Volume10 July2003 Number4
CHINESE JOURNAL OF INTEGRATED TRADITIONAL
AND WESTERN MEDICINE IN INTENSIVE AND CRITICAL CARE
Volume 10 July 2003 Number 4
PAGE：197-200
Randomized control study of integrated traditional Chinese and western medicine in treatment of 77 patients with severe acute respiratory syndrome
ZHAO Chun-hui, LI Xiu-hui, ZHANG Ke, JIN Rong-hua, GOU Chun-yan, HU Zhong-jie, YE Jun, YANG Yu, GUO Xin-hui, LIANG Lian-chun, HU Jian-hua, LI Xue-mei, WU Ju-shan Beijing Youan Hospital, Capital Medical University, Beijing100054, China.
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Abstract: Objective: To evaluate the treatment effects of integrated traditional Chinese and western medicine (TCM WM) on severe acute respiratory syndrome (SARS). Methods: Therapeutic effects of 77 SARS patients treated with TCM WM or western medicine (WM) alone were analyzed by the randomized control method. Results: All the 37 cases of TCM WM group and 39 cases of WM group were restored and discharged from hospital, one case in WM group died. CD +4 T lymphocyte decreased from (497±262)cells/μl to (377±190)cells/μl in 27 cases of WM group in the stage of acute period, and increased from (584±440)cells/μl to (662±316)cells/μl in 24 cases of TCM WM group 7 days after treatment (P<0.05). The average time of chest X-ray radiogram absorption were (18.4±8.2)days in 6 cases of WM group in the stage of acute period, which was two days fewer more than that of 22 cases of TCM WM〔(16.2±8.8)days〕. The average time of SARS patients from severe type turn to common type were (10.9±3.4)days in the WM group, which was one day fewer than that of TCM WM group〔(9.3±3.8)days〕. In WM group, the average of sum dosage of corticosteriod for 20 patient was (1 325±623)mg, which was slightly lower than that of 15 patients in TCM WM group〔(1 400±685)mg〕. The average time of first dosage reduction of corticosteriods was (8.1±3.8)days, which was two days longer than that of the TCM WM group〔(6.4±3.7)days, P>0.05〕. Conclusion: Compare to the WM group, TCM WM treatment can improve immunity of SARS patients quickly, accelerate absorption of chest X-ray radiogram, reduce the using time of corticosteroid, accelerate recovery of SARS patients.
, 百拇医药
PAGE：201-203
Analysis on traditional Chinese medicine syndrome characteristics of severe acute respiratory syndrome patients in emergency department
LUO Yi, OU Ai-hua, YAN Xia, LIU Tao, LI Ji-qiang, HUA Rong, ZHONG Shi-jie, FANG Tong-nian, XI Xiao-tu, YE Ye, ZHANG Hong-ye, HAN Fan, FAN Cai-xia
Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China.
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Abstract: Objective: To investigate the characteristics of traditional Chinese medicine (TCM) syndrome in severe acute respiratory syndrome (SARS) in emergency department. Methods: SARS clinical information collection list was used to set up a clinical presentations and four examination techniques database. Then descriptive statistics and cluster statistics were used to analyze the data. TCM syndromes were recorded in 61 SARS patients first visiting to doctor in emergency department. Results: The mainly two types of the 61 SARS patients first visiting to doctor were epidemic toxin's incursion, syndrome of both the defense and Qi phases(疫毒侵袭,卫气同病), and toxin invading in the lung and stomach, obstruction by turbid dampness (毒蕴肺胃,湿浊阻遏). Among the two types, the former occupied 77.05 percent(47 cases), and the later 22.95 percent(14 cases). Conclusion: SARS's TCM name ought to be pestilence, which caused by seasonal pathogens and epidemic toxin. In the early period, the toxin makes incursions into the upper and middle heaters, manifested mostly with syndrome of both the defense and Qi phases and obstruction by turbid dampness. The therapy is disspating the superficial and clearing interior heat， curing both the defense and Qi phases (疏表清理,卫气同治), dissolving the turbid with aromatics and removing damp pathogen(芳香宣化,分消走泄) respectively.
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PAGE：204-207
Clinical investigation of traditional Chinese medicine in treatment of 71 patients with severe acute respiratory syndrome
PAN Jun-hui, YANG Hui, YU Qing-he， WANG Feng，QIU Zhi-nan, ZHONG Shu-qing， ZENG Qing-en， ZHONG Nan-shan.
The First Affiliated Hospital, Medical College of Guangzhou, Guangzhou 510120, Guangdong, China.
Abstract: Objective: To observe the therapeutic efficacy of traditional Chinese medicine (TCM) in treatment of severe acute respiratory syndrome(SARS). Methods: The therapeutic efficacy of TCM in treatment of 71 patients with SARS from December 22, 2002 to May 30, 2003 were reviewed. The therapy was divided into three periods according to the pathological changes and course of diseases. ①Fever period: the means of cure were clearing away lung-heat and removing toxic agents (清肺解毒)， cooling the blood and activating Qi (凉血行气)， leting out the evil factors and reaching the exterior (透邪外达). The medicines were Kangyan I recipe(抗炎I号方), Yuxingcao injection(鱼腥草注射液), Chuanhuning injection(穿琥宁注射液), Tianlong tea(天龙茶). ②Losing one's breath period: the means of cure were clearing away heat and relieving asthma (清热平喘)， eliminating the heat of Ying system and counteracting toxin (透营败毒)， clearing epidemic disease and turbid (宣通疫浊). The medicines were Kangyan Ⅱ recipe(抗炎Ⅱ号方)， Shenfu injection(参附注射液), Shenmai injection (参麦注射液), Eshuyou injection(莪术油注射液). ③Convalescence: the means of cure were clearing away the remaining poisonous substances (清化余毒)， replenishing Qi and nourishing Yin (益气养阴)， regulating and nourishing the lung and spleen (调补肺脾). The medicines were Kangyan Ⅲ recipe(抗炎Ⅲ号方)， Shenmai injection(参麦注射液), astragalus injection(黄芪注射液), Tianlong Chuankeling capsule (天龙喘咳灵胶囊). Results: The days of hospitalization for 71 patients of SARS were 9-78 days 〔mean (27.1±14.4)days〕 and the patients of clinical cure were 70 (the heal rate was 98.6 percent). One patient died, the mortality was 1.4 percent. All patients were fever in the early stage, and the days of fever were (6.3±5.5)days before being in hospital. The temperature was 37.3-40.5 ℃ and most patients' temperature was over 39 ℃, the average days of fever reduce through medicine was (5.7±3.4)days (ranged 1-15 days). Conclusion: Integrated TCM and western medicine therapy could improve the clinical symptoms and reduce the mortality of severe patients. It is very important to use the clearing Qi and heat in the Ying system (清气清营) medicine expecially reducing fever in the early stage.
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PAGE：208-210
Characters of traditional Chinese medicine occurrence time and the circulation of Qi theory(运气学说) in 103 severe acute respiratory syndrome patients
LIU Min-wen, ZHONG Shi-jie, LIU Tao
Department of Emergency, Guangdong Traditional Chinese Medical Hospital, Guangzhou 510120, Guangdong, China.
Abstract: Objective: To discuss the occurrence characters and the relationship of traditional Chinese medicine(TCM) time and circulation of Qi theory(运气学说) of severe acute respiratory syndrome(SARS) and to provide relevant clues for studying the pathology of it. Methods: By combining 103 SARS patients in Guangzhou admitted from January 2003 to April 2003, differentiation method of TCM and the circulation of Qi theory were used to expand some occurrence characters of SARS initially. Results: TCM name of SARS was suggested to be defined infectious atypical pneumonia and epidemic disease, which was possibly related to abnormal climate. Its characters had two sides. First, based on fire of Yang(阳) heat, cold water of greater Yang was turbulent by dry metal of Yang brightness. Second, based on fire deficient, damp earth was turbulent by wind-wood of reverting Yin(阴). “Damp-heat toxin complicated with stasis” accompanied with the whole process of dynamics transmutation. Conclusion: Individual treatment of TCM should be used based on the TCM character and developing regularity of SARS.
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PAGE：211-213
Analysis on diagnosis and treatment with integrated traditional Chinese and western medicine in 20 severe acute respiratory syndrome patients infected in hospital
LOU Tan-qi, LIU Xun，BI Xiao-gang, ZHANG Kou-xing, XIE Qi-feng
Nephrology Department of Internal Medicine, The Third Affiliated Hospital of Zhongshan University, Medical Branch, Guangzhou 510630, Guangdong, China
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Abstract: Objective: To summarize the clinical features and managements of hospital staff with severe acute respiratory syndrome (SARS) infected in hospital. Methods: Clinical data of 20 SARS staffs in our hospital from February 2003 to May 2003 were retrospective analyzed. Results: All had a direct personal contact with SARS patients. The incubation period of the disease was 2-7 days. Fever and cough were the initial symptoms. The respiratory symptoms progressed in some of the patients. Laboratory features included normal peripheral white blood cell (WBC) count. Focal involvement was common in chest X-ray radiographs. It was easy to meet the diagnostic criteria of SARS. The clinical outcome was good. Aggressive infection control measures were effective in preventing further transmission of this disease. Conclusion: The diagnosis of SARS in hospital staff is easy to make. The treatment with glucocorticoid in a short period is safe. Integrated traditional Chinese and western medicine therapy is benefit to the improving of symptom, and the clinical outcome is good.
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PAGE：214-216
Clinical study on treatment of severe acute respiratory syndrome with integrated traditional Chinese and western medicine
LI Zhi-jun， BAO Feng-he， LI Qing， WANG Bing-shen, LI Yin-ping， WANG Chin-ta
The First Central Hospital of Tianjin, Tianjin 300192, China.
Abstract: Objective: To evaluate the effect of integrated traditional Chinese and western medicine treatment on severe acute respiratory syndrome (SARS). Methods: Twenty-eight SARS cases were randomly divided into treatment group (using integrated traditional Chinese and western medicine therapy) and control group (purely using western medicine), 14 cases for each group. Both groups were given routine anti-SARS of western medicine, i. e. antivirotics, corticosteroids, immunomodulation agent and non-invasive ventilation. The treatment group was treated with the Chinese herbs on the basis of traditional Chinese medicine differentiation, i.e. Chuanhuning injection(穿琥宁注射液), Shenmai injection(参麦注射液)， Hufei Qingsha drink(护肺清痧饮)， Jiedu Zhitong capsule(解毒止痛胶囊), Zhuyin Sanjie capsule(逐饮散结胶囊), Qingshaling spray (清痧灵喷剂). Results: After treatment the time of decreasing of temperature, improvement of symptoms, absorption of chest X-ray, recovery of degree of blood oxygen saturation in treatment group were better than those in control group, but they had no discrepancy significantly (all P>0.05). The dosage of glucocorticoid in treatment group was less than that in control group〔(699.29±111.66)mg vs. (1257.14±247.90)mg, P<0.01〕.Conclusion: It is showed that the integrated traditional Chinese and western medicine treatment can significantly decrease the dosage of glucocorticoid and the incidence of complications
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PAGE：217-219
Observation on therapeutic effects of traditional Chinese medicine in 26 patients with severe acute respiratory syndrome
SUN Zhong-ji，LI Yu-ming，JI Jin-li，BI Gui-quan，MU Yu，CHEN Xiao，LIU Yang
The Hospital Attached to Medical College of Chinese People's Armed Polices Forces， Tianjin 300162, China.
Abstract: Objective: To summarize the therapeutic experience of severe acute respiratory syndrome(SARS). Methods: The characteristics and kinetic changes of course in 26 patients suffered from SARS were retrospected. The imaging features of pulmonary lesions in chest X-ray radiograms and laboratory's data including hemogram, blood gas, blood glucose, electrolyte, renal function, liver function, and myocardial enzyme were observed. The effects of the medications and noninvasive mechanical ventilation in western medicine (WM) group (n=18) and traditional Chinese medicine (TCM) combined WM group (n=8) were evaluated. Results: ①The courses of SARS might be distinguished with early period of fever, inflammatory exudation of lungs, severe hypoxemia and absorption of pulmonary exudative inflammation. ②Ribavirin had no effect on the SARS coronavirus. Glucocorticoid could relieve intoxication of the patients suffered from SARS. The Yuxingcao injection(鱼腥草注射液) and Qingkailing injection(清开灵注射液) had secondary treatment effectiveness in early period. ③The continuous positive airway pressure(CPAP) could increase blood oxygen content for the patients with hypoxemia. ④The continuous time of fever and hypoxemia, the time in hospital and the number of dead patients in TCM combined WM group were all lower than those of the WM group. Conclusion: Appropriate use of glucocorticoid and maintaining treatment for body function should be used in the treatment of SARS. TCM is beneficial to the improvement of clinical symptoms and prognosis and oxygen therapy in time by CPAP should be recommended.
, 百拇医药
PAGE：220-222
Effects of hyperventilation on cerebral oxygen supply and consumption in perioperative patients with severe head injury and their significance
CHENG Ming-hua, YAO Yong-ming
Department of Anesthesiology, First Affiliated Hospital of Medical College of Shantou University, Shantou 515041, Guangdong, China.
Abstract: Objective: To investigate the effects of hyperventilation on jugular venous oxygen saturation (SjvO2), arteriovenous oxygen content difference(A-VDO2) and lactate concentration difference(V-ADL) perioperative patients with severe head injury and their significance. Methods: Sixteen patients with severe head injury for operation were studied. The changes of SjvO2, A-VDO2 and V-ADL in response to changes in partial pressure of oxygen in artery (PaO2) and partial pressure of carbon dioxide in artery (PaCO2) were studied through adjusting respiratory rate and fraction of inspired oxygen. Results: SjvO2 decreased significantly and A-VDO2 increased significantly when PaCO2 deceased from 30 mm Hg to 25 mm Hg (1 mm Hg=0.133 kPa) at a PaO2 of 100-150 mm Hg or 200-250 mm Hg. The absolute value of SjvO2 was greater and the absolute value of A-VDO2 was lower at a PaO2 of 200-250 mm Hg for any given PaO2. V-ADL did not change significantly only at a PaO 200-250 mm Hg and PaCO2 30 mm Hg. Conclusion: Moderate hyperventilation to a PaCO2 of 30 mm Hg in combination with higher PaO2 (200-250 mm Hg) may be beneficial for patients with severe head injury.
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PAGE：223-225
Diagnosis value of high density lipoprotein phospholipids on coronary heart disease of kidney-Yang deficiency syndrome(肾阳虚证)
GUO Ping-qing, LIN Qiu-cheng, GUO Yin-geng, SHEN Zong-guo
First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian, China. Abstract: Objective: To look for a new biochemical index for diagnosis of coronary heart disease (CHD) of kidney-Yang deficiency (KYD, 肾阳虚) syndrome. Methods: Sixty-one patients with CHD were divided into three groups according to their traditional Chinese medicine(TCM) syndrome differentiation, 10 patients in the group without heart-Qi deficiency(HQD，心气虚, group A),25 patients in the group with HQD but without KYD (group B) and 26 patients in the group both with HQD and KYD (group C).Levels of 17-hydroxy-corticosteroid in urine(17-OHCS) per 24 hours, serum level of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein phospholipids (HDL-PL) were determined in synchronization and compared with those in the control group of 23 healthy aged persons. 17-OHCS per 24 hours was taken as the diagnostic standard to screen a new index for diagnosis of KYD syndrome, and preliminary appraisal to the index was made. Results: Serum HDL-PL in the CHD-KYD patients (group C) was (616±157)mg/L, which was obviously lower than that in the patients of group A (911±189)mg/L and B(763±167)mg/L. With low HDL-PL(<650 mg/L) used as the index to diagnose CHD-KYD,the sensitivity was 73 percent, the specificity was 86 percent and the accuracy was 80 percent. Conclusion: HDL-PL<650 mg/L could be adopted as an index for CHD-KYD diagnosis,which is simple and practical.
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PAGE：226-228
Analysis on complications and mortality in patients with hypertensive middle and large amount cerebral hemorrhage after integrated traditional Chinese and western medicine treatment including surgical operation
LU Ming, HUANG Yan, DU Bao-xin, LIANG Wei-xiong, HUANG Pei-xin, LIU Mao-cai
Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China.
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Abstract：Objective：To analyze effect on complications and mortality in patients with hypertensive middle and large amount primary intra-cerebral hemorrhage (ICH) treated with traditional Chinese medicine (TCM) and surgical operation. Methods： A simple prospective randomized control trial was applied in 201 cases of ICH with Yang-or Yin-block sign(阳闭证或阴闭证) involved in Zang-fu organs (中脏腑). The cases were randomly divided into two groups: 103 cases in treatment group were treated with surgical operation, TCM syndrome differentiation 〔the cases with Yang-block sign were treated with Tongfu Xingshen capsule (通腑醒神胶囊), Naomai Ⅱ capsule(脑脉Ⅱ号胶囊) and Qingkailing injection(清开灵注射液), the cases with Yin-block sign were treated with Tongfu Xingshen capsule, Naomai Ⅰ capsule(脑脉Ⅰ号胶囊) and tetramethylpyrazine injection(川芎嗪注射液)〕 and the routine therapy. Ninety-eight cases in control group were treated with comprehensive therapy including surgical operation, the routine therapy and western medicine. The therapeutic course was 28 days. Complications and mortality in relation to them were analyzed at 28 days and 6 months' follow-up. Results： Fifty-four cases suffered complications in treatment group, and 75 cases in control group(χ2=11.38, P<0.01). The mortality of two groups in 7 days was insignificant (P>0.05); 5 cases died from 7 to 28 days in treatment group, and 17 cases in control group (χ2=8.04, P<0.01); 5 cases and 13 cases died from pneumonia in treatment group and control group respectively (χ2=4.36,P<0.05). The main factors of death were cerebral hemorrhage within one week and lung infection from 7 to 28 days. Conclusion： Complications after surgical operation are the predictors of fatal outcome in ICH. Comprehensive therapy integrated TCM and western medicine can lessen the mortality of hypertensive middle and large amount ICH, the mechanism maybe related to treatment according to the TCM syndrome differentiation, modulating an organic whole and decreasing complications especially pneumonia.
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PAGE：229-231
Clinical study of therapeutic effect of Shenkang capsule (肾康胶囊) in treatment of acute glomerulonephritis
WU Xi-xin
Department of Nephrology, The Fifth Affiliated Hospital of Zhongshan University, Zhuhai 519000, Guangdong, China.
Abstract: Objective: To observe the clinical effect of Shenkang capsule (SKC,肾康胶囊) for treating acute glomerulonephritis(AGN). Methods: SKC was prepared by modern pharmacy technique with Chinese herbs of poria(茯苓), alisma(泽泻), rhizoma imperatae(茅根), gryllotulpa africana(蝼蛄), carapax trionycis(鳖甲), nephritis herb(肾炎草) and raw rhubarb(生大黄). Thirty-eight cases with AGN were divided into the control group (18 cases) and the SKC group (20 cases) randomly. Patients in the control group were treated with penicillin G 80×104 U by muscle injection, two times every day for two weeks, and patients accompanied edema and hypertension symptom were treated to symptom. Patients in the SKC group were treated with SKC, 5tables each time, three times every day on the base of treatment of penicillin and to symptom. The courses in two groups were all two weeks. At the end of the treatment, the weight, mean arterial pressure, 24 hours urine protein quantity, 1 hour urine red blood cell excreting rate(1huRBCer), blood urea nitrogen, serum creatinine, potassium and sodium before and after the treatment were observed, and 24 hours urine protein quantity and 1huRBCer were observed for six weeks followed the treatment. Results: SKC could significantly lighten 24 hours protein urine quantity 〔reduced from (267±162)mg/24 h to (148±110) mg/24 h two weeks after giving SKC, P<0.05〕 and significantly reduce 1huRBCer 〔reduced from (46±7)×10 4/h to (11±6)×10 4/h two weeks after giving SKC, P<0.05; (5±3)×10 4/h in SKC group six weeks after giving SKC and (13±8)×10 4/h in control group, P<0.05〕 for AGN. There was no side-effect in the course of using SKC. Conclusion: AGN could be treated with SKC for preventing its delay.
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PAGE：232-233
Experimental study of astragalus membranaceus on nitric oxide synthase in brain tissue activity after acute brain injury in rats
TANG Zong-chun, YANG Xi-min, LI Shuan-de, WANG Xiao-feng, LI Ying-guo.
Neurosurgery Institute of Lanzhou Command, Third Hospital of People's Liberation Army, Baoji 721004, Shanxi, China.
Abstract：Objective： To bserve the effect of astragalus membranaceus(AM) on nitric oxide synthase (NOS) activity in brain tissue after injury and investigate its therapeutic action and mechanism in acute cerebral injury rats. Methods： Rat cerebral injury models were established and the NOS concentration was tested at 30 minutes, 2 hours, 6 hours, 24 hours after injury. Results： NOS activity increased sharply in 30 minute after injury 〔(46.44±13.45)nmol/L, P<0.05〕 and the step-up was great higher contrasting with control group〔(40.46±12.85)nmol/L, P<0.01〕， from 6 hours to 24 hours after injury it declined to normal level. In the AM treated group， NOS activity dropped at 2 hours〔(64.26±19.78)nmol/L〕 and 6 hours〔(52.91±21.36)nmol/L〕 after injury contrasting with injury group 〔(67.49±22.45)nmol/L and (63.46±24.68)nmol/L respectively, P<0.05 and P<0.01 respectively〕. Conclusion： NOS activity increase in the injuried brain tissue and AM could protect injuried neuron by depress NOS activity.
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PAGE：234-235
Effects of puerarin injection(葛根素注射液) on plasma endothelin-1 in patients with congestive heart failure
ZHANG Yan-li
Anyang District Hospital, Anyang 455000, Henan, China.
Abstract: Objective: To investigate the mechanism of puerarin in patients with congestive heart failure (CHF). Methods: One hundred and twenty patients suffered from CHF were randomly divided into two groups, and they were treated with the same western medicine therapy. In addition, the puerarin treatment group (n=60) was treated with puerarin injection(葛根素注射液) intravenously drip of 300 mg mixed 250 ml of 5 percent glucose once a day for 15 days. At the end of the course, the alterations of heart function and plasma endothelin-1(ET-1), the therapeutic effects were observed before and after the treatments, and the difference between the two groups was compared. Results: In puerarin treatment group, the effective rate was higher than that in control group (86.7 percent vs. 75.0 percent, P<0.05), plasma ET-1 was decreased significantly after treatment〔(152.60±11.54)ng/L vs. (106.98±12.44)ng/L, P<0.05〕, but in routine treatment group the plasma ET-1 was not decreased significantly〔(147.65±9.78)ng/L vs. (142.60±11.36)ng/L, P>0.05〕. Conclusion: Puerarin can improve the heart function of CHF patients, the mechanism maybe decrease plasma ET-1 level and improve the blood supplying of myocardium.
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PAGE：236-238
Estimation on curative effect of the surgical operation combining traditional Chinese medicine for the comminuted and intra-articular fractures of the distal radius
ZHAO Qing， TANG Yu-xing, CHEN Shao-min， CAI Dao-zhang
Department of Bone, the Fifth Affiliated Hospital of Zhongshan University， Zhuhai 519000, Guangdong, China.
Abstract： Objective： To estimate the curative effect of the surgical operation combining traditional Chinese medicine (TCM) for the comminuted and intra-articular fractures of the distal radius. Methods： Thirty-two cases of suffering from the comminuted and intra-articular fractures of the distal radius by different operation method treatment in three years were synthetically analyzed and 7 cases of them were treated with TCM after operation. All cases were sorted according to AO principle. Thirty-two cases were operated upon either with internal fixation with the Titanium screw plane or with simple internal fixation adding external fixator or with simple external fixator according to the types of fracture. Results： All patients were followed-up regularly. According to AO evaluation of the wrist joint movement, 81.25 percent (26 cases) of the patients had satisfactory functional outcome, 15.62 percent (5 cases) of the patients had quite satisfactory functional outcome and only 3.13 percent (1 case) of the patients had unsatisfactory functional outcome. The time of the fracture concrescence and being in hospital in the patients of applied TCM were significantly shortened by X-ray photo. Conclusion： The reduction of the distal radial fractures should include the maintenance of the relative length of the radius and ulna, the smoothness of the articular surface and the palmar and ulnar deviation angles. The shortening of the radius results in the pain with movement and the restriction of function, and hence is considered to be the most important factor affecting the joint function. The ulnar deviation is quite easy to restore, and its mal-angulation is rare. The reduce palmar deviation angle results in the restriction of the wrist flexion. For the comminuted and intra-articular distal radial fractures, the surgical reduction for the maintenance of the relative length of the radius and ulna, a good reduction of articular surface, reduction of palmar and ulnar deviation angle are the key points for a successful outcome. Early functional exercise is equally important for the best recovery of wrist function. Applying TCM after the operation could help the fracture concrescence.
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PAGE：239-241
Effect of Qibai decoction(芪百汤) on the immune function in patients with senile polydrug-tolerant pulmonary tuberculosis
LI Fu-jian, SHI Xin-hong
Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou 310004, Zhejiang, China.
Abstract: Objective: To study the regulatory action of Qibai decoction(QBD, 芪百汤) on the immune state in patients with senile polydrug-tolerant pulmonary tuberculosis. Methods: Sixty patients with senile polydrug-tolerant pulmonary tuberculosis were randomly divided into the control group and the QBD treatment group. The changes of T-lymphocyte subgroup (TL-CFU) and soluble interleukin-2 receptor (sIL-2R) were observed before and after treatment, meantime 40 healthy persons were as the normal control group. Results: CD3, CD4 and the ratio of CD4/CD8 of 60 patients were lower than those of the normal control group (all P<0.01). In the patients of QBD treatment group, the levels of CD3,CD4 and the ratio of CD4/CD8 raised significantly after treatment(P<0.05 or P<0.01)，the level of CD8 obviously dropped (P<0.05). In comparison with the control group, the changes of the treatment group were superior to those of the control group (P<0.01). The contents of sIL-2R in 60 patients with polydrug-tolerant pulmonary tuberculosis were obviously higher than that of the normal control group(P<0.01). After treatment the levels of sIL-2R in the control group and the QBD treatment group were obviously decreased respectively than that before treatment(P<0.01), and there was an obvious difference between the control group and the QBD treatment group (P<0.01). Conclusion: The patients with senile polydrug-tolerant pulmonary tuberculosis exist a serious hypoimmunity and immunologic dysfunction. TL-CFU and sIL-2R could be synthetic immune index and have good clinic applied value in estimating the immune state of the human body. QBD has a good regulatory action on the immune state in patients with senile polydrug-tolerant pulmonary tuberculosis.
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PAGE：242-244
Prevention and treatment effect of composite salvia miltiorrhiza injection(复方丹参注射液) on acute myocardial infarction patients with reperfusion injury by thrombolytic cure
QIN Qing-tong, WANG Xiao-ming
Taizhou Center Hospital, Taizhou 318000, Zhejiang, China; 2. Linhai Hospital of Traditional Chinese Medicine, Taizhou 317000, Zhejiang, China.
Abstract: Objective: To explore the prevention and treatment of acute myocardial infarction (AMI) with reperfusion injury. Methods: One hundred and twenty-six AMI patients with signs of thrombolysis were randomly divided into two groups. The therapeutic group and the control group (n=63 for each group). Both groups were given thrombolytic therapy with urokinase intraveously. The therapeutic group was given composite salvia miltiorrhiza injection(复方丹参注射液) 250 ml 10-30 minutes before giving urokinase or at the same time, once a day and lasted seven days. The control group was only given urokinase and routine treatment. Results: In therapeutic group and the control group, 48(76.19 percent) and 40 (63.49 percent) patients repassed, 2(3.17 percent) and 8(12.69 percent) patients died in hospital, 2(3.17 percent)and 8 (12.69 percent) patients suffered from severe heart failure, 16 (25.39 percent) and 33 (52.38 percent) patients suffered from reperfusion arrhythmias, there were significant differences between two groups(P<0.05 or P<0.01). At the same time, the effects of therapeutic group were better than the control group in reducing myocardial consumption of oxyen, releasing cardiac infarction size, enhencing left ventricular stroke volume and other inspects (all P<0.05). Conclusion: Composite salvia miltiorrhiza injection have the function against reperfusion injury of AMI.
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PAGE：245-246
Effects of isorsorbide dinitrate combined with Shenmai injection (参麦注射液) on acute exacerbation of chronic obstructive pulmonary disease accompaning myocardial injury
LIU Zhi-hong, ZHANG Shun-ling, ZENG Zhong-bo
Department of Emergency Care, Huizhou Central People's Hospital, Huizhou 516001, Guangdong, China.
Abstract: Objective: To observe the therapeutic effect of isorsorbide dinitrate combined with Shenmai injection(参麦注射液) in treatment for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and myocardial injury. Methods: Sixty-three patients with AECOPD admitted from April 1999 to April 2003 were randomly divided into two groups: isorsorbide and Shenmai injection therapeutic (7-10 days) group (treatment group, n=30) and conventional therapy group (control group, n=33). Recovery time of patients' symptom, sign, electrocardiogram and myocardial enzyme were observed. Results: The markedly effective rate (53.3 percent) and total effective rate (80.0 percent) were higher in the treatment group than those in the control group (21.2 percent and 54.5%), P<0.01 or P<0.05. Compared with the control group, the treatment group had shorter recovery time of heart rate, electrocardiogram, myocardial enzyme and for the disappearance of symptoms and signs. Conclusion: Treatment of AECOPD accompaning myocardial injury with isorsorbide dinitrate combined with Shenmai injection shows satisfactory clinical effects., 百拇医药
AND WESTERN MEDICINE IN INTENSIVE AND CRITICAL CARE
Volume 10 July 2003 Number 4
PAGE：197-200
Randomized control study of integrated traditional Chinese and western medicine in treatment of 77 patients with severe acute respiratory syndrome
ZHAO Chun-hui, LI Xiu-hui, ZHANG Ke, JIN Rong-hua, GOU Chun-yan, HU Zhong-jie, YE Jun, YANG Yu, GUO Xin-hui, LIANG Lian-chun, HU Jian-hua, LI Xue-mei, WU Ju-shan Beijing Youan Hospital, Capital Medical University, Beijing100054, China.
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Abstract: Objective: To evaluate the treatment effects of integrated traditional Chinese and western medicine (TCM WM) on severe acute respiratory syndrome (SARS). Methods: Therapeutic effects of 77 SARS patients treated with TCM WM or western medicine (WM) alone were analyzed by the randomized control method. Results: All the 37 cases of TCM WM group and 39 cases of WM group were restored and discharged from hospital, one case in WM group died. CD +4 T lymphocyte decreased from (497±262)cells/μl to (377±190)cells/μl in 27 cases of WM group in the stage of acute period, and increased from (584±440)cells/μl to (662±316)cells/μl in 24 cases of TCM WM group 7 days after treatment (P<0.05). The average time of chest X-ray radiogram absorption were (18.4±8.2)days in 6 cases of WM group in the stage of acute period, which was two days fewer more than that of 22 cases of TCM WM〔(16.2±8.8)days〕. The average time of SARS patients from severe type turn to common type were (10.9±3.4)days in the WM group, which was one day fewer than that of TCM WM group〔(9.3±3.8)days〕. In WM group, the average of sum dosage of corticosteriod for 20 patient was (1 325±623)mg, which was slightly lower than that of 15 patients in TCM WM group〔(1 400±685)mg〕. The average time of first dosage reduction of corticosteriods was (8.1±3.8)days, which was two days longer than that of the TCM WM group〔(6.4±3.7)days, P>0.05〕. Conclusion: Compare to the WM group, TCM WM treatment can improve immunity of SARS patients quickly, accelerate absorption of chest X-ray radiogram, reduce the using time of corticosteroid, accelerate recovery of SARS patients.
, 百拇医药
PAGE：201-203
Analysis on traditional Chinese medicine syndrome characteristics of severe acute respiratory syndrome patients in emergency department
LUO Yi, OU Ai-hua, YAN Xia, LIU Tao, LI Ji-qiang, HUA Rong, ZHONG Shi-jie, FANG Tong-nian, XI Xiao-tu, YE Ye, ZHANG Hong-ye, HAN Fan, FAN Cai-xia
Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China.
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Abstract: Objective: To investigate the characteristics of traditional Chinese medicine (TCM) syndrome in severe acute respiratory syndrome (SARS) in emergency department. Methods: SARS clinical information collection list was used to set up a clinical presentations and four examination techniques database. Then descriptive statistics and cluster statistics were used to analyze the data. TCM syndromes were recorded in 61 SARS patients first visiting to doctor in emergency department. Results: The mainly two types of the 61 SARS patients first visiting to doctor were epidemic toxin's incursion, syndrome of both the defense and Qi phases(疫毒侵袭,卫气同病), and toxin invading in the lung and stomach, obstruction by turbid dampness (毒蕴肺胃,湿浊阻遏). Among the two types, the former occupied 77.05 percent(47 cases), and the later 22.95 percent(14 cases). Conclusion: SARS's TCM name ought to be pestilence, which caused by seasonal pathogens and epidemic toxin. In the early period, the toxin makes incursions into the upper and middle heaters, manifested mostly with syndrome of both the defense and Qi phases and obstruction by turbid dampness. The therapy is disspating the superficial and clearing interior heat， curing both the defense and Qi phases (疏表清理,卫气同治), dissolving the turbid with aromatics and removing damp pathogen(芳香宣化,分消走泄) respectively.
, 百拇医药
PAGE：204-207
Clinical investigation of traditional Chinese medicine in treatment of 71 patients with severe acute respiratory syndrome
PAN Jun-hui, YANG Hui, YU Qing-he， WANG Feng，QIU Zhi-nan, ZHONG Shu-qing， ZENG Qing-en， ZHONG Nan-shan.
The First Affiliated Hospital, Medical College of Guangzhou, Guangzhou 510120, Guangdong, China.
Abstract: Objective: To observe the therapeutic efficacy of traditional Chinese medicine (TCM) in treatment of severe acute respiratory syndrome(SARS). Methods: The therapeutic efficacy of TCM in treatment of 71 patients with SARS from December 22, 2002 to May 30, 2003 were reviewed. The therapy was divided into three periods according to the pathological changes and course of diseases. ①Fever period: the means of cure were clearing away lung-heat and removing toxic agents (清肺解毒)， cooling the blood and activating Qi (凉血行气)， leting out the evil factors and reaching the exterior (透邪外达). The medicines were Kangyan I recipe(抗炎I号方), Yuxingcao injection(鱼腥草注射液), Chuanhuning injection(穿琥宁注射液), Tianlong tea(天龙茶). ②Losing one's breath period: the means of cure were clearing away heat and relieving asthma (清热平喘)， eliminating the heat of Ying system and counteracting toxin (透营败毒)， clearing epidemic disease and turbid (宣通疫浊). The medicines were Kangyan Ⅱ recipe(抗炎Ⅱ号方)， Shenfu injection(参附注射液), Shenmai injection (参麦注射液), Eshuyou injection(莪术油注射液). ③Convalescence: the means of cure were clearing away the remaining poisonous substances (清化余毒)， replenishing Qi and nourishing Yin (益气养阴)， regulating and nourishing the lung and spleen (调补肺脾). The medicines were Kangyan Ⅲ recipe(抗炎Ⅲ号方)， Shenmai injection(参麦注射液), astragalus injection(黄芪注射液), Tianlong Chuankeling capsule (天龙喘咳灵胶囊). Results: The days of hospitalization for 71 patients of SARS were 9-78 days 〔mean (27.1±14.4)days〕 and the patients of clinical cure were 70 (the heal rate was 98.6 percent). One patient died, the mortality was 1.4 percent. All patients were fever in the early stage, and the days of fever were (6.3±5.5)days before being in hospital. The temperature was 37.3-40.5 ℃ and most patients' temperature was over 39 ℃, the average days of fever reduce through medicine was (5.7±3.4)days (ranged 1-15 days). Conclusion: Integrated TCM and western medicine therapy could improve the clinical symptoms and reduce the mortality of severe patients. It is very important to use the clearing Qi and heat in the Ying system (清气清营) medicine expecially reducing fever in the early stage.
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PAGE：208-210
Characters of traditional Chinese medicine occurrence time and the circulation of Qi theory(运气学说) in 103 severe acute respiratory syndrome patients
LIU Min-wen, ZHONG Shi-jie, LIU Tao
Department of Emergency, Guangdong Traditional Chinese Medical Hospital, Guangzhou 510120, Guangdong, China.
Abstract: Objective: To discuss the occurrence characters and the relationship of traditional Chinese medicine(TCM) time and circulation of Qi theory(运气学说) of severe acute respiratory syndrome(SARS) and to provide relevant clues for studying the pathology of it. Methods: By combining 103 SARS patients in Guangzhou admitted from January 2003 to April 2003, differentiation method of TCM and the circulation of Qi theory were used to expand some occurrence characters of SARS initially. Results: TCM name of SARS was suggested to be defined infectious atypical pneumonia and epidemic disease, which was possibly related to abnormal climate. Its characters had two sides. First, based on fire of Yang(阳) heat, cold water of greater Yang was turbulent by dry metal of Yang brightness. Second, based on fire deficient, damp earth was turbulent by wind-wood of reverting Yin(阴). “Damp-heat toxin complicated with stasis” accompanied with the whole process of dynamics transmutation. Conclusion: Individual treatment of TCM should be used based on the TCM character and developing regularity of SARS.
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PAGE：211-213
Analysis on diagnosis and treatment with integrated traditional Chinese and western medicine in 20 severe acute respiratory syndrome patients infected in hospital
LOU Tan-qi, LIU Xun，BI Xiao-gang, ZHANG Kou-xing, XIE Qi-feng
Nephrology Department of Internal Medicine, The Third Affiliated Hospital of Zhongshan University, Medical Branch, Guangzhou 510630, Guangdong, China
, 百拇医药
Abstract: Objective: To summarize the clinical features and managements of hospital staff with severe acute respiratory syndrome (SARS) infected in hospital. Methods: Clinical data of 20 SARS staffs in our hospital from February 2003 to May 2003 were retrospective analyzed. Results: All had a direct personal contact with SARS patients. The incubation period of the disease was 2-7 days. Fever and cough were the initial symptoms. The respiratory symptoms progressed in some of the patients. Laboratory features included normal peripheral white blood cell (WBC) count. Focal involvement was common in chest X-ray radiographs. It was easy to meet the diagnostic criteria of SARS. The clinical outcome was good. Aggressive infection control measures were effective in preventing further transmission of this disease. Conclusion: The diagnosis of SARS in hospital staff is easy to make. The treatment with glucocorticoid in a short period is safe. Integrated traditional Chinese and western medicine therapy is benefit to the improving of symptom, and the clinical outcome is good.
, 百拇医药
PAGE：214-216
Clinical study on treatment of severe acute respiratory syndrome with integrated traditional Chinese and western medicine
LI Zhi-jun， BAO Feng-he， LI Qing， WANG Bing-shen, LI Yin-ping， WANG Chin-ta
The First Central Hospital of Tianjin, Tianjin 300192, China.
Abstract: Objective: To evaluate the effect of integrated traditional Chinese and western medicine treatment on severe acute respiratory syndrome (SARS). Methods: Twenty-eight SARS cases were randomly divided into treatment group (using integrated traditional Chinese and western medicine therapy) and control group (purely using western medicine), 14 cases for each group. Both groups were given routine anti-SARS of western medicine, i. e. antivirotics, corticosteroids, immunomodulation agent and non-invasive ventilation. The treatment group was treated with the Chinese herbs on the basis of traditional Chinese medicine differentiation, i.e. Chuanhuning injection(穿琥宁注射液), Shenmai injection(参麦注射液)， Hufei Qingsha drink(护肺清痧饮)， Jiedu Zhitong capsule(解毒止痛胶囊), Zhuyin Sanjie capsule(逐饮散结胶囊), Qingshaling spray (清痧灵喷剂). Results: After treatment the time of decreasing of temperature, improvement of symptoms, absorption of chest X-ray, recovery of degree of blood oxygen saturation in treatment group were better than those in control group, but they had no discrepancy significantly (all P>0.05). The dosage of glucocorticoid in treatment group was less than that in control group〔(699.29±111.66)mg vs. (1257.14±247.90)mg, P<0.01〕.Conclusion: It is showed that the integrated traditional Chinese and western medicine treatment can significantly decrease the dosage of glucocorticoid and the incidence of complications
, 百拇医药
PAGE：217-219
Observation on therapeutic effects of traditional Chinese medicine in 26 patients with severe acute respiratory syndrome
SUN Zhong-ji，LI Yu-ming，JI Jin-li，BI Gui-quan，MU Yu，CHEN Xiao，LIU Yang
The Hospital Attached to Medical College of Chinese People's Armed Polices Forces， Tianjin 300162, China.
Abstract: Objective: To summarize the therapeutic experience of severe acute respiratory syndrome(SARS). Methods: The characteristics and kinetic changes of course in 26 patients suffered from SARS were retrospected. The imaging features of pulmonary lesions in chest X-ray radiograms and laboratory's data including hemogram, blood gas, blood glucose, electrolyte, renal function, liver function, and myocardial enzyme were observed. The effects of the medications and noninvasive mechanical ventilation in western medicine (WM) group (n=18) and traditional Chinese medicine (TCM) combined WM group (n=8) were evaluated. Results: ①The courses of SARS might be distinguished with early period of fever, inflammatory exudation of lungs, severe hypoxemia and absorption of pulmonary exudative inflammation. ②Ribavirin had no effect on the SARS coronavirus. Glucocorticoid could relieve intoxication of the patients suffered from SARS. The Yuxingcao injection(鱼腥草注射液) and Qingkailing injection(清开灵注射液) had secondary treatment effectiveness in early period. ③The continuous positive airway pressure(CPAP) could increase blood oxygen content for the patients with hypoxemia. ④The continuous time of fever and hypoxemia, the time in hospital and the number of dead patients in TCM combined WM group were all lower than those of the WM group. Conclusion: Appropriate use of glucocorticoid and maintaining treatment for body function should be used in the treatment of SARS. TCM is beneficial to the improvement of clinical symptoms and prognosis and oxygen therapy in time by CPAP should be recommended.
, 百拇医药
PAGE：220-222
Effects of hyperventilation on cerebral oxygen supply and consumption in perioperative patients with severe head injury and their significance
CHENG Ming-hua, YAO Yong-ming
Department of Anesthesiology, First Affiliated Hospital of Medical College of Shantou University, Shantou 515041, Guangdong, China.
Abstract: Objective: To investigate the effects of hyperventilation on jugular venous oxygen saturation (SjvO2), arteriovenous oxygen content difference(A-VDO2) and lactate concentration difference(V-ADL) perioperative patients with severe head injury and their significance. Methods: Sixteen patients with severe head injury for operation were studied. The changes of SjvO2, A-VDO2 and V-ADL in response to changes in partial pressure of oxygen in artery (PaO2) and partial pressure of carbon dioxide in artery (PaCO2) were studied through adjusting respiratory rate and fraction of inspired oxygen. Results: SjvO2 decreased significantly and A-VDO2 increased significantly when PaCO2 deceased from 30 mm Hg to 25 mm Hg (1 mm Hg=0.133 kPa) at a PaO2 of 100-150 mm Hg or 200-250 mm Hg. The absolute value of SjvO2 was greater and the absolute value of A-VDO2 was lower at a PaO2 of 200-250 mm Hg for any given PaO2. V-ADL did not change significantly only at a PaO 200-250 mm Hg and PaCO2 30 mm Hg. Conclusion: Moderate hyperventilation to a PaCO2 of 30 mm Hg in combination with higher PaO2 (200-250 mm Hg) may be beneficial for patients with severe head injury.
, 百拇医药
PAGE：223-225
Diagnosis value of high density lipoprotein phospholipids on coronary heart disease of kidney-Yang deficiency syndrome(肾阳虚证)
GUO Ping-qing, LIN Qiu-cheng, GUO Yin-geng, SHEN Zong-guo
First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian, China. Abstract: Objective: To look for a new biochemical index for diagnosis of coronary heart disease (CHD) of kidney-Yang deficiency (KYD, 肾阳虚) syndrome. Methods: Sixty-one patients with CHD were divided into three groups according to their traditional Chinese medicine(TCM) syndrome differentiation, 10 patients in the group without heart-Qi deficiency(HQD，心气虚, group A),25 patients in the group with HQD but without KYD (group B) and 26 patients in the group both with HQD and KYD (group C).Levels of 17-hydroxy-corticosteroid in urine(17-OHCS) per 24 hours, serum level of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein phospholipids (HDL-PL) were determined in synchronization and compared with those in the control group of 23 healthy aged persons. 17-OHCS per 24 hours was taken as the diagnostic standard to screen a new index for diagnosis of KYD syndrome, and preliminary appraisal to the index was made. Results: Serum HDL-PL in the CHD-KYD patients (group C) was (616±157)mg/L, which was obviously lower than that in the patients of group A (911±189)mg/L and B(763±167)mg/L. With low HDL-PL(<650 mg/L) used as the index to diagnose CHD-KYD,the sensitivity was 73 percent, the specificity was 86 percent and the accuracy was 80 percent. Conclusion: HDL-PL<650 mg/L could be adopted as an index for CHD-KYD diagnosis,which is simple and practical.
, 百拇医药
PAGE：226-228
Analysis on complications and mortality in patients with hypertensive middle and large amount cerebral hemorrhage after integrated traditional Chinese and western medicine treatment including surgical operation
LU Ming, HUANG Yan, DU Bao-xin, LIANG Wei-xiong, HUANG Pei-xin, LIU Mao-cai
Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China.
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Abstract：Objective：To analyze effect on complications and mortality in patients with hypertensive middle and large amount primary intra-cerebral hemorrhage (ICH) treated with traditional Chinese medicine (TCM) and surgical operation. Methods： A simple prospective randomized control trial was applied in 201 cases of ICH with Yang-or Yin-block sign(阳闭证或阴闭证) involved in Zang-fu organs (中脏腑). The cases were randomly divided into two groups: 103 cases in treatment group were treated with surgical operation, TCM syndrome differentiation 〔the cases with Yang-block sign were treated with Tongfu Xingshen capsule (通腑醒神胶囊), Naomai Ⅱ capsule(脑脉Ⅱ号胶囊) and Qingkailing injection(清开灵注射液), the cases with Yin-block sign were treated with Tongfu Xingshen capsule, Naomai Ⅰ capsule(脑脉Ⅰ号胶囊) and tetramethylpyrazine injection(川芎嗪注射液)〕 and the routine therapy. Ninety-eight cases in control group were treated with comprehensive therapy including surgical operation, the routine therapy and western medicine. The therapeutic course was 28 days. Complications and mortality in relation to them were analyzed at 28 days and 6 months' follow-up. Results： Fifty-four cases suffered complications in treatment group, and 75 cases in control group(χ2=11.38, P<0.01). The mortality of two groups in 7 days was insignificant (P>0.05); 5 cases died from 7 to 28 days in treatment group, and 17 cases in control group (χ2=8.04, P<0.01); 5 cases and 13 cases died from pneumonia in treatment group and control group respectively (χ2=4.36,P<0.05). The main factors of death were cerebral hemorrhage within one week and lung infection from 7 to 28 days. Conclusion： Complications after surgical operation are the predictors of fatal outcome in ICH. Comprehensive therapy integrated TCM and western medicine can lessen the mortality of hypertensive middle and large amount ICH, the mechanism maybe related to treatment according to the TCM syndrome differentiation, modulating an organic whole and decreasing complications especially pneumonia.
, 百拇医药
PAGE：229-231
Clinical study of therapeutic effect of Shenkang capsule (肾康胶囊) in treatment of acute glomerulonephritis
WU Xi-xin
Department of Nephrology, The Fifth Affiliated Hospital of Zhongshan University, Zhuhai 519000, Guangdong, China.
Abstract: Objective: To observe the clinical effect of Shenkang capsule (SKC,肾康胶囊) for treating acute glomerulonephritis(AGN). Methods: SKC was prepared by modern pharmacy technique with Chinese herbs of poria(茯苓), alisma(泽泻), rhizoma imperatae(茅根), gryllotulpa africana(蝼蛄), carapax trionycis(鳖甲), nephritis herb(肾炎草) and raw rhubarb(生大黄). Thirty-eight cases with AGN were divided into the control group (18 cases) and the SKC group (20 cases) randomly. Patients in the control group were treated with penicillin G 80×104 U by muscle injection, two times every day for two weeks, and patients accompanied edema and hypertension symptom were treated to symptom. Patients in the SKC group were treated with SKC, 5tables each time, three times every day on the base of treatment of penicillin and to symptom. The courses in two groups were all two weeks. At the end of the treatment, the weight, mean arterial pressure, 24 hours urine protein quantity, 1 hour urine red blood cell excreting rate(1huRBCer), blood urea nitrogen, serum creatinine, potassium and sodium before and after the treatment were observed, and 24 hours urine protein quantity and 1huRBCer were observed for six weeks followed the treatment. Results: SKC could significantly lighten 24 hours protein urine quantity 〔reduced from (267±162)mg/24 h to (148±110) mg/24 h two weeks after giving SKC, P<0.05〕 and significantly reduce 1huRBCer 〔reduced from (46±7)×10 4/h to (11±6)×10 4/h two weeks after giving SKC, P<0.05; (5±3)×10 4/h in SKC group six weeks after giving SKC and (13±8)×10 4/h in control group, P<0.05〕 for AGN. There was no side-effect in the course of using SKC. Conclusion: AGN could be treated with SKC for preventing its delay.
, 百拇医药
PAGE：232-233
Experimental study of astragalus membranaceus on nitric oxide synthase in brain tissue activity after acute brain injury in rats
TANG Zong-chun, YANG Xi-min, LI Shuan-de, WANG Xiao-feng, LI Ying-guo.
Neurosurgery Institute of Lanzhou Command, Third Hospital of People's Liberation Army, Baoji 721004, Shanxi, China.
Abstract：Objective： To bserve the effect of astragalus membranaceus(AM) on nitric oxide synthase (NOS) activity in brain tissue after injury and investigate its therapeutic action and mechanism in acute cerebral injury rats. Methods： Rat cerebral injury models were established and the NOS concentration was tested at 30 minutes, 2 hours, 6 hours, 24 hours after injury. Results： NOS activity increased sharply in 30 minute after injury 〔(46.44±13.45)nmol/L, P<0.05〕 and the step-up was great higher contrasting with control group〔(40.46±12.85)nmol/L, P<0.01〕， from 6 hours to 24 hours after injury it declined to normal level. In the AM treated group， NOS activity dropped at 2 hours〔(64.26±19.78)nmol/L〕 and 6 hours〔(52.91±21.36)nmol/L〕 after injury contrasting with injury group 〔(67.49±22.45)nmol/L and (63.46±24.68)nmol/L respectively, P<0.05 and P<0.01 respectively〕. Conclusion： NOS activity increase in the injuried brain tissue and AM could protect injuried neuron by depress NOS activity.
, 百拇医药
PAGE：234-235
Effects of puerarin injection(葛根素注射液) on plasma endothelin-1 in patients with congestive heart failure
ZHANG Yan-li
Anyang District Hospital, Anyang 455000, Henan, China.
Abstract: Objective: To investigate the mechanism of puerarin in patients with congestive heart failure (CHF). Methods: One hundred and twenty patients suffered from CHF were randomly divided into two groups, and they were treated with the same western medicine therapy. In addition, the puerarin treatment group (n=60) was treated with puerarin injection(葛根素注射液) intravenously drip of 300 mg mixed 250 ml of 5 percent glucose once a day for 15 days. At the end of the course, the alterations of heart function and plasma endothelin-1(ET-1), the therapeutic effects were observed before and after the treatments, and the difference between the two groups was compared. Results: In puerarin treatment group, the effective rate was higher than that in control group (86.7 percent vs. 75.0 percent, P<0.05), plasma ET-1 was decreased significantly after treatment〔(152.60±11.54)ng/L vs. (106.98±12.44)ng/L, P<0.05〕, but in routine treatment group the plasma ET-1 was not decreased significantly〔(147.65±9.78)ng/L vs. (142.60±11.36)ng/L, P>0.05〕. Conclusion: Puerarin can improve the heart function of CHF patients, the mechanism maybe decrease plasma ET-1 level and improve the blood supplying of myocardium.
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PAGE：236-238
Estimation on curative effect of the surgical operation combining traditional Chinese medicine for the comminuted and intra-articular fractures of the distal radius
ZHAO Qing， TANG Yu-xing, CHEN Shao-min， CAI Dao-zhang
Department of Bone, the Fifth Affiliated Hospital of Zhongshan University， Zhuhai 519000, Guangdong, China.
Abstract： Objective： To estimate the curative effect of the surgical operation combining traditional Chinese medicine (TCM) for the comminuted and intra-articular fractures of the distal radius. Methods： Thirty-two cases of suffering from the comminuted and intra-articular fractures of the distal radius by different operation method treatment in three years were synthetically analyzed and 7 cases of them were treated with TCM after operation. All cases were sorted according to AO principle. Thirty-two cases were operated upon either with internal fixation with the Titanium screw plane or with simple internal fixation adding external fixator or with simple external fixator according to the types of fracture. Results： All patients were followed-up regularly. According to AO evaluation of the wrist joint movement, 81.25 percent (26 cases) of the patients had satisfactory functional outcome, 15.62 percent (5 cases) of the patients had quite satisfactory functional outcome and only 3.13 percent (1 case) of the patients had unsatisfactory functional outcome. The time of the fracture concrescence and being in hospital in the patients of applied TCM were significantly shortened by X-ray photo. Conclusion： The reduction of the distal radial fractures should include the maintenance of the relative length of the radius and ulna, the smoothness of the articular surface and the palmar and ulnar deviation angles. The shortening of the radius results in the pain with movement and the restriction of function, and hence is considered to be the most important factor affecting the joint function. The ulnar deviation is quite easy to restore, and its mal-angulation is rare. The reduce palmar deviation angle results in the restriction of the wrist flexion. For the comminuted and intra-articular distal radial fractures, the surgical reduction for the maintenance of the relative length of the radius and ulna, a good reduction of articular surface, reduction of palmar and ulnar deviation angle are the key points for a successful outcome. Early functional exercise is equally important for the best recovery of wrist function. Applying TCM after the operation could help the fracture concrescence.
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PAGE：239-241
Effect of Qibai decoction(芪百汤) on the immune function in patients with senile polydrug-tolerant pulmonary tuberculosis
LI Fu-jian, SHI Xin-hong
Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou 310004, Zhejiang, China.
Abstract: Objective: To study the regulatory action of Qibai decoction(QBD, 芪百汤) on the immune state in patients with senile polydrug-tolerant pulmonary tuberculosis. Methods: Sixty patients with senile polydrug-tolerant pulmonary tuberculosis were randomly divided into the control group and the QBD treatment group. The changes of T-lymphocyte subgroup (TL-CFU) and soluble interleukin-2 receptor (sIL-2R) were observed before and after treatment, meantime 40 healthy persons were as the normal control group. Results: CD3, CD4 and the ratio of CD4/CD8 of 60 patients were lower than those of the normal control group (all P<0.01). In the patients of QBD treatment group, the levels of CD3,CD4 and the ratio of CD4/CD8 raised significantly after treatment(P<0.05 or P<0.01)，the level of CD8 obviously dropped (P<0.05). In comparison with the control group, the changes of the treatment group were superior to those of the control group (P<0.01). The contents of sIL-2R in 60 patients with polydrug-tolerant pulmonary tuberculosis were obviously higher than that of the normal control group(P<0.01). After treatment the levels of sIL-2R in the control group and the QBD treatment group were obviously decreased respectively than that before treatment(P<0.01), and there was an obvious difference between the control group and the QBD treatment group (P<0.01). Conclusion: The patients with senile polydrug-tolerant pulmonary tuberculosis exist a serious hypoimmunity and immunologic dysfunction. TL-CFU and sIL-2R could be synthetic immune index and have good clinic applied value in estimating the immune state of the human body. QBD has a good regulatory action on the immune state in patients with senile polydrug-tolerant pulmonary tuberculosis.
, 百拇医药
PAGE：242-244
Prevention and treatment effect of composite salvia miltiorrhiza injection(复方丹参注射液) on acute myocardial infarction patients with reperfusion injury by thrombolytic cure
QIN Qing-tong, WANG Xiao-ming
Taizhou Center Hospital, Taizhou 318000, Zhejiang, China; 2. Linhai Hospital of Traditional Chinese Medicine, Taizhou 317000, Zhejiang, China.
Abstract: Objective: To explore the prevention and treatment of acute myocardial infarction (AMI) with reperfusion injury. Methods: One hundred and twenty-six AMI patients with signs of thrombolysis were randomly divided into two groups. The therapeutic group and the control group (n=63 for each group). Both groups were given thrombolytic therapy with urokinase intraveously. The therapeutic group was given composite salvia miltiorrhiza injection(复方丹参注射液) 250 ml 10-30 minutes before giving urokinase or at the same time, once a day and lasted seven days. The control group was only given urokinase and routine treatment. Results: In therapeutic group and the control group, 48(76.19 percent) and 40 (63.49 percent) patients repassed, 2(3.17 percent) and 8(12.69 percent) patients died in hospital, 2(3.17 percent)and 8 (12.69 percent) patients suffered from severe heart failure, 16 (25.39 percent) and 33 (52.38 percent) patients suffered from reperfusion arrhythmias, there were significant differences between two groups(P<0.05 or P<0.01). At the same time, the effects of therapeutic group were better than the control group in reducing myocardial consumption of oxyen, releasing cardiac infarction size, enhencing left ventricular stroke volume and other inspects (all P<0.05). Conclusion: Composite salvia miltiorrhiza injection have the function against reperfusion injury of AMI.
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Effects of isorsorbide dinitrate combined with Shenmai injection (参麦注射液) on acute exacerbation of chronic obstructive pulmonary disease accompaning myocardial injury
LIU Zhi-hong, ZHANG Shun-ling, ZENG Zhong-bo
Department of Emergency Care, Huizhou Central People's Hospital, Huizhou 516001, Guangdong, China.
Abstract: Objective: To observe the therapeutic effect of isorsorbide dinitrate combined with Shenmai injection(参麦注射液) in treatment for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and myocardial injury. Methods: Sixty-three patients with AECOPD admitted from April 1999 to April 2003 were randomly divided into two groups: isorsorbide and Shenmai injection therapeutic (7-10 days) group (treatment group, n=30) and conventional therapy group (control group, n=33). Recovery time of patients' symptom, sign, electrocardiogram and myocardial enzyme were observed. Results: The markedly effective rate (53.3 percent) and total effective rate (80.0 percent) were higher in the treatment group than those in the control group (21.2 percent and 54.5%), P<0.01 or P<0.05. Compared with the control group, the treatment group had shorter recovery time of heart rate, electrocardiogram, myocardial enzyme and for the disappearance of symptoms and signs. Conclusion: Treatment of AECOPD accompaning myocardial injury with isorsorbide dinitrate combined with Shenmai injection shows satisfactory clinical effects., 百拇医药