目的 分析厄贝沙坦+美托洛尔治疗慢性充血性心力衰竭(congestive heart failure,CHF)的临床效果及对患者心功能影响。方法 选取本院2018年12月—2020年12月住院治疗的200例慢性CHF患者,根据不同的治疗方法分组,参照组100例患者采用厄贝沙坦治疗,治疗组100例患者采用厄贝沙坦+美托洛尔治疗,比较2组临床疗效、心功能指标、血清炎性因子、血清N端脑利钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、同型半胱氨酸(homocysteine,Hcy)水平、不良反应发生率。结果 治疗组临床总有效率(97.00%)高于参照组(87.00%),治疗组治疗后左室射血分数(left ventricular ejection fraction,LVEF)高于参照组,治疗组治疗后左室舒张末期内径(left ventricular end diastolic diameter,LVEDd)、左室收缩末期内径(left ventricular end systolic diameter,LVESd)、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitivity C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)、NT-proBNP、Hcy水平均低于参照组,差异均具有统计学意义(P＜0.05)。治疗组不良反应发生率(4.00%)与参照组(5.00%)比较,P>0.05。结论 厄贝沙坦+美托洛尔可有效改善慢性CHF患者心功能,减轻炎症反应,抑制NT-proBNP、Hcy释放,且不良反应较少。

Objective To analyze the clinical effect of irbesartan combined with metoprolol in the treatment of chronic congestive heart failure (CHF) and its influence on cardiac function. Methods A total of 200 patients with chronic CHF in our hospital from December 2018 to December 2020 were selected and divided into two groups according to different treatment methods. One handred patients in the control group were treated with irbesartan, and 100 patients in the treatment group were treated with irbesartan + metoprolol. The clinical efficacy, cardiac function indexes, serum inflammatory factors, serum NT-proBNP, Hcy levels and adverse reactions of the two groups were compared. Results The total effective rate of the treatment group (97.00%) was higher than that of the control group (87.00%), LVEF of the treatment group was higher than that of the control group, LVEDd, LVESd, serum TNF-α, hs-CRP, IL-6, NT-proBNP, Hcy levels of the treatment group were lower than those of the control group, the differences were statistically significant (P<0.05). The incidence of adverse reactions in the treatment group (4.00%) was higher than that in the control group (5.00%),P>0.05. Conclusion Irbesartan + metoprolol could effectively improve cardiac function, reduce inflammatory reaction, inhibit the release of NT-proBNP and Hcy in patients with chronic CHF, with less adverse reactions.

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.

目的 探究在胸腰段椎体成形术椎再骨折患者中采用后路椎体次全切治疗的临床疗效,并对其进行探讨与分析。方法 随机选取2019年1月—2021年1月于我院骨科治疗的胸腰段椎体成形术椎再骨折患者58例作为研究对象。给予患者后路椎体次全切治疗,记录患者的手术时间及术中出血量,对比手术前以及手术后6个月患者的VAS疼痛评分、后凸Cobb角、椎体高度、椎管容积率以及美国脊柱损伤协会(ASIA)损伤分级。结果 患者的手术时间为1.4～3.8 h,手术平均时间为(2.45±0.61)h,患者术中出血量为580～1 470 mL,术中平均出血量为(835.48±134.75)mL。手术后6个月患者的VAS疼痛评分低于手术前(P＜0.05);手术后6个月患者的后凸Cobb角小于手术前(P＜0.05);手术后6个月患者的椎体高度和椎管容积率均大于手术前(P＜0.05);患者手术前ASIA损伤分级: A级12例、B级14例、C级16例、D级12例、E级4例;患者手术后6个月ASIA损伤分级:A级5例、B级8例、C级13例、D级15例、E级17例。结论 在胸腰段椎体成形术椎再骨折患者中采用后路椎体次全切治疗可缓解患者的疼痛感,减小后凸Cobb角,增大椎体高度和椎管容积率以及改善患者的ASIA损伤分级。

Objective To investigate the clinical efficacy of posterior subtotal vertebral dissection in patients with vertebral re-fractures of thoracolumbar segmental vertebroplasty. Methods Fifty-eight patients with thoracolumbar segmental vertebroplasty vertebral re-fractures treated in the orthopedic department of our hospital from January 2019 to January 2021 were randomly selected as study subjects.The patients were treated with posterior subtotal vertebral dissection, and the operating time and intraoperative bleeding of the patients were recorded, and the VAS pain score, posterior convex Cobb angle, vertebral body height, spinal canal volume ratio, and American Spinal Injury Association (ASIA) injury classification were compared in patients before and 6 months after surgery. Results The operating time was 1.4-3.8 hours, with a mean of (2.45±0.61) hours, and the intraoperative bleeding was 580-1470 mL, with a mean of (835.48±134.75) mL.The VAS pain scores at 6 months after surgery were lower than those before surgery (P<0.05); the posterior convex Cobb angle at 6 months after surgery was smaller than that before surgery (P<0.05); the vertebral body height and spinal canal volume ratio at 6 months after surgery were greater than those before surgery (P<0.05). Preoperative ASIA injury grading: 12 cases with grade A, 14 cases with grade B, 16 cases with grade C, 12 cases with grade D and 4 cases with grade E; six months after surgery, 5 cases with grade A, 8 cases with grade B, 13 cases with grade C, 15 cases with grade D, and 17 cases with grade E. Conclusion Posterior subtotal vertebral body resection could relieve pain of thoracolumbar vertebroplasty fractures, reduce the posterior convex Cobb angle, increase vertebral body height and spinal canal volume, and improve ASIA injury classification.

目的 分析补阳还五汤加减治疗肾病综合征(NS)的临床疗效。方法 选择本院2019年1月—2021年1月住院治疗的120例NS患者,通过随机数字表法分组,参照组60例患者采纳常规西医治疗,试验组60例患者在参照组基础上予以补阳还五汤治疗,对比2组临床疗效、中医症候积分、肾功能指标、不良反应总发生率。结果 试验组临床总有效率(96.67%)高于参照组(80.00%),试验组治疗后浮肿少尿、腰膝酸软、腹部胀满、头晕乏力积分均低于参照组,差异均有统计学意义(P＜0.05)。治疗后试验组24 h尿蛋白、尿素氮均比参照组低,差异有统计学意义P＜0.05,血肌酐治疗前后差异无统计学意义P>0.05。试验组不良反应总发生率(5.00%)与参照组(6.67%)比较,差异无统计学意义(P>0.05)。结论 补阳还五汤可有效改善NS患者临床症状、肾功能,降低蛋白尿,且不良反应较少,安全性较高,疗效确切。

Objective To analyze the clinical effect of addition or reduction of Buyang Huanwu decoction in the treatment of nephrotic syndrome (NS). Methods A total of 120 NS patients in our hospital from January 2019 to January 2021 were divided into two groups by random digital table method. Sixty patients in the control group were treated by conventional western medicine, 60 patients in the experimental group were treated with Buyang Huanwu decoction on the basis of control group.The clinical efficacy, traditional Chinese medicine syndrome score, renal function index and total incidence of adverse reactions were compared. Results The total clinical effective rate of the experimental group (96.67%) was higher than that of the control group (80.00%). The scores of edema and oliguria, lumbar and knee pain and limpness, abdominal distention and dizziness after treatment in the experimental group were all lower than those in the control group, with statistical significance (P<0.05). After treatment, 24 h urinary protein volume and blood urea nitrogen level in the experimental group were lower than those in the control group, the differences were statistically significant (P<0.05), while there was no statistically significant difference in serum creatinine before and after treatment (P>0.05). There was no significant difference in the total incidence of adverse reactions between the experimental group (5.00%) and the control group (6.67%,P>0.05). Conclusion Buyang Huanwu decoction could effectively improve the clinical symptoms and renal function, reduce proteinuria, and had less adverse reactions, high safety level and accurate curative effect.

目的 分析心力衰竭伴快速心房颤动(简称:心衰伴快速房颤)患者接受胺碘酮急诊抢救治疗的效果及对24 h心室率的影响。方法 将2017年1月—2020年12月急诊接诊且行西地兰治疗的60例心衰伴快速房颤患者作为对照组,将同期急诊接诊且行胺碘酮治疗的60例心衰伴快速房颤患者作为观察组,对组间心功能指标、炎症因子水平、心室率、临床疗效、药物不良反应展开分析。结果 ①组间心功能指标、炎症因子水平在治疗前无差异,P>0.05;观察组心功能指标、炎症因子水平在治疗后优于对照组,P<0.05;②组间心室率在治疗前无差异,P>0.05;观察组治疗后4 h、12 h、24 h心室率均低于对照组,P<0.05;③观察组5例无效(8.33%),对照组14例无效(23.33%),P<0.05;④观察组药物不良反应率(3.33%)与对照组药物不良反应率(5.00%)无差异,P>0.05。结论 在急诊抢救心衰伴快速房颤患者时采用胺碘酮,可以改善患者心功能、炎症反应、心室率,加之无明显不良反应,值得推广。

Objective To analyze the efficacy of emergency treatment with amiodarone and its influence on 24-hour ventricular rate in patients with heart failure and rapid atrial fibrillation. Methods From January 2017 to December 2020, 60 patients with heart failure and rapid atrial fibrillation who received emergency treatment and cedilanide treatment were selected as the control group, and 60 patients with heart failure and rapid atrial fibrillation who received emergency treatment and amiodarone treatment at the same period were selected as the observation group. Results ① There was no significant difference in cardiac function index and inflammatory factors level between the two groups before treatment, P>0.05.The cardiac function index and inflammatory factors level of the observation group were more improved than those of the control group after treatment, P<0.05. ② There was no significant difference in ventricular rate between the two groups before treatment, P>0.05.The ventricular rates of the observation group at 4 h, 12 h and 24 h after treatment were lower than those of the control group, P< 0.05. ③ Treatment for 5 cases (8.33%) in the observation group, 14 cases (23.33%) in the control group were ineffective, P<0.05. ④ There was no significant difference in the adverse drug reaction incidence between the observation group (3.33%) and the control group (5.00%), P>0.05. Conclusion Amiodarone could improve the cardiac function, inflammatory reaction and ventricular rate of patients with heart failure and rapid atrial fibrillation in emergency treatment, and there was no obvious adverse reaction, so it is worthy of promotion.

目的 观察靳三针治疗卒中后认知功能障碍(PSCI)的临床疗效。方法 选取广州市第一人民医院南沙医院中医科、神经内科、精神科卒中后出现认知功能障碍的患者60 例,随机分为治疗1组,治疗2组和对照组,每组20例。对照组予盐酸多奈哌齐片口服,治疗1组予靳三针治疗,治疗2组予多奈哌齐口服及靳三针治疗。各组均在治疗前、治疗12周进行中医症候临床疗效评定和精神状态简易量表(MMSE)评定。结果 MMSE疗效评定中,治疗1组和对照组总有效率相当,治疗2组治疗有效率高于对照组及治疗1组。中医症候疗效评定中,治疗2组愈显率高于对照组及治疗1组,治疗2组愈显率较治疗1组明显升高,对比差异有统计学意义(P<0.05)。对照组、治疗1组、治疗2组经过12周治疗后MMSE评分较前升高,治疗前后比较差异均有统计学意义(P<0.05)。3组中风病诊断与疗效评定评分治疗后有所下降,治疗前后比较差异有统计学意义(P<0.05)。治疗2组与对照组、治疗1组对比,2组对比差异均有统计学意义(P<0.05)。结论 靳三针联合多奈哌齐治疗PSCI效果明显,针刺与药物结合应用治疗更有利于PSCI的恢复。

Objective To observe the clinical effect of Jin's three-needle therapy on post-stroke cognitive impairment (PSCI). Methods A total of 60 patients with cognitive dysfunction after stroke in the department of traditional Chinese medicine (TCM), department of neurology and department of psychiatry in Nansha Hospital of Guangzhou First People's Hospital were randomly divided into treatment group 1, treatment group 2 and control group, 20 cases in each group.The control group was given donepezil hydrochloride orally, the treatment group 1 was given Jin's three-needle therapy, the treatment group 2 was given donepezil oral therapy and Jin's three-needle therapy.All groups were assessed with mini-mental state examination (MMSE) before and 12 weeks after treatment. Results In MMSE, the total effective rate of treatment group 1 was similar to that of control group, and the effective rate of treatment group 2 was higher than that of control group and treatment group 1.In the evaluation of TCM symptom curative effect, the cure rate of the group 2 was higher than that of the control group and the group 1.The effective rate of group 2 was significantly higher than that of group 1 (P< 0.05). After 12 weeks of treatment, MMSE scores in control group, group 1 and group 2 were significantly higher than those before treatment (P< 0.05). The score of diagnosis and curative effect of stroke in three groups decreased after treatment, and the difference was statistically significant (P<0.05). There were significant differences between control group, group 1 and group 2 (P< 0.05). Conclusion Jin's three-needle therapy combined with donepezil is effective in the treatment of PSCI.Acupuncture combined with medicine is more beneficial to the recovery of PSCI.

目的 考察灯盏花素辅助阿替普酶治疗溶栓时间窗外急性脑梗死的疗效。方法 选取82例溶栓时间窗外急性脑梗死患者,随机分成实验组(40例)和对照组(42例)。对照组给予阿替普酶治疗,实验组在对照组基础上给予灯盏花素治疗。比较治疗前及治疗2周后,2组患者的神经功能缺损程度[国立卫生研究院卒中量表(NIHSS)]、脑梗死区域组织灌注情况[相对脑血容量(rCBV)、脑血流量水平(CBF)]、血流变学指标[高切全血黏度(HSBV)、低切全血黏度(LSBV)、血浆黏度(PV)、红细胞比容(HCT)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]。结果 治疗2周后,2组NIHSS评分及HSBV、LSBV、PV、HCT、MDA水平皆低于治疗前,且实验组低于同一时间对照组(P＜0.05);2组rCBV、CBF、SOD水平皆高于治疗前,且实验组高于同一时间对照组(P＜0.05)。结论 灯盏花素辅助阿替普酶治疗溶栓时间窗外急性脑梗死的治疗效果较好,有利于逆转患者神经功能缺损程度,增加梗死区域灌注量,改善患者血流情况,对其预后康复有利。

Objective To investigate the efficacy of breviscapine combined with alteplase in the treatment of acute cerebral infarction beyond thrombolytic time window. Methods A total of 82 patients with acute cerebral infarction beyond thrombolytic time window were randomly divided into experimental group (40 cases) and control group (42 cases). The control group was treated with alteplase, and the experimental group was treated with breviscapine on the basis of the control group. Before and 2 weeks after treatment, the degree of neurological deficit [National Institutes of Health Stroke Scale (NIHSS)], regional tissue perfusion of cerebral infarction [relative cerebral blood volume (rCBV), cerebral blood flow (CBF)], hemorheological indexes [high shear whole blood viscosity (HSBV), low shear whole blood viscosity (LSBV), plasma viscosity (PV), hematocrit (HCT)], the indexes of oxidative stress [malondialdehyde (MDA) and superoxide dismutase (SOD)] were compared between the two groups. Results After 2 weeks of treatment, NIHSS score, HBSV, LSBV, PV, HCT and MDA levels of the two groups were significantly lower than those before treatment, and those of the experimental group were significantly lower than the control group at the same time (P＜0.05). The rCBV, CBF and SOD levels of the two groups were significantly higher than those before treatment, while those of the experimental group was significantly higher than the control group (P＜0.05). Conclusions Breviscapine combined with alteplase in the treatment of acute cerebral infarction beyond thrombolytic time window had good therapeutic effect, which was beneficial to improve the degree of neurological deficit, increase the perfusion volume of infarcted area, improve the cerebral blood flow of patients, and was beneficial to the prognosis and rehabilitation.

目的 探讨结核病相关重症患者的诊治特点,提高此类疾病的诊治水平。方法 回顾性分析2020年7月—8月我科收住的4例临床表现类似的结核病相关重症患者的临床资料。结果 4例患者均诊断为活动性结核病或结核潜伏感染,均为合并1个或多个器官功能衰竭的重症患者,均表现为发热、血小板减少、肝肾损伤,经予以个体化的积极抢救治疗,均获得满意疗效。结论 结核病相关重症患者往往病情复杂危重,可能临床特点相似,但实际病因不同,因而治疗重点各异,需临床医生认真剖析病情,找到关键病因,以尽量挽救患者生命。

Objective To explore the characteristics of diagnosis and treatment of severe tuberculosis-related patients and improve diagnosis and treatment of such diseases. Methods Retrospectively analyzed the clinical data of 4 severe tuberculosis-related patients with similar clinical symptoms admitted to our department from July to August, 2020. Results All 4 patients were diagnosed as active tuberculosis or latent tuberculosis infection, with one or several organs failure, fever, thrombocytopenia, liver and renal injury. They were given individualized positive rescue treatment, and achieved satisfying outcomes. Conclusions Severe tuberculosis-related patients often have complex and critical conditions, and may have similar clinical characteristics, but the actual causes are different, so the treatment focuses are different. Clinicians need to carefully analyze the condition, find out the key causes, and try to save the lives of patients.

目的 系统评价心脉通治疗冠心病的临床疗效及其安全性。方法 2名研究者独立系统地检索心脉通治疗冠心病的文献,其中包括维普中文科技期刊全文数据库(VIP)、PubMed 电子期刊全文数据库、中国学术期刊全文数据库(CNKI)、The Cochrane Library 数据库、万方数据库等6个数据库。同时运用Review Manager 5.4 软件进行本研究的数据处理。结果 最终共纳入8篇文献,共计985名心脉通治疗冠心病患者。治疗前后的临床疗效、发作频率、血脂水平的Meta分析结果显示心脉通组优于常规治疗组。有3项纳入试验报告不良反应。结论 心脉通治疗冠心病的临床疗效优于常规治疗。心脉通不仅可以降低冠心病发作频率,缩短其发作持续时间,还能调节血脂水平,在治疗冠心病方面疗效确切,值得临床参考应用。

Objective To systematically evaluate the clinical efficacy and safety of Xinmaitong in the treatment of coronary heart disease (CHD). Methods Two researchers searched the literatures of Xinmaitong in the treatment of coronary heart disease independently and systematically, including VIP Chinese Sci-tech Journal full-text Database (VIP), PubMed Electronic Journal full-text Database, Chinese Academic Journal full-text Database (CNKI), The Cochrane Library Database and Wanfang Database. At the same time, Review Manager 5.4 software was used to process the data of this study. Results A total of 8 articles were included, and a total of 985 patients with coronary heart disease were treated with Xinmaitong. The results of Meta analysis of clinical efficacy, attack frequency and blood lipids level before and after treatment showed that Xinmaitong group was better than routine treatment group. Three items were included in the report of adverse reactions. Conclusions The clinical effect of Xinmaitong in the treatment of coronary heart disease was better than that of routine treatment. Xinmaitong can not only reduce the frequency and duration of coronary heart disease attack, but also regulate blood lipids level. Xinmaitong was effective in the treatment of coronary heart disease and is worthy of clinical reference.

目的 观察龙氏正骨手法配合浮针临床上治疗颈源性头痛的疗效。方法 将本院80例颈源性头痛患者按1:1随机分为观察组和对照组,观察组采用龙氏正骨手法配合浮针治疗,对照组采用龙氏正骨手法治疗,于1疗程后比较2组临床疗效、疼痛视觉模拟评分(VAS)和颈椎活动度评分(ROM)情况。结果 治疗后两组VAS较治疗前均有改善(P<0.05),观察组较对照组明显(P<0.05)。2组ROM较治疗前均有改善(P<0.05),组间差异无统计学意义(P>0.05)。治疗组的愈显率高于对照组(P<0.05)。结论 龙氏正骨手法配合浮针治疗颈源性头痛能更好地减轻疼痛程度,方便高效。

Objective To observe the clinical effect of Long's bone-setting manipulation combined with floating acupuncture therapy on cervicogenic headache. Methods A total of 80 patients with cervicogenic headache in our hospital were randomly divided into observation group and control group evenly. The observation group was treated with Long's bone-setting manipulation combined with floating acupuncture therapy, and the control group was treated with Long's bone-setting manipulation only. After one course of treatment, the clinical efficacy,pain visual analogue score (VAS) and cervical joint range of motion (ROM) in the two groups were compared. Results After treatment, the VAS of the two groups was improved compared with that before treatment (P<0.05), and the VAS of the observation group was significantly higher than that of the control group (P<0.05). ROM in the two groups was improved compared with that before treatment (P<0.05), and there was no significant difference between the two groups (P>0.05). The effective rate of the treatment group was higher than that of the control group (P<0.05). Conclusions Long's bone-setting manipulation combined with floating acupuncture therapy in the treatment of cervicogenic headache can better reduce the degree of pain, which is convenient and efficient.