小青龙汤对慢性支气管哮喘患者肺功能的影响

目的:探讨小青龙汤治疗慢性支气管哮喘的临床疗效。方法:选取2009年1月至2011年1月我院收治入院的哮喘患者84例,随机分为对照组和治疗组,对照组采用西药对症治疗,治疗组在对照组的基础上联合应用小青龙汤,治疗结束后对两组患者的临床疗效和肺功能进行分析。结果:临床疗效比较:治疗组总有效率显著高于对照组(95.42%VS 80.95%,P<0.05);治疗结束后,两组患者肺功能FEV1占预计值%和PEF占预计值%均显著升高,肺功能明显好转(P<0.05),且治疗组肺功能改善更为明显(P<0.05)。结论:小青龙汤作为中医经典方剂治疗慢性支气管哮喘,可显著改善肺功能,提高临床疗效。     

布地奈德治疗支气管哮喘的临床效果观察

目的观察布地奈德治疗支气管哮喘的临床效果。方法选取2014年3月~2016年3月在我院检查并接受治疗的支气管哮喘患者120例,随机分为对照组55例和观察组65例,对照组采用常规方法治疗,观察组在常规治疗上加入布地奈德治疗,观察比较两组患者的临床疗效和不良反应情况。结果观察组的治疗有效率明显高于对照组,差异有统计学意义(P0.05);而且观察组的不良反应发生率明显低于对照组,差异有统计学意义(P0.05)。结论使用常规疗法联合布地奈德治疗支气管哮喘的疗效显著,而且不良反应少,值得临床推广。     

沙丁胺醇雾化吸入辅助治疗小儿支气管哮喘急性发作的疗效观察

目的:观察沙丁胺醇雾化吸入辅助治疗小儿支气管哮喘急性发作的疗效。方法:将纳入研究的170例处于支气管哮喘急性发作期的患儿随机分为A组和B组,各85例。A组给予常规西医治疗,B组在常规治疗的基础上给予沙丁胺醇雾化吸入治疗。治疗1周后观察疗效,并复查肺功能。结果:B组总有效率90.59%显著优于A组总有效率69.41%,比较有显著性差异(x2=11.912P0.05);治疗后,B组各肺功能指标改善幅度明显优于A组,比较均有显著性差异(P0.05)。结论:沙丁胺醇雾化吸入辅助治疗可迅速缓解小儿哮喘急性发作,且有助于改善肺功能,临床效果满意。     

综合护理干预在支气管哮喘合并过敏性鼻炎中的临床应用效果

目的评价综合护理干预在支气管哮喘合并过敏性鼻炎中的临床应用效果。方法选取2014~2016年我院收治的60例支气管哮喘合并过敏性鼻炎患者,按随机法分为观察组和对照组各30例,观察组采取综合护理干预,对照组采取常规护理干预,比较两组的临床效果及护理满意度情况。结果观察组的临床治疗总有效率为96.67%,对照组为66.67%,组间比较差异有统计学意义(P0.05);观察组患者的护理满意度为93.33%,对照组为70%,两组比较差异有显著统计学意义(P0.05)。结论支气管哮喘合并过敏性鼻炎患者实施综合护理干预,可提高患者的临床效果及护理满意度,值得推广应用。     

中西医结合治疗支气管哮喘疗效分析

笔者运用小青龙汤加减结合西药阿莫西林／舒巴坦钠针治疗支气管哮喘,疗效满意,值得临床推广。 1 资料与方法 1．1 陆床资料 96例慢性支气管哮喘患者均为金华市中医院门诊哮喘病例。年龄16～58岁,病程1～30年不等,病情以轻、中度为主。随机分为中医（药）治疗组、中西医治疗组。     

氧驱动雾化吸入联合针对性干预治疗小儿支气管哮喘的效果及安全性分析

目的观察针对性干预联合氧驱动雾化吸入用于小儿支气管哮喘的疗效及安全性。方法将我院收治的116例小儿支气管哮喘患者采用随机数字表法进行分组,对照组58例采用氧驱动雾化吸入及常规干预,观察组58例在对照组治疗的基础上实施针对性干预,比较两组患儿的临床疗效及安全性。结果观察组总有效率为96.55%,明显高于对照组的82.76%,差异有统计学意义(P0.05);并发症发生率比较,观察组为1.72%显著低于对照组的13.79%,差异有统计学意义(P0.05)。结论氧驱动雾化吸入联合针对性干预能有效提高支气管哮喘患儿的治疗效果,降低并发症发生率,且安全性高。     

小青龙汤对慢性支气管哮喘患者肺功能的影响

目的：探讨小青龙汤治疗慢性支气管哮喘的临床疗效。方法：选取2009年1月至2011年1月我院收治入院的哮喘患者84例,随机分为对照组和治疗纽,对照组采用西药对症治疗,治疗组在对照纽的基础上联合应用小青龙汤,治疗结束后对两组患者的临床疗效和肺功能进行分析。结果：临床疗效比较：治疗组总有效率显著高于对照组（95．42％VS80．95％,P〈0．05）;治疗结束后,两组患者肺功能FEV1占预计值％和PEF占预计值％均显著升高,肺功能明显好转（P〈0．05）,且治疗组肺功能改善更为明显（P〈0．05）。结论：小青龙汤作为中医经典方剂治疗慢性支气管哮喘,可显著改善肺功能,提高临床疗效。     

壮药(救必应颗粒)辅助治疗急性上呼吸道感染(风热犯表证)的临床研究

目的观察壮药(救必应颗粒)治疗急性上呼吸道感染(风热犯表证)的临床疗效。方法收集我科2017年7月～2018年6月符合诊断为急性上呼吸道感染(风热犯表证)的患者200例,随机分为治疗组与对照组,对照组给予常规西医治疗,治疗组在对照组基础上加用救必应颗粒治疗,观察比较两组临床疗效。结果两组患者在1个疗程(3天)后比较整体效果,治疗组的临床有效率为97.0%,对照组为89.0%,两组比较差异有统计学意义(P0.05);两组患者经治疗后,主症(发热、咽痛、流涕、咳嗽、肌肉酸痛)有效缓解时间比较,治疗组显著短于对照组(P0.05);两组患者经治疗后,中医症候积分均有所下降,但治疗组下降显著,两组比较差异有统计学意义(P0.05)。结论在常规西药治疗基础上加用壮药救必应颗粒治疗急性上呼吸道感染(风热犯表证)具有良好临床疗效,能快速减轻患者发热、咽痛、流涕、咳嗽等临床症状,缩短治疗时间,且无明显毒副作用及不良反应。     

多索茶碱治疗支气管哮喘40例临床观察

目的 为了评价多索茶碱治疗支气管哮喘的临床疗效.方法 将2010年以来我院收治的80例支气管哮喘患者随机分为观察组和治疗组各40例,观察组应用多索茶碱治疗,对照组应用氨茶碱治疗,并对两组的疗效及不良反应进行观察比较.结果 观察组总有效率为95%,明显高于对照组的70%,而且不良反应发生率较对照组低.结论 多索茶碱治疗支气管哮喘疗效显著,且不良反应少,值得临床推广应用.     

五味消毒饮联合西药治疗胃溃疡的临床分析

目的观察五味消毒饮联合西药治疗胃溃疡的临床效果。方法选择2013年12月~2014年11月我院诊治的胃溃疡患者68例为研究对象,随机分为对照组和观察组各34例。对照组给予常规西医治疗,观察组给予五味消毒饮联合西药治疗,比较两组的临床疗效、幽门螺杆菌(Hp)根除率、不良反应以及6个月复发率。结果观察组的治疗总有效率及Hp根除率均较对照组显著提高,差异具有统计学意义(均P0.05)。观察组6个月复发率为2.94%,与对照组的26.47%比较,差异有显著统计学意义(P0.05)。两组不良反应发生率比较,差异无统计学意义(P0.05)。结论五味消毒饮联合西药治疗胃溃疡的效果确切,复发率较低,而且能够有效清除Hp,临床应用价值较高。     

Evidence-based medicine,opinion-based medicine,and real-world medicine

The freedom of a doctor to treat an individual patient in the way he believes best has been markedly limited by the concept of evidence-based medicine. Clearly all would wish to practice according to the best available evidence, but it has become accepted that "evidence-based" means that which is derived from randomized, and preferably double-blind, clinical trials. The history of clinical trial development, which can be traced to the use of oranges and lemons for the treatment of scurvy in 1747, has reflected a progressive need to establish whether smaller and smaller effects of treatment are real. It has led to difficult concepts such as "equivalence" and aberrations such as "meta-analysis." An examination of evidence-based practice shows that it has usually been filtered through the opinions of experts and journal editors, and "opinion-based medicine" would be a more appropriate term. In the real world of individual patients with multiple diseases who are receiving a number of different drugs, the practice of evidence-based (or even opinion-based) medicine is extremely difficult. For each patient a judgment has to be made by the clinician of the likely balance of risks and benefits of any therapy. Good practice still requires clinical freedom for doctors.     

Hints of western medicine from Chinese medicine

As a biochemist, I have been studying lipolytic and lipogenic pathways in fat cells since 1963. In 1966, I proposed a hormone-sensitive substrate theory in which catecholamines might not act on lipase but on substrate during their lipolytic processes. The lipolytic and lipogenic pathways are negative and positive processes in triglyceride content of fat cells. Insulin inhibits the negative process (lipolysis) and stimulates the positive process (lipogenesis from glucose). On the other hand, catecholamine stimulates the negative process and inhibits the positive one. These hormones discriminate the negative and positive rules and regulate opposite ways. We tried to find these hormone-like substances in various natural products. We isolated tea saponins, chitosan, and others as insulin-like substances and dimethyl-xanthine as a catecholamine-like one. It is well known that extracellular fluid pH changes from 7.4 to 6.8. Reduction of the pH from 7.4 causes insulin resistance. Insulin failed to stimulate glucose uptake at pH 7.0 of the extracellular fluid. We found minus ions, which stimulated lipogenesis from glucose by raising extracellular fluid pH to 7.4. These are our approaches to find functional substances that prevent lifestyle-related diseases.     

From evidence-based medicine to genomic medicine

The concept of ‘evidence-based medicine’ dates back to mid-19th century or even earlier. It remains pivotal in planning, funding and in delivering the health care. Clinicians, public health practitioners, health commissioners/purchasers, health planners, politicians and public seek formal ‘evidence’ in approving any form of health care provision. Essentially ‘evidence-based medicine’ aims at the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients. It is in fact the ‘personalised medicine’ in practice. Since the completion of the human genome project and the rapid accumulation of huge amount of data, scientists and physicians alike are excited on the prospect of ‘personalised health care’ based on individual’s genotype and phenotype. The first decade of the new millennium now witnesses the transition from ‘evidence-based medicine’ to the ‘genomic medicine’. The practice of medicine, including health promotion and prevention of disease, stands now at a wide-open road as the scientific and medical community embraces itself with the rapidly expanding and revolutionising field of genomic medicine. This article reviews the rapid transformation of modern medicine from the ‘evidence-based medicine’ to ‘genomic medicine’.     

Philosophy of medicine is what philosophers of medicine do

Philosophy of medicine cannot be precisely defined because neither philosophy nor medicine can be precisely defined. Furthermore, philosophers of medicine do not constitute a well-defined class because they come not only from the fields of philosophy and medicine, but also from various other disciplines. Hence, I argue for a broad conception of philosophy of medicine that includes philosophical reflection on any matter considered to belong to medicine. A brief survey of the philosophy of medicine literature supports this view. Of the 625 articles surveyed for the years 1997-2006, nearly three-quarters dealt with matters of ethics, and of the 36 books surveyed, nearly 60% were primarily on ethics. Nonetheless, articles and books focusing on all other major branches of philosophy--metaphysics, epistemology, aesthetics, and logic--were also published. Moreover, many of the articles, even those primarily on ethics, dealt in significant ways with more than one branch of philosophy. I conclude that philosophy of medicine includes all sorts of philosophical reflection on medicine but is currently dominated by ethics. Given the stated purpose of journals and book series devoted to philosophy and medicine, this leaves ample room to expand other philosophical reflection on medicine.     

Bio-psycho-social medicine is a comprehensive form of medicine bridging clinical medicine and public health

This article introduces key concepts of work-related stress relevant to the clinical and research fields of psychosomatic medicine. Stress is a term used to describe the body's physiological and/or psychological reaction to circumstances that require behavioral adjustment. According to the Japanese National Survey of Health, the most frequent stressors are work-related problems, followed by health-related and then financial problems. Conceptually, work-related stress includes a variety of conditions, such as overwork, unemployment or job insecurity, and lack of work-family balance. Job stress has been linked to a range of adverse physical and mental health outcomes, such as cardiovascular disease, insomnia, depression, and anxiety. Stressful working conditions can also impact employee well-being indirectly by directly contributing to negative health behaviors or by limiting an individual's ability to make positive changes to lifestyle behaviors, such as smoking and sedentary behavior. Over the past two decades, two major job stress models have dominated the occupational health literature: the job demand-control-support model and the effort-reward imbalance model. In both models, standardized questionnaires have been developed and frequently used to assess job stress. Unemployment has also been reported to be associated with increased mortality and morbidity, such as by cardiovascular disease, stroke, and suicide. During the past two decades, a trend toward more flexible labor markets has emerged in the private and public sectors of developed countries, and temporary employment arrangements have increased. Temporary workers often complain that they are more productive but receive less compensation than permanent workers. A significant body of research reveals that temporary workers have reported chronic work-related stress for years. The Japanese government has urged all employers to implement four approaches to comprehensive mind/body health care for stress management in the workplace: focusing on individuals, utilizing supervisory lines, enlisting company health care staff, and referring to medical resources outside the company. Good communications between occupational health practitioners and physicians in charge in hospitals/clinics help employees with psychosomatic distress to return to work, and it is critical for psychosomatic practitioners and researchers to understand the basic ideas of work-related stress from the viewpoint of occupational health.