目的 观察早期经鼻肠内营养(ENEN)对中-重度急性胰腺炎(MSAP+SAP)患者的治疗效果。方法 回顾性分析2014年9月—2019年5月期间,广东药科大学附属第一医院消化内科收治的50例MSAP及SAP患者临床资料,根据患者营养支持治疗方式不同,将患者分为观察组(n=25)和对照组(n=25)。观察组患者采用ENEN治疗,对照组采用肠外肠内营养联合(PNEN)治疗。对比两组患者治疗后血清白蛋白(ALB)、血清前白蛋白(PA)、C-反应蛋白(CRP)、急性生理与慢性健康(APACHE Ⅱ)评分、序贯器官功能衰竭(SOFA)评分及多器官功能障碍综合征(MODS)发生率。结果 经过治疗后,观察组患者ALB水平、PA水平高于对照组,CRP水平低于对照组,差异有统计学意义(P＜0.05)。经过治疗后,观察组患者APACHE Ⅱ评分、SOFA评分低于对照组,差异有统计学意义(P＜0.05)。经过治疗后,观察组患者MODS发生率低于对照组,差异有统计学意义(P＜0.05)。结论 ENEN治疗MSAP及SAP患者可有效改善患者营养状态和健康状况,降低机体炎症反应,减少MODS发生率。

Objective To observe the effect of early nasal enteral nutrition(ENEN) on patients with moderate to severe acute pancreatitis(MSAP+SAP). Methods A retrospective analysis of the clinical data of 58 patients with(MSAP+SAP) admitted to the department of gastroenterology, the First Affiliated Hospital of Guangdong Pharmaceutical University from September 2014 to May 2019, according to the different nutritional support treatment methods, the patients were divided into observation groups(n=25) and control group(n=25). Patients in the observation group were treated with ENEN, and the control group was treated with Parenteral nutrition and enteral nutrition(PNEN). Serum albumin(ALB), serum prealbumin(PA), C-reactive protein(CRP), acute physiology and chronic health evaluation(APACHE II) score, sequential organ failure assessment(SOFA) score, and incidence of multiple organ dysfunction syndrome(MODS) were compared between the two groups. Results After treatment, the ALB and PA level of the observation group were higher than those of the control group, and the CRP level was lower than that of the control group, the difference was statistically significant(P<0.05). After treatment, the APACHE II score and SOFA score of the observation group were lower than those of the control group, and the difference was statistically significant(P<0.05). After treatment, the incidence of MODS in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion ENEN treatment of MSAP and SAP may effectively improve the nutritional status and health of patients, reduce the body's inflammatory response and reduce the incidence of MODS.

目的 研究我院自拟肿痛消方中药离子导入联合关节镜手术治疗膝骨性关节炎的疗效。方法 将76 例膝骨性关节炎患者分为2组,即肿痛消方离子导入联合关节镜组和单纯关节镜组,在治疗前、后分别对两组患者进行Lysholm膝关节功能评分。结果 肿痛消方联合关节镜手术治疗对膝骨性关节炎的治疗效果有明显的提高,总有效率达到92.11%,高于对照组。结论 肿痛消方联合关节镜手术治疗对膝骨性关节炎具有良好的治疗效果。可明显降低患者的疼痛感,改善膝关节功能,促进骨关节的恢复。

Objective To study the effect of Zhongtongxiao formula combined with arthroscopy in the treatment of knee osteoarthritis. Methods 76 patients with knee osteoarthritis were divided into two groups, namely, the group of Zhongtongxiao square ion-implantation combined with arthroscopy and the group of arthroscopy alone. Lysholm knee function scores were performed on the two groups before and after treatment. Results The therapeutic effects of Zhongtongxiao formula combined with arthroscopic surgery on knee osteoarthritis were improved, the total effective rate was 92.11%, higher than the control group. Conclusion Zhongtongxiao formula combined with arthroscopy has good therapeutic effect on knee osteoarthritis.It can obviously reduce the pain of patients, improve the function of knee joint and promote the recovery of bone and joint.

目的 探讨运用李可老中医学术思想,从“中气”论治术后肠梗阻的疗效。方法 采用前瞻性临床观察队列研究方法,选择82例术后肠梗阻患者,按照随机化原则平均分为两组:观察组为西医治疗基础上,联合从“中气”论治应用方剂,对照组为单纯西医治疗。结果 观察组的有效率为95.12%,首次排气时间为(12.46±2.75)h,首次排便时间为(31.52±5.38)h,腹痛腹胀完全消失时间为(15.71±3.57)h,平均住院时间为(18.69±3.82)d;对照组的有效率为73.17%,首次排气时间为(36.57±2.75)h,首次排便时间为(62.39±5.73)h,腹痛腹胀完全消失时间为(42.58±8.27)h,平均住院时间为(25.95±5.84)d;有效率对比,观察组高于对照组(P＜0.05),观察组症状改善时间较对照组明显缩短(P＜0.05)。结论 对于术后肠梗阻的治疗,西医联合从“中气”论治疗效优于单纯西医治疗。

Objective To explore the therapeutic effect on postoperative ileus with Li Ke's academic thought of traditional Chinese medicine: by mediating the Qi in the middle energizer(Stomach and Spleen). Methods Using prospective clinical observation cohort study, 82 patients with postoperative ileus were randomly divided into two groups on average: the observation group was treated with Western medicine and Chinese medicine decoction in which prescribed by the principle of mediating the Qi in the middle energizer(stomach and spleen). while the control group was treated with Western medicine only. Results The effective rate of the observation group was 95.12%, the average time of first farting of the patients was(12.46±2.75) h, the average time of first defecation was (31.52±5.38)h, the average time of complete disappearance of abdominal pain and abdominal distension was (15.71±3.57) h, and the average hospital stays was (18.69±3.82) d. In the control group, the effective rate was 73.17%, the average time of first farting of the patients was (36.57±2.75)h, the average time of first defecation was (62.39±5.73)h, the average time of complete disappearance of abdominal pain and abdominal distension was (42.58±8.27)h, and the average hospital stays was (25.95±5.84)d. Compared with the control group, the effective rate was higher in the observation group (P <0.05), and the symptom improvement time in the observation group was shorter than that in the control group (P <0.05). Conclusion For the treatment of postoperative ileus, western medicine combined with Chinese medicine decoction in which prescribed by the principle of mediating the Qi in the middle energizer(stomach and spleen) is better than Western medicine only.

目的 探讨四金石灵膏联合间苯三酚治疗输尿管结石伴肾绞痛的应用价值。方法 随机将76例输尿管结石伴肾绞痛患者分为两组,以接受中药安慰剂联合间苯三酚治疗者为对照组,以接受四金石灵膏联合间苯三酚治疗者为观察组,每组38例。对比两组临床治疗效果,并分析尿液相关指标的变化情况。结果 两组7 d治疗过程中VAS评分及尿Ga水平呈降低趋势、WHOQL-BREF评分及尿OPN水平呈升高趋势(P<0.05),而治疗3 d及7 d后,治疗组VAS评分及尿Ga水平低于对照组、WHOQL-BREF评分及尿OPN水平高于对照组(P<0.05)。同时,治疗7 d后,观察组排石率高于对照组(P<0.05),而观察组排石时间及止痛时间短于对照组(P<0.05)。此外,治疗7 d后,治疗组治疗总有效率高于对照组(P<0.05),而两组间治疗不良反应发生率比较未见差异有统计学意义(P>0.05)。结论 四金石灵膏联合间苯三酚可有效的提高输尿管结石伴肾绞痛的临床治疗效果,具有较为理想的应用价值。

Objective To explore the application value of four-gold-stone-ling confection and phloroglucinol in the treatment of ureteral calculus with renal colic. Methods 76 patients with ureteral calculus with renal colic were randomly divided into two groups, with those receiving traditional Chinese medicine placebo combined with phloroglucinol as the control group, and those receiving four-gold-stone-ling confection combined with phloroglucinol as the observation group,38 cases in each group. The clinical treatment effects of the two groups were compared, and the changes of urine-related indicators were analyzed. Results The VAS score and urine Ga level of the two groups showed a decreasing trend during 7d treatment, and the WHOQL-BREF score and urine OPN level showed an increasing trend(P<0.05). After 3d and 7d treatment, the VAS score and urine Ga level of the treatment group were lower than that of control group, the WHOQL-BREF score and urine OPN level were higher than that of control group(P<0.05). Meanwhile, After 7d of treatment, the rate of stone drainage in the observation group was higher than that of control group(P<0.05), while the time of stone drainage and pain relief in the observation group was shorter than control group(P<0.05). In addition, after 7d treatment, the total effective rate of the treatment group was higher than control group (P<0.05), while the difference of incidence of adverse reactions between the two groups was not significant(P>0.05). Conclusion Four-gold-stone-ling confection combined with phloroglucinol may effectively improve the clinical effect of ureteral calculi with renal colic, and have ideal application value.

目的 探讨尿清舒颗粒治疗泌尿系统感染伴有尿路结石的疗效。方法 选取我院2015年1月—2017年1月收治的80例泌尿系统感染伴有尿路结石患者纳入研究对象,以随机数表法分为观察组与对照组,各40例。对照组静脉滴注亚胺培南-西司他丁进行治疗,观察组在对照组基础上加服尿清舒颗粒。对比两组结石排出疗效及治疗前后尿白细胞镜检、中段尿液的普通细菌和真菌培养数量,尿频、尿急、尿痛、血尿、排尿不尽、腰酸乏力评分各项指标。结果 观察组结石排出疗效优于对照组差异有统计学意义(P＜0.05);观察组治疗后尿白细胞镜检与治疗前及对照组治疗后对比下降、两组治疗后中段尿液的普通细菌和真菌培养数量与治疗前对比降低,差异有统计学意义(P＜0.05);观察组治疗后尿频、尿急、尿痛、血尿、排尿不尽、腰酸乏力评分与治疗前及对照组治疗后对比降低,差异有统计学意义(P＜0.05)。结论 尿清舒颗粒治疗泌尿系统感染伴有尿路结石可有效发挥抗菌作用,排出结石,缓解患者临床症状,且安全性较高,具有较高的临床应用价值。

目的 本研究观察应用鼻喷激素联合白三烯受体拮抗剂在腺样体肥大患儿中治疗的效果。方法 选择2016年2月—2018年3月期间在广州市某区妇幼保健院耳鼻咽喉科确诊腺样体肥大的患儿,在患儿及家长知情同意的基础上,按照随机数字表法将87例耳鼻咽喉科诊断为腺样体肥大的儿童分为研究组和对照组。前者给予鼻喷激素联合白三烯受体拮抗剂进行治疗,后者独立使用白三烯受体拮抗剂进行治疗,比较两组患儿的临床治疗效果和不适症状的改善程度。结果 研究组腺样体肥大患儿临床症状得分小于对照组,优于对照组的治疗效果,差异有统计学意义(P＜0.05);且对比对照组,研究组患儿经鼻呼吸困难、入睡时打鼾、鼻部阻塞感等不适症状明显减轻。结论 鼻喷激素联合白三烯受体拮抗剂治疗儿童腺样体肥大,临床症状改善较为明显,具有经济性,家属及患儿接受度较高,相比手术创伤小,在基层医院推广有一定的价值。

目的 观察重组牛碱性成纤维细胞生长因子应用于治疗浅Ⅱ度烧伤创面的临床效果。方法 选取90例小面积浅Ⅱ度烧伤患者,随机平均分为2组:应用重组牛碱性成纤维细胞生长因子治疗的患者为治疗组,使用碘伏油纱治疗的患者为对照组,观察创面愈合时间、患者疼痛程度及远期色素沉着、瘢痕增生几率情况。结果 重组牛碱性成纤维细胞生长因子治疗组效果优于对照组,治疗组创面愈合时间(8.56±2.51)d短于对照组(12.42±2.13)d(P﹤0.05),平均愈合时间较提前3~5 d;患者疼痛度减轻[VAS评分分别是:(1.66±0.05)和(3.25±0.12),P﹤0.05];部分患者一年后随访发现治疗组远期色素沉着较轻,疤痕增生几率低。结论 应用重组牛碱性成纤维细胞生长因子治疗小面积浅度烧伤能够缩短创面愈合时间,在有效促进烧伤创面愈合同时,可减轻换药时疼痛,减轻远期色素沉着,降低瘢痕增生率。

Objective To observe effect of the recombinant bovine basic fibroblast growth factor in the treatment of superficial Ⅱ degree burn wounds. Methods Ninety cases of small area of superficial Ⅱ degree burn wounds were randomly divided into 2 groups: recombinant bovine basic fibroblast growth factor group(rb-bFGF) and control group (Iodophor gauze group). The wound healing time,patient pain, long-term hyperpigmentation and scar chance of proliferation were observed. Results The effect of rb-bFGF treatment group was better than that of control group. The healing time of the treatment group was (8.56 ± 2.51)d, it was shorter than that of the control group (12.42±2.13)d(P<0.01). The average healing time was 3~5 days, it was ahead of the control group; Compared to the control group, the rb-bFGF group had less pain (VAS scores were: 1.66±0.05 and 3.25±0.12,P<0.01); Some patients were followed up a year later, we found that the treatment group long-term pigmentation was lighter, scar chance of proliferation was lower. Conclusion Application of rb-bFGF in the treatment of small area of shallow Ⅱ degree of burns may shorten the wound healing time. As effective promotion of burn wound healing, it may reduce the pain when dressing, reduce long-term pigmentation and scarring rate.

目的 观察关节镜下清理术联合中药熏洗治疗痛风性膝关节炎的临床疗效。方法 收集2013年7月—2016年7月期间收治于我院骨科的痛风性膝关节炎患者,根据纳入及排除标准,获得44例患者,共44个膝关节。根据术后是否采用中药熏洗治疗,将其分为治疗组25例及对照组19例。观察内容:术后1周及术后3月的WBC、BUA、ESR、CRP、膝关节疼痛VAS、Lysholm关节功能评分;2组患者术后6月、12月随访时的膝关节疼痛VAS、Lysholm关节功能评分。结果 ①2组患者术前与术后1周的膝关节疼痛VAS、 Lysholm关节功能评分组内比较差异有统计学意义(P＜0.05),术后1周的膝关节疼痛VAS、 Lysholm关节功能评分组间比较差异无统计学意义(P＞0.05)。②2组患者术前与术后3月随访的WBC、BUA、ESR、CRP组内比较差异有统计学意义(P＜0.05),术后3月随访的WBC、BUA、ESR、CRP组间比较差异无统计学意义(P＞0.05)。③2组患者术后3月、6月、12月随访的膝关节疼痛VAS、Lysholm关节功能评分组间比较,差异有统计学意义(P＜0.05)。结论 关节镜下清理术结合中药治疗痛风性膝关节炎能有效减轻患者膝关节疼痛,值得临床使用。

Objective Retrospective evaluation of the curative effect of the arthroscopic debridement combined with Chinese medicine fumes in the treatment of the gouty arthritis of knee joint.Methods We analyzed 44 patients (from July 2013 to July 2016 in the orthopaedic department of the Sichuan Second T.C.M.Hospital)with gouty arthritis of knee joint. The all 44 patients were divided into treatment group and control group according to postoperative management that whether or not to apply Chinese medicine fumes.The treatment group,25 patients, were all treated by arthroscopic debridement combined with Chinese medicine fumes,and the control group,19 patients, were all treated by arthroscopic debridement only.The observation targets were as follows: VAS、Lysholm、WBC、BUA、ESR、CRP of postoperative after 1 week, 3 months,and VAS、Lysholm. postoperative VAS、Lysholm after 6months、12months.Results Compared the preoperative contents with postoperative contents after1 week,there was statistically significant difference in VAS、Lysholm of both groups(P＜0.05).There was no statistically significant difference in VAS、Lysholm in postoperative 1 week between two groups (P＞0.05). Compared the preoperative contents with postoperative contents after 3 month,there was statistically significant difference in WBC、BUA、ESR、CRP of both groups(P＜0.05).There was no statistically significant difference in WBC、BUA、ESR、CRP of postoperative 3 months between two groups(P＞0.05). There was statistically significant difference in VAS、Lysholm of postoperative 3 months and 6 months between two groups(P＜0.05).Conclusion Arthroscopic debridement combined with Chinese medicine fumes may improve the quality of life in the treatment of gouty arthritis of knee joint,and it is worthy of wide clinical application.

目的 观察脑血管球囊成形支架置入术治疗急性脑梗死的疗效。方法 选取我院和珠江医院2015年1月—2017年7月收治的急性脑梗死患者40例,根据随机数表法分为观察组及对照组,各20例。对照组单纯施以药物治疗,观察组在对照组基础上加以脑血管球囊成形支架置入术治疗,对比两组治疗前后凝血功能指标水平变化情况及疗效。结果 治疗后,观察组APTT、PT、TT、INR水平高于对照组,Fbg水平低于对照组,治疗总有效率高于对照组,差异有统计学意义(P＜0.05)。结论 脑血管球囊成形支架置入术治疗急性脑梗死疗效确切,患者临床症状得到更好更快的改善,可改善患者凝血功能,对急性脑梗死的早期救治有着极为重要的应用价值。

目的 观察⁹⁹锝-亚甲基二膦酸盐对前列腺癌骨转移患者骨痛、骨质疏松的治疗效果。方法 对76例前列腺癌骨转移患者给予⁹⁹锝-亚甲基二膦酸盐治疗1年(每疗程15 d,每天静滴22 mg,15 d为一个疗程,共12个疗程),比较治疗前及治疗1年后患者骨密度(BMD)值及血清钙、磷、碱性磷酸酶、骨钙素、I型胶原交联羧基末端肽、1,25二羟维生素D3等指标的变化。结果 云克治疗后腰椎(L1-4)及左股骨颈、大转子及小转子骨密度(BMD)值均较治疗前增加(P＜0.05);云克治疗后AKP、ICTP均较治疗前明显下降(P＜0.01)。OC云克治疗后较治疗前增加(P＜0.05)。血钙、血磷、1,25-二羟维生素D3云克治疗后与云克治疗前相比无明显变化,P<0.05。前列腺癌骨转移轻度骨痛组及中度骨痛组治疗1年后骨痛VAS评分明显降低,差异有统计学意义,P＜0.05。重度骨痛组云克治疗前、治疗后VAS评分比较,差异无统计学意义,P<0.05。结论 ⁹⁹锝-亚甲基二膦酸盐在治疗前列腺癌骨转移的骨痛、骨质疏松方面,具有缓解骨痛,促进骨增殖,抑制骨吸收,提高骨密度,防治骨质疏松的作用。