目的 分析乙型肝炎病毒（HBV）感染患者并发2型糖尿病（T2DM）相关风险因素。方法 研究收集2024年1月~2025年5月期间，于周口市传染病医院（周口市结核病防治所、周口市第五人民医院）接受治疗的HBV感染患者临床资料，共纳入患者95例，根据HBV感染后是否并发T2DM分组，合并T2DM患者纳入并发组（n=21），非合并T2DM患者纳入对照组（n=74），比较两组患者基线资料及实验室检查数据，逻辑回归分析HBV感染患者并发T2DM风险因素。结果 并发组年龄、体重指数（BMI）、甘油三酯（TG）高于对照组（P＜0.05），年龄≥45岁、BMI肥胖、HBV感染时间≥6个月、TG≥1.7mmol/L、吸烟、乙型肝炎表面抗原（HBsAg）阳性及纤维化-4（FIB-4）指数≥2.67例数占比高于对照组（P＜0.05）。年龄≥45岁[OR=21.599（95%CI：2.875-162.262）]、BMI（肥胖）[OR=16.729（95%CI：1.443-193.981）]、HBV感染时间≥6个月[OR=6.199（95%CI：1.101-34.904）]、吸烟[OR=9.429（95%CI：1.344-66.141）]、TG≥1.7mmol/L[OR=71.834（95%CI：7.060-730.897）]是HBV感染患者并发T2DM危险因素（P＜0.05）。结论 HBV感染患者并发T2DM受人口学特征年龄、BMI、临床病程HBV感染时间、共病血脂异常及生活方式吸烟的共同影响。
Abstract: Objective To analyze risk factors associated with the development of type 2 diabetes mellitus (T2DM) in patients with hepatitis B virus (HBV) infection. Methods Clinical data were collected from HBV-infected patients treated at the Zhoukou City Infectious Disease Hospital (Zhoukou City Tuberculosis Prevention and Control Institute)between January 2024 and May 2025. A total of 95 patients were included in the study, Patients were grouped based on the presence or absence of T2DM following HBV infection. Patients with T2DM were included in the T2DM group (n=21), while those without T2DM were included in the control group (n=74). Baseline characteristics and laboratory test data were compared between the two groups, and logistic regression analysis was performed to identify factors associated with the development of T2DM in HBV-infected patients. Results The age, body mass index (BMI), and triglycerides (TG) in the intervention group were higher than those in the control group (P < 0.05); The proportion of cases with age ≥45 years, obese BMI, HBV infection duration ≥6 months, TG ≥1.7 mmol/L, smoking, hepatitis B surface antigen (HBsAg) positivity, and a FIB-4 score ≥2.67 was higher than that in the control group (P < 0.05). Age ≥ 45 years [OR = 21.599 (95% CI: 2.875–162.262)], BMI (obesity) [OR = 16.729 (95% CI: 1.443–193.981)], duration of HBV infection ≥ 6 months [OR = 6.199 (95% CI: 1.101–34.904)], smoking [OR=9.429 (95% CI: 1.344–66.141)], and TG ≥ 1.7 mmol/L [OR=71.834 (95% CI: 7.060–730.897)] were risk factors for T2DM in patients with HBV infection (P < 0.05). Conclusion The development of T2DM in patients with HBV infection is influenced by a combination of demographic factors (age and BMI), clinical course (duration of HBV infection), comorbid dyslipidemia, and lifestyle factors (smoking).
2型糖尿病（T2DM）作为临床常见代谢性疾病，其病机阐释多从“阴虚燥热”立论，然临证所见，单纯养阴清热往往难收全功。本文尝试以彭子益圆运动理论“中气如轴，四维如轮，轴运轮行，轮运轴灵”为核心框架，结合五脏相关、气机升降、气化失常理论，重新阐释T2DM的病因病机：认为脾胃中气亏虚、枢机失运是发病之本，肝木失疏、肺金失降、心火失敛、肾水失藏为四维轮动失常之标，痰、湿、瘀、热为病理产物，共同导致“一气周流”失圆、精微不布、血糖失稳。治疗以复圆为纲，提出“运轴复轮、轴轮并调、标本同治”的核心治法，分阶段、分脏腑辨证施治，兼顾气机升降与气化功能，为T2DM的中医诊疗提供新的理论视角与临床思路。
2型糖尿病（T2DM）作为临床常见代谢性疾病，其病机阐释多从“阴虚燥热”立论，然临证所见，单纯养阴清热往往难收全功。本文尝试以彭子益圆运动理论“中气如轴，四维如轮，轴运轮行，轮运轴灵”为核心框架，结合五脏相关、气机升降、气化失常理论，重新阐释T2DM的病因病机：认为脾胃中气亏虚、枢机失运是发病之本，肝木失疏、肺金失降、心火失敛、肾水失藏为四维轮动失常之标，痰、湿、瘀、热为病理产物，共同导致“一气周流”失圆、精微不布、血糖失稳。治疗以复圆为纲，提出“运轴复轮、轴轮并调、标本同治”的核心治法，分阶段、分脏腑辨证施治，兼顾气机升降与气化功能，为T2DM的中医诊疗提供新的理论视角与临床思路。
目的 分析2021-2025年某社区卫生服务中心失眠患者用药趋势，为社区失眠规范化管理提供参考。方法 回顾性收集某社区卫生服务中心2021年1月至2025年12月失眠相关药物处方数据，共纳入处方18,042张，涉及患者3,805人。统计处方量、药物种类、患者年龄、性别、伴随疾病等信息。根据处方次数及平均处方间隔天数将患者分为三类：偶发就诊型（1次）、短期治疗型（2~10次且平均间隔≥60天）和长期用药型（>10次或平均间隔<60天），分析各类患者的用药特征及伴随疾病分布。结果 处方量从2021年2,688张增至2025年5,734张，增长2.1倍，就诊人数增长1.6倍。艾司唑仑占比从66.22%降至41.75%，右佐匹克隆从13.28%升至54.99%，2024年为关键转折点；各年龄组右佐匹克隆使用均呈上升趋势，2025年组间差异趋于消失（48%~61%）。患者平均年龄从73.2岁降至69.5岁（Tukey HSD，P<0.05），≥80岁组占比从29.36%降至14.28%。偶发就诊型占42.6%，短期治疗型占25.9%，长期用药型占31.6%。长期用药型消耗全部处方的68.2%，平均处方间隔37.3 d（中位34 d），右佐匹克隆占比43.2%。高血压是最常见伴随疾病，患病率随年龄升高（28.17%~68.17%）；高血脂和焦虑呈倒U型分布。结论 社区失眠就诊需求快速增长，药物结构向新型非苯二氮?类药物明显转变。失眠患者呈年轻化趋势。长期用药型患者消耗了大部分处方资源，其用药管理模式需结合处方间隔特征进行精准分层，并重视老年患者心血管代谢共病的综合管理。
To analyze the medication trends and characteristics of insomnia patients in a community health service center from 2021 to 2025, and to provide evidence for standardized community-based insomnia management. METHODS A retrospective analysis was conducted on insomnia-related prescription data from a community health service center between January 2021 and December 2025. A total of 18,042 prescriptions involving 3,805 patients were included. Prescription volume, drug types, patient age, sex, and comorbidities were analyzed. Patients were classified into three types based on prescription count and average prescription interval: episodic consultation type (1 prescription), short-term treatment type (2–10 prescriptions with interval ≥60 days), and long-term medication type (>10 prescriptions or interval <60 days). RESULTS Prescriptions increased from 2,688 in 2021 to 5,734 in 2025 (2.1-fold), with a 1.6-fold increase in patient visits. Estazolam decreased from 66.22% to 41.75%, while eszopiclone increased from 13.28% to 54.99%, with 2024 as the turning point. Eszopiclone usage increased across all age groups, converging to 48%–61% by 2025. Mean age decreased from 73.2 to 69.5 years (Tukey HSD, P<0.05), and the proportion of patients aged ≥80 years dropped from 29.36% to 14.28%. Episodic consultation type accounted for 42.6%, short-term treatment type 25.9%, and long-term medication type 31.6%. The long-term type consumed 68.2% of all prescriptions, with an average prescription interval of 37.3 days (median 34 days) and eszopiclone accounting for 43.2%. Hypertension was the most common comorbidity, increasing with age (28.17%–68.17%). Hyperlipidemia and anxiety showed an inverted U-shaped distribution. CONCLUSION Community insomnia treatment demand is growing rapidly, with a significant shift toward newer non-benzodiazepines and a trend toward younger patient demographics. Long-term medication patients consume the majority of prescription resources and require precise stratification based on prescription interval patterns, along with integrated management of cardiometabolic comorbidities in older adults.
目的 探讨达格列净在行经皮冠状动脉介入治疗（Percutaneous Coronary Intervention，PCI）后2型糖尿病（Type 2 Diabetes Mellitus,T2DM）伴不稳定型心绞痛（Unstable Angina，UA）患者中的应用价值及短期心功能改善效果。方法 本研究为单中心、随机对照试验，纳入90例PCI术后2型糖尿病合并不稳定型心绞痛患者，随机分为达格列净组（n=43）和二甲双胍组（n=47），规范调整降糖药物保证降糖强度一致。治疗期间及治疗后6-12个月通过心脏彩超测量左心室射血分数（Left Ventricular Ejection Fraction，LVEF）、左室舒张末期内径（Left Ventricular End-Diastolic Diameter，LVEDD），并采集静脉血样检测N端B型利钠肽前体（N-terminalpro-Brain Natriuretic Peptide，NT-proBNP）水平，以评估心功能变化。 结果 PCI治疗后的6-12个月随访中，观察组NT-proBNP（P<0.01）显著降低，左心室射血分数LVEF（P<0.01）显著提升。与对照组相比：观察组NT-ProBNP水平明显下降（P<0.01），且低于对照组。结论 在PCI术后合并不稳定型心绞痛的T2DM患者中，加用达格列净治疗可显著改善NT-proBNP和LVEF等心功能替代指标，且安全性良好。
Objective:To explore the application value of dapagliflozin and its short-term cardiac function improvement effect in patients with type 2 diabetes mellitus (T2DM) combined with unstable angina (UA) after percutaneous coronary intervention (PCI). Methods: This was a single-center, randomized controlled trial. A total of 90 patients with type 2 diabetes mellitus (T2DM) complicated with unstable angina (UA) after percutaneous coronary intervention (PCI) were enrolled and randomly assigned to a dapagliflozin group (n=43) and a metformin group (n=47). Hypoglycemic agents were adjusted routinely to ensure consistent glycemic control intensity between the two groups. During treatment and at 6–12 months after treatment, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were measured by echocardiography, and venous blood samples were collected to determine the level of N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) for the evaluation of cardiac function changes. Results: During the 6-month follow-up after PCI treatment, the N-terminal pro-brain natriuretic peptide (NT-proBNP) level in the observation group decreased significantly (P<0.01), and the left ventricular ejection fraction (LVEF) increased significantly (P<0.01).Compared with the control group, the NT-proBNP level in the observation group was notably lower (P<0.01) and also remained below that of the control group. Conclusion: For type 2 diabetes mellitus (T2DM) patients complicated with unstable angina pectoris after PCI, adjuvant treatment with dapagliflozin for 6 months can significantly improve cardiac function surrogate markers such as NT-proBNP and LVEF, with favorable safety profile.
目的：评价络合统血疗法治疗脾不统血证痔出血的临床疗效与安全性。方法：采用回顾性病例研究设计，连续纳入广州医科大学附属中医医院肛肠科门诊数据库中2023年1月5日至2025年12月24日痔出血病例。原始记录317条，去重后311例，排除4例，最终纳入307例；其中271例接受络合统血疗法，构成主要疗效与安全性分析集。全部纳入病例中医辨证均为脾不统血证。主要观察指标为治疗前后便血评分、症状总积分、止血时间、疗效分级、不良反应、复发及改行手术情况。计量资料以均数±标准差或M（P25，P75）表示，治疗前后比较采用Wilcoxon符号秩检验。结果：271例络合统血疗法患者中，男性181例（66.79%），女性90例（33.21%）；年龄（47.83±16.37）岁。治疗前后便血评分分别为3.96±1.34分和0.72±1.33分，症状总积分分别为9.80±3.27分和2.01±2.37分，差异均有统计学意义（均P < 0.001）。止血时间为3（2，5.5）d。显效201例（74.17%），有效45例（16.61%），无效25例（9.23%），总有效率为90.77%。不良反应18例（6.64%），均为轻中度；复发32例（11.81%）；改行手术9例（3.32%）。结论：在脾不统血证痔出血门诊病例中，接受络合统血疗法后，便血评分与症状总积分显著下降，且短期安全性较好。
目的：评价络合统血疗法治疗脾不统血证痔出血的临床疗效与安全性。方法：采用回顾性病例研究设计，连续纳入广州医科大学附属中医医院肛肠科门诊数据库中2023年1月5日至2025年12月24日痔出血病例。原始记录317条，去重后311例，排除4例，最终纳入307例；其中271例接受络合统血疗法，构成主要疗效与安全性分析集。全部纳入病例中医辨证均为脾不统血证。主要观察指标为治疗前后便血评分、症状总积分、止血时间、疗效分级、不良反应、复发及改行手术情况。计量资料以均数±标准差或M（P25，P75）表示，治疗前后比较采用Wilcoxon符号秩检验。结果：271例络合统血疗法患者中，男性181例（66.79%），女性90例（33.21%）；年龄（47.83±16.37）岁。治疗前后便血评分分别为3.96±1.34分和0.72±1.33分，症状总积分分别为9.80±3.27分和2.01±2.37分，差异均有统计学意义（均P < 0.001）。止血时间为3（2，5.5）d。显效201例（74.17%），有效45例（16.61%），无效25例（9.23%），总有效率为90.77%。不良反应18例（6.64%），均为轻中度；复发32例（11.81%）；改行手术9例（3.32%）。结论：在脾不统血证痔出血门诊病例中，接受络合统血疗法后，便血评分与症状总积分显著下降，且短期安全性较好。
