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Objective:To investigate the risk factors of duodenal papilla hemorrhage after endoscopic papillary balloon dilatation (EPBD) for choledocholithiasis.Methods:Clinical data of 411 cases of choledocholithiasis treated by EPBD in Hangzhou First People′s Hospital from January 2016 to December 2019 were analyzed retrospectively. Based on the development of hemorrhage after EPBD, patients were divided into the hemorrhage group and the non-hemorrhage group. The risk factors of hemorrhage after EPBD were analyzed by single and Logistic regression.Results:Among 411 patients who received EPBD, 29 patients had EPBD-related duodenal papilla hemorrhage and the overall incidence was 7.1%.Univariate analysis showed that there were significant differences between the hemorrhage group and the non-hemorrhage group in diameter≥1.2 cm of balloon dilation ( P=0.001), endoscopic sphincterotomy (EST) ( P=0.002)and the incision length of EST ( P<0.001). Logistic regression analysis showed that the incision length of EST ( OR=69.771, 95% CI: 7.544-645.296, P<0.001) was the independent risk factor for duodenal papilla hemorrhage after EPBD. Diameter≥1.2 cm of balloon dilation( OR=0.192, 95% CI: 0.071-0.524, P=0.001) was a protective factor. Conclusion:The incision length of EST is an independent risk factor of duodenal papilla hemorrhage after EPBD. Endoscopic papillary large balloon dilation is a protective factor for postoperative hemorrhage, which can reduce the incidence of bleeding.
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OBJECTIVE: To discuss the distribution laws of traditional Chinese medicine (TCM) syndrome factor and their combination in coronary heart disease (CHD), and to study the correlation between the TCM syndrome factor combination and cardiac function as well as blood-lipid. METHODS: The parameters of the cardiac function of 300 patients with a final diagnosis of CHD by coronary angiography were measured by echocardiography, and the levels of blood lipids in the CHD patients were detected. An analysis of the correlation was done between the TCM syndrome factor combination and cardiac function as well as blood-lipid in CHD. RESULTS: The TCM syndrome factor combinations of CHD were blood stasis due to qi deficiency, qi and yin deficiency, intermingled phlegm and blood stasis, and yang deficiency and blood stasis. The ejection fraction of CHD patients with yang deficiency and blood stasis was markedly decreased. The levels of triglyceride and low-density lipoprotein cholesterol in CHD patients with intermingled phlegm and blood stasis were markedly increased, and the level of triglyceride in CHD patients with qi and yin deficiency was markedly increased too. CONCLUSION: The treatment of CHD should aim directly at the symptoms and causes. It is also proved that some compound traditional Chinese herbal medicines for supplementing qi and activating blood circulation, nourishing yin and resolving phlegm, and activating yang should be used in treatment of CHD. In cases of CHD with low cardiac function, particular emphasis should be laid on activating yang and blood circulation, while in cases of CHD with blood-lipid disturbance, particular emphasis should be laid on resolving phlegm and activating blood circulation, replenishing qi and nourishing yin.
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OBJECTIVE: To explore the laws of traditional Chinese medicine (TCM) syndromes in unstable angina, and to establish the preliminary diagnostic criteria for TCM syndromes. METHODS: Multi-center prospective research on TCM syndromes in 815 cases of unstable angina was done with the nonlinear dimension reduction by factor analysis. RESULTS: There were five extracted factors in factor analysis: F1, F2, F3, F4 and F5. F1 was yin deficiency of heart and kidney, F2 was deficiency of both heart and spleen, F3 was intermingled phlegm and blood stasis, F4 was qi deficiency and blood stasis, and F5 was yang deficiency and coagulated cold. Qi deficiency and blood stasis (F4) syndrome accounted for the maximum proportion. The diagnostic criteria for TCM syndromes were preliminarily and respectively established. CONCLUSION: Qi deficiency and blood stasis is the key factor of pathogenesis. The factor analysis can help us classify traditional Chinese medicine syndromes and establish the preliminary diagnostic criteria.
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Objective To study the symptomatic characteristics distribution of Chinese medicine of patients with pulmonary hypertension.Methods Symptomatic information of 52 patients with pulmonary hypertension was collected to find the symptomatic characteristics of Chinese medicine,and analyse the correlation of symptom and pulmonary hypertension with different types and degrees.Results The proportion of TCM symptom of pulmonary hypertension from high to low were syndrome of strong Qi sinking(96.2%),syndrome of blood stasis(75.0%),syndrome of deficiency of lung Qi(42.3%),syndrome of deficiency of heart Qi(30.8%),syndrome of deficiency of spleen Qi(17.3%).Syndrome of blood stasis was the most closely related to the congenital cardiopathy(CC) with pulmonary hypertension.Syndrome of deficiency of heart Qi was the most closely related to the degree of pulmonary hypertension increased pressure.The next one was syndrome of deficiency of lung Qi.Conclusion Syndrome of strong Qi sinking,syndrome of blood stasis,syndrome of deficiency of heart Qi and syndrome of deficiency of lung Qi are the main syndromes of pulmonary hypertension.Syndrome of strong Qi sinking is the most closely related to the pulmonary hypertension.
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Objective To study the effect of promoting blood circulation to remove blood stasis by Qiangxin Fumai Granule (QXFMG). Method The rat model with blood stasis was induced by the hyodermic injection of adrenaline and ice water-bathing. The blood sample was collected by the puncture of the abdomen aorta and the effect of QXFMG on hemorheological parameters was observed. Result Comparing with the control groups, the QXFMG groups can depress the whole blood viscosity under low shear rate, the erythrocytic clustering index and the content of fibrinogen obviously. Conclusion QXFMG can improve the hemorheology level of rat with acute blood stasis by depressing the whole blood viscosity under low shear rate, restraining the clustering of erythrocyte and depressing the content of fibrinogen, which is prior to the Compound Danshen piece.