柴胡疏肝散加减治疗胆汁反流性胃炎疗效的Meta分析

目的:系统评价柴胡疏肝散治疗胆汁反流性胃炎(BRG)的有效性与安全性。方法:检索四大数据库中发表柴胡疏肝散治疗BRG的临床随机对照试验并运用Revman 5.2软件进行Meta分析,检索时限为建库至2016年7月。结果:所纳入7个研究中合计有392例胆汁反流性胃炎受试者,治疗干预予柴胡疏肝散加减,对照干预予常规西药。两者总有效率的Meta分析结果为柴胡疏肝散治疗BRG的临床有效率优于常规西药,差异有统计学意义[OR=5.73,95%Cl为(3.68,8.92),P0.000001]。总有效率漏斗图中可见散点分布不对称,由此说明文章存在偏倚,通过方法学评价而知纳入的RCT均属于高偏倚风险级别。结论:柴胡疏肝散在治疗BRG总有效率高于常规西药,但所纳入的RCT均属于高偏倚风险级别,RCT质量评价低,目前还没有足够证据支持推荐柴胡疏肝散用于治疗BRG。     

柴胡疏肝汤加减治疗胃神经官能症

胃神经官能症是一种全身性疾病，乃是由于高级神经活动障碍而导致植物神经系统机能失调，临床主要表现为胃的分泌及运动机能紊乱，而出现呕吐或频繁暖气，患者多为中年妇性，运用柴胡疏肝汤加减治疗胃神经官能症56例均为1997年至1999年杭州市第一人民医院中医科门诊病例，治疗结果提法，只要谨守病机，在中医辨证论治的基础上灵活运用，即可取得满意的疗效。     

柴胡疏肝汤治疗癫痫的研究进展

癫痫是最常见的神经系统疾病之一,癫痫的反复发作严重影响患者的身心健康.癫痫的发病机理尚不十分明了,已有的西药抗癫痫治疗仍不能取得令人满意的疗效.近年来,"从肝论治癫痫"的理论被广泛认可,柴胡疏肝汤治疗癫痫的相关研究也取得显著的成效,中医药在癫痫治疗中发挥着重要的作用,文章就柴胡疏肝汤对癫痫的实验及临床研究作一综述.     

柴胡的药理学分析以及临床应用

柴胡是常用中药之一,有南柴胡、北柴胡之分。本文总结了柴胡的成分、药理药性及临床应用情况等,并具体阐述引占床验案研究概况。     

虎力散胶囊治疗风湿骨病的研究概况

虎力散胶囊作为一种纯中药制剂,由制草乌、三七、断节参和白云参配伍而成。临床上常应用于风湿骨病的治疗,具有一定的抗炎、镇痛、免疫抑制作用,亦存在乌头碱样作用等不良反应。文章通过查阅近年来的文献,整理、归纳出虎力散胶囊在治疗风湿骨病中的应用情况、药效机制及不良反应,拟为虎力散胶囊的临床应用及进一步的药效机制研究提供参考。     

柴胡桂枝汤的研究进展

近年来，在临床应用方面柴胡桂枝汤被用于治疗感冒、呼吸道感染、消化道炎症、女性更年期综合征、慢性耳鸣、冠心病、癫痫、神经疼痛、肿瘤等疾病并取得良好疗效。药理研究有所突破，但对柴胡桂枝汤配伍规律研究尚未见报道。因此该问题还有待进一步研究。     

疏肝健脾法在非酒精性脂肪肝中的应用概况

非酒精性脂肪肝(NAFLD)是指非酒精性因素造成的脂肪肝,在我国NAFLD的发病率越来越高,同时NAFLD是增加2型糖尿病、心血管疾病和慢性肾病易感性的危险因素,甚至有部分严重者发展成肝癌,随着发病率的增高,NAFLD已成为严重危害人们健康的疾病之一。中医对脂肪肝未有确切的病名,主要是由于脾虚、湿停、气滞、血瘀等引起,并且相互作用,互为影响,笔者回顾近几年治疗非酒精性脂肪肝的国内外文献,发现中医工作者在经过大量的临床研究后,证实了中医在治疗NAFLD中有着独特的优势,其中肝郁脾虚型脂肪肝最为常见,并取得了甚好的疗效,现综述疏肝健脾法在该病的应用。     

金纳多临床应用概况

综述了金纳多近年来在国内的临床应用，指出其在缺血性脑血管病、耳聋、眩晕、糖尿病并发症及冠心痛等方面的应用及疗效。金纳多治疗上述疾病的机理是：改善血液流变状态、抑制血小板聚集、抗氧化、清除自由基、缓解缺血缺氧和舒张血管平滑肌等有益作用。     

复方藏药嘎久咖擦散治疗黄疸型肝炎100例临床疗效观察

目的：证明复方藏药嘎久咖擦丸治疗黄疸型肝炎的疗效。方法：以藏医理论为指导选择100例黄疸型肝炎患者随机分为治疗组50例和对照组50例。对照组用促肝细胞生长素80mg和茵栀黄20ml静脉滴注,每日1次;治疗组用嘎久咖擦散口服,每日3次,每次1包。疗程共4周,观察嘎久咖擦散的临床疗效。结果：嘎久咖擦散对黄疸型肝炎的疗效好,总有效率为91．83％,显著高于对照组58．79％,P〈0．05。     

PBL教学模式在肝病科临床带教中的应用

探讨以问题为基础的教学模式在肝病科临床带教中效果。选取中医学本科60名学生随机分为PBL教学组和传统教学组,采用发放调查问卷及理论考核等方式评价其作用,结果显示PBL教学模式可提高学生自主学习的能力,增强学生分析临床问题能力,增加学生学习的兴趣及积极性、主动性,明显优于传统教学模式,值得推广应用。     

肝包虫疾病中螺旋CT的应用价值

目的：评价肝包虫病检查、诊断中CT的应用价值。方法：分析我院经临床、手术、病理证实的90例肝包虫疾病CT表现,讨论其在肝包虫病检查中的CT应用价值。结论：CT在肝包虫疾病的检查中,对诊断肝包虫病提供了更加直观的影像学证据,凭借其良好的密度分辨率及无重叠影对肝包虫病的定位、定性诊断、鉴别诊断有着重要意义。现代螺旋CT检查对该病的检查、诊断,甚至成为“金标准”。     

典型病例结合PBL教学法在肝病科临床实习生教学中的应用以及体会

根据广西中医药大学第一附属医院开展PBL教学法的成果,总结自身多年的带教经验,运用典型病例结合PBL教学法进行带教,不断提高自身教学水平,激发学生的学习热情,鼓励学生进行理论联系临床问题独立思考以及自主学习,提高临床思维,培养学生独立解决问题能力,强化专业技能,重视医德医风,提高教学质量。     

瑶医特色疗法在常见病中的临床应用综述

目的:了解瑶医特色疗法在常见病中的临床应用。方法:检索10余年来瑶医常用特色疗法药浴、挑针、熏洗、药灸等治疗常见病的相关文献,对查找的资料进行分析、总结。结果:瑶医常用特色疗法外治产后妇女康复、风湿病、关节痛、原发性痛经、肠易激综合征等均有较好疗效。结论:瑶医常用特色疗法在常见病的治疗方面疗效肯定,操作简便,适宜在临床上推广。     

血清透明质酸放射免疫测定在肝病诊断中的应用

血清透明质酸(HA),主要由肝内皮细胞摄取分解,小分子由肾小球滤过、排泄。当肝、肾功能受损时,血清HA升高,且与病变的严重程度有关。本文用放射免疫法检测了87例肝病患者血清HA及甲胎蛋白(AFP)的水平,通过对比分析发现,以血清HA水平判断肝脏疾病较AFP敏感。     

Studies on some serum enzyme levels in various liver diseases

Serum alkaline phosphatase (ALP) (EC 3.1.3.1), 5′nucleotidase (5′NT) (EC 3.1.3.5), aldolase (ALD) (EC 4.1.2.13) and sorbitol dehydrogenase (SDH) (EC 1.1.1.14) were estimated in infective hepatitis, alcoholic hepatitis, chronic active hepatitis, obstructive jaundice, cirrhosis of liver and amoebic liver abscess. It was observed that serum ALP and 5′NT were significantly increased in all cases of chronic active hepatitis and obstructive hepatic disease. However, the elevation observed in the latter was much higher than the former. Serum SDH and ALD levels were elevated in all cases of infective hepatitis, studied though increase in the former was much higher than the latter, suggesting its significance in the diagnostic confirmation of this disease. Results presented suggest 5′NT and SDH as more reliable diagnostic test compared to ALP and ALD for obstructive jaundice and infective hepatitis respectively.     

Glutathione and some related enzymes in erythrocytes of patients with liver diseases

Red-cell glutathione (GSH) contents and enzyme activities of glutathione peroxidase (GSH-Px) as well as glutathione reductase (GSSG-R) were assayed in 30 normal subjects, 60 cirrhotic patients and 60 cancer patients. The mean GSH level and GSSG-R activity studied showed increased values in all diseased groups compared to normal values with significant elevations only in liver metastases group. Reduced enzyme activity of GSH-Px has been noted in both the cirrhotic groups but the decrease was significant only in alcoholic cirrhotic group. Decreased red-cell GSH-Px activities below the normal range were found in all the cancer patients with remarkable reduction in liver metastases than in hepatocellular carcinoma.     

Monitoring oxidative stress in patients with non-alcoholic and alcoholic liver diseases

Ethanol-induced liver injury may be linked, at least partly, to an oxidative stress resulting from increased free radical production and/or decreased antioxidant defence. Distinguishing alcoholic and non-alcoholic liver disease has important implications. This study looked at the possible changes between alcoholic and non-alcoholic liver diseases by examining the presence of oxidative damage, as monitored by several parameters relating to oxidative stress. Lipid peroxides concentration, superoxide dismutase activity and glutathione S-transferase activity increased, where as glutathione content, glutathione peroxidase activity and glutathione reductase activity decreased among the tested subjects in comparison to normal healthy group. Determination of these parameters may be valuable in the evaluation of liver disease. However, oxidative stress related enzymes and non-enzymes can not be utilized as a marker for alcoholic liver diseases, as these parameters responded in the same way after liver is damaged irrespective of their cause. Their level may help in determining the degree of liver damage. Degree of oxidative injury was similar in patients with non-alcoholic liver disease and in moderate drinkers; while significantly higher in heavy drinkers. The differences between the groups might be based on the type of liver pathological condition rather than its etiology (i.e. alcohol and non alcohol related causes).     

拉萨地区肝硬化临床病因分析

目的：了解肝硬化在拉萨地区的流行病因学特点，探索预防和减少肝硬化发生的对策，提高人们对该病的重视和认识。方法：对我院1991年1月至2001年12月11年间收治的1439例确诊的肝硬化病例进行回顾性统计分析。结果：肝硬化的病因中以乙型病毒性肝炎居多，占45.1%；其次为乙型肝炎病毒感染合并酒精性肝损害和酒精中毒。发病年龄高峰多在38-56岁，死亡年龄多在42-63岁，死亡原因以上消化首大出血、肝性脑病、肝肾综合征为主。结论：肝硬化一旦发展为肝功能失代偿期，常常不可塑转，病情也越来越严重。提醒人们为了保持身体健康，要积极预防肝炎，不要酗酒，尤其患有肝炎后要严格禁酒。积极预防和治疗上消化出血、肝性脑病对降低肝硬化的残废率极为重要。