ABSTRACT
Objective:To evaluate the clinical efficacy of external therapy with self-made Huatan Prescription combined with conventional western medicine therapy in the treatment of severe pneumonia of phlegm turbidity obstructing lung.Methods:Randomized controlled trial. A total of 114 patients with severe pneumonia of phlegm turbidity obstructing lung in the hospital between July 2020 and December 2021 were enrolled in this study. The patients were divided into two groups by the random number table method, with 57 in each group. On the basis of conventional western medicine therapy, the treatment group was given external therapy of self-made Huatan Prescription, and the control group was given the placebo. Both groups were applied continuously for 5 days. The TCM syndromes were scored before and after treatment. The disease severity was evaluated by Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ). The levels of WBC and procalcitonin (PCT) were detected by automatic blood analyzer. The levels of serum CRP and IL-6 were detected by ELISA. The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results:After treatment, the total respinse rate was 92.98% (53/57) in treatment group and was 70.18% (40/57) in control group ( χ2=9.87, P=0.002). The scores of fever, unconsciousness, cough and expectoration, nausea and vomiting, tongue coating and pulse and total score in treatment group were significantly lower than those in the control group ( t=8.95, 7.30, 6.93, 7.37, 12.02, 12.59, 14.29, P<0.01). SOFA (18.12±3.55 vs. 21.46±3.58, t=5.00) and APACHE Ⅱ (13.39±2.72 vs. 16.52±3.13, t=5.70) in treatment group were significantly lower than those in the control group ( P<0.01). The levels of WBC [(11.12±1.61) ×10 9/L vs. (12.69±1.82) ×10 9/L, t=4.88], PCT [(3.72±0.81) μg/L vs. (5.19±0.92) μg/L, t=9.05], serum CRP [(62.09±11.41) mg/L vs. (91.77±15.54) mg/L, t=11.62] and IL-6 [(193.14±32.28) ng/L vs. (235.68±38.75) ng/L, t=6.37] in treatment group were significantly lower than those in the control group ( P<0.01). During treatment, there were no obvious adverse reactions in both groups. Conclusion:Self-made Huatan Prescription external therapy combined with conventional western medicine therapy can improve the clinical symptoms, inhibit the inflammatory response, relieve the disease condition and improve the prognosis of patients with severe pneumonia of phlegm turbidity obstructing lung safely.
ABSTRACT
OBJECTIVE： To study the effects of Dengzhan shengmai capsules combined with isosorbide mononitrate on serum TIMP-1 and MMP-9 levels， blood lipid level and cardiac function in patients with unstable angina pectoris （UAP）. METHODS： Totally 198 UAP patients admitted to our hospital from Apr. 2016 to Apr. 2019 were selected， and divided into observation group （n＝102） and control group （n＝96） according to therapy plan. Control group received Isosorbide mononitrate tablets 40 mg， qd， orally； observation group additionally received Dengzhan shengmai capsules， 2 capsules per time， tid， orally， on the basis of control group. Both groups received treatment for consecutive 4 weeks. The clinical efficacy， serum levels of MMP-9 and TIMP-1， blood lipid indexes [low density lipoprotein cholesterol （LDL-C）， high density lipoprotein cholesterol （HDL-C）， triglyceride （TG）， total cholesterol （TC）]， cardiac function indexes [end-diastolic volume （EDV）， left ventricular ejection fraction （LVEF）， end-systolic volume （ESV）] and ADR were compared between 2 groups. RESULTS： The total response rate of observation group was significantly higher than control group （91.18％ vs. 70.83％， P＜0.05）. Before treatment， there was no statistical significance in the levels of ESV， MMP-9， TIMP-1， TC， LDL-C， TG， HDL-C， EDV and LVEF between 2 groups （P＞0.05）. After treatment， the levels of MMP-9， TC， LDL-C， TG， ESV and EDV in 2 groups were decreased significantly in both groups， and the observation group was significantly lower than the control group （P＜0.05）； meanwhile， the levels of TIMP-1， HDL-C and LVEF in 2 groups were increased significantly， and the observation group was significantly higher than control group （P＜0.05）. There was no statistical significance in the incidence of total ADR in 2 groups （P＞0.05）. CONCLUSIONS： Dengzhan shengmai capsules combined with isosorbide mononitrate show good clinical efficacy for UAP， which can effectively reduce serum MMP-9 level and increase serum TIMP-1 level， reduce blood lipid levels， as well as improve cardiac function for UAP patients， with good safety.
ABSTRACT
Objective To determine the prevalence,trends and risk factors of drug-resistant tuberculosis (TB) in Ningbo during 2007-2010,and to explore the efficient control strategy of drugresistant TB.Methods A cross-sectional study of regional anti-TB drug resistance was conducted in Ningbo.The registered and culture-positive TB patients were enrolled and drug sensitivity test was performed.The demographic and clinical information were collected from the national TB report system.Logistic regression model was used to determine the risk factors of drug resistance.Results Of 1613 enrolled TB patients,39.3％-48.3％ were resistant to any first-line anti-TB drug and 14.0％-19.9％ were multidrug resistant (MDR)-TB.The proportion of new cases resistant to any first-line anti-TB drug was 35.4 ％-42.1％ and MDR TB was 9.8％- 12.2 ％,which were both significantly lower than those of retreated patients (69.5％-72.7％ and 33.9％ - 54.5％,respectively).The multivariate Logistic regression model showed that anti-TB treatment history and migration were significantly associated with any drug resistance (OR=3.298,95 ％ CI 2.391 4.550and OR=0.771,95 ％CI 0.608 - 0.978,respectively) ; while age,treatment history and migration were also significantly associated with MDR-TB.Conclusions Drug-resistant TB prevalence showed a decrease trend in Ningbo,while the resistant rates in both new cases and retreated cases still remain at high levels. Improved case management,including directly observed treatment short-course and appropriate treatment regimens specifically for drug-resistant TB,should be developed to prevent further transmission and development of drug-resistant TB in this setting.