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论著

补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床观察及疗效评价:一项随机对照试验

Clinical observation and curative effect evaluation of Shenshu Tuina combined with Bushen Yiqi herbal ointment on cancer-induced fatigue in convalescent stage of colorectal cancer

:333-340
 
       目的  观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法  收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者,随机平均分为两组。行常规对症支持治疗的为对照组;在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组;两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标(CD3+  、CD4+、CD8+  、CD4+ /CD8+ )较治疗前均有明显改善;干预组发生不良反应少于对照组。结论  补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果,提高生活质量和免疫功能,减少不良反应。
       Objective  To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy.Methods  From June 2023 to June 2025,80 inpatients and outpatients of colorectal cancer in the  recovery period were collected and  randomly divided into two groups.The patients who received routine symptomatic supportive treatment were enrolled as the control group.The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group.The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment.Adverse reactions were detected on the day before treatment,theseventh day and 14th day during treatment.Results  The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment.Adverse  reactions occurred less in the intervention group than in the control group.Conclusions  Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer,improve the quality of life and immune function,reduce adverse reactions.
临床诊疗

氨溴索静脉用药联合不同通气方式治疗新生儿呼吸窘迫综合征的疗效评价

:76-79
 
目的 研究氨溴索静脉用药联合不同通气方式治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法 选取2019年2月—2021年1月我院收治的98例NRDS患儿,根据治疗方案不同分为对照组(49例)和观察组(49例)。2组均给予常规治疗,对照组采用氨溴索静脉用药、常规机械通气治疗,观察组采用氨溴索静脉用药、高频振荡通气(HFOV)治疗。比较2组临床疗效、胸部X线评分、新生儿评分(Apgar评分)、不同时间点(治疗前、治疗后2 h、治疗后12 h)动脉血气指标[氧合指数(OI)、动脉氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)]、呼吸力学指标[呼吸指数(RI)、呼吸道阻力(R)、肺动态顺应性(Crs)]、并发症发生率、死亡率。结果 2组治疗后总有效率比较,观察组93.88%高于对照组77.55%(P<0.05);治疗后,观察组胸部X线评分、Apgar评分均高于对照组(P<0.05);治疗后2 h、治疗后12 h时观察组OI、PaCO2均低于对照组,PaO2高于对照组(P<0.05);治疗后,观察组RI、AR水平低于对照组,Crs水平高于对照组(P<0.05);观察组死亡率2.04%低于对照组14.29%(P<0.05)。结论 氨溴索静脉用药联合HFOV治疗NRDS的临床疗效显著,可有效促进患儿呼吸功能、动脉血气改善,降低新生儿死亡率。
论著

雾化吸入干扰素-α治疗儿童疱疹性咽峡炎临床疗效评价

Evaluation on the clinical efficacy of interferon-α nebulized inhalation in the treatment of herpetic angina in children

:82-86
 
目的 探讨雾化吸入干扰素-α治疗对儿童疱疹性咽峡炎的治疗效果的影响。方法 本研究纳入2019年1月—2021年1月在清远市妇幼保健院住院治疗的126例疱疹性咽峡炎儿童。所有参与该研究的患儿被随机平均分为2组:对照组(63人)和干预组(63人)。对照组进行常规治疗方案,干预组在对照组基础上雾化吸入干扰素-α治疗。比较2组治疗效果的差异性。结果 干预组患儿平均发热天数(1.86±0.97天)较对照组(2.44±0.89天)低;干预组心肌酶升高比例较对照组低,组间差异有统计学意义(P<0.01)。干预组中显效(50.8%)占主要比例,而对照组中有效(74.6%)占主要比例,并且干预组总有效率(98.4%)高于对照组(96.8%)(P<0.05)。干预组住院天数(5.02±1.85天)较对照组(5.68±1.68天)降低,组间差异有统计学意义(P<0.05)。结论 在常规治疗的基础上加用雾化吸入干扰素-α治疗对提高儿童疱疹性咽峡炎的疗效有促进作用,值得临床推广。
Objective To investigate the effect of nebulized inhalation of interferon-α on the therapeutic effect of herpes angina in children. Methods This study included 126 children with herpetic angina who were hospitalized in Maternal and Child Health Hospital of Qingyuan City from January 2019 to January 2021.All children participating in the study were randomly divided into 2 groups: control group (63 children) and intervention group (63 children). The control group received conventional treatment, and the intervention group was treated with aerosol inhalation of interferon-α on the basis of the control group.The difference of the treatment effect between the two groups were compared. Results The average number of fever days of children in the intervention group (1.86±0.97 days) was lower than that of the control group (2.44±0.89 days); the increase of myocardial enzymes in the intervention group was lower than that of the control group, and the difference was statistically significant (P<0.01). The “obviously effective” (50.8%) in the intervention group accounted for the main proportion, while the “effective” (74.6%) in the control group accounted for the main proportion, and the total effective rate of the intervention group (98.4%) was higher than that of the control group (96.8%,P< 0.05). The length of hospitalization in the intervention group (5.02±1.85 days) was smaller than that of the control group (5.68±1.68 days), and the difference was statistically significant (P<0.05). Conclusion The addition of nebulized interferon-α on the basis of conventional treatment could improve the curative effect of herpetic angina in children, and it is worthy of clinical promotion.
临床诊疗

腹腔镜下早期宫颈癌根治术与开腹手术的临床疗效评价

:127-130
 
目的 通过与开腹广泛全子宫切除术+盆腔淋巴结清扫术对比,评估腹腔镜下广泛全子宫切除术+盆腔淋巴结清扫术治疗早期宫颈癌的疗效及安全性。方法 研究对象为广东省揭阳市人民医院妇科2013年9月—2015年12月完成手术的宫颈癌Ia2期-IIa期患者200例,分为两组,治疗组:100例实施腹腔镜治疗,年龄32~67岁,平均(45±4.15)岁;对照组:100例开腹手术切除治疗,年龄35~61岁,平均(43±5.33)岁。两组比较手术时间、术中出血量、术后尿潴留及淋巴回流障碍发生率、住院时间、复发率及死亡率等。结果 腹腔镜手术均顺利完成,无一例中转开腹,与开腹手术相比,治疗组手术时间缩短(3.5±0.7)h,术中出血少(48.3±17.8)mL,肛门排气时间(1.2±0.7)d,住院时间短(15.2±0.5)d,手术并发症少(5/5%),均优于对照组手术时间(6.3±0.5)h,术中出血(221.4±102.1) mL,肛门排气时间(2.5±0.9) d,住院时间(18.7±0.9),手术并发症(27/27%),上述各项指标治疗组优于对照组,差异均有统计学意义(P均<0.05)。结论 腹腔镜手术治疗早期宫颈癌疗效显著, 可显著降低患者术中出血量,缩短手术时间,减少术后并发症,缩短住院时间,两者术后生存率与复发率无统计学差别。
论著

唑来膦酸对预防腰椎PVP术后再发骨折的疗效评价

Effect of zoledronic acid on prevention of recurrent fracture after PVP

:52-55
 
目的 比较唑来膦酸对 PVP(椎体成形术)治疗OVCF(骨质疏松椎体压缩性骨折)术后再发骨折的影响。方法 收集2016年12月—2018年6月在我院骨科接受PVP治疗患者共70例,其中40人在术后接受了唑来膦酸治疗(观察组),30人在术后接受了安慰剂治疗(对照组),两组患者均给予维生素D和钙剂基础治疗。记录术后6个月、1年、2年腰椎骨密度;术后2年内伤椎及邻近椎体再发骨折情况。结果 观察组伤椎再发骨折率(1/40,2.5%)低于对照组(2/30,6.67%)(P<0.05);观察组邻椎再发骨折率(2/40,5%)低于对照组(7/30,23.33%)(P<0.05)。结论 唑来膦酸能较好地预防PVP术后再发骨折。
Objective To compare the effect of zoledronic acid on the treatment of osteoporotic vertebral compression fracture after percutaneous vertebroplasty PVP. Methods From December 2017 to June 2019, a total of 70 patients who received PVP in the hospital medical plastic surgery clinic, 40 patients were collected received zoledronic acid (group A) and 30 patients received placebo (group B) after operation. Both groups received basic treatment of vitamin D and calcium. The bone mineral densits (BMD) of lumbar vertebrae were recorded at 6 months, 1 year and 2 years after operation, and the recurrent fractures of injured vertebrae and adjacent vertebrae were recorded at 2 years after operation. Results The rate of recurrent fracture of vertebrae in group A (1/40, 2.5%) was lower than that in group B (2/30, 6.67%); the rate of recurrent fracture of adjacent vertebrae in group A (2/40, 5%) was grcartly lower than that in group B (7/30, 23.33%). Conclusion Zoledronic acid can prevent recurrent fracture after PVP.
论著

二甲双胍用于治疗多囊卵巢综合征促排卵的疗效评价

Effect of metformin on ovulation induction in polycystic ovarian syndrome

:80-82
 
目的 探究二甲双胍在多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者中的促排卵效果。方法 选取2019年1月—2020年12月收治的66例PCOS患者进行回顾性分析,以治疗方案为依据进行分组(对照组、观察组),对照组均采用炔雌醇环丙孕酮进行治疗(n=33),观察组则在其基础上联合二甲双胍进行治疗(n=33),对比两组患者的性激素水平[黄体酮生成素(luteinizing hormone,LH)、睾酮(testosterone,T)]、血糖指标[空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数]及促排卵效果。结果 观察组在治疗后的LH、T水平均低于对照组(P<0.05);且观察组在治疗后的FPG、FINS、胰岛素抵抗指数水平均低于对照组(P<0.05);此外,经过治疗后,观察组患者的排卵率为54.5%,高于对照组的30.3%(P<0.05)。结论 将二甲双胍应用于PCOS患者的治疗方案中,可显著改善其性激素水平及血糖代谢情况,促进排卵率的提升,在PCOS导致的不孕症治疗中具有积极的应用价值。
Objective To explore the effect of metformin on ovulation induction in patients with polycystic ovarian syndrome (PCOS). Methods A total of 66 cases of PCOS patients from January 2019 to December 2020 were retrospectively analyzed and divided into control group and observation group according to the treatment plan. The control group was treated with ethinylestradiol and cyproterone (n=33), while the observation group was treated with metformin additionally (n=33). The levels of sex hormone (luteinizing hormone,testosterone),the indexes of fasting plasma glucose (FPG), fasting insulin (FINS) and homeostasis model assessment for insulin resistance (HOMA-IR) in the two groups were compared. The effects of ovulation induction were evaluated. Results The hormone levels of the observation group after treatment were lower than those of the control group (P<0.05); and the FPG, FINS and HOMA-IR levels of the observation group after treatment were lower than those of the control group (P<0.05); in addition,the ovulation rate of the observation group was 54.5% after treatment, which was higher than that of the control group (30.3%, P<0.05). Conclusion Metformin in the treatment of PCOS patients could greatly improve their sex hormone levels and blood glucose metabolism, promote ovulation rate, and has application value in the treatment of infertility caused by PCOS.
论著

神经导航辅助神经内镜经鼻蝶入路切除垂体瘤的疗效评价

Analysis of resection for pituitary tumors through transsphenoidal approach with endoscopic neuronavigation assisted

:67-70
 
目的 探讨神经导航辅助神经内镜经鼻蝶入路切除垂体瘤的疗效。方法 将2014年10月—2018年4月我院接诊的20例垂体瘤患者纳入本研究,按照随机数字表法均分为观察组和对照组各10例,对照组患者行常规神经内镜下经鼻蝶入路垂体瘤切除术,观察组患者行神经导航辅助神经内镜下经鼻蝶入路垂体瘤切除术,比较两组患者手术及术后住院情况(包括手术时间、术中出血量及术后住院时间)、手术效果(包括显效率和总有效率)、手术前后血清内分泌指标变化情况(包括GH、PRL水平)以及术后并发症情况(即术后并发症发生率)。结果 观察组患者手术时间、术中出血量及术后住院时间均低于对照组,差异有统计学意义(P<0.05);观察组显效率和总有效率均略高于对照组,但两组间手术效果并差异无统计学意义(P>0.05);观察组患者治疗后血清生长激素(GH)、催乳素(PRL)水平均低于对照组,差异有统计学意义(P<0.05);两组患者术后并发症发生率无统计学差异。结论 神经导航辅助神经内镜经鼻蝶入路切除垂体瘤疗效显著,手术时间短、术中出血少、术后恢复快,可明显改善患者内分泌指标,值得临床推荐。
Objective To evaluate the efficacy of resection for pituitary tumors through transsphenoidal approach with endoscopic neuronavigation assisted. Methods From October 2014 to April 2018, 10 patients with pituitary tumor were operated in our hospital with neuronavigation, which were set as the observation group. Meanwhile, 10 patients with pituitary tumor underwent surgical treating through transsphenoidal approach without neuronavigation were set as the control group. SPSS 19.0 were used for statistical analysis to compare the difference between the two groups, including the operation time, blood loss, hospitalization time, hormone level, clinical total efficiency, and complications in the two groups. Results The operation time, blood loss and hospitalization time of the observation group were less than that of the control group, and there was statistical significance (P<0.05). The efficiency rate and overall efficiency rate of the observation group were a little more than that of the control group, but there was no statistical significance (P>0.05). The level of growth hormone (GH) and prolactin (PRL) of the observation group were less than that of the control group, and there was statistical significance (P<0.05). And there was no statistical significance between the incidence rate of postoperative complications of the two groups. Conclusion The efficacy of resection for pituitary tumors through transsphenoidal approach with endoscopic neuronavigation is significant, which may shorten the course, reduce the blood loss, quicken recovery of a patient from operation, and improve the hormone level. It is worthy to be recommended to clinical application.
论著

醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效评价

Evaluation of curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy

:40-42
 
目的 探讨醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效。方法 选取我院2014年6月—2016年6月收治的76例脓毒症相关性脑病患者作为研究对象,按照随机数字表法将其分成两组,每组38例。观察组给予醒脑静联合连续肾脏替代疗法治疗,对照组给予连续肾脏替代疗法治疗,比较两组患者的临床疗效,治疗前后格拉斯哥昏迷(Glasgow coma scale,GCS)评分、神经元特异性烯醇化酶(neuron-specifie enolase,NSE)含量、C-反应蛋白(C-reactive protein,CRP)含量及治疗后退热时间、恢复意识时间的长短。结果 观察组总有效率为89.47%,相对于对照组明显上升(P<0.05);观察组治疗后GCS评分较对照组明显升高,NSE含量、CRP含量较对照组明显降低,差异均有统计学意义(P<0.01);观察组治疗后的退热时间、恢复意识时间较对照组明显降低(P<0.01)。结论 醒脑静联合连续肾脏替代疗法对脓毒症相关性脑病的疗效显著,可有效缩短退热及恢复意识时间,降低患者痛苦,值得临床推广应用。
Objective To investigate the curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy. Methods 76 cases of sepsis associated encephalopathy in our hospital from June 2014 to June 2016 were selected as the research objects, and they were divided into two groups according to the random number table method, 38 cases in each group. The observation group were treated with Xingnaojing combined with continuous renal replacement therapy. The control group was given continuous renal replacement therapy. The clinical efficacy of two groups were compared before and after treatment about the Glasgow coma (Glasgow coma scale, GCS) score, neuron specific enolase (neuron-specifie enolase, NSE) content, C- reactive protein (C-reactive protein, CRP)content, and the length of the consciousness recovery time and pyretolysis time. Results In the observation group, the total effective rate was 89.47%. Compared with the control group. it increased significantly (P<0.05); After treatment the GCS score in the observation group was significantly higher than the control group, the content of NSE and CRP were significantly lower than the control group, the differences were statistically significant (P<0.01); In the observation group, after treatment the pyretolysis time, consciousness recovery time was significantly lower than the control group(P<0.01). Conclusion The curative effect of Xingnaojing combined with continuous renal replacement therapy on sepsis associated encephalopathy is significant and may effectively shorten the pyretolysis and the recovery of consciousness time, which is worthy of clinical application.
论著

针刺解结法治疗颈性眩晕的临床疗效评价

Evaluation of the clinical effect of curing cervical vertigo with acupuncture thrawing method

:64-66
 
目的 探讨颈性眩晕应用针刺解结法治疗的临床疗效。方法 选取广东省中医院进修期间2016年3月—2016年9月收治的60例颈性眩晕患者,按照随机数字表法均分为两组。对照组:予以常规针刺治疗;观察组:在此基础上,行针刺解结法治疗。记录比较两组治疗前后基底动脉(BA)、左侧椎动脉(LVA)、右侧椎动脉(RVA)等部位的血流速度,改良颈性眩晕症状与功能评估量表(ESCV)总评分,临床疗效。结果 两组治疗后BA、LVA及RVA部位的血流速度,均明显高于治疗前(P<0.05);与对照组治疗后比较,观察组TCD检测参数改善幅度更为显著(P<0.01);与治疗前相比,两组治疗后改良ESCV总评分均显著更高(P<0.01);且观察组改善情况显著优于对照组(P<0.01);观察组总有效率为96.7%较对照组的76.7%相比,明显更高(P<0.05)。结论 颈性眩晕应用针刺解结法治疗更能有效改善脑部血液循环,缓解临床症状,提高生活质量,疗效显著,具有较高临床推广价值。
Objective To analyze the clinical effect of curing cervical vertigo with acupuncture thrawing method. Methods To select 60 patients with cervical vertigo in Cantonese Chinese Medicine Hospital from March 2016 to September 2016 as the research objects. According to the random number table method, they were randomly divided into the control group and the study group. The control group: treated with normal acupuncture; The observation group: plus with acupuncture thrawing method. We recorded and compared the blood flow velocity in the basilar artery(BA), the left vertebral artery(LVA) and the right vertebral artery(RVA), the overall score of the improved cervical Evaluation Scale for Cervical Vertigo(ESCV), and the clinical therapeutic effect of the two groups. Results After treatment, the blood flow velocity of the two groups in the basilar artery(BA), the left vertebral artery(LVA) and the right vertebral artery(RVA) was obviously higher than before treatment (P<0.05). Compared with the control group, the improvement level of TCD verifying arguments in the observation group was more significant (P<0.01). Compared with before treatment, the overall score of the improved ESCV in the two groups after treatment was significantly higher (P<0.01). And the improved conditions in the observation group were better than in the control group. The total effective rate 96.7% in the observation group was apparently higher than that of 76.7% in the control group (P<0.05). Conclusion Curing cervical vertigo with acupuncture thrawing method may improve the brain blood circulation, relieve clinical symptoms, enhance the living quality, which is a good way with evident clinic efficacy and higher clinical popularization value.
论著

布地奈德对支气管哮喘患者气道重塑及肺功能影响的疗效评价

Evaluation of Budesonide on airway remodeling and lung functionin in asthma

:31-32
 
目的 本研究通过检测吸入布地奈德治疗支气管哮喘患儿前、后气道重塑、肺功能及外周血TGF-β浓度的变化,探讨布地奈德在哮喘患儿气道重塑早期干预的作用。方法 将2013年1月—2014年10月在我院确诊为支气管哮喘患儿18例,给予规律吸入布地奈德治疗6个月,分别于治疗前、后检测肺功能、外周血TGF-β浓度以及通过高分辨CT(HRCT)测量支气管管壁厚度(T)并计算管壁面积(WA)、支气管管壁厚度与气管外径之比(WT%)、气道壁横截面面积占气道总截面积的的百分比(WA%)。结果 吸入布地奈德治疗治疗6个月后,哮喘患儿WT%、WA%、肺功能以及TGF-β浓度均明显改善,与治疗前比较差异有统计学意义(P<0.05)。结论 规律吸入布地奈德治疗能减轻支气管哮喘患儿早期气道重塑,改善肺功能,可能通过下调细胞因子TGF-β的表达有关。
Objective We detected the changes of Airway remodeling,lung function and peripheral blood concentrations of TGF-β in asthmatic children before and after inhaled budesonide, and explored the role of budesonide in airway remodeling before early intervention in asthmatic children. Methods 32 cases of children were diagnosed asthma in our hospital,and given treatment of inhaled budesonide for 6 months, and to detect lung function,pheral blood TGF-β concentration as well as measuring the bronchial wall thickness (T) and calculate the wall area (WA), the outer diameter of the trachea and bronchial wall thickness ratio (WT%), the cross-sectional area of the airway wall accounted for airway percentage (WA%) of the total cross-sectional area by high-resolution CT (HRCT) before and after treatment. Results After treatment with inhaled budesonide in six months, the asthma WT%, WA%, lung function, and TGF-β concentrations were significantly improved, the differences compared with that before treatment were statistically significant(P<0.05). Conclusion The treatment of inhaled budesonide can alleviate asthmatic airway remodeling in early, improve lung function,possibly related to down the expression TGF-β.
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