目的 探讨丙酸睾酮注射液联合乌司他丁对脓毒症患者免疫失衡的调节作用。方法 选取我院2019年10月—2020年1月收治的88例脓毒症患者,随机分成观察组和对照组各44例,对照组采用乌司他丁配合常规治疗,观察组在此基础上联合丙酸睾酮注射液对患者治疗,比较治疗1周2组临床疗效差异,观察治疗前及治疗1周,2组炎症因子水平[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-1β(IL-1β)]、睾酮(T)、白蛋白(Alb)水平及疾病危重程度(APACHEⅡ评分)、器官衰竭程度(SOFA评分)变化,分析治疗1周内2组患者药物不良反应发生情况差异。结果 治疗1周,观察组总有效率高于对照组(P＜0.05);2组患者IL-6、IL-1β水平及APACHEⅡ、SOFA评分均降低,且观察组较对照组更低(P＜0.05);2组患者IL-10、T、Alb水平均升高,且观察组较对照组更高(P＜0.05);2组药物不良反应总发生率比较无统计学意义(P>0.05)。结论 丙酸睾酮注射液联合乌司他丁治疗脓毒症可取得良好临床疗效,可有效改善病情及预后,对患者免疫失衡调节有积极意义。

Objective To investigate the regulatory effect of testosterone propionate injection combined with ulinastatin on immune imbalance in patients with sepsis.Methods A total of 88 patients with sepsis treated in our hospital from October 2019 to January 2020 were randomly divided into observation group and control group,with 44 cases each.The control group was treated with ulinastatin combined with routine treatment,while the observation group was treated with testosterone propionate injection additionally.The clinical efficacy difference between the two groups were compared after treating 1 week.The levels of inflammatory factors [interleukin-6 (IL-6),interleukin-10 (IL-10),interleukin-1 β (IL-1β)],testosterone (T),albumin (Alb),the severity of disease (APACHE II score) and the degree of organ failure (SOFA score) in the two groups were observed before and 1 week after treatment.The differences of adverse drug reactions between the two groups within 1 week of treatment were analyzed.Results The total effective rate of the observation group was higher than that of the control group (P＜0.05).IL-6 and IL-1β levels and APACHE II and SOFA scores decreased after treatment,while those of the observation group were lower than the control group (P＜0.05).The levels of IL-10,T and Alb in the two groups were increased,while those in the observation group were higher than the control group (P ＜ 0.05); the total incidence of adverse drug reactions in the two groups was not statistically significant (P>0.05).Conclusions Testosterone propionate injection combined with ulinastatin had good clinical efficacy in the treatment of sepsis,effectively improved the condition and prognosis,and had positive significance in the regulation of immune imbalance.

目的 探讨不同中医体质老年糖尿病患者心率变异性与自主神经功能的关系。方法 选取2016年3月—2017年4月在我院治疗的老年糖尿病患者250例,检测各中医体质患者SDNN、SDANN、SDNNI、RMSSD、PNN50%、LF、HF、LF/HF以及空腹血糖(FBG)、糖化血红蛋白(HbA1c)。结果 总偏颇体质患者SDNN、SDANN、SDNNI、RMSSD、PNN50%、LF和HF分别为(88.37±10.02)ms、(78.82±9.44)ms、(41.14±11.43)ms、(22.28±6.53)ms、(10.03±4.33)ms、(203.38±78.23)ms²和(122.21±80.03)ms²,低于平和质患者(P＜0.05),而LF/HF为(1.68±0.43),高于平和质患者(P＜0.05);血瘀质患者SDNN、SDANN、SDNNI、RMSSD和PNN50低于气虚质、阴虚质、痰湿质、湿热质和其他型患者(P＜0.05);阴虚质患者LF、HF低于气虚质、血瘀质、痰湿质、湿热质和其他型患者(P＜0.05);阴虚质患者LF/HF低于气虚质、血瘀质、痰湿质、湿热质患者(P＜0.05);其他型患者SDNN、SDANN、SDNNI、RMSSD、PNN50、LF、HF高于气虚质、阴虚质、痰湿质、湿热质患者(P＜0.05),而LF/HF低于气虚质、阴虚质、痰湿质、湿热质患者(P＜0.05);不同中医体质患者FBG、HbA1c比较差异无统计学意义(P＞0.05)。结论 糖尿病患者偏颇体质较平和质患者心率变异性降低,表现为交感神经张力增大,迷走神经张力降低,其平衡协调破坏。

Objective To explore the relationship between heart rate variability and autonomic nervous function in elderly diabetic patients with different constitutions of traditional Chinese medicine. Methods 250 elderly patients with diabetes mellitus in our hospital from March 2016 to April 2017 were selected; the SDANN, SDNNI, RMSSD, PN50%, LF, HF, LF/HF, fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) were measured. Results In patients with general biased constitution, SDANN, SDNNI, RMSSD, PN50%, LF and HF were (88.37±10.02) ms, (78.82±9.44) ms, (41.14±11.43) ms, (22.28±6.53) ms, (10.03 ±4.33) ms, (203.38±78.23) ms² and (122.21±80.03) ms², which were lower than those in patients with plain constitution (P＜0.05), while LF/HF was (1.68±0.43), which was higher than that in patients with plain constitution (P＜0.05); in patients with blood stasis, SDANN, SDNNI, RMSSD and PN50 were lower than those with Qi deficiency, Yin deficiency, phlegm-dampness, damp-heat and other types (P＜0.05); LF and HF in Yin deficiency type patients were lower than those in Qi deficiency type, blood stasis type, phlegm-dampness type, damp-heat type and other types (P＜0.05); LF/HF in Yin deficiency patients was lower than that in Qi deficiency patients, blood stasis patients, phlegm-dampness patients and damp-heat patients (P＜0.05); SDANN, SDNNI, RMSSD, PN50, LF and HF in other types of patients were higher than Qi deficiency, Yin deficiency, phlegm-dampness and damp-heat (P＜0.05), while LF/HF was lower than those with Qi deficiency, Yin deficiency, phlegm-dampness and damp-heat (P＜0.05); there was no significant difference in FBG and HbA1c in patients with different constitutions of TCM (P>0.05). Conclusion The heart rate variability of biased constitution patients with diabetes mellitus was lower than that of patients with mild constitution, manifested by increased sympathetic nerve tension, decreased vagal nerve tension and destroyed balance and coordination.

目的 研究孟鲁斯特治疗哮喘的临床疗效及其对患者Th1/Th2细胞免疫平衡和相关炎症因子水平的影响。方法 选取哮喘患者68例随机分为对照组31例及观察组37例,对照组予以常规糖皮质激素吸入治疗,观察组在此基础上加服孟鲁斯特。用药3个月后流式细胞仪检测两组患者外周血Th1、Th2数量变化,ELISA定量外周血IL-4及IFN-γ含量变化并作临床效果评定。结果 两组患者经治疗后,外周血Th1/Th2比例均升高,IL-4/IFN-γ细胞因子水平下降,但观察组较对照组变化更为明显,差异有统计学意义(P＜0.01)。疗效方面,观察组总有效率94.59%,高于对照组的74.19%,差异具有统计学意义(P＜0.01),同时两组均未见明显不良反应。结论 哮喘患者加用孟鲁斯特具有明显免疫调节功能,使Th1/Th2水平趋于平衡,作为哮喘辅助治疗药物疗效确切。

目的 观察动静平衡康复训练对胫骨平台骨折术后患者平衡和行走功能的影响。方法 将2012年7月—2014年12月100例胫骨平台骨折患者,随机分为两组,每组50例。对照组术后展开常规康复训练,观察组实施动静平衡康复训练,观察两组膝关节功能、康复效果以及肌力恢复情况。结果 观察组患者的膝关节功能优良率为98.0%,高于对照组的60.0%,差异有统计学意义(P＜0.05)。观察组患者的Lysholm评分,高于对照组(P＜0.05)。观察组患者的肌力恢复情况,优于对照组(P＜0.05)。结论 基于“动静平衡”理念针对胫骨平台骨折患者实施术后康复指导与训练,有利于促进患者关节功能以及肌力恢复,巩固康复疗效,在训练过程中实现动态平衡,具有积极的临床意义。

Objective To investigate the static and dynamic balance rehabilitation training on the tibial plateau fracture patients balance and walking functions. Methods 100 cases of patients with tibial plateau fractures from July 2012 to December 2014, were randomly divided into two groups, 50 cases of each group. The control group was launched conventional rehabilitation, observation group received static and dynamic balance rehabilitation training. The knee function, rehabilitation and muscle recovery of the two groups were observed and statistically analyzed. Results The knee function excellent rate of observation group was 98.0%, significantly higher than control group 60.0%, there was statistical significance(P＜0.05). Lysholm score of observation group was higher than control group(P＜0.05). Muscle recovery of observation group was better than control group(P＜0.05). Conclusion Based on the “static and dynamic balance” concept for tibial plateau fractures postoperative rehabilitation for patients with guidance and training, and it will be promoting joint function in patients with muscle recovery and consolidate the recovery effect, to achieve dynamic equilibrium in the training process, with positive clinical significance.