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《广州医药》编辑部

广州医药杂志服务号
医学教育

医工融合教育的创新路径与实践:以广州医科大学跨学科协同培养复合型人才为例

Innovative pathways and practices of medical-engineering integrated education:A case study on interdisciplinary collaboration cultivation of compound talents at Guangzhou Medical University

:651-656
 
       在“健康中国2030”战略框架下,医工融合已成为推动医疗技术创新与复合型医学人才培养的关键路径。“三维协同”教育体系:课程维度打造“基础模块—交叉课程—项目实训”渐进式矩阵;实践维度建立校企共建实验室与临床转化基地的产教融合平台;师资维度创新“临床医师+工程师+科研导师”三师型导师协同机制。基于广州医科大学等高校的实证分析,该模式显著提升了学生跨学科创新能力与工程实践转化能力。研究进一步提出“政产学研用”五螺旋发展模型,倡导通过建立医工融合特区、构建智能医疗科研共享平台、完善学科交叉质量评价体系等策略,为“新医科”建设提供理论范式与实践路径。本研究为医学教育改革提供了系统化、可复制的解决方案,对推进健康中国战略实施具有重要理论与实践意义。

      Under the framework of the “Healthy China 2030” strategy,the integration of medicine and engineering has become a key path to promoting medical technological innovation and the cultivation of interdisciplinary medical talents.This study has constructed a “three-dimensional synergy” education system:in the curriculum dimension,a progressive matrix of “basic modules - cross-disciplinary courses - project training” is created;in the practical dimension,a platform for industry-education integration is established through the joint construction of university-enterprise laboratories and clinical transformation bases;in the faculty dimension,an innovative “Clinician + Engineer + Research mentor” tripartite mentorship collaboration mechanism is developed.Based on empirical analysis from universities such as Guangzhou Medical University,this model has significantly enhanced students’ cross-disciplinary innovation capabilities and engineering practice transformation abilities.The study further proposes a “government-industry-academia-research-application” five-spiral development model,advocating strategies such as establishing special zones for medicine-engineering integration,building intelligent medical research sharing platforms,and improving the quality evaluation system for interdisciplinary studies,to provide theoretical paradigms and practical paths for the construction of “new medicine”.This research offers a systematic and replicable solution for medical education reform and holds significant theoretical and practical significance for the implementation of the Healthy China strategy.

专题:体重管理

体成分变化对肥胖患者肾小球高滤过的影响

The impact of alterations in body composition on glomerular hyperfiltration in obese patients

:671-678
 
       目的 探究体成分变化对肥胖患者肾小球高滤过的影响。方法 根据纳入排除标准,连续收集在中南大学湘雅二医院营养科及代谢内分泌科就诊的肥胖患者(体质指数≥28 kg/m2),对其随访3个月以上,纳入体质量减轻≥5%的患者,记录一般人口学、人体测量学、体脂率(BFP)、体脂肪量(BFM)、内脏脂肪面积(VFA)和骨骼肌量(SMM)等体成分和实验室检验数据,计算估计肾小球滤过率(eGFR)。肾小球高滤过被定义为eGFR大于普通人群第95个百分位数,根据此标准分为肾小球高滤过组和正常滤过组,比较组间一般人口学资料、生化指标及体成分的差异,绘制限制性立方样条图分析体成分的变化与eGFR变化之间的非线性关联。结果 (1)共收集85例肥胖患者初复诊资料,其中肾小球正常滤过患者43例,肾小球高滤过患者42例,男性35例,女性50例;(2)单因素分析提示肾小球高滤过患者减重前后eGFR差异有统计学意义[143.34 mL/(min·1.73 m2 vs 125.68 mL/(min·1.73 m2);(3)非线性相关分析结果显示肥胖肾小球高滤过患者eGFR的变化与VFA的变化相关(P=0.015 1),与BFP的变化相关(P=0.022 6)。结论 肥胖患者减重后,随着VFA和BFP的下降可能改善肾小球高滤过。
    Objective This study aimed to investigate the impact of alterations in body composition on glomerular hyperfiltration in obese patients.Methods According to predefined inclusion and exclusion criteria,obese patients(body mass index ≥28 kg/m2)from the department of clinical nutrition and the department of metabolism and endocrinology at Second Xiangya Hospital of Central South University were consecutively enrolled.Patients who achieved a weight loss of ≥5% after more than three months of follow-up were included.Data on general demographics,anthropometric measurements,body composition parameters-including body fat percent(BFP),body fat mass(BFM),visceral fat area(VFA),and skeletal muscle mass(SMM)-and laboratory test results were collected.The estimated glomerular filtration rate(eGFR)was calculated.Glomerular hyperfiltration was defined as an eGFR greater than the 95th percentile for the general population.Based on this criterion,patients were categorized into a hyperfiltration group and a normofiltration group.Differences in demographic characteristics,biochemical indices,and body composition parameters between the two groups were compared.Restricted cubic spline curves were plotted to analyze the non-linear relationship between changes in body composition and changes in eGFR.Results (1)A total of 85 obese patients(35 males and 50 females) with initial and follow-up data were included,comprising 43 patients with normofiltration and 42 with hyperfiltration;(2)Univariate analysis indicated a statistically significant difference in eGFR before and after weight loss in the hyperfiltration group(143.34 mL/min/1.73m2 vs 125.68 mL/min/1.73m2P<0.001);(3)Non-linear correlation analysis revealed that changes in eGFR among obese patients with hyperfiltration were significantly associated with changes in VFA(P=0.015 1)and changes in BFP(P=0.022 6).Conclusions Weight loss in obese patients may ameliorate glomerular hyperfiltration,potentially mediated through reductions in VFA and BFP.
论著

多组分运动训练对老年 COPD 稳定期病人骨骼肌功能的影响

The effect of multi-component exercise training on skeletal muscle function in elderly patients with stable COPD

:345-351
 
       目的  探讨多组分运动训练对老年慢性阻塞性肺疾病(COPD)稳定期病人骨骼肌功能的影响。方法 瞻性选择2022年10月—2024年10月90例COPD稳定期患者,采用抽签法随机分为观察组与对照组,对照组45例采取常规运动干预,观察组45例在对照组基础上增加多组分运动训练。干预前、干预后3个月比较两组患者四肢骨骼肌含量,四肢肌群力量,运动耐力与肺功能,生活质量。结果 干预后,两组上肢、下肢骨骼肌含量均略增加,观察组高于对照组(P<0.05);干预后,两组膝伸肌、膝屈肌、肘伸肌、肘屈肌肌群力量均增加,观察组高于对照组(P<0.05);干预后,两组6 min步行试验、用力肺活量及第一秒用力呼气量均升高,观察组高于对照组(P<0.05);干预后,两组圣乔治呼吸问卷各维度分数及总分均降低,观察组低于对照组(P<0.05)。结论  针对老年COPD稳定期患者采取多组分运动训练可提升患者四肢骨骼肌含量与四肢肌群力量,改善患者运动耐力与肺功能,减轻COPD及骨骼肌功能障碍对患者生活质量造成的负面影响。
        Objective  To explore the effect of multi-component exercise training on skeletal muscle function in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods  From October 2022 to October 2024,90 stable COPD patients were prospectively selected and randomly divided into an observation group and a control group using a lottery method.The control group consisted of 45 patients who received routine exercise care,while the observation group  consisted of 45 patients who received multi-component exercise training in addition to the routine care.Skeletal muscle content,muscle group strength,exercise endurance,lung function,and quality of life between two groups of patients were compared before and three months after intervention.Results  After intervention,the skeletal muscle content of both upper and lower extremities slightly increased in both groups,with the observation group  being higher than the control group(P<0.05).After intervention,the strength of the knee extensor,knee flexor,elbow extensor,and elbow flexor muscle groups increased in both groups,with the observation group  had better results than the control group(P<0.05).After intervention,both groups showed an increase in six-minute walking test,forced vital capacity,and forced expiratory volume in first second,with the observation group  had better  results than the control group(P<0.05).After intervention,the scores of each dimension and total score of the SGRQ in both groups decreased,and the observation group had lower scores than the control group(P<0.05).Conclusions  Multi-component exercise training for stable elderly COPD patients can improve the skeletal muscle content and muscle strength of the extremities,enhance exercise endurance and lung function,and alleviate the negative impact of COPD and skeletal muscle dysfunction on patients’quality of life.
论著

多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭并发衰弱患者的效果

The effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure and frailty

:202-208
 
       目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭(CHF)并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低(P<0.05)。与对照组相比,观察组干预后左室射血分数(LVEF)水平明显更高,超敏心肌肌钙蛋白T(hs-cTnT)、N末端B型利钠肽前体(NT-proBNP)、左室舒张末期内径(LVEDD)水平更低(P<0.05)。与对照组相比, 观察组干预后主观整体营养状况评价表(PG-SGA)评分明显更低,血红蛋白(Hb)、前白蛋白(PA)、白蛋白(ALB)水平更高(P<0.05)。与对照组相比,观察组干预后症状、身体、情感及总分更低(P<0.05)。观察组不良事件发生率(1.96%)低于对照组(15.69%)(P<0.05)。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。
       Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure(CHF)and frailty.Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included. According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention.The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups.Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention(P<0.05).Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention(P<0.05).Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention(P<0.05).Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention(P<0.05).The incidence of adverse events in the observation group(1.96%)was lower than that in the control group(15.69%)(P<0.05).Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events.
临床研究

儿童颈内静脉血液透析临时导管原位换管的应用及效果观察

Application and effect observation of in situ replacement of temporary catheter of internal jugular vein hemodialysis in children

:198-202
 
目的 通过对原位换管与首次置管比较,验证采用原位换管方式的可行性。方法 选取儿童肾内科先后采用了首次置管与原位换管的病例20例。将原位换管作为原位换管组,首次置管作为首次置管组,比较两组操作成功有效率、导管留置天数、最大血流速/体质量[mL/(min·kg)]、操作并发症的差异。结果 两组均一次性穿刺成功,两组在管道留置天数和血流速/体质量[mL/(min·kg)]及并发症比较差异均无统计学意义(P>0.05)。结论 原位换管与首次置管的效果相同,原位换管操作简单、对患者的损伤更小。
论著

复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的安全性及疗效分析

Efficacy and safety analysis of compound brain peptide ganglioside injection combined with alteplase intravenous thrombolysis in the treatment of acute ischemic stroke

:306-310
 
目的 探讨复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效。方法 选择2019年6月—2023年1月在河南省许昌中医院诊治的79例缺血性脑卒中患者,按照入院就诊顺序采用奇偶法把患者分为联合组40例与传统组39例。传统组给予阿替普酶静脉溶栓治疗,联合组给予复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗,评价与记录联合组与传统组的疗效与安全性及治疗前、治疗14 d后Fugl-Meyer评定量表(FMA)与改良版Banhel评价指数(MBI)、血清β-内啡肽、前列腺素E2(PGE2)水平变化。结果 治疗14 d后联合组的总有效率更高(97.5% vs 82.1%,P<0.05),并发症发生率更低(5.0% vs 20.5%,P<0.05)。联合组与传统组治疗14 d后的FMA与MBI评分高于治疗前(P<0.05),联合组治疗14 d后的FMA评分、MBI评分比传统组提高(P<0.05)。联合组与传统组治疗14 d后的血清β-内啡肽、PGE2水平低于治疗前(P<0.05),联合组治疗14 d后的血清β-内啡肽、PGE2水平低于传统组(P<0.05)。结论 复方脑肽节苷脂注射液联合阿替普酶静脉溶栓治疗急性缺血性脑卒中能提高效果,降低患者的肺部感染、尿路感染、静脉血栓、褥疮等并发症发生率,改善患者的运动与日常生活功能,还可降低患者血清β-内啡肽、PGE2水平。
Objective To explore and analysis the efficacy and safety of compound brain peptide ganglioside injection combined with alteplase intravenous thrombolysis in the treatment of acute ischemic stroke. Methods From June 2019 to January 2023,79 patients with ischemic stroke who were diagnosed and treated at Henan Xuchang Traditional Chinese Medicine Hospital were selected as the research subjects.According to the order of admission,the patients were divided into the combination group of 40 cases and the traditional group of 39 cases.The traditional group received intravenous thrombolytic therapy with alteplase,while the combination group received treatment with compound brain peptide ganglioside injection on the basis of the traditional group.The efficacy and safety and changes of the Fugl-Meyer rating Scale(FMA)and modified Banhel Evaluation Index(MBI),serum β-endorphin,and PGE 2 levels in the combined and traditional groups were evaluated and recorded. Results After 14 days of treatment,the combined group had a higher overall response rate(97.5% vs 82.1%,P<0.05)and a lower complication rate(5.0% vs 20.5%,P<0.05).FMA scores and MBI scores of the two groups after 14 days of treatment were higher than those before treatment(P<0.05),and FMA scores and MBI scores of the combined group after 14 days of treatment were higher than those of the traditional group(P<0.05).The contents of β-endorphin and prostaglandin E2 in two groups after 14 days of treatment were lower than those before treatment(P<0.05),and the contents of β-endorphin and prostaglandin E2 in combination group after 14 days of treatment were lower than those in traditional group(P<0.05). Conclusions The combination of compound brain peptide ganglioside injection and alteplase intravenous thrombolysis in the treatment of acute ischemic stroke can improve the treatment effect,reduce the incidence of complications such as pulmonary infections,urinary tract infections,venous thrombosis and bedsores in patients,improve patients' motor and daily life functions,and also reduce patients' serum levels of β-endorphins and prostaglandin E2.
论著

成分输血治疗羊水栓塞所致DIC的疗效分析

Analysis of therapeutic effect of component blood transfusion on DIC caused by amniotic fluid embolism and review of literature

:267-273
 
目的 分析我院羊水栓塞患者的临床资料及诊治经过,总结羊水栓塞致弥散性血管内出血(DIC)患者输血治疗救治经验。方法 回顾性分析2016年1月1日—2022年12月31日在广州医科大学附属第二医院番禺院区分娩并发羊水栓塞患者的症状、实验室辅助检查、用药诊治经过及妊娠结局。结果 在6 104次孕晚期分娩记录中,共发生3例羊水栓塞,高龄产妇1例、经产妇2例、多产1例。3例均并发DIC,产后出血1 500~3 000 mL。其中1例行子宫切除术,2例保留子宫,均抢救成功,无患者死亡。结论 根据有限数据推论羊水栓塞罕见、凶险,病情进展快,多继发产后出血、DIC,主要依靠临床表现进行诊断,早期识别诊断和处理,产科快速反应团队及多学科协作,给予高级生命支持,有效止血并科学地成分输血纠正凝血功能障碍及DIC,是改善孕产妇结局的关键。
Objective To analyze the clinical data,diagnosis and treatment of patients with amniotic fluid embolism in our hospital,and to summarize the experience of blood transfusion treatment for disseminated intravascular coagulation(DIC) patients with amniotic fluid embolism. Methods From January 1,2016 to December 31,2022,the symptoms,laboratory tests,drug treatments and pregnancy outcomes of patients with amniotic fluid embolism during delivery in Panyu Hospital,the Second Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. Results There were 3 cases of amniotic fluid embolism in 6 104 late pregnancy records,accounting for 1/3 of the elderly parturients,2/3 of the multiparas and 1/3 of the prolific parturients.All three cases had DIC and postpartum hemorrhage of 1 500-3 000 mL.Among them,1 case underwent hysterectomy and 2 cases saved the uterus,all of which were successfully rescued without death. Conclusions Amniotic fluid embolism is rare,dangerous disease with rapid progression,often followed by secondary postpartum hemorrhage and DIC,and mainly relies on clinical manifestations for diagnosis.Early identification,diagnosis and treatment,rapid response team in obstetrics and multidisciplinary collaboration,advanced life support,effective hemostasis and scientific component blood transfusion to correct coagulation dysfunction and DIC,are the keys to improve maternal outcomes.
论著

纤维桩联合复合树脂及氧化锆烤瓷冠修复在根管治疗后后牙楔状缺损患者中的应用效果

Effect of fiber post combined with composite resin and zirconia porcelain crown on the posterior wedge-shaped defects after root canal therapy

:377-381
 
目的 探究纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗根管治疗(RCT)后后牙楔状缺损(WSD)的效果。方法 选取2019年8月—2022年8月在新乡市口腔医院治疗的300例(300牙)RCT后后牙WSD患者,按随机数字表法分成A组(n=150)、B组(n=150)。A组接受纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗,B组接受金属烤瓷冠(PFM)联合金属桩核(MPC)修复治疗。对比2组修复成功率、修复效果、修复前后牙周健康指标[牙龈指数(GI)、菌斑指数(PLI)、牙周探诊深度(PD)]、龈沟液炎性因子[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]水平。结果 A组修复成功率为97.33%(146/150),高于B组的87.33%(131/150)(P<0.05);A组边缘密合性、表面质地、颜色匹配均优于B组(P<0.05);修复6个月后A组GI、PLI、PD较B组低(P<0.05);修复1个月后A组龈沟液TNF-α、IL-6水平较B组低,IL-10水平较B组高(P<0.05)。结论 与PFM联合MPC修复治疗RCT后后牙WSD患者相比,应用纤维桩联合复合树脂及氧化锆烤瓷冠修复治疗更有助于提升修复成功率及修复效果,改善牙周健康,且对组织产生创伤更小。
Objective To investigate the restorations outcome of fibre post + composite resin + zirconia porcelain crown for patients with wedge-shaped defects(WSD)in posterior teeth after root canal therapy(RCT).Methods A total of 300 patients(300 teeth)with posterior WSD after RCT in our hospital(from August 2019 to August 2022)were selected and divided into group A(n=150)and group B(n=150)according to random number table method.Group A received composite resin + zirconia porcelain crown + fiber post repair treatment,while group B received porcelain fused to metal(PFM)+ metal post core(MPC)repair treatment.The success rate of repair,the effect of repair,the periodontal health indicators before and after repair[gingival index(GI),plaque index(PLI),periodontal probing depth(PD)],and the levels of gingival creval fluid inflammatory factors[interleukin-6(IL-6),IL-10,tumor necrosis factor-α(TNF-α)] were compared between the two groups.Results The success rate of repair in group A was 97.33%(146/150),higher than 87.33%(131/150)of group B(P<0.05).The edge tightness,surface texture and color matching of group A were better than those of group B(P<0.05).After 6 months of repair,GI,PLI and PD in group A were lower than those in group B(P<0.05).After one month of repair,the contents of TNF-α and IL-6 in gingival crevicular fluid of group A were lower than those of group B,and the contents of IL-10 were higher than those of group B(P<0.05).Conclusions Compared with PFM+MPC in the treatment of posterior WSD patients after RCT,the application of composite resin + zirconia porcelain crown + fiber post repair is more helpful to improve the success rate and effect of repair,improve periodontal health,and cause less tissue trauma.
论著

复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期患者的疗效及安全性研究

Study on the efficacy and safety of compound licorice oral liquid combined with prednisone in the treatment of patients with acute exacerbation of idiopathic pulmonary interstitial fibrosis

:1177-1182
 
目的 探讨复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期患者的疗效。方法 选取张掖市第二人民医院2020年1月—2023年10月收治的128例特发性肺间质纤维化急性加重期患者,应用随机数字表法分为两组,每组各64例。对照组采取泼尼松治疗,观察组采取复方甘草口服液联合泼尼松治疗。对比其临床疗效,治疗前后血清肺纤维化指标及炎症因子水平,最后对比其不良反应发生率。结果 观察组总有效率93.75%,高于对照组的79.69%(χ2=5.490,P=0.019);治疗前两组层黏连蛋白(LN)、Ⅲ型前胶原肽(PC-Ⅲ)、透明质酸(HA)对比差异无统计学意义(P>0.05),治疗后两组患者LN、PC-Ⅲ、HA均降低,观察组[(89.25±7.61)μg/L;(68.33±7.68)mg/L;(81.53±8.54)μg/L]低于对照组[(96.17±8.34)μg/L;(75.68±8.25)mg/L;(95.68±9.25)μg/L],对比差异有统计学意义(t1=4.903,P1<0.001;t2=5.217,P2<0.001;t3=8.992,P3<0.001);治疗前两组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、IL-10、转化生长因子(TGF-β1)对比差异无统计学意义(P>0.05),治疗后两组TNF-α、IL-4、IL-10、TGF-β1水平降低,观察组[(61.94±8.24)ng/L;(4.43±1.17)ng/mL;(65.49±13.24)g/L;(114.73±13.12)pg/mL]低于对照组[(75.52±9.43)ng/L;(6.31±1.28)ng/mL;(79.27±9.38)g/L;(147.76±15.46)pg/mL],对比差异有统计学意义(t1=8.675,P1<0.001;t2=8.673,P2<0.001;t3=6.794,P3<0.001;t4=13.032,P4<0.001);两组不良反应发生率对比差异无统计学意义(7.81% vs 6.25%,χ2=0.120,P=0.730)。结论 复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期疗效显著,可辅助延缓患者肺纤维化发展进程,减轻机体炎症反应,安全性较高。
Objective To investigate the efficacy of compound licorice oral liquid combined with prednisone in patients with acute exacerbations of idiopathic pulmonary interstitial fibrosis. Methods A total of 128 patients with acute exacerbation of idiopathic pulmonary interstitial fibrosis admitted to Zhangye Second People's Hospital from January 2020 to October 2023 were divided into two groups by random number table method,with 64 patients in each group.The control group received prednisone treatment,while the observation group received compound licorice oral liquid combined with prednisone treatment.Compare its clinical efficacy,serum pulmonary fibrosis indicators and inflammatory factor levels before and after treatment,and finally compare its incidence of adverse reactions. Results The total response rate in the observation group was 93.75%,which was higher than the 79.69% in the control group(χ2=5.490,P=0.019).There was no difference between the two groups of LN,PC-III,and HA(P>0.05),LN,PC-III and HA were decreased in both groups,while the observation group[(89.25±7.61)μg/L;(68.33±7.68)mg/L;(81.53±8.54)μg/L] was lower than the control group[(96.17±8.34)μg/L;(75.68±8.25)mg/L;(95.68±9.25)μg/L],the contrast difference was statistically significant(t1=4.903,P1<0.001;t2=5.217,P2<0.001;t3=8.992,P3<0.001).There was no difference in TNF-α,IL-4,IL-10,and TGF-β1 between the two groups before treatment(P>0.05),lower levels of TNF-α,IL-4,IL-10,and TGF-β1 in the two patient groups after treatment,the observation group[(61.94±8.24)ng/L;(4.43±1.17)ng/mL;(65.49±13.24)g/L;(114.73±13.12)pg/mL] was lower than the control group[(75.52±9.43)ng/L;(6.31±1.28)ng/mL;(79.27±9.38)g/L;(147.76±15.46)pg/mL],the contrast difference was statistically significant(t1=8.675,P1<0.001;t2=8.673,P2<0.001;t3=6.794,P3<0.001;t4=13.032,P4<0.001).There was no difference in the incidence of adverse effects between the two groups(7.81% vs 6.25%,χ2=120,P=0.730). Conclusions The combination of compound licorice oral liquid and prednisone has a significant therapeutic effect on the acute exacerbation of idiopathic pulmonary interstitial fibrosis.It can assist in delaying the progression of pulmonary fibrosis in patients,reducing the body's inflammatory response,and has high safety.
论著

复方甘草酸苷联合卡泊三醇乳膏治疗寻常型银屑病的效果观察

The effect of compound glycyrrhizin and caspotriol cream in treating psoriasis vulgaris

:1172-1176
 
目的 探讨复方甘草酸苷联合卡泊三醇乳膏治疗寻常型银屑病的效果观察。方法 选取辽健集团阜新矿总医院2019年12月—2022年12月收治的96例寻常型银屑病患者,分为联合组与对照组,每组48例。对照组使用卡泊三醇乳膏治疗,联合组在对照组基础上联用复方甘草酸苷治疗,对比临床疗效,以皮质含量、经表皮水分流失(TEWL)、角质层水含量变化评价患者的皮肤屏障功能,并对比两组患者治疗前后T细胞相关炎症因子表达水平。结果 联合组治疗总有效率较对照组高[93.75% vs 77.08%,χ2=5.352,P=0.021];治疗后两组皮质含量、角质层水含量升高,联合组高于对照组,TEWL降低,联合组低于对照组[皮质含量:(73.59±7.24)μg/cm2 vs(110.12±13.64)μg/cm2,t=16.389,P<0.001;角质层水含量:(25.28±3.25)% vs(16.24±2.14)%,t=16.095,P<0.001;TEWL:(8.06±1.44)g/(h·m2)vs(11.71±2.68)g/(h·m2),t=8.312,P<0.001];治疗后两组患者白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、γ干扰素(IFN-γ)表达水平均降低,且联合组低于对照组[IL-2:(22.25±3.32)vs(26.62±3.24)pg/mL,t=6.661,P<0.001;IL-6:(80.46±5.11)vs(112.62±12.16)pg/mL,t=16.892,P<0.001;IFN-γ:(68.62±10.73)vs(51.26±6.37)ng/L,t=9.639,P<0.001]。结论 复方甘草酸苷联合卡泊三醇乳膏可改善寻常型银屑病皮肤屏障功能,降低炎症因子,改善Th1/Th2细胞因子失衡情况。
Objective To investigate the effect of compound glycyrrhizin and caspotriol cream in psoriasis vulgaris. Methods The 96 psoriasis patients admitted to Fuxin Mine General Hospital from December 2019 to December 2022 were selected and divided into combined group and control group,with 48 patients in each group.The control group was treated with caspotriol cream,the combined group treated with compound glycyrrhizin treatment,the clinical efficacy was compared,and the skin barrier function of patients was evaluated by cortical content,transepidermal water loss(TEWL),and changes in stratum corneum water content.The expression levels of T cell related inflammatory factors before and after treatment were compared between the two groups. Results The overall effective treatment rate in the combined group was higher than in the control group[93.75% vs 77.08%,χ2=5.352,P=0.021].After treatment,cortical and stratum corneum water levels increased in both groups,with the combined group being higher than the control group.TEWL decreased and the combined group was lower than the control group[cortical content:(73.59±7.24)μg/cm2 vs(110.12±13.64)μg/cm2,t=16.389,P<0.001;water content in the stratum corneum:(25.28±3.25)% vs(16.24±2.14)%,t=16.095,P<0.001;TEWL:(8.06±1.44)g/(h·m2)vs(11.71±2.68)g/(h·m2),t=8.312,P<0.001].After treatment,two groups of patients were treated with interleukin-2(IL-2),interleukin-6(IL-6) and interferon(IFN)-γ,and the combined group was lower than the control group[IL-2:(22.25±3.32)pg/mL vs(26.62±3.24)pg/mL,t=6.661,P<0.001;IL-6:(80.46±5.11)pg/mL vs(112.62±12.16)pg/mL,t=16.892,P<0.001;IFN-γ:(68.62±10.73)ng/L vs(51.26±6.37)ng/L,t=9.639,P<0.001]. Conclusions The combination of compound glycyrrhizin and carpotriol cream can improve the skin barrier function of psoriasis vulgaris,reduce inflammatory factors,and improve the imbalance of Th1/Th2 cytokines.
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