Background Community-acquired pneumonia(CAP)is one of the common infectious diseases,especially in elderly patients,with atypical clinical symptoms,which is susceptibility to serious complications,lacks effective treatment measures,and often has a poor prognosis.Objective To investigate the effect of traditional Chinese medicine(TCM)syndrome differentiation therapy on the quality of life and efficacy satisfaction of elderly patients with CAP discharged from hospital(within 1 week).Methods This study was designed as a multicentre,randomized double-blind placebo clinical study.Elderly CAP post-discharge patients admitted to the respiratory departments of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Henan Chest Hospital,Henan People's Hospital,Zhengzhou Hospital of Traditional Chinese Medicine and Zhengzhou People's Hospital from April 2018 to January 2020 were selected as the study subjects and divided into the experimental group and control group by using a central randomized group enrolment model.The patients in the experimental group were treated with corresponding TCM granules based on syndrome differentiation,and the lung-tonifying spleen-invigorating phlegm-reducing formula was given for syndrome of phlegm-dampness due to qi deficiency,and the qi-supplementing yin-nourishing lung-clearing formula was given for qi and yin deficiency and phlegm-heat syndrome.The control group was given a placebo with the same appearance,weight,color,and smell as the Chinese medicine granules.The treatment course was 2 months,and the follow-up was up to 6 months.The quality of life evaluated by the Chinese version of the Quality of Life Rating Scale(SF-36)and efficacy satisfaction evaluated by the Efficacy Satisfaction Questionnaire for CAP(ESQ-CAP)were compared between the two groups before the treatment,1 month after the treatment,2 months after the treatment,3 months after the follow-up,and 6 months after the follow-up.Results Among the 120 subjects included,8 were dislodged and 112 were finally included that met the protocol set,including 54 cases in the experimental group and 58 cases in the control group.There was no significant difference in gender,age,time after discharge,TCM syndrome differentiation,CUBR-65 score,and underlying diseases between the two groups before treatment(P>0.05).The main effects of the group were significant on SF-36 physiological function domain score(Fgroup=5.057,Pgroup=0.027),general health domain score(Fgroup=7.286,Pgroup=0.008),and role limitations due to emotional problems domain score(Fgroup=6.858,Pgroup=0.010).Comparison between the two groups showed that SF-36 physical function domain score of the experimental group was higher than that of the control group at 2 months of treatment,3 months of follow-up,and 6 months of follow-up(P<0.05);SF-36 general health status domain and role limitations due to emotional problems domain scores of the experimental group were higher than those of the control group at 1 and 2 months of treatment,3 and 6 months of follow-up(P<0.05);the SF-36 domain score for role limitations due to mental health was higher than that of the control group(P<0.05)at 3 and 6 months of follow-up.The main effect of group on ESQ-CAP daily living and ability domain score(Fgroup=16.218,Pgroup<0.001),convenience domain score(Fgroup=25.013,Pgroup<0.001),and ESQ-CAP total score(Fgroup=13.843,Pgroup<0.001)was significant.The ESQ-CAP daily living and ability domain scores were higher in the experimental group than the control group at 2 months of treatment,3 and 6 months of follow-up(P<0.05).At 1 and 2 months of treatment and 3 and 6 months of follow-up,ESQ-CAP convenience domain score and ESQ-CAP total score were higher in the experimental group than in the control group(P<0.05).At 3 months of follow-up,the ESQ-CAP overall efficacy domain score was higher in the experimental group than the control group(P<0.05).Conclusion The TCM syndrome differentiation therapy scheme can improve the quality of life and efficacy satisfaction of elderly patients with CAP after discharge.

目的 评价益肺灸治疗慢性阻塞性肺疾病(COPD)的临床疗效.方法 检索中国知网、PubMed等数据库从建库至2021 年5 月公开发表的益肺灸治疗COPD的随机对照试验(RCT),按照纳入排除标准筛选文献,对文献质量进行评价,双人独立提取研究数据,采用RevMan5.3 软件对结局指标(急性加重次数、呼吸困难、肺功能等)进行Meta分析.结果 共筛选107 篇文献,纳入15 个研究,1 355 例患者.对照组为西医常规治疗,试验组在对照组基础上进行益肺灸(督灸)治疗.由于受外治法技术限制,导致文献方法学质量较低,风险偏倚较大.Meta分析结果显示:呼吸困难评分[95％CI(-0.40～-0.09),P＜0.05],6 min步行距离(6MWD)[95％CI(20.15～52.08),P＜0.05],1 s用力呼吸容积(FEV1)％[95％CI(3.36～9.52),P＜0.05]等12 个结局指标组间差异具有统计学意义,不良反应发生率较低,未见卫生经济学评价报告.结论 益肺灸治疗COPD稳定期患者能够改善呼吸困难,提高生存质量,减少COPD急性加重,提高运动耐力,改善临床症状,改善肺功能.所得结论有待高质量临床研究进一步证实.加强外治法盲法设计有助于提高益肺灸技术循证研究质量和水平;加强卫生经济学评价,能够更客观评价益肺灸技术的比较效益.

目的:分析基于世界卫生组织临床试验注册平台(WHO ICTRP)的慢性阻塞性肺疾病(COPD)远程医疗相关临床试验注册现状.方法:检索WHO ICTRP中注册的COPD远程医疗相关临床试验,检索时限从建库至2021年12月31日,由2位研究者独立筛选文献,提取数据,对纳入的临床试验进行统计分析.结果:共纳入COPD远程医疗相关临床试验139项,注册数量随时间大体呈增长趋势,美国(18项)、英国(17项)和中国(10项)是主要注册国家,多中心临床试验较少(23项),研究类型以干预性研究(122项)为主,29项(20.86％)使用了盲法.干预性研究中,4项(3.29％)报道了随机方法,干预措施可归纳为远程监护(45项,36.89％)、远程教育(40项,32.79％)、远程康复(21项,17.21％)和远程治疗(16项,13.11％).纳入的临床试验结局指标种类较多,量表应用较多.结论:COPD远程医疗相关临床试验注册数量大体呈上升趋势,但部分临床试验注册信息不规范,试验设计欠佳,今后应加强临床试验注册规范化.

肺纤维化在呼吸系统疾病中较常见,且随着年龄的增长呈进行性发展,至后期可因呼吸衰竭导致患者死亡.其发病机制尚无明确定论,激素及抗炎治疗效果不佳,仅能部分延缓肺纤维化的进展.对近年来中医药治疗肺纤维化相关研究进行总结,发现辨痰浊阻肺、痰热壅肺、肺气虚、肺阳虚、肺脾气虚、肺肾气虚、肺肾阴虚、阴虚内热、络虚不荣证型,辨肺、脾、肾、肝不同病位,辨易感、虚实、三阴三阳体质,辨络病,单药、复方等治疗均取得了一定疗效,不同经验及观点的提出,可为临床治疗本病提供更多的思路和方向.

在完成文献检索、文献评价及文献总结的基础上,采用德尔菲法进行3轮专家问卷调查,经过专家论证会,专家质量方法学评价和临床一致性评价,形成《三伏贴干预儿童哮喘专家共识》,提出三伏贴干预儿童哮喘专家共识的范围、术语和定义、诊断、分期、适用人群、敷贴方法与禁忌、注意事项与调护等,以规范该疗法的临床应用,本共识适用于各级医疗机构,使用人群为中医科、儿科、儿童保健中心和治未病中心等相关临床医师,目标人群为1～18岁哮喘迁延期和缓解期患儿.

目的:评价中医辨证治疗方案对老年社区获得性肺炎(CAP)患者再住院率、医生报告结局及患者报告结局的影响.方法:采用多中心随机双盲安慰剂对照试验设计,以老年CAP出院后患者为研究对象,120例患者中央随机分为试验组和对照组各60例,试验组辨证给予相应中药颗粒剂,对照组辨证给予相应中药安慰剂,均治疗2个月,随访6个月.主要结局指标为再住院率(肺炎再住院率、全因再住院率),次要结局指标包括肺炎的医生报告结局量表(CAP-CRO)、肺炎患者报告结局量表(CAP-PRO),采用SPSS 23.0进行统计分析.结果:共纳入120例患者,脱落8例,符合方案集112例(试验组54例、对照组58例).①再住院率:试验组治疗2个月及随访3、6个月的肺炎再住院率显著低于对照组(P＜0.05);各时间点的全因再住院率组间比较差异均无统计学意义.②CAP-CRO:疾病症状领域、病情改善综合评价领域和量表总评分不同时间点重复测量方差分析有时间效应和组别效应(P＜0.01),主要体征领域评分有时间效应(P＜0.01).③CAP-PRO:疾病症状领域评分和量表总评分不同时间点重复测量方差分析有时间效应和组别效应(P＜0.01);健康满意度领域评分、疗效满意度领域评分有时间效应(P＜0.01).结论:中医辨证治疗能够降低老年CAP患者肺炎再住院率,改善咳嗽、咳痰、乏力、胸痛等症状,提高临床疗效.

Background China owns a huge number of asthma patients and an increasing incidence of asthma, but low rate of overall control and high rate of acute asthma exacerbation. Moreover, there is a lack of methods for systematically screening the risks of acute exacerbation of asthma. Objective To develop a risk prediction questionnaire for acute exacerbation of asthma after screening the associated risk factors using the modified Delphi technique, providing a reference for building a multidimensional risk prediction model of asthma acute exacerbation. Methods Based on literature reports and our clinical pre-investigation results, an expert consultation questionnaire on risk predictors of acute exacerbation of asthma was developed, and was distributed through E-mail to 30 experts for review through two rounds of online consultation survey using the modified Delphi technique conducted from April to October 2021. SPSS 25.0 was used to assign weight and analyze the risk predictors. Then according to the screening criteria developed by the experts, the risk predictors were finally determined. Results Both two rounds of consultation achieved a 100% response rate. The familiarity, judgment, and authority coefficients as well as Kendall's W were 0.894, 0.963, 0.929, and 0.331, respectively, for the first round of expert consultation (P<0.001) , and were 0.920, 0.976, 0.948, and 0.437, respectively, for the second round of expert consultation (P<0.001) . The determined risk predictors of acute exacerbation of asthma include six domains (clinical symptoms and signs, conditions, quality of life, biological information, traditional Chinese medicine syndromes and basic demographics) , and 29 indices including severity of asthma, Asthma Control Test, wheezing, chest tightness, allergy history, hormone therapy, work and living environment, eosinophils, number of exacerbations in the past year, treatment compliance, climate and seasonal changes, and so on. Conclusion The based on the modified Delphi method, the risk predictors of acute exacerbation of asthma determined using expert consultation with the modified Delphi technique include the aforementioned six domains and 29 indices, which is relatively concise, and can provide a reference for follow-up studies.

目的 评价二陈汤合三子养亲汤治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效与安全性.方法 检索中国知网、万方、维普、CBM、PubMed、Embase、Cochrane Library数据库,检索时间从建库至2020年6月27日.由2位研究者独立筛选文献、提取资料及评价偏倚风险后,使用RevMan5.3软件进行Meta分析.结果 共纳入27篇文献,2444例AECOPD患者.Meta分析结果显示:二陈汤合三子养亲汤联合西医常规治疗临床总有效率明显优于单用西医常规治疗(P<0.00001);呼吸困难(mMRC)评分、圣乔治呼吸问卷(SGRQ)评分明显低于西医常规治疗;第1秒用力呼气量(FEV1)、FEV1占用力肺活量百分比(FEV1/FVC)、FEV1占预计值的百分比(FEV1％)均明显优于单用西医常规治疗.依据推荐分级的评估、制定与评价(GRADE)系统进行证据分级,总有效率为中等质量证据,mMRC评分为低质量证据,SGRQ评分为极低质量证据.结论 二陈汤合三子养亲汤联合西医常规治疗AECOPD的疗效优于单用西医常规治疗,安全性高,但仍缺乏高质量证据支持.

流行病学显示,慢性呼吸道疾病导致的死亡和健康损失呈上升趋势,2017年估计有391万人死于慢性呼吸道疾病,占全球所有死亡人数的7％ [1].因此,呼吸系统疾病的防控尤为关键.呼吸肌是呼吸运动的动力泵,膈肌是胸腔与腹腔间的肌肉-纤维结构,占呼吸肌功能的60％ ～80％,膈肌功能障碍是引起呼吸衰竭的重要机制之一.对膈肌结构及功能的评价在疾病的诊断和评估慢性阻塞性肺疾病( COPD)、重症患者的病情严重程度评估及预后等方面应用广泛.因此,在呼吸系统疾病的临床实践和研究中,膈肌疗效评价方法是其重要的组成部分.

Background Asthma is a complex heterogeneous disease, whose frequent acute attacks seriously affect the quality of life of patients, and cause a heavy economic burden. The recent development of serum biomarkers provides a new idea for accurate treatment of asthma and diagnosis and treatment of refractory asthma. Objective To analyze the difference of serum biomarkers between different stages of asthma patients and healthy people, and to explore the predictive potential of different serum biomarkers for acute asthma attack. Methods A cross-sectional design was used. Participants were recruited from the First Affiliated Hospital of Henan University of Chinese Medicine during November 2018 to December 2020, including 293 asthma patients (155 in the acute attack stage, and 138 in non-acute attack stage) , and 39 healthy volunteers from physical examinee center of this hospital. ELISA was used to detect the contents of serum biomarkers〔interleukin 4 (IL-4) , interleukin 6 (IL-6) , interleukin 8 (IL-8) , interleukin17 (IL-17) , interferon-γ (IFN-γ) , transforming growth factor-β2 (TGF-β2) , tumor necrosis factor-α (TNF-α) , total immunoglobulin E (TIgE) , specific immunoglobulin E (SIgE) , eosinophil-selective chemokine (Eotaxin) , eosinophil cationic protein (ECP) , periostin, leukotriene D4 (LTD4) , high mobility group protein B1 (HMGB1) , chitinase 3-like protein 1 (YKL-40) 〕. Results Compared with healthy volunteers, both acute and non-acute attack asthma patients had higher levels of serum IL-4, IL-6, IL-8, IL-17, TGF-β2, TNF-α, HMGB1, TIgE and SIgE, and lower level of serum IFN-γ (P<0.05) . The levels of serum Eotaxin and YKL-40 in acute attack asthma patients were higher than those in non-acute attack asthma patients and healthy volunteers (P<0.05) . The levels of Eotaxin and YKL-40 in non-acute attack asthma patients were higher than those in healthy volunteers (P<0.05) . In addition, the level of periostin in non-acute attack asthma patients was lower than that in healthy volunteers (P<0.05) . Conclusion Serum IL-4, IL-6, IL-8, IL-17, IFN-γ, TGF-β2, TNF-α, SIgE, TIgE, HMGB1 may be related to asthma, but their expression levels may not be related to disease stage. Eotaxin and YKL-40 may be potential predictors of the acute attack of asthma.

Background Our previous study showed that Yifei moxibustion has good effect on chronic obstructive pulmonary disease (COPD) in stable stage, but the effect could be enhanced according to the suggestions of an expert questionnaire survey. It is of great significance to carry out clinical research on the relationship of moxibustion duration with clinical efficacy and suitability in COPD. Objective To study and optimize the appropriate duration of moxibustion treatment in COPD, and to evaluate its clinical efficacy and suitability. Methods One hundred and twenty patients with stable COPD were recruited from the First Affiliated Hospital of Henan University of Chinese Medicine from June to July 2017, and randomly divided into groups A and B with SAS software. Both groups received routine western medicine treatment and one course of Yifei moxibustion treatment (1.5 h each time for group A, and 2 h each time for group B, once every 15 days, for a total of six times in three months) . The primary outcome index was the number of colds during treatment, and the secondary outcome indices included clinical symptoms and signs scores, COPD Assessment Test (CAT) , pulmonary function, suitability evaluation〔using the Visual Analogue Scale (VAS) 〕, and the safety was evaluated. Results Except 29 dropouts, 91 cases (47 in group A and 44 in group B) were included in the Per Protocol Set and analyzed with full data set analysis. The results of repeated measures ANOVA showed that the main effects on the number of colds, score of chest tightness, CAT score and VAS score were significant between groups (P<0.05) . There were significant intergroup differences in the number of colds, the total score of clinical symptoms and signs, the score of each of the clinical symptoms and signs, the score of each of the clinical symptoms and signs, CAT score and VAS score at different time points (P<0.05) . No adverse events occurred in both groups. Conclusion Both types of Yifei moxibustion could reduce the number of colds, improve the cough, chest tightness and other clinical symptoms as well as the quality of life in stable COPD patients. But the efficacy of Yifei moxibustion lasting for 1.5 h each time was better, and was more applicable.

Background Community-acquired pneumonia (CAP) is one of the common infectious diseases with high morbidity and heavy disease burden. Despite the continuous advancement of diagnostic technology and the launch of new antimicrobial drugs, the morbidity and mortality of CAP are still high. The clinical research of Shufeng Jiedu capsules in the adjuvant treatment of CAP is increasing, but there is still a lack of systematic review and meta-analysis. Objective To systematically evaluate the efficacy and safety of Shufeng Jiedu capsules in the treatment of CAP. Methods Randomized controlled trials (RCTs) about Shufeng Jiedu capsules in the treatment of CAP was retrieved in CNKI, Wanfang Data, VIP, SinoMed, PubMed, Cochrane Library and EMBase from inception to November 2021 by computer. The control group was treated with routine western medicine, and the experimental group was treated with Shufeng Jiedu capsules orally on the basis of the control group. The retrieval time was from the establishment of the database to November 2021. RevMan 5.3 software was used for data analysis, and GRADE criteria were used to evaluate the level of evidence for the outcome indicators. Results A total of 13 studies with 1 355 patients were included. The results of meta-analysis showed that the cure rate of the test group〔RR=1.49, 95%CI (1.28, 1.74), P<0.000 01〕, the total effective rate〔RR=1.18, 95%CI (1.13, 1.24), P<0.000 01〕, imaging complete absorption rate〔RR=1.57, 95%CI (1.13, 1.89), P<0.000 01〕 were higher than the control group, antibiotic use time〔MD=-1.25, 95%CI (-1.90, -0.61), P=0.000 1〕, time of fever disappearance〔MD=-1.15, 95%CI (-1.93, -0.37), P=0.004〕, time of cough disappearance〔MD=-0.96, 95%CI (-1.13, -0.80), P<0.000 01〕, time of expectoration disappearance〔MD=-1.44, 95%CI (-2.40, -0.48), P=0.003〕 and time of lung rales disappearance〔MD=-1.60, 95%CI (-2.33, -0.87), P<0.000 1〕 were shorter than the control group, C-reactive protein〔MD=-4.12, 95%CI (-6.95, -1.30), P=0.004〕 and white blood cell count〔MD=-2.20, 95%CI (-3.36, -1.05), P=0.000 2〕 were lower than the control group. There was no significant difference in the incidence of adverse events between the two groups〔RR=0.84, 95%CI (0.26, 2.67), P=0.76〕. The funnel chart of the cure rate showed that the left and right sides were asymmetrical, suggesting that there may be publication bias. GRADE grading results showed that the cure rate, total effective rate, the time of cough disappearance and imaging complete absorption rate were of moderate quality, the time of fever disappearance, expectoration disappearance and lung rales disappearance, C-reactive protein and white blood cell count were of low quality, the time of antibiotic use and the incidence of adverse events were of very low quality. Conclusion Shufeng Jiedu capsule has significant curative effect and good safety in the adjuvant treatment of CAP. However, due to the low quality of the included research methodology, more high-quality, multi-center and large sample trails are still needed for verification.

背景 重症哮喘临床控制较差,且欠缺有效的治疗方法 ,故亟需更多相关临床研究;临床注册试验可为临床防治工作奠定基础,而目前重症哮喘临床注册现状尚不清楚,尚不能为临床试验提供新视角.目的 基于WHO国际临床试验注册平台(ICTRP)数据,了解重症哮喘临床试验注册特点.方法 计算机检索WHO ICTRP数据库,搜集建库起至2019-12-15注册的重症哮喘相关临床试验资料.由2名研究者独立筛选文献、提取资料后,对纳入试验进行描述性分析.结果 共检索到重症哮喘相关临床试验235个,临床试验注册数量自建库起逐年上升,近4年有下降趋势.试验申请国家分布不均,重症哮喘患病率较高国家试验申请极少.各注册中心试验大多来自本国家.资金主要来源于单位和企业.研究病种以重症哮喘为主(89.36％),涉及年龄以成人为主(90.64％).试验类型以干预性为主(65.96％),干预性试验中随机试验占67.10％,仅9个试验描述其采用的随机方法 ;观察性研究中以队列研究居多(38.75％);44.26％的试验未注明盲法情况,其余试验双盲占据较多(25.53％);试验分期以N/A(32.77％)、Ⅲ期试验(20.00％)最多.干预措施以药物干预为主(77.42％).结局指标以肺功能、哮喘加重情况、生存质量评价为主.结论 重症哮喘临床试验近几年呈下降趋势,试验申请国家分布不均,研究病种以重症哮喘为主,研究类型以干预性为主,干预措施多为西药干预.

支气管哮喘(简称哮喘)是一组由多种炎症细胞,如嗜酸性粒细胞( EOS)、肥大细胞、淋巴细胞、中性粒细胞( PMN )、平滑肌细胞、气道上皮细胞等和细胞组分参与的慢性气道炎症性疾病〔1〕,属中医学中"哮病"的范畴.中医学认为,哮喘是因痰气交阻,闭塞气道,肺的升降失职所致.病因多以风、寒、痰、热、瘀、湿为标,以肺、脾、肾三脏俱虚为本,证属本虚标实.哮喘的炎症表型的异质性与中医辨证论治的理论相类似,因此推测哮喘炎症表型与中医证候可能存在一定的相关性〔2〕.

支气管哮喘中医学认为其属“哮病”范畴,辨证论治是中医治疗支气管哮喘的优势和特色所在,实现对支气管哮喘中医证候动态定性及定量的把握是提高支气管哮喘临床疗效的关键环节.生物标志物是生物体受刺激或扰动后,生物学介质中可以检测到细胞、生物化学或分子改变;而生物标志物与支气管哮喘中医证候具有一定相关性,其可能是实现支气管哮喘中医证候的定性和量化的突破点,且相关的研究较少,故本文以期找到可以划分各证候的客观参考指标,从而提高支气管哮喘的中医诊疗能力,同时为以后的研究提供参考.

对近40年来中医药治疗儿童多动症临床研究、实验研究进行分析评述,并提出不足和展望.临床学术观点主要分从虚论治和从实论治;临床用药以补益、安神、平肝为主,且缺少治疗实证的中成药;临床路径制订及指南修订促进了行业规范化;中医药治疗具有不可替代的优势.实验研究获得国家自然科学基金大力资助,取得一定成果.规范临床试验研究,研发确有疗效的中药新药,研究“病证结合”的动物模型,揭示中医药治疗儿童多动症的科学内涵是今后努力的方向.

目的:铵明矾为白矾的常见伪品,铵明矾炮制品为枯矾的常见伪品,该文旨在建立鉴别白矾、枯矾、铵明矾及其炮制品的方法.方法:利用扫描电子显微镜及X射线衍射技术对样品进行分析.结果:白矾、铵明矾在炮制前后形貌特征变化明显.白矾、铵明矾在×250,×1 000倍数下均能显示明显的形貌差异.白矾呈不规则的碎片或碎块,边缘棱角清晰,表面较平滑,散有不规则块小颗粒,偶见孔洞和纵棱;铵明矾呈不规则团块状,边缘较钝圆,棱角不明显,表面多凹凸不平,散有较小、呈类圆形的小颗粒.枯矾及伪品枯矾在×250倍数下,两者形貌特征区分度不大,在×1 000倍数下,枯矾表面凹凸不平,呈明显的粗颗粒状,伪品枯矾表面较平坦,粗颗粒状特征不明显.通过粉晶X射线衍射,能快速、准确的鉴别白矾、枯矾、铵明矾、铵明矾炮制品的主要物相为KAl(SO4)2·12H2O,NH4Al(SO4)2·12H2O,KAl(SO4)2,NH4Al(SO4)2,X射线衍射峰2θ角度特征值分别为23,12,22,5个.结论:扫描电子显微镜及X射线衍射技术均可用于白矾、枯矾及其相应伪品的鉴别.

目的:观察并评价小儿智力糖浆治疗儿童抽动障碍阴虚风动证的临床疗效及安全性.方法:采用多中心分层、区组随机、阳性对照的研究方法,在北京、郑州、南京共纳入抽动障碍患儿120例,随机分为A组(60例,小儿智力糖浆口服)、B组(30例,盐酸硫必利片口服)、C组(30例,小儿智力糖浆和硫必利联合用药).3组均以12周为1个疗程,首诊和第12周治疗后运用耶鲁综合抽动严重程度量表(YGTSS)记录抽动症状积分变化情况,同时在首诊、用药4、8、12周后运用中医适应证候分级量化标准表记录抽动主症和次症积分变化情况,12周治疗结束后判定疗效.最后对各组患儿治疗后的疗效、症状改善情况和不良反应等进行统计分析.结果:YGTSS积分判定综合疗效显示,A组、B组、C组的控显率分别为63.3％、63.3％、82.8％;中医证候积分判定疗效显示,A组、B组、C组控显率为70.0％、70.0％、89.7％;各组治疗前后YGTSS各类别总积分比较,差异有统计学意义(P＜0.05).治疗后中医证候积分比较,治疗4周时,A组与其余两组比较,主症积分显著升高(P＜0.05);治疗12周时,C组与其余两组比较,主症积分显著降低(P＜0.05).结论:小儿智力糖浆治疗儿童抽动障碍阴虚风动证有效,与西药硫必利相比疗效相当,且不良反应少,值得进一步研究及推广.

多发性抽动症日渐成为困扰学龄期孩子正常学习、生活的因素之一,西药治疗症状缓解明显,却易复发,越来越多的家长选择中医药干预,且疗效确切.本文从中医脏腑辨证理论入手,探讨多发性抽动症病因病机及治疗.

完成文献检索、文献评价及文献总结,2轮专家问卷调查,专家论证会,专家质量方法学评价和临床一致性评价,形成《中医儿科临床诊疗指南·流行性腮腺炎》修订稿,提出流行性腮腺炎诊疗指南的范围、术语和定义、诊断、辨证、治疗、预防和调护,供中医儿科行业使用.