0.944),责任病灶侧Ⅲ级与Ⅳ级发生率明显高于非责任病灶侧(χ2=8.394,P=0.004).颈动脉低回声斑块厚度与斑块内新生血管强化程度之间存在正相关关系(r=0.599,P<0.001).结论 前循环脑梗死的发生与病灶侧颈动脉低回声斑块新生血管强化程度有关,Ⅲ、Ⅳ级增强者斑块更易损,并随着斑块厚度的增加,斑块强化程度增加.颈动脉低回声斑块新生血管强化程度对急性前循环脑梗死发生预测有一定意义.

To observe the efficacy of intravenous and oral pulse administration of calcitriolin treatment of hemodialysis patients with secondary hyperparathyroidism.40 cases were divided into intravenous calcitriol group (the treatmentgroup) and oral calcitriol group (the control group). According to iPTH level, each group was divided into 2 subgroups,the treatment group 1 and the control group 1 (300 pg/ ml≤iPTH≤600 pg/ ml),the treatment group 2 and the control groups (iPTH >600 pg/ ml), and treated for 3 months. The levels of iPTH, alkaline phosphatase(AKP), serum calcium and phosphorus in the two groups were measured at 1, 2 and 3 months after treatment. After 3 months, the levels of iPTH and AKP in the four groups were significantly lower than those before treatment (P<0. 05). Compared with the control group 1, the levels of AKP and iPTH in the treatment group 1 were not statisticallysignificant (P <0. 05). Compared with control group 2, the levels of iPTH and AKP in treatment group 2 were significantly higher than those in control group 2 (P < 0. 05). Compared with oral calcitriol group, intravenous calcitriol can effectively reduce the level of iPTH and less cause hypercalcemia.

目的:探讨补阳还五汤联合α-硫辛酸治疗糖尿病肾病的临床疗效.方法:将符合标准的60例患者分为治疗组和对照组,每组各30例.治疗组予以补阳还五汤联合α-硫辛酸治疗,对照组仅予以阿魏酸哌嗪片治疗.治疗2周后,观察相关指标.结果:2组在应用相应方法治疗后,24h尿蛋白和尿微量白蛋白均有降低(P＜0.05),但治疗组效果比对照组更加显著(P＜0.05).结论:补阳还五汤联合α-硫辛酸治疗糖尿病肾病疗效显著.

膏方具有防治疾病、改善症状、调整体质的疗效,体现了中医“治未病”思想.张教授认为慢性支气管炎病理因素主要为“风、痰、火、气、虚”五个方面,临证做到“二定一观”、膏方以“三个平衡”及顾护胃气为总原则,运用膏方治疗慢性支气炎疗效显著.慢性支气管炎(简称慢支)是气管、支气管黏膜及其周围组织的慢性非特异性炎症[1].临床上依据患者具有咳嗽、咳痰或伴有喘息症状,同时每年发病持续3个月,连续2年或2年以上,并排除其他可以引起类似症状的慢性病即可诊断为慢性支气管炎.临床分为急性加重期和缓解期.多属于中医学中“咳嗽”范畴.

目的:探讨补阳还五汤联合α-硫辛酸治疗糖尿病周围神经病变的临床疗效.方法:将60例符合标准的患者分为治疗组30例和对照组30例.治疗组予以补阳还五汤联合α-硫辛酸治疗,对照组仅予以α-硫辛酸.治疗两周后,观察相关指标.结果:2组治疗后临床症状及神经传导速度明显改善(P＜0.05);治疗组治疗后效果优于对照组(P＜0.05).结论:补阳还五汤联合α--硫辛酸治疗糖尿病周围神经病变疗效显著.

目的：探讨丹红注射液配合复方α－酮酸治疗早期糖尿病肾病的临床疗效。方法：随机选择60例患者分为2组：对照组30例给予西医基础治疗加复方α－酮酸治疗，治疗组30例在对照组治疗基础上加丹红注射液治疗，治疗2周后观察疗效及相关指标变化。结果：2组治疗后，肾功能、尿蛋白等相关指标均有不同程度改善，治疗组更为明显。结论：丹红注射液配合复方α－酮酸治疗早期糖尿病肾病有一定疗效。

目的:观察丹蛭降糖胶囊对2型糖尿病颈动脉病变患者血清VEGF和VCAM-1的影响,探讨益气养阴活血中药复方防治糖尿病颈动脉血管病变的作用机制.方法:62例“气阴两虚夹瘀证”的2型糖尿病颈动脉病变患者对照组(31例)和治疗组(31例),2组患者均进行常规的基础治疗,在保持2组患者间用药的均衡性的基础上,根据患者实际情况选择使用一种或多种降糖药物联合治疗,治疗组口服西药降糖治疗基础上加服兼具益气养阴活血功效的中药复方制剂丹蛭降糖胶囊,每次3粒,每日3次.疗程为24周.观察治疗前后中医症状积分、血糖(FPG、2hPG)、糖化血红蛋白(HbA1c)、血脂(TC、TG、LDL-C、HDL-C)、血清血管内皮生长因子(VEGF)和血管细胞黏附因子(VCAM-1)水平、颈动脉内膜中层厚度(C IMT)水平.结果:治疗后,治疗组中医证候积分、HbA1c、VEGF、VCAM-1、颈动脉IMT均低于对照组(P＜0.05);治疗组HDL高于对照组(P＜0.05).结论:丹蛭降糖胶囊可以显著改善血管内皮功能,对糖尿病颈动脉血管病变疗效显著.

目的:探讨自拟健脾补肾活血利水方治疗糖尿病肾病的临床疗效.方法:将符合标准的61例患者随机分为治疗组32例和对照组29例.治疗组32例给予西医基础治疗加自拟健脾补肾活血利水方治疗,对照组29例给予西医常规治疗,30d为1个疗程,治疗3个疗程后观察疗效及相关指标变化.结果:2组治疗后尿蛋白显著降低(P＜0.05);治疗组治疗后效果优于对照组(P＜0.05).结论:健脾补肾活血利水方治疗糖尿病肾病疗效显著.

目的:观察脑络欣通颗粒对抗氧化低密度脂蛋白抗体(oLAB)和C反应蛋白(CRP)的影响,评价脑络欣通颗粒治疗缺血性中风(脑梗死)急性期气虚血瘀证的临床疗效.方法:将符合纳入病例标准的90例缺血性中风(脑梗死)急性期气虚血瘀证患者随机分为脑络欣通组,通心络组,常规组,常规组给予西医神经内科常规处理,通心络组在常规治疗基础上给予通心络胶囊,脑络欣通组在常规治疗基础上加用脑络欣通颗粒.观察患者治疗前,治疗后7天,14天3个不同时间点的神经功能缺损程度评分,日常生活活动能力评分,中医证候评分,抗氧化低密度脂蛋白抗体(o LAB)和C-反应蛋白(CRP),检测观察指标数值的变化,评价3组的临床疗效.结果:通心络组和常规组各脱落2例患者.3组均有变化,常规组虽有变化,但无统意义计学,与常规组相比,通心络组和脑络欣通组均有明显的改变(P＜0.05或P＜0.01),脑络欣通组又明显优于通心络组(P＜0.05),说明脑络欣通颗粒可以更好的改善以上指标.结论:脑络欣通颗粒对脑梗死急性期气虚血瘀证患者可明显降低o LAB和CRP水平,且优于通心络胶囊.

目的:观察培哚普利联合尿毒清颗粒对早期糖尿病肾病疗效.方法:入选57例患者随机分为对照组28例及治疗组29例,对照组给予培哚普利4mg每日1次口服;治疗组在培哚普利4mg每日1次口服基础上,加用尿毒清颗粒每日4次,其中6,12,18时各服1袋(5g),22时(睡前)服2袋.用药间隔不超过8h.2组均以12周为1个疗程.观察治疗前及治疗后4、8、12周尿微量白蛋白排泄率(UAER),空腹血糖(FPG),血清总胆固醇(Tc),血清甘油三酯(TG),血清胱抑素-C(Cys-C)的变化.结果:2组UAER水平均随着治疗时间延长而不断降低,治疗后12周为最低,且治疗组明显低于对照组(P＜0.05).治疗后2组FPG、TC、TG、Cys-C水平均显著降低,治疗组降低程度较对照组更显著(P＜0.05).结论:培哚普利联合尿毒清颗粒治疗DN可以有效降低尿微量白蛋白排泄率,改善血糖、血脂水平,降低胱抑素-C水平.二者联用具有协同保护肾脏、辅助降糖降脂作用.

In recent years,research on carotid atherosclerosis has turned to the aspect of neovascularization in vulnerable plaques.The evaluation of neovascularization in plaques using contrast-enhanced ultrasonography has become one of the novel technologies to determine the plaque stability.This article reviews the principles of contrast-enhanced ultrasonography and its application in the evaluation of neovascularization in carotid atherosclerotic plaques and vulnerable plaques.

<正>糖尿病合并骨质疏松症(Diabbetic Osteoporosis,DOP)是由于糖尿病(diabetes Mellitus,DM)患者胰岛素绝对或相对缺乏,引起机体糖、脂肪、蛋白质代谢紊乱,钙、磷、镁等元素代谢障碍而导致骨组织骨量减少的一种代谢性疾病。患者除了有DM的症状及并发症外,还可能出现腰背酸疼、骨密度减低和骨痛、骨折等。围绝经期妇女在40岁以后开始

目的观察逐瘀通脉胶囊治疗急性脑梗死疗效观察。方法60例急性脑梗死患者随机分成2组,对照组和治疗组各30例,治疗组在对照组治疗的基础上加用逐瘀通脉胶囊,两组疗程均为14 d。比较治疗前后两组患者临床疗效、神经功能评分的变化和日常生活能力。结果总有效率治疗组为86.7%,对照组为76.7%,两组比较,差异有显著性P<0.01。2组神经功能缺损评分与治疗前比较,均明显下降,P<0.01;组间治疗后比较,神经功能缺损评分治疗组优于对照组,有显著性差异,P<0.01。ADL量表功能评定,治疗组治疗后生活基本能自理24例,生活需要帮助4例,需要很大甚至完全帮助2例;对照组治疗后生活基本能自理18例,生活需要帮助5例,需要很大甚至完全帮助7例;两组比较,差异有显著性P<0.01。结论逐瘀通脉胶囊治疗急性脑梗死疗效明显,使用方便,值得临床推广使用。

目的:观察步长稳心颗粒治疗期前收缩的临床疗效。方法:65例期前收缩患者随机分为2组,对照组30例使用心律平治疗,治疗组35例使用稳心颗粒治疗,2组疗程均为4周,比较2组治疗前后的疗效、心电图变化,以及不良反应。结果:治疗组有效率、心电图好转率明显优于对照组,治疗组不良反应也优于对照组,P均<0.05。结论:步长稳心颗粒用于治疗期前收缩,疗效确切、安全,值得临床推广。