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OBJECTIVE@#To explore the clinical therapeutic effect of herb-partitioned moxibustion at point in patients of diabetic gastroparesis differentiated as spleen and stomach deficiency and retention of turbid dampness as well as its effect mechanism.@*METHODS@#A total of 134 patients with diabetic gastroparesis were randomized into an observation group and a control group, 67 cases in each one. In the observation group, herb-partitioned moxibustion at point was adopted, 40 min each time, once a day for 5 times a week. In the control group, itopride hydrochloride tablets were prescribed for oral administration, 50 mg each time, three times a day. A total of 6 weeks of treatment was required in the two groups. Before and after treatment, the gastroparesis cardinal symptom index (GCSI) scores, 4-hour gastric emptying rate, TCM symptom score, as well as the levels of plasma motilin and serum gastrin were observed in the patients of the two groups. Additionally, the clinical therapeutic effect was evaluated in the two groups.@*RESULTS@#After treatment, the score of every item of GCSI, TCM symptom scores and the levels of plasma motilin and serum gastrin were all reduced as compared with those before treatment in the patients of the two groups (<0.05), and those in the observation group were lower than the control group (<0.05). Regarding 4-hour gastric emptying rates, which were increased as compared with those before treatment in the two group (<0.05), and the rate in the observation group was higher remarkably than that in the control group (<0.05). The total effective rate was 92.5% (62/67) in the observation group, higher than 74.6% (50/67) in the control group (<0.05).@*CONCLUSION@#Herb-partitioned moxibustion at point relieves the clinical symptoms in the patients with diabetic gastroparesis and increases the gastric emptying rate, which is probably related to the regulation of the levels of plasma motilin and serum gastrin.
Subject(s)
Humans , Acupuncture Points , Diabetes Mellitus , Gastric Emptying , Gastrins , Blood , Gastroparesis , Therapeutics , Motilin , Blood , MoxibustionABSTRACT
OBJECTIVE@#To observe the clinical therapeutic effect of herb-separated moxibustion at Jinsuo (GV 8)- eight-diagram points on diarrhea-type irritable bowel syndrome (IBS-D) of liver stagnation and spleen deficiency as compared with oral administration of pinaverium bromide tablets and Chinese herbal decoction, .@*METHODS@#A total of 126 patients with IBS-D of liver stagnation and spleen deficiency were randomized into a herb-separated moxibustion group (moxibustion group), a western medication group and a Chinese herbal medication group, 42 cases in each one. In the moxibustion group, the herb-separated moxibustion was applied to Jinsuo (GV 8)-eight-diagram points. The herbs in (fried , fried , and ) were ground into herbal paste and the paste was put on Jinsuo (GV 8)-eight-diagram points. The suspending moxibustion was exerted over the points for 40 min, once daily. In the western medication group, pinaverium bromide tablets were taken orally, 50 mg each time, three times a day. In the Chinese herbal medication group, the decoction of was taken orally, one dose a day, taking separately in two times. The duration of treatment was 8 weeks in each group. Before and after treatment, the symptom score of traditional Chinese medicine (TCM), gastrointestinal (GI) symptom score, the score of IBS symptom severity scale (IBS-SSS) and the score of IBS quality of life (IBS-QOL) scale were observed in patients of each group separately. The clinical therapeutic effect was evaluated.@*RESULTS@#After treatment, the scores of TCM symptoms, GI symptom scores and IBS-SSS scores were all obviously reduced in each group (<0.05). Each of the scores in the moxibustion group was lower than the western medication group and the Chinese herbal medication group respectively (<0.05). After treatment, the scores of each of eight subscale structures of IBS-QOL scale, named dysphoria, interference with activity, body image, health worry, food avoidance, social reaction, sexual intercourse and relationship, were all increased obviously in each group (<0.05). The scores of each of eight subscale structures in the moxibustion group were higher than the western medication group and the Chinese herbal medication group respectively (<0.05). The total effective rate was 92.9% (39/42) in the moxibustion group, higher than 71.4% (30/42) in the western medication group and 73.8% (31/42) in the Chinese herbal medication group respectively (<0.05).@*CONCLUSION@#Herb-separated moxibustion at Jinsuo (GV 8)-eight-diagram points remarkably relieves gastrointestinal symptoms and improves the quality of life in patients of diarrhea-type irritable bowel syndrome of liver stagnation and spleen deficiency, and its clinical therapeutic effect is superior to oral administration of either pinaverium bromide tablets or .
Subject(s)
Humans , Diarrhea , Therapeutics , Drugs, Chinese Herbal , Irritable Bowel Syndrome , Therapeutics , Liver , Medicine, Chinese Traditional , Moxibustion , Quality of Life , Spleen , Treatment OutcomeABSTRACT
Objective: To observe the clinical efficacy difference in treating irritable bowel syndrome-diarrhea (IBS-D) of liver-qi stagnation and spleen-deficiency pattern with different treatment protocols, and the effects on serum levels of 5-hydroxytryptamine (5-HT), substance P (SP) and vasoactive intestinal peptide (VIP), for unveiling the mechanism of intradermal needle therapy plus pinaverium bromide in treating IBS-D. Methods: A total of 123 IBS-D patients were divided into an observation group, a Western medication group and an integrated Western and Chinese medication group using the random number table method, with 41 cases in each group. The Western medication group was given oral pinaverium bromide, 50 mg each time and 3 times a day. The integrated Western and Chinese medication group was given additional Chinese herbal medicine Tong Xie Yao Fang, one dose each day. The observation group was given additional intradermal needle therapy on the basis of the Western medication group. The whole intervention lasted for 6 weeks. Before and after treatment, the scores of gastrointestinal symptoms, traditional Chinese medicine (TCM) symptoms, irritable bowel syndrome (IBS) symptom severity scale (IBS-SSS) and IBS quality of life (IBS-QOL) questionnaire, as well as the serum levels of 5-HT, SP and VIP were observed. The clinical efficacy was estimated. Results: The total effective rate was 92.7％ in the observation group, 68.3％ in the Western medication group and 78.1％ in the integrated Western and Chinese medication group. The total effective rate was higher in the observation group than in the other two groups, and higher in the integrated Western and Chinese medication group than in the Western medication group, showing statistical significance (all P<0.05). After treatment, the scores of gastrointestinal symptoms, TCM symptoms and IBS-SSS showed significant decreases in the three groups, presenting statistical significance compared with the baseline (all P<0.05); the scores of gastrointestinal symptoms, TCM symptoms and IBS-SSS were notably lower in the observation group than in the other two groups (all P<0.05), and lower in the integrated Western and Chinese medication group than in the Western medication group (all P<0.05). After treatment, the eight component scores of IBS-QOL showed significant increases in the three groups compared with the baseline (all P<0.05); the eight component scores in IBS-QOL were significantly higher in the observation group than in the other two groups (all P<0.05), and higher in the integrated Western and Chinese medication group than in the Western medication group (all P<0.05). After treatment, the serum levels of 5-HT, SP and VIP decreased markedly in the three groups compared with the baseline (all P<0.05); the serum levels of 5-HT, SP and VIP were significantly lower in the observation group than in the other two groups (all P<0.05), and lower in the integrated Western and Chinese medication group than in the Western medication group (P<0.05). Conclusion: Treatment with intradermal needle therapy plus pinaverium bromide results in significant improvements in the gastrointestinal symptoms and quality of life in patients with IBS-D of liver-qi stagnation and spleen deficiency pattern, and effectively regulates the gastrointestinal hormone production.
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Objective To investigate the clinical and antenatal sonographic characteristics of placenta previa accreta after cesarean section. Methods The data of 21 inpatients diagnosed as placenta previa accreta after cesarean section in PUMC Hospital from 2006 to 2016 were retrospectively reviewed. The clinical and ultrasound features were recorded and compared among three placental accreta groups,including placenta accrete group(n=5),increta group(n=12),and percreta group(n=4). The relationship between the placental thickness at the uterine anterior lower segment level and the blood loss of the following cesarean section was tested. Results Of 21 patients,placenta previa was diagnosed by ultrasound in 20 cases(95.2%) and placenta previa accreta was diagnosed in 9 cases(42.9%). Antenatal ultrasound findings included following signs:loss of "clear zone"(15/18,83.3%),myometrial thinning(12/18,66.7%),abnormal placental lacunae(12/19,63.2%),bladder wall interruption(2/18,11.1%),and uterovesical hypervascularity(4/9,44.4%). Myometrial thinning(J-T=64.000,P=0.036),abnormal placental lacunae(J-T=74.500,P=0.032) and the placental thickness at the uterine anterior lower segment level(U=83.000,P=0.010) showed significant difference among different placenta accreta groups. Placental thickness at the uterine anterior lower segment level showed linear correlation with the blood loss of the following cesarean section(r=0.669,P=0.002). The blood loss of the following cesarean section showed significant difference among different placenta accreta groups(U=118.500,P=0.000). Conclusions The clinical and sonographic manifestations of placenta previa accreta after cesarean section show a spectrum of demographic characteristics. The measurement of thickness of placenta at the anterior lower segment may help the evaluation of the clinical prognosis of this special pathology.
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<p><b>OBJECTIVE</b>To compare the differences in the therapeutic effect on irritable bowel syndrome (IBS) between acupuncture at Tianshu (ST 25) and Dachangshu (BL 25) and western medication with Trimebutine Maleate.</p><p><b>METHODS</b>Forty cases were divided randomly into an acupuncture group and a western medication group, 20 cases in each one. In acupuncture group, acupuncture was applied to Tianshu (ST 25) and Dachangshu (BL 25). Ziwu Daojiu needling technique was adopted, once daily. In western medication group, Trimebutine Maleate capsule was administered, 2 capsules in each time, 3 times per day. The assessment on the therapeutic effect was performed in 4 weeks of treatment in two groups.</p><p><b>RESULTS</b>As compared with those before treatment, the time of abdominal pain, the frequency of abdominal pain, the morbidity of abnormal stool appearance, the morbidity of defecation abnormality, the morbidity of mucus stool and the score of bloating or abdominal pain on bowel movement were all reduced after treatment in two groups (all P < 0.01). The results in acupuncture group were much more significant than those in western medication group (the total score: 16.70 +/- 2.40 vs 15.70 +/- 3.01, P < 0.01). The total effective rate in acupuncture group was 95.0% (19/20), which was superior to that of 70.0% (14/20) in western medication group (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture at Tianshu (ST 25) and Dachangshu (BL 25) may remarkably relieve the clinical symptoms of IBS and its efficacy is superior to that of oral medication with Trimebutine Maleate.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Acupuncture Therapy , Irritable Bowel Syndrome , Drug Therapy , Therapeutics , Trimebutine , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To investigate the possible role of inflammation factors in the pathogenesis of impaired glucose tolerance (IGT) with concurrent obstructive sleep apnea/hypopnea syndrome (OSAHS) in pregnant women.</p><p><b>METHODS</b>Twenty-five pregnant women with IGT and concurrent OSAHS and 35 pregnant women with IGT but not OSAHS were monitored for all night polysomnography (PSG), and the apnea hypopnea index (AHI) and the lowest pulse oxygen saturation (LSpO2) were recorded. The body mass index, glycated serum protein (GSP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured in these women.</p><p><b>RESULTS</b>IL-6 and TNF-α levels increased significantly in women with IGT and OSAHS as compared with those in women without OSAHS. AHI showed significant positive correlations to GSP, IL-6 and TNF-α, whereas LSpO2 was inversely correlated to GSP, IL-6 and TNF-α. IL-6 and TNF-α were significantly correlated to GSP, with correlation coefficients of 0.510 and 0.476, respectively.</p><p><b>CONCLUSION</b>The inflammatory factors may play important roles in IGT complicated by OSAHS in pregnant women, and as a potential risk factor, OSAHS may contribute to the occurrence of progression of IGT.</p>