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Objective To observe the clinical curative effect of combination of traditional Chinese and western medicine for treatment of patients with hepatitis B virus (HBV) related acute-on-chronic (subacute) liver failure (ACLF). Methods A prospective randomized controlled trial was conducted; 66 cases of HBV-ACLF patients were randomly divided into two groups: a test group (44 cases) and a control group (22 cases). Conventional western medicine treatment was given to both groups; the patients in test group additionally received the traditional Chinese medicine (TCM) in accord to the principles of differentiation of syndromes in TCM, in cases with damp-heat and blood stasis syndrome with yellow appearance, Liangxue Jiedu Huayu decoction (Paeoniae Radix Rubra 60 - 150 g, Artemisiae Scopariae Herba 30 - 90 g, Gardeniae Fructus 9 - 12 g, Hedyotis diffusa Willd 20 - 30 g, Salviae Miltiorrhizae Radix et Rhizoma 30 g, Atractylodis Macrocephalae Rhizoma 30 g, Rubiae Radix et Rhizoma 30 - 45 g, Siegesbeckiae Herba 30 - 45 g, Bletillae Rhizoma 15 g ) was given, in cases with Qi deficiency and blood stasis with yellow appearance, Yiqi Jiedu Huayu decoction (Astragali Radix Preparata Cum Melle 30 g, Pseudostellariae Radix 15 g, Artemisiae Scopariae Herba 30 - 60 g, Polygoni Cuspidati Rhizoma et Radix 15 - 30 g, Salviae Miltiorrhizae Radix et Rhizoma 30 g, Aconiti Lateralis Radix Preparata 10 - 15 g, Atractylodis Macrocephalae Rhizoma 30 g, Rubiae Radix et Rhizoma 30 - 45 g, Siegesbeckiae Herba 30 - 45 g, Gigeriae Galli Endothelium Corneum 20 g) was given, the dosage in both groups being 1 dose daily, one dose was prepared to a water decoction 250 - 300 mL which was divided into two parts, one part taken twice a day; the control group received only western medicine treatment. After 2 weeks of treatment, the clinical comprehensive curative effect, the syndrome score efficacy, and the changes of main indexes of liver function,cholinesterase (ChE), albumin (Alb), prothrombin activity (PTA) were observed in the two groups.Results The clinical total efficacy in the test group was significantly higher than that in the control group [75.0% (33/44) vs. 45.5% (10/22),P 0.05). After treatment, the alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and direct bilirubin (DBil) were all lower than those before treatment in both groups, while the ChE, Alb and PTA were higher than those before treatment, and the degree of changes was more significant in the test group [test group: ALT (U/L): 63.28±99.28 vs. 574.58±571.08, AST (U/L): 86.84±92.88 vs. 438.20±482.74, TBil (μmol/L): 161.90±178.34 vs. 269.46±95.10, DBil (μmol/L): 115.32±126.51 vs. 209.12±79.78, ChE (U/L): 4 239.14±1 505.00 vs. 3 341.49±1 609.40, Alb (g/L): 32.65±4.77 vs. 29.73±3.31, PTA: (69.69±44.92)% vs. (32.84±7.47)%; control group: ALT (U/L): 93.28±93.86 vs. 365.24±376.98, AST (U/L): 126.26±121.35 vs. 287.17±301.04, TBil (μmol/L): 226.80±187.38 vs. 281.02±103.73, DBil (μmol/L): 172.50±147.32 vs. 227.96±87.20, ChE (U/L): 4 484.66±1 886.53 vs. 3 918.77±1 417.77, Alb (g/L): 33.17±4.76 vs. 30.47±3.03, PTA: (63.80±36.80)% vs. (33.96±6.32)%,P < 0.05 orP < 0.01].Conclusion The combination of TCM and western medicine for treatment of HBV-ACLF can improve liver function, and the prognosis is superior to using western medicine treatment alone.
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Objective To observe the therapeutic effect of Qili Qiangxin capsule combined with glucocorticoid for treatment of patients with dilated cardiomyopathy accompanied by refractory heart failure. Methods A prospective study was conducted. Forty-eight patients with dilated cardiomyopathy and refractory heart failure in Hebei Cangzhou Central Hospital were enrolled,and they were randomly divided into three groups:control group,treatmentⅠand treatmentⅡgroups(each,16 cases). All groups were treated with conventional anti-heart failure western treatment, meanwhile additionally prednisone was given to treatment groupⅠand groupⅡ,firstly 40 mg/d,then the dosage of 5 mg was decreased in every 5 days until reaching 5 mg per day;in treatment groupⅡ,besides the same treatment of group I,the traditional Chinese medicine therapy Qili Qiangxin capsule 4 granules(one capsule 0.3 g)each time and 3 times a day was added,2 months being the therapeutic course in all the patients. The clinical efficacy and cardiac functional indexes,such as the left ventricular end-diastolic volume(LVEDV),the left ventricular end-systolic volume(LVESV),the left ventricular ejection fraction(LVEF)and the plasma B type brain natriuretic peptide (BNP),etc. were observed in 1 week and 2 months after treatment. Meanwhile the electrocardiogram(ECG),aspartate transaminase(AST),alanine aminotransferase(ALT),urea nitrogen(BUN),serum creatinine(SCr),blood routine, urine routine examination and the adverse effects were investigated. Results The total effective rates in treatment groupⅠand treatment groupⅡwere significantly higher than those in the control group〔after treatment for 1 week:81.2%(13/16),81.2%(13/16)vs. 43.8%(7/16);after 2 months:87.5%(14/16),93.7%(15/16)vs. 50.0%(8/16), all P<0.05〕. After treatment,the LVEDV,LVESV and BNP were lowered and the LVEF was increased in the three groups,and the above indexes in treatment groupⅡwere improved more significantly than those in groupⅠ〔LVEDV (mL):142.4±33.0 vs. 174.8±52.5,LVESV(mL):111.6±23.7 vs. 132.4±29.0,LVEF:0.421±0.037 vs. 0.390±0.045,BNP(μg/L):1.944±0.751 vs. 3.038±1.905,all P<0.05〕. Conclusion Qili Qiangxin capsule combined with glucocorticoid may effectively improve the cardiac function and clinical symptoms in near and forward future in patients with dilated cardiomyopathy accompanied by refractory heart failure,thus it may elevate the patients' life quality.
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ObjectiveTo evaluate the clinical efficacy and safety of astragalus injection on the immune function in patients with senile sepsis.Methods Sixty patients with old age sepsis in Critical Care Medicine Department of Guangdong Provincial Traditional Chinese Medicine Hospital were enrolled and randomly assigned into control and treatment groups according to the table of random numbers, 30 cases in each group. According to 2012 sepsis guidelines for treatment, including antibacterial drug, mechanical ventilation, visceral function support, etc., the therapy was given to the control group; besides the treatment in the control group, intravenous drip of 60 mL astragalus injection(10 mL per ampoule) in 250 mL 0.9% normal saline was additionally given in the treatment group, once a day for 7 days. Before and after treatment, the immunological indexes, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, sequential organ failure assessment(SOFA) score, duration of mechanical ventilation and time of stay in intensive care unit(ICU), 28-day mortality and adverse drug reactions were compared between the two groups.Results Before treatment, there were no statistically significant differences in CD3+, CD3+CD4+, CD3+CD8+ and T helper cells /T suppressor cells(Th/Ts)levels between the two groups(allP>0.05), while CD3-NK+ of the control group was significantly higher than that in the treatment group〔(10.47±6.22)% vs. (6.26±4.13)%,P0.05). After treatment in the treatment group, IgG was increased compared with that in the control group〔IgG(g/L): 13.07±5.43 vs. 10.10±3.96,P 0.05〕. The differences in IgA, IgM, complement(C3,C4) and total serum complement activity(CH50) in the comparisons between the two groups had no statistical significance after treatment(allP>0.05). The differences in APACHEⅡ score(13.83±6.18 vs. 15.90±7.48), SOFA score(7.38±4.66 vs. 6.89±4.19), time of stay in ICU(day: 11.63±5.13 vs. 13.62±8.08), invasive ventilation time(hour: 155.44±119.68 vs. 224.08±174.15) and noninvasive ventilation time(hour: 55.55±42.24 vs. 98.57±43.17) had no statistical significance in comparisons between the treatment group and control group after treatment(allP>0.05). The difference in 28-day mortality had no statistical significance in comparison between the treatment group and control group〔16.7%(5/30) vs. 20.0%(6/30),P>0.05〕. In 60 cases, there were 2 patients with adverse drug reaction, one diarrhea and another little rashes, the rest of the patients did not appear any drug side effect.ConclusionAstragalus injection combined with conventional western medicine therapy possibly has certain effect on adjustment of disturbance of immunologic functions in old patients with sepsis, and its therapeutic safety is well.
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ObjectiveTo investigate the mechanism of protective effect of Xuebijing injection on vascular endothelial cells in rats with heat stress.Methods Ninety Sprague-Dawley(SD) rats were randomly divided into control, model and Xuebijing injection treatment groups, 30 rats in each group. Heat stress model was reproduced by placing rats in constant temperature box at 40℃, 60% relative humidity for 1 hour, Xuebijing injection group was treated by intraperitoneal injection of Xuebijing 2.5 g/kg, while the control and model groups were treated by intraperitoneal injection of normal saline 2 mL/kg, once a day only in 1 day for both groups. After model establishment, the rectum temperature, heart rate and the mean arterial pressure(MAP) were recorded at 2, 6, 12 hours in each group. At the same time, the rat abdominal aortic blood was collected and serum was separated, the enzyme-linked immunosorbent assay(ELISA) was used to determine the aortic serum levels of lipopolysaccharide(LPS), nuclear factor-κB(NF-κB) and p53, and the prothrombin time(PT), activated partial thromboplastin time(APTT) and D-dimer of venous blood were detected by automatic blood coagulation analyzer(ACLTOP).Results Compared with those in control group, the rectum temperature, heart rate, LPS, NF-κB, p53, PT, APTT, D-dimer were significantly increased, and MAP was obviously decreased in model group(P<0.05 orP<0.01). Compared with model group, the above indexes were improved significantly in Xuebijing injection treatment group at 2 hours〔rectum temperature(℃): 38.02±0.22 vs. 39.32±0.33, heart rate(bpm): 507±14 vs. 562±35, MAP(mmHg, 1 mmHg=0.133 kPa): 98±6 vs. 87±13, LPS(ng/L): 0.65±0.03 vs. 0.82±0.05, NF-κB(ng/L): 1.10±0.04 vs. 1.33±0.05, p53(ng/L): 1.33±0.03 vs. 1.73±0.02, PT(s):15.47±1.03 vs. 20.28±2.01, APTT(s): 40.26±2.46 vs. 47.46±3.51, D-dimer(μg/L): 238.54±8.32 vs. 323.12±8.14,P<0.05 orP<0.01〕.Conclusion Xuebijing injection can correct the disorders of blood PT, APTT, D-dimer via decreasing the secretion of the levels of NF-κB, p53 from vascular endothelial cells in rats with heat stress, thus the integrity of the vascular endothelium can be protected, and LPS entering into the blood stream can be inhibited.
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Objective To analyze the clinical efficacy and safety of combined therapy of traditional Chinese and Western medicine (heparin sodium cream massage, induced treatment by micro-needle, and external application of herbal membrane) and micro-explosion method for facial pigmentation after trauma, and to explore an effective and safety therapy for skin-whitening and anti-freckle. Methods A total of 100 cases with pigmentation on face were divided randomly into two groups with 50 cases each: the cases in treatment group were massaged with heparin sodium cream, needled skin pigmentation spot densely by micro-needle and applied with herbal membrane; the cases in control group only were massaged with heparin sodium cream, and applied with herbal membrane, without needling on skin. Short-term efficacy, long-term efficacy, safety and satisfaction of patients were observed. Results These cases were followed-up for 3-6 months. There was no significant difference between treatment group and control group after treatment for 15 days, and then significant difference was found after 1, 2 and 3 months (P<0. 05). There was no side effect after treatment for 6 months, and all cases were satisfactory. Conclusions There is rapid regression of pigmentation, with stable effect and without recurrence and obvious side effect, and the satisfactory rate of patients is high after treated by combined therapy of herbal membrane external application, heparin sodium cream massage and induced treatment by micro-needle.
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Objective To observe the effects of modified Shenmaiyin on arrhythmia in CHD. Methods A total of 180 patients were randomly recruited into a control group (80 cases) and a treatment group (100 cases). Both groups were treated with conventional western medicines. On this basis, the treatment group was treated with modified Shenmaiyin. The conditions of myocardial ischemia and arrhythmia were observed for both groups. Results The total effective rate of ischemia and arrhythmia were 50.00% and 80.00% in the treatment group, constrating to 32.50% and 60.00% in the control group, showing statistical difference (P＜0.05). Conclusion Modified Shenmaiyin had sound effects in improving ischemia and arrhythmia.
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For probing into therapeutic effect, action, and proper and effective administration way of Jiang Ni Fu Sheng Liquid for treatment of acute cerebral hemorrhage, 150 cases were assigned at random to two groups to receive different therapies. Integral of hyponeuria, change of disturbance of consciousness, change of blood pressure, CT and clinical therapeutic effect were observed before and after treatment in the two groups. Results showed that the therapeutic effect in the treated group was obviously superior to that in the control group, with a markedly effective rate of 51. 1% and an effective rate of 90. 0%. It is suggested that Jiang Ni Fu Sheng Liquid has the action of relieving disturbance of consciousness, promoting recovery of nervous function, keeping stability of blood pressure, accelerating absorption of cerebral hemorrage, alleviating cerebral edema and hemorrhage of digestive tract, and so on.