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活血解毒方治疗干燥综合征63 例临床观察.pdf

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活血解毒方治疗干燥综合征63 例临床观察.pdf

北京中医药大学学报G21中医临床版G22G21G22G23G22年G24月G23G23G25G21G26G22朱跃兰G23女G23博士G23主任医师G23博士生导师G27北京中医药大学校级课题干燥综合征是一种以侵犯泪腺和唾液腺等外分泌腺为主且具有以高度淋巴细胞浸润为特征的系统性自身免疫疾病G23其病变除主要累及唾液腺和泪腺G23以口干G24眼干为主要临床表现外G23尚有呼吸系统G24消化系统G24泌尿系统等多系统的受累G23出现多系统损害G25笔者以活血解毒为治法G23通过活血解毒方治疗G28G29例干燥综合征患者的临床研究G23观察中医药防治干燥综合征的临床疗效G25G21临床资料G23G2AG23一般资料G28G29例均为G21G2BG2BG25年G29月G26G21G2BG2BG24年G29月在北京中医药大学东方医院住院及门诊治疗的干燥综合征患者G23随机分为治疗组G24对照组G25治疗组G29G21例G23女性G29G2B例G23男性G21例G23平均年龄G21G26G21G2AG2BG2BG21G23G2BG2AG29G25G22岁G23平G21临床研究G21活血解毒方治疗干燥综合征G22G23例临床观察G24朱跃兰韦尼侯秀娟G21北京中医药大学东方医院风湿科北京G23G2BG2BG2BG25G2CG22摘要G22目的观察自拟活血解毒方治疗干燥综合征的临床疗效G21方法将G28G29例干燥综合征患者分为治疗组G22对照组G21组G21治疗组给予活血解毒方中药口服G23对照组给予雷公藤多甙片口服G21观察临床疗效G22症状体征及相关实验室检查指标G21结果治疗组G22对照组临床疗效比较无显著性差异G24G21G2DG2BG2AG2BG26G25G21G21组口干G22眼干G22关节疼痛G22便秘G22肌肤干燥G22舌质G22脉象评分均较本组治疗前降低G24G21G2EG2BG2FG2BG30G23G21G2EG2BG2FG2BG26G25G23治疗组口干症状较对照组明显改善G24G21G2EG2BG2FG2BG30G25G21G21组左右眼滤纸试验G22血沉G24G31G32G33G25G22G34G35反应蛋白G24G34G33G36G25值均较本组治疗前改善G24G21G2EG2BG2FG2BG23G23G21G2EG2BG2FG2BG26G25G23G21组比较无统计学意义G24G21G2DG2BG2FG2BG26G25G21结论活血解毒方能有效缓解干燥综合征主要症状并改善相关实验室检查指标G23具有较好的临床疗效G21关键词G22干燥综合征G26活血解毒G26燥毒瘀互结中图分类号G22G33G21G26G24G25G26G27G28G29G2AG27G2BG29G2CG2DG2EG2FG2CG30G26G27G2BG23G31G31G32G2BG33G26G2CG2AG27G34G35G29G36G37G38G2CG39G38G27G2FG35G27G33G38G3AG2CG26G2AG38G3BG28G35G2BG22G3CG3DG28G31G27G31G37G38G39G3AG3BG3CG35G3DG3EG3FG23G40G31G41G42G43G23G38G44G39G45G43G3BG35G46G3BG3EG3FG21G47G3CG48G3EG49G4AG4BG3CG3FG4AG4CG4DG33G4EG3CG3BG4BG3EG4AG43G4FG4BG23G47G4CG3FG50G4DG3EG3FG50G38G4CG4FG48G43G4AG3EG3DG23G51G3CG43G46G43G3FG50G39G3FG43G52G3CG49G4FG43G4AG53G4CG4DG34G4EG43G3FG3CG4FG3CG54G3CG55G43G56G43G3FG3CG23G51G3CG43G46G43G3FG50G30G22G22G22G25G2CG22G3EG3FG31G29G26G28G3DG29G22G40G3FG2FG27G3DG29G35G41G27G57G4CG4CG58G4FG3CG49G52G3CG4AG4EG3CG56G3BG49G3EG4AG43G52G3CG3CG4DG4DG3CG56G4AG4CG4DG4FG3CG3DG4DG35G4BG3EG55G3CG38G3BG4CG59G3BG3CG46G43G3CG55G3BG5AG4CG49G4BG3BG3DG3EG4CG3FG32G46G4CG50G49G3CG3FG27G4FG4FG53G3FG55G49G4CG4BG3CG2FG42G27G29G36G2CG33G5BG3DG3DG28G29G48G3EG4AG43G3CG3FG4AG4FG5CG43G4AG4EG32G46G4CG50G49G3CG3FG27G4FG4FG53G3FG55G49G4CG4BG3CG5CG3CG49G3CG55G43G52G43G55G3CG55G43G3FG4AG4CG4AG4EG3CG4AG49G3CG3EG4AG4BG3CG3FG4AG50G49G4CG3BG48G3EG3FG55G56G4CG3FG4AG49G4CG3DG50G49G4CG3BG48G2FG57G4EG3CG4AG49G3CG3EG4AG4BG3CG3FG4AG50G49G4CG3BG48G5CG3EG4FG4AG49G3CG3EG4AG3CG55G5CG43G4AG4EG38G3BG4CG59G3BG3CG46G43G3CG55G3BG5AG4CG49G4BG3BG3DG3EG4CG49G3EG3DG3DG53G23G3EG3FG55G4AG4EG3CG56G4CG3FG4AG49G4CG3DG50G49G4CG3BG48G5CG3EG4FG4AG49G3CG3EG4AG3CG55G5CG43G4AG4EG57G49G43G48G4AG3CG49G53G50G43G3BG4BG5DG3DG3BG56G4CG4FG43G55G3CG4FG57G3EG58G3DG3CG4AG4FG2FG57G4EG3CG56G3BG49G3EG4AG43G52G3CG3CG4DG4DG3CG56G4AG23G4FG53G4BG48G4AG4CG4BG4FG3EG3FG55G4FG43G50G3FG4FG23G3EG3FG55G49G3CG3DG3CG52G3EG3FG4AG3DG3EG58G4CG49G3EG4AG4CG49G53G43G3FG55G3CG59G3CG4FG5CG3CG49G3CG4CG58G4FG3CG49G52G3CG55G2FG43G27G31G38G3BG29G57G4EG3CG56G4CG4BG48G3EG49G43G4FG4CG3FG43G3FG56G3BG49G3EG4AG43G52G3CG3CG4DG4DG3CG56G4AG58G3CG4AG5CG3CG3CG3FG4AG4EG3CG4AG49G3CG3EG4AG4BG3CG3FG4AG50G49G4CG3BG48G3EG3FG55G56G4CG3FG4AG49G4CG3DG50G49G4CG3BG48G4FG4EG4CG5CG3CG55G3FG4CG4FG43G50G3FG43G4DG43G56G3EG3FG4AG55G43G4DG4DG3CG49G3CG3FG56G3CG21G21G2DG22G2FG22G26G22G2FG57G4EG3CG4FG56G4CG49G3CG4FG4CG4DG55G49G53G4BG4CG3BG4AG4EG3EG3FG55G3CG53G3CG4FG23G3EG49G4AG4EG49G3EG3DG50G43G3EG23G56G4CG3FG4FG4AG43G48G3EG4AG43G4CG3FG23G55G49G53G4FG5EG43G3FG23G4BG3EG3FG43G4DG3CG4FG4AG3EG4AG43G4CG3FG4FG4CG4DG4AG4CG3FG50G3BG3CG3EG3FG55G48G3BG3DG4FG3CG55G3CG56G49G3CG3EG4FG3CG55G43G3FG4AG5CG4CG50G49G4CG3BG48G4FG56G4CG4BG48G3EG49G3CG55G5CG43G4AG4EG4AG4EG4CG4FG3CG43G3FG4AG4EG3CG4FG3EG4BG3CG50G49G4CG3BG48G58G3CG4DG4CG49G3CG4AG4EG3CG4AG49G3CG3EG4AG4BG3CG3FG4AG21G21G2EG2BG2FG2BG30G23G21G2EG2BG2FG2BG26G22G2FG57G4EG3CG4FG53G4BG48G4AG4CG4BG4CG4DG55G49G53G4BG4CG3BG4AG4EG5CG3EG4FG49G3CG3DG43G3CG52G3CG55G4FG43G50G3FG43G4DG43G56G3EG3FG4AG3DG53G43G3FG4AG4EG3CG4AG49G3CG3EG4AG4BG3CG3FG4AG50G49G4CG3BG48G56G4CG4BG48G3EG49G3CG55G5CG43G4AG4EG4AG4EG3CG56G4CG3FG4AG49G4CG3DG50G49G4CG3BG48G21G21G2EG2BG2FG2BG30G22G2FG57G4EG3CG52G3EG3DG3BG3CG4FG4CG4DG32G56G4EG43G49G4BG3CG49G4AG3CG4FG4AG4CG4DG4AG4EG3CG49G43G50G4EG4AG3EG3FG55G3DG3CG4DG4AG3CG53G3CG23G3CG49G53G4AG4EG49G4CG56G53G4AG3CG4FG3CG55G43G4BG3CG3FG4AG3EG4AG43G4CG3FG49G3EG4AG3CG21G31G32G33G22G3EG3FG55G34G35G49G3CG3EG56G4AG43G52G3CG48G49G4CG4AG3CG43G3FG21G34G33G36G22G5CG3CG49G3CG3EG3DG3DG43G4BG48G49G4CG52G3CG55G43G3FG4AG5CG4CG50G49G4CG3BG48G4FG56G4CG4BG48G3EG49G3CG55G5CG43G4AG4EG4AG4EG4CG4FG3CG43G3FG4AG4EG3CG4FG3EG4BG3CG50G49G4CG3BG48G58G3CG4DG4CG49G3CG4AG4EG3CG4AG49G3CG3EG4AG4BG3CG3FG4AG21G21G2EG2BG2FG2BG30G23G21G2EG2BG2FG2BG26G22G2FG57G4EG3CG56G4CG4BG48G3EG49G43G4FG4CG3FG58G3CG4AG5CG3CG3CG3FG4AG5CG4CG50G49G4CG3BG48G4FG4FG4EG4CG5CG3CG55G3FG4CG4FG4AG3EG4AG43G4FG4AG43G56G3EG3DG4FG43G50G3FG43G4DG43G56G3EG3FG56G3CG21G21G2DG2BG2FG2BG26G22G2FG44G2CG2BG3DG3BG38G31G35G2CG2BG38G3BG4CG59G3BG3CG46G43G3CG55G3BG5AG4CG49G4BG3BG3DG3EG56G3EG3FG49G3CG3DG43G3CG52G3CG3CG4DG4DG3CG56G4AG43G52G3CG3DG53G4AG4EG3CG4BG3EG43G3FG4FG53G4BG48G4AG4CG4BG4FG3EG3FG55G3DG3EG58G4CG49G3EG4AG4CG49G53G43G3FG55G3CG59G3CG4FG4CG4DG32G46G4CG50G49G3CG3FG27G4FG4FG53G3FG55G49G4CG4BG3CG3EG3FG55G4EG3EG4FG3EG58G3CG4AG4AG3CG49G56G3BG49G3EG4AG43G52G3CG3CG4DG4DG3CG56G4AG2FG45G27G32G34G2CG26G33G31G22G32G46G4CG50G49G3CG3FG27G4FG4FG53G3FG55G49G4CG4BG3CG28G3EG56G4AG43G52G3EG4AG43G3FG50G58G3DG4CG4CG55G56G43G49G56G3BG3DG3EG4AG43G4CG3FG3EG3FG55G55G3CG4AG4CG59G43G4DG53G43G3FG50G28G58G43G3FG55G43G3FG50G4CG4DG55G49G53G3FG3CG4FG4FG23G4AG4CG59G43G3FG3EG3FG55G4FG4AG3EG4FG43G4FG30G29G29北京中医药大学学报G21中医临床版G22G21G22G23G22年G24月G23G23G25G21G26G22均病程G21G27G28G29G2AG21G26G2BG23G25G22年G24对照组G2AG23例G23女性G2AG2C例G23男性G23例G23平均年龄G21G26G23G28G2CG27G21G24G28G2AG24G22岁G23平均病程G21G26G28G24G2DG21G26G28G21G26G22年G25G21组在性别G26年龄G26病程及治疗前症状体征积分等方面比较无统计学差异G21G21G2EG2CG2BG2CG26G22G23具有可比性G25G2FG2BG21诊断标准西医诊断标准参照G21G2CG2CG21年G26月第八届干燥综合征国际专题会议推荐的干燥综合征诊断标准G30G2FG31G25中医G27瘀毒G28诊断标准参照G21G2CG2CG21年G29中药新药临床研究指导原则G2AG30G21G31制定G25G2FG2BG2A纳入标准G21符合干燥综合征西医诊断标准G24G22符合中医G27瘀毒G28诊断标准G25G2FG2BG2D排除标准G21年龄G32G23G33岁或G2EG25G26岁者G23妊娠或哺乳期妇女G23过敏体质及对该类治疗药物过敏者G24G22合并心血管G26脑血管G26肝肾及造血系统等严重原发性疾病者G23精神病患者G24G23晚期的淋巴组织增生和淋巴瘤患者G24G24符合纳入标准G23但未按规定用药G23无法判断疗效G23或资料不全等影响疗效和安全性判断者G25G21方法G21G2BG23治疗方法治疗组G2B予自拟活血解毒方治疗G25活血解毒方由丹参G26当归G26川芎G26鸡血藤G26玄参G26连翘G26甘草G26生地黄G26麦门冬G26石斛G26南沙参G26北沙参G26太子参等药物组成G25采用韩国制造煎煮机煎制G25G23剂G34G35G23早晚G21次口服G23疗程为G2A个月G25对照组G2B常规给予雷公藤多甙片G21湖南协力药业有限公司生产G23批号G36G2DG2AG29G21G29G23G2AG33G22G23G21G29G37G38G34次G23G2A次G34G35G23疗程为G2A个月G25G21G39G21观察指标G21观察临床疗效G24G22观察眼干G26口干G26便秘G26关节疼痛G26肌肤干燥G26舌质G26脉象等症状体征G24G23观察血沉G21G3AG3BG3CG22G26G3DG3E反应蛋白G21G3DG3CG3FG22G26滤纸试验G21G3BG40G41G42G43G37G44G43试验G22等实验室指标G25G21G2BG2A统计方法使用G3BG3FG3BG3BG2FG2AG2BG22软件进行统计分析G23计数资料采用G21G21检验G23计量资料符合正态分布G23采用配对G22检验G26独立样本G22检验G23计量资料以G21G23G21G24G22表示G23等级资料用G3CG42G35G42G45分析G25G22结果G2AG2BG2F疗效判定标准疗效判定标准参照文献G30G2AG31制定G25临床缓解G2B口干G26眼干症状消失G23G3BG40G41G42G43G37G44G43试验G26G3AG3BG3CG26G3DG3CG3F等实验室指标明显改善G25显效G2B口干G26眼干症状明显好转G23全身症状好转G23G3BG40G41G42G43G37G44G43试验G26G3AG3BG3CG26G3DG3CG3F等实验室指标有所改善G25有效G2B口干G26眼干症状好转G23全身症状好转G23G3BG40G41G42G43G37G44G43试验G26G3AG3BG3CG26G3DG3CG3F实验室指标改善G25无效G2B口干G26眼干症状改善不明显或不稳定G23G3BG40G41G42G43G37G44G43试验G26G3AG3BG3CG26G3DG3CG3F实验室指标改善不明显G25中医证候疗效判定标准采用尼莫地平法计算治疗前后的疗效指数G25公式如下G2B疗效指数G22G21治疗前评分G23治疗后评分G22G46治疗前评分G24G2FG22G22G47G25临床控制G2B疗效指数G21G33G2CG47G24显效G2BG26G2CG47G22疗效指数G25G33G2CG47G24有效G2BG2AG2CG47G22疗效指数G25G26G2CG47G24无效G2B疗效指数G25G2AG2CG47G25G2AG2BG21G21组临床疗效比较治疗后治疗组临床缓解G2C例G23显效G2D例G21G23G21G2BG26G47G22G23有效G21G26例G21G25G33G2BG23G2AG47G22G23无效G2A例G21G24G2BG2AG33G47G22G24对照组临床缓解G2C例G23显效G2A例G21G24G2BG27G33G47G22G23有效G21G2A例G21G25G2DG2BG23G24G47G22G23无效G26例G21G23G27G2BG23G2AG47G22G25经G3CG42G35G42G45分析G23G21组临床疗效无显著性差异G21G25G2EG2CG2BG2CG26G22G25见表G23G25组别G26临床缓解显效有效无效例G47例G47例G47例治疗组G2AG21G2CG2CG2DG23G21G2BG26G2CG21G26G25G33G2BG23G2AG2A对照组G2AG23G2CG2CG2AG24G2BG27G33G21G2AG25G2DG2BG23G24G26G47G24G2BG2AG33G23G27G2BG23G2A表G23G21组临床疗效比较G2AG2BG2AG21组症状体征改善情况比较治疗组治疗后G23口干G26眼干G26关节疼痛G26便秘G26肌肤干燥G26舌质及脉象方面评分较治疗前降低G21G25G32G2CG2BG2CG23G23G25G32G2CG2BG2CG26G22G25对照组经口服雷公藤多甙片后口干G26眼干G26关节疼痛G26便秘G26肌肤干燥G26舌质及脉象方面评分均较治疗前降低G21G25G32G2CG2BG2CG23G23G25G32G2CG2BG2CG26G22G25治疗组口干症状评分较对照组降低明显G23治疗前后评分差值与对照组比较有统计学意义G21G25G32G2CG2BG2CG23G22G25见表G21G25G2AG2BG2DG21组实验室指标改善情况比较治疗组治疗后左右眼G3BG40G41G42G43G37G44G43试验G26G3AG3BG3CG26G3DG3CG3F值较本组治疗前降低G21G25G32G2CG2BG2CG23G22G24对照组治疗后左右眼G3BG40G41G42G43G37G44G43试验G26G3AG3BG3CG26G3DG3CG3F值较本组治疗前改善G21G25G32G2CG2BG2CG23G23G25G32G2CG2BG2CG26G22G25G21组以上实验室指标治疗前后差值比较无统计学意义G21G25G2EG2CG2BG2CG26G22G25见表G2AG25注G2BG27G48G2CG2BG26G24G23G23G21G2EG2CG2BG2CG26G25G21G2CG2C北京中医药大学学报G21中医临床版G22G21G22G23G22年G24月G23G23G25G21G26G22表G21G21组症状体征改善情况比较G21G21G21G22G22注G24与本组治疗前比较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治疗组G21G25G2BG30G21G22对照组G21G25G2BG30G23G22治疗前治疗后G30G29G2EG2CG23G23G29G2EG2DG21G29G23G24G23G23G29G21G2FG31G31G23G29G25G2EG23G2FG29G2EG26G23G29G26G26G23G2FG29G26G23G2C治疗前治疗后G30G29G24G2EG23G23G29G23G24G21G29G2FG30G23G23G29G2FG23G32G33G2AG29G2CG2EG23G2FG29G30G25G2AG29G25G21G23G2FG29G2EG2DG2D项目眼干脉象G24G2FG29G30G2AG2FG29G2DG2DG23G2FG29G25G2DG2FG29G26G2AG30G29G25G2EG23G2AG29G2EG2EG21G29G21G2DG23G2FG29G2CG2DG28G28G2EG29G30G2CG23G2AG29G21G24G2AG29G2AG2DG23G2FG29G2CG26G21G21口干G26G29G24G25G2FG29G2FG2FG2A舌质G2EG29G2FG2FG23G2AG29G2AG2EG21G29G21G2CG23G2FG29G24G21G25G25G30G29G2EG2CG23G2AG29G2FG30G21G29G2FG2DG23G2FG29G30G2DG2BG2BG2AG29G2EG25G2FG29G2AG26肌肤干燥G2AG29G24G2EG23G2FG29G25G2DG2AG29G30G2EG23G2FG29G25G2FG2EG2EG2AG29G25G25G23G2FG29G25G21G2AG29G2FG2DG23G2FG29G2DG30G2AG2AG2FG29G30G24G2FG29G25G2F便秘G21G29G2FG30G23G2FG29G2CG2DG2FG29G26G2DG23G2FG29G2DG25G2FG23G21G29G2AG24G23G2FG29G2DG2FG2FG29G25G2EG23G2FG29G2DG30G22G22G2FG29G2AG2AG2FG29G24G2A关节疼痛G2AG29G2CG2EG23G2FG29G2CG26G2FG29G2CG2EG23G2FG29G25G21G22G22G2AG29G25G25G23G2FG29G2CG26G2FG29G25G2AG23G2FG29G2DG24G29G29G2FG29G2EG25G2FG29G2DG2E治疗组G21G25G2BG30G21G22对照组G21G25G2BG30G2AG22治疗前治疗后G25G29G2EG2CG23G2AG29G24G2DG2AG2FG29G2AG24G23G2AG29G24G2AG31G31G30G2EG29G2DG2CG23G25G29G24G2EG21G30G29G21G2DG23G2AG2AG29G21G25G23G23治疗前治疗后G25G29G2EG25G23G21G29G2FG26G2AG2FG29G25G21G23G21G29G2AG2FG27G27G30G30G29G21G2CG23G24G29G24G2CG21G2FG29G26G30G23G24G29G2FG2AG25G25项目G34G35G36G37G38G39G3AG38试验左眼G3BG21G39G39G3BG26G39G37G3CG22G3DG3EG3FG40G21G39G41G3BG42G22G24G2AG43G21G2AG2FG43G2DG2CG23G2FG43G21G30G2FG43G26G2FG44G34G3EG3BG21G39G39G3BG36G22G26G21G43G21G21G23G23G21G43G2CG2FG21G2DG43G21G2CG23G23G26G43G25G2EG22G22G2EG24G43G23G24G23G23G23G43G30G2FG21G25G43G30G26G23G23G2DG43G23G2DG29G23G43G30G30G2FG43G23G24G34G35G36G37G38G39G3AG38试验右眼G3BG21G39G39G3BG26G39G37G3CG22G25G43G30G2CG23G23G43G25G2DG23G2FG43G2FG2FG23G23G43G24G30G21G21G2CG43G2FG2FG23G23G43G25G24G23G2FG43G2CG23G23G23G43G2CG21G28G28G2FG43G2EG23G2FG43G2DG24表G22G21组实验指标改善情况比较G21G21G21G22G22注G24与本组治疗前比较G33G33G23G21G2FG43G2FG23G21G24G2BG24G43G2CG2DG22G23G21G21G23G21G2FG43G2FG23G21G24G2BG24G43G2DG2EG22G23G22G22G23G21G2FG43G2FG23G21G24G2BG23G30G43G26G21G22G23G25G25G23G21G2FG43G2FG23G21G24G2BG23G23G43G24G25G22G23G31G31G23G21G2FG43G2FG23G21G24G2BG24G43G23G2FG22G23G28G28G23G21G2FG43G2FG23G21G24G2BG25G43G24G21G22G23G29G23G21G2FG43G2FG26G21G24G2BG2CG43G24G24G22G23G23G23G23G21G2FG43G2FG23G21G24G2BG2DG43G2CG24G22G25G23讨论干燥综合征之燥具有邪毒的性质G23在本病初期燥毒就已经存在G23并通过伤津耗阴G26阻塞气机等多种途径导致瘀血内生G25瘀血形成之后G23气为血阻G23水津不能随气敷布G23从而加重病情G25故治疗本病时应重视解毒清燥G26活血化瘀法的运用G25雷公多甙片是一种具有免疫抑制G26抗炎等作用的中药G23已用于治疗多种自身免疫性疾病G23取得了较肯定的疗效G25但长期服用可有肝肾损害等不良反应G23在一定程度上限制了其临床运用G25活血解毒方与雷公藤多甙片相比G23二者治疗干燥综合征总体疗效相近G23活血解毒方在缓解口干症状方面优于雷公藤多甙片G23同时活血解毒方能随证加减用药G23临床运用范围广G25活血解毒方中丹参可活血化瘀G26凉血消痈G26清心除烦G23为君药G23当归G26川芎助君活血之功G23玄参G26连翘解毒凉血清热G23生地黄G26麦门冬G26石斛G26沙参生津G23太子参益气养阴G23鸡血藤活血养血通络G23生甘草解毒调和诸药G23全方共奏活血解毒G26养血生津之效G25现代研究表明G23丹参G26当归G26川芎G26鸡血藤等活血化瘀药不仅可以改善微循环G23还可以调节机体的免疫功能G23单味丹参药理试验表明其能提高小鼠巨噬细胞功能G23提高大鼠血中淋巴细胞转化率G45G2EG46G25生地黄中主要含有甾醇类G26苷类和多糖类等G23具有抗炎G26调节免疫反应等作用G45G26G46G23而现代研究还表明玄参G26麦门冬G26石斛G26南沙参G26北沙参等药物内含大量的多糖及多糖复合物G23是其发挥调节免疫反应G26促进腺体分泌作用的主要成分G45G2DG46G23上述研究结果为本方治疗干燥综合征提供了理论依据G25参考文献G21G45G2AG46赵岩G23董怡G43第八届干燥综合征国际专题会议纪要G45G47G46G43中华内科杂志G23G21G2FG2FG30G23G2EG21G21G21G22G24G2AG30G2AG48G23G30G21G43G45G21G46郑筱萸G43中药新药临床研究指导原则G45G49G46G43北京G24中国医药科技出版社G23G21G2FG2FG21G24G30G2CG30G48G30G2CG2EG43G45G30G46冯福海G23张二中G24白芍总苷治疗干燥综合征G2EG21例G45G47G46G24中医研究G23G21G2FG2FG2CG23G21G23G21G23G21G22G24G30G2DG24G45G2EG46杨锋G23沈翔G23胡利平G23等G24活血化瘀中药对免疫活性细胞调节作用的实验研究G45G47G46G24中国实验临床免疫学杂志G23G23G24G24G30G23G26G21G23G22G24G30G25G48G2EG23G24G45G26G46初晓峰G23徐福财G43地黄的加工G26药理与临床应用G45G47G46G43中国保健G23G21G2FG2FG2CG23G23G2DG21G21G2DG22G24G23G30G24G23G43G45G2DG46郑琴G23冯怡G23徐德生G24从多糖看养阴中药的药理作用G45G47G46G24时珍国医国药G23G21G2FG2FG2DG23G23G25G21G23G23G22G24G21G30G2FG2FG48G21G30G2FG21G43G21收稿日期G24G21G2FG23G2FG48G2FG26G48G23G21G22G30G27G27北京中医药大学学报G21中医临床版G22G21G22G23G22年G24月G23G23G25G21G26G22孙彩霞G23女G23主治医师带状疱疹是由水痘G27带状疱疹病毒引起的一种常见的急性疱疹性皮肤病G24此病多发于春秋季节G23以成群成簇性水疱沿身体一侧周围神经分布G23排列成带状G23宛如蛇形且疼痛剧烈为特征G24皮疹常在G21G28G29周消失G23但疼痛可持续较长时间G23严重影响患者的生活质量G24笔者采用针灸综合疗法配合中药治疗G21G2A例带状疱疹患者G23取得满意疗效G23现介绍如下G24G21临床资料G2BG2CG23一般资料G2AG2D例均为G21G2EG2EG2F年G2A月G25G21G2EG23G2E年G29月在北京中医药大学东直门医院针灸科门诊就诊的患者G24按照随机数字表分为治疗组G26对照组G24治疗组G21G2A例中G23男性G23G2A例G23女性G23G2E例G27最小年龄G29G21岁G23最大年龄G2FG29岁G23平均年龄G21G2AG25G2CG26G21G21G23G2DG2CG2DG29G22岁G27病程最短G23G30G23最长G25G30G23平均病程G21G21G2CG26G2DG21G23G2CG21G2AG22G30G27累及颈神经G2D例G26三叉神经G21例G26肋间神经G23G21例G26腰骶神经G2A例G24对照组G21G21例中G23男性G23G21例G23女性G23G2E例G27最小年龄G29G2A岁G23最大年龄G25G24岁G23平均年龄G21G2AG2FG2CG29G23G21G23G2AG2CG2FG25G22岁G27病程最短G23G30G23最长G25G30G23平均病程G21G21G2CG23G2FG21G23G2CG29G25G22G30G27累及颈神经G26例G26三叉神经G21例G26肋间神经G23G29例G26腰骶神经G21例G24G21组基本情况及疼痛程度积分比较G23差异无统计学意义G21G21G22G2EG2CG2EG26G22G23具有可比性G24G23G2CG21诊断标准采用G28中医病证诊断疗效标准G29G31G23G32中G2A蛇串疮G2B的针灸综合疗法配合中药治疗带状疱疹临床观察孙彩霞G21汤立新G21王丽丽G22李厚臣G23杨晓倩G24G21G2B北京中医药大学东直门医院针灸科北京G2BG22G22G25G22G22G22G21成都市新华人民医院G22G29北京王府中西医结合医院G22G2A北京中医药大学G23摘要G21目的观察针灸综合疗法配合中药治疗带状疱疹的临床疗效G21方法将G2AG2D例带状疱疹患者分为治疗组G21G2A例G22对照组G21G21例G21治疗组予针灸综合疗法配合中药治疗G23对照组予常规西药治疗G21结果治疗组疗效明显优于对照组G24G21G33G22G2CG22G26G25G26治疗第G21天及第G25天视觉模拟评分G24G34G35G36G25治疗组均低于对照组G24G21G33G2EG2CG2EG26G25G26治疗组止疱时间G22结痂时间均较对照组缩短G24G21G33G2EG2CG2EG26G25G21结论针灸综合疗法配合中药治疗带状疱疹具有较好的疗效G21关键词G21带状疱疹G26针刺G26中药中图分类号G21G37G21G2AG2DG2CG25G25G26G27G28G29G2AG2BG2CG2BG2DG2EG2FG30G2FG27G2EG28G2FG31G2AG28G29G2AG31G2DG30G26G2EG32G33G34G2CG27G2AG35G36G2CG28G29G37G29G2CG27G2AG2BG2AG33G2AG35G2CG2EG2CG27G2DG38G39G32G31G28G31G2AG2DG28G2CG27G3AG29G2AG31G30G2AG2BG3BG32G2BG28G2AG31G36G38G39G3AG3BG3CG27G3DG3CG3BG2BG23G3EG35G39G3FG40G3CG27G3DG3CG41G23G23G42G35G39G3FG40G3CG27G43G3CG21G23G40G44G45G46G47G27G48G49G4AG41G29G23G4BG35G39G3FG4CG3CG3BG46G27G4DG3CG3BG41G2AG21G2BG4EG4A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G34G3AG3BG27G25弥可保G27G36G2DG24按说明服药G24G21G3CG21观察指标G21临床疗效G27G22视觉模拟评分G21G39G3DG3EG22G27G23止疱时间G25结痂时间G24G21G3CG29统计方法采用的G3EG3FG3EG3EG27G26G3CG36统计软件进行统计处理G24计数资料采用G21G21检验G23两独立样本的均数比较采用G21检验G23等级资料采用秩和检验G24G22结果G29G21G27疗效判定标准G29G3CG27G3CG27整体疗效判定标准参照G28中医病证诊断疗效标准G29G2AG27G2B中G2A蛇串疮G2B的疗效判定标准G24治愈G26皮疹消退G23临床体征消失G23无疼痛后遗症G24好转G26皮疹消退G29G36G40以上G23疼痛明显减轻G24未愈G26皮疹消退不足G29G36G40G23仍有疼痛G24G29G28G27G28G21疼痛强度评定标准采用G39G3DG3E测定患者治疗前后的疼痛强度G23以分值表示G23最低G21无痛G22G36分G23最高G27G36分G24G21组患者均于治疗前G25治疗第G21天及第G25天根据G39G3DG3E评分判断疼痛程度G24G29G28G21G21组临床疗效比较治疗组治愈G27G41例G21G25G26G28G36G40G22G23好转G30例G21G21G26G28G36G40G22G27对照组治愈G30例G21G21G25G28G29G40G22G23好转G27G27例G21G26G36G28G36G40G22G23无效G26例G21G21G21G28G25G40G22G24G21组疗效比较G23有显著性差异G23治疗组疗效优于对照组G24见表G27G24G26G2CG2C北京中医药大学学报G21中医临床版G22G21G22G23G22年G24月G23G23G25G21G26G22治愈例G27G28G28例G29G23G2AG25G26G2BG2CG27G21G25G2BG2D组别治疗组对照组G21G21G2EG21G21好转G29G21G26G2BG2CG26G2CG2BG2C无效例G29G2CG2CG26G21G21G2BG25表G21G22组临床疗效比较注G24G22G2FG30G21G2BG2DG2EG28G23G23G2FG2CG2BG2CG28G21G23G23G31G2CG2BG2CG26G25G2DG2BG2DG21组G32G33G34评分比较治疗前G21组G32G33G34评分比较无统计学差异G21G23G35G2CG2BG2CG26G22G23治疗第G21天及第G25天G32G33G34评分治疗组均低于对照组G21G23G31G2CG2BG2CG26G22G23见表G21G25表G22G22组G23G24G25评分比较G21G24G21G25G22G2DG2BG2EG21组止疱时间G21结痂时间比较治疗组止疱时间G26结痂时间均较对照组缩短G21G23G31G2CG2BG2CG26G22G23见表G2DG25表G26G22组止疱时间G21结痂时间比较G21G36G27G24G21G25G22G27讨论中医认为本病的形成多由情志不畅G26肝气郁结G26久而化火G23或过食辛辣G26耗散脾气G26脾失健运G26湿浊内生G26郁而化热G23复因外感毒邪G23以致湿热火毒蕴积肌肤而生G25西医认为G23带状疱疹的发生与患者脊髓后根神经纤维受损有关G23现代研究表明G23夹脊穴位于第G28胸椎至第G26腰椎棘突旁G22G2BG26寸区G23浅层有胸或腰部神经后支的皮支部分G23深层有胸或腰神经后支和胸肋后动脉腰动脉分支G23针刺夹脊穴可以起到阻滞神经G26止痛的作用G37G2DG38G25带状疱疹局部往往伴有疼痛及颜色温度的变化G23G28气伤则痛G23血伤则肿G29G23围刺病灶可以使局部经络运行血气顺畅G25阳陵泉为足少阳胆经合穴G23行间为足厥阴肝经之荥穴G23侠溪为胆经荥穴G23G28荥主身热G29G23G2D穴相配具有泄肝胆火G26疏肝行气的作用G25阴陵泉为足太阴脾经之合穴G23具有清利湿热G26健脾理气的功效G27三阴交是足三阴经的交会穴G23有健脾益气的功效G23与阴陵泉穴同用有温中运脾的作用G27内庭是胃经之荥穴G23可清泻胃火G25曲池为手阳明经的合穴G23合谷为手阳明经原穴G23G21穴具有清热的功效G23合用可以清头面之热G25支沟为手少阳三焦经的经穴G23属火G23有清利三焦功效G23善治胁痛G23太冲为肝经的原穴G23G21穴相合可治疗胸胁部的带状疱疹G25足三里G26血海分别为足阳明胃经和足太阴脾经的穴位G23根据穴位的近治作用G23均可以治疗腰骶部及下肢部位的带状疱疹G25针刺有助于调整和增强机体的免疫功能G23有效地抑制炎症G23提高痛阈G23而局部的针刺治疗G23更有助于发挥其调节微循环的作用G23促进新陈代谢G23从而达到了止痛消炎的作用G37G2EG38G25红光治疗仪照射有温通经脉G26通经活血的功效G23可缓解症状G23以达到治疗疾病的目的G25火针特点是将针体烧红后刺入人体一定穴位或部位G23达到通经活络G26祛除疾病的目的G25火针具有悠久的历史G23G2A灵枢G2B经筋G2C云G24G28悴刺者G23刺寒急也G25热则筋纵不收G23无用燔针G25G29指出火针只用于治疗寒痹G23若因热邪使筋脉驰缓不收者G23不宜用火针G25火针沿用至今其主治范围已超出前人的论述G23随着人们对风湿热痹的认识G23火针的应用范围也进一步扩大G25火针可以激发人体的阳气G23达到通络止痛的目的G25拔火罐疗法可以疏通经络G26祛除瘀滞G26行气活血G26拔毒止痛G23具有调整人体的阴阳平衡G26增强体质的功能G23从而达到扶正祛邪G26治愈疾病的目的G25龙胆泻肝汤见于G2A医方集解G2CG23主要治疗由肝胆实火G26肝经湿热循经上扰下注所致诸病G25肝主藏血G23肝经有热G23本易耗伤阴血G23方中苦寒燥湿之药G23易耗其阴G23故用玄参G26麦冬滋阴养血G25冬瓜仁性凉味甘G23并有健脾利水的功效G23适用于治疗脾经湿热G25针刺配合红光G26火针配合拔罐G26中药G2D者同时使用可达到清热解毒G26疏泄瘀滞G26加速疱疹痊愈的效果G25针灸综合疗法配合中药治疗带状疱疹G23有很好的疗效G23并且能有效缓解疼痛G23缩短止疱时间和结痂时间G23值得临床推广运用G25参考文献G22G37G28G38中医病证诊断疗效标准编审委员会G2B中医病证诊断疗效标准G37G34G38G21南京G24南京大学出版社G23G28G24G24G2EG24G28G2EG2EG21G37G21G38高学敏G23党毅G2B中医美容学G37G39G38G21北京G24中国科学技术出版社G23G21G22G22G22G24G26G21G22G30G26G21G28G2BG37G2DG38魏玲G2B穴位注射夹脊穴加针刺治疗老年疱疹后遗神经痛疗效观察G37G3AG38G21中国针灸G23G21G2CG2CG28G23G21G28G21G27G22G24G2DG2DG2DG30G2DG2DG2EG21G37G2EG38李扬缜G2B围刺加中药治疗带状疱疹G21G28例G37G3AG38G2B甘肃中医G23G28G24G24G25G23G28G21G2DG22G24G26G27G2BG21收稿日期G24G21G2CG28G2CG30G2CG26G30G2DG28G22组别G21治疗前第G21天第G25天治疗组G21G2EG2AG2BG24G28G22G28G2BG2DG21G26G2BG25G2AG22G2CG2BG24G2AG21G2BG2DG26G22G28G2BG21G2C对照组G21G21G24G2BG2CG25G22G28G2BG28G2AG25G2BG21G27G22G28G2BG2CG2DG2EG2BG26G21G22G28G2BG2CG25G26G2CG2BG28G2DG21G2CG2BG25G25G26G21G2BG27G2EG2DG23G2CG2BG2DG21G2DG2CG2BG2CG21G25G2CG2BG2CG28G2E组别G21止疱时间结痂时间治疗组G21G2EG28G2BG2AG25G22G2CG2BG24G27G2DG2BG28G26G22G21G2BG21G2E对照组G21G21G2DG2BG2CG21G22G28G2BG2EG24G26G2BG2DG27G22G2DG2BG2AG2DG26G30G28G2BG28G21G2CG30G21G2BG21G2CG24G23G2CG2BG2CG2DG27G2CG2BG2CG28G2AG27G2BG2B北京中医药大学学报G21中医临床版G22G21G22G23G22年G24月G23G23G25G21G26G22高树彪G23男G23硕士G23副主任医师G27北京中医药大学校级课题二尖瓣口舒张早期血流峰速G21G28G22与二尖瓣环舒张早期运动峰速G21G29G22的比值G21G28G2AG29比值G22做为超声评价左室舒张功能的指标G23与目前临床常用二尖瓣口舒张早期血流峰速G21G28G22与二尖瓣口舒张晚期血流峰速G21G2BG22的比值G21G28G2AG2B比值G22相比G23在左室收缩功能差G24心率快G24二尖瓣血流信号融合及房颤患者中仍然准确G23可能是反映左室舒张功能最好的无创性评价指标G2CG23G2DG25随着对高血压病研究的深入G23高血压舒张功能异常越来越受到临床医生的重视G25中医药治疗高血压病具有明显改善患者临床症状G24减少西药降压带来的毒副作用等优势G25我们对高血压病不同中医证型之间G28G2AG29比值的变化规律进行观察研究G23现报告如下G25高血压病不同中医证型左室舒张功能评价指标G21G22G23比值的变化G24高树彪戴雁彦王硕仁李国红G21北京中医药大学东直门医院北京G23G2EG2EG25G2EG2EG22摘要G21目的探讨高血压病不同中医证型之间二尖瓣口舒张早期血流峰速G21G28G22与二尖瓣环舒张早期运动峰速G21G29G22的比值变化规律G23方法将G23G21G2E例高血压病患者按照中医辨证分为肝火亢盛证组G24阴虚阳亢证组G24痰湿壅盛证组G24阴阳两虚证组G25每组各G2FG2E例G25并设G2FG2E例健康人做为对照组G23应用彩色多普勒超声诊断仪G25于心尖标准四腔心切面G25使用脉冲频谱多普勒G21G30G31G32G22与组织多普勒显像G21G33G32G34G22同步分别检测G28值G24G29值G25计算G28G35G29比值G25并对各组G28G35G29比值进行比较G23结果高血压病各中医证型组与对照组比较G28G35G29比值均升高G25差异有统计学意义G21G21G21G2EG36G2EG23G22G26阴虚阳亢证组G24痰湿壅盛证组G24阴阳两虚证组与肝火亢盛证组比较G28G35G29比值均升高G25差异有统计学意义G21G21G21G2EG36G2EG23G22G26阴阳两虚证组与痰湿壅盛证组比较G28G35G29比值升高G25差异有统计学意义G21G21G21G2EG36G2EG26G22G23结论G28G35G29比值可做为高血压病中医证型客观量化评价指标的参考依据G23关键词G21高血压病G26中医证型G26左室功能G26G28G35G29比值中图分类号G21G37G21G26G24G25G26G27G28G29G23G2AG2BG2CG21G22G23G2DG27G2EG2FG2BG22G27G2AG2AG23G2AG2AG30G23G28G2EG2FG28G31G23G32G2BG2CG33G23G2CG2EG34G23G28G2EG2DG2FG35G36G33G27G2DG2CG36G28G35G2EG2FG2BG28G22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及测量G23然后启用G3DG3EG3FG40G3DG41G42键G23于心尖标准四腔心切面G23同步分别测量二尖瓣口G37峰及二尖瓣环室间隔侧G43峰值G23仪器自动计算G37G44G43比值G25G27G28G2E统计方法所有数据用G21G21G21G22G22表示G23数据处理采用G3AG45G3AG3AG27G2EG28G2A软件进行单因素方差分析G21G35G46G47G48G35G22G23组间比较采用G49G3AG3D法G25G22结果G21G28G23二尖瓣脉冲频谱多普勒G21G45G4AG3DG22与二尖瓣组织多普勒显像G21G34G3DG33G22对左室舒张功能检出率比较利用G45G4AG3D技术对G23G26G2A例受检者二尖瓣舒张期血流进行检测G23其中有G21G31例因房颤G28心率过快使二尖瓣频谱融合G23无法计算二尖瓣口G37G44G35比值G23占受检者患者G23G25G28G2EG2EG4BG25G27G26G2A例受检者G27G2AG2AG4B完成了二尖瓣环G34G3DG33G43值测量G23并计算出了G37G4CG43比值G25G21G4DG21各组G37G44G43比值比较高血压病各中医证型组与对照组比较G37G44G43比值均升高G23差异有统计学意义G21G23G22G2AG28G2AG23G22G25高血压病各中医证型组间比较G23阴虚阳亢证组G28痰湿壅盛证组G28阴阳两虚证组与肝火亢盛证组比较G37G44G43比值均升高G23差异有统计学意义G21G23G22G2AG28G2AG23G22G29阴阳两虚证组与痰湿壅盛证组比较G37G44G43比值升高G23差异有统计学意义G21G23G22G2AG28G2AG26G22G25见表G23G25表G21各组G23G24G25比值比较G21G21G21G22G29G24G4EG2EG22G22注G2A与对照组比较G4FG50G25G22G29G4DG29G27G29与肝火亢盛证组比较G51G51G23G22G22G4DG22G27G29与痰湿壅盛证组比较G21G23G22G22G4DG22G26G25G26讨论中医认为高血压属G2B眩晕G2CG2B头痛G2C等病的范畴G25中医治疗高血压病G23提倡首先辨病G21诊断和鉴别诊断G22G25随着中西医结合的不断发展G23为使高血压中医证型标准化G28客观化G23将其与现代诊疗技术相结合G23探索其客观依据G23众多学者做了大量的临床研究G2CG30G52G26G2DG25G26中药新药临床研究指导原则G27G2CG2EG2D将高血压病中医证型分为肝火亢盛证G28阴虚阳亢证G28痰湿壅盛证和阴阳两虚证G23其分型反映了高血压病不同发展阶段病因G28病机G28病位G28病势的综合特点G25心脏舒张功能降低是高血压患者早期表现之一G23它又伴随高血压病的发展而加重G25高血压左室舒张功能异常与多种因素有关G23早期可能由交感神经活性和肾素G53血管紧张素活性增强所介导G2CG31G2DG23其他还包括心肌细胞肥大G28心肌细胞间胶原间质积聚G28异常的钙离子内流G23以及长期血压高所致的心肌主动松弛延缓和左室顺应性降低G25左室舒张功能异常多普勒超声心动图评价主要表现为G2E种形式G2A左室充盈减低G28左室充盈假性正常化及晚期的限制性充盈异常G25传统用测量二尖瓣口前向血流G37峰G28G35峰及G37G54G35比值来判断左室舒张功能简便实用G23能区分正常与左室舒张功能减低及限制性充盈障碍患者G23但较难单纯根据此参数将正常与假性正常化患者加以区分G23另外当患者因房颤G28心率过快使二尖瓣血流频谱融合时G23此方法无法进行G37峰G28G35峰测量及G37G54G35比值计算G25本研究G27G26G2A例受检者中有G21G31例出现这种情况G23占受检者的G27G25G4DG2EG2EG55G23进一步说明了传统测量方法的局限性G25本研究使用G34G3DG33测量二尖瓣环G43峰值G23G27G26G22例受检者全部检测成功G23说明利用G34G3DG33测量方便G28实用性强G23G34G3DG33所测G43值能将舒张功能受损患者与正常患者加以区分G23而不能将舒张功能受损的不同程度加以区分G25已有研究证实G2CG25G2DG23G37G44G43比值是评价左室组别G37G44G43对照组G31G4DG24G25G23G27G4DG2BG26肝火亢盛证组G24G4DG30G21G24G21G4DG27G25G50G50阴阳两虚证组G27G2BG4DG26G27G24G30G4DG21G24G50G50G51G51G21G26G31G21G4DG25G31G23G22G22G4DG22G22G22G27阴虚阳亢证组G27G31G4DG31G24G24G30G4DG21G2BG50G50G51G51痰湿壅盛证组G27G26G4DG21G21G24G30G4DG21G26G50G50G51G51G2BG2DG2D北京中医药大学学报G21中医临床版G22G21G22G23G22年G24月G23G23G25G21G26G22G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21G21舒张功能的指标G23G27G28G29比值与心导管所测左室舒张末压高度相关G24本研究发现高血压病不同中医证型间G27G28G29比值变化由低至高顺序为肝火亢盛证G25痰湿壅盛证G25阴虚阳亢证G25阴阳两虚证G24高血压病各中医证型之间G27G28G29比值比较G23阴虚阳亢证组G25痰湿壅盛证组G25阴阳两虚证组与肝火亢盛证组比较G27G28G29比值均升高G23差异有统计学意义G21G21G21G2AG2BG2CG23G22G26阴阳两虚证组与痰湿壅盛证组比较G27G28G29比值升高G23差异有统计学意义G21G21G21G2CG2BG2CG26G22G24说明高血压病中医证型的演变规律与G27G28G29比值变化规律有高度的相关性G24G27G28G29比值可能成为高血压病中医证型客观化评价的参考依据G24参考文献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中国高血压防治指南G29修订委员会G2B中国高血压防治指南G27G21G2AG2AG26修订版G2DG30G2EG2B北京G27人民卫生出版社G23G21G2AG2AG54G27G23G55G4FG23G54G2BG2DG55G2E郑筱萸G2B中药新药临床研究指导原则G2DG30G2EG2B北京G27中国医药科技出版社G23G21G2AG2AG21G27G25G53G4FG25G26G2BG2DG53G2E朱伟G23李世军G23阮新民G2B高血压病患者动脉弹性与中医辨证分型的相关性研究G2DG51G2EG2B时珍国医国药G23G21G2AG2AG24G23G21G2AG21G23G22G27G55G52G4FG53G2AG2BG2DG26G2E黄玉贞G23潘光明G23许艳G23等G2B高血压病患者中医辨证分型与经颅多普勒的关系G2DG51G2EG2B辽宁中医杂志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收稿日期G27G21G22G58G22G4FG22G54G4FG21G21G22李宏艳G23女G23在读硕士生G23副主任医师自拟芪地益气润燥汤配合白芍总苷治疗原发性干燥综合征G21G22例李宏艳G21北京市房山区良乡医院北京G58G22G21G53G22G58G22摘要G21目的观察自拟芪地益气润燥汤配合口服白芍总苷治疗原发性干燥综合征的临床疗效G21方法对G55G58例原发性干燥综合征患者给予口服芪地益气润燥汤剂配合口服白芍总苷治疗G22观察临床疗效G22口干G23眼干症状积分变化及不良反应发生情况G21结果G55G58例中显效G52例G24G21G26G2BG52G58G5EG25G22有效G21G22例G24G54G53G2BG26G58G5EG25G22无效G55例G24G24G2BG54G52G5EG25G22总有效率为G24G22G2BG55G21G5EG21治疗后患者口干G23眼干症状积分与治疗前比较明显降低G24G26G5FG22G2BG22G58G25G21结论自拟芪地益气润燥汤配合口服白芍总苷治疗原发性干燥综合征具有较好疗效G21关键词G21干燥综合征G26芪地益气润燥汤G26白芍总苷中图分类号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