Résumé
Objective: To study the clinical efficacy of modified Zhenwutang combined with Zhengji technique on cold-dampness arthralgia syndrome caused by knee osteoarthritis (KOA) at episode and the effect on inflammatory factors of joint fluid. Method: One hundred and forty-eight patients were randomly divided into control group and observation group by random number table. Patients in control group got celecoxib capsules, 0.2 g/time, 1 time/day, and Zhengji technique with lumbar positioning oblique pulling and finger pressing for 12 times, 1 time for every two days, 3 times/week. Patients in observation group got modified Zhenwutang, 1 dose/day, and the same Zhengji technique. The course of treatment was 4 weeks. Before and after treatment, western Ontario and McMaster University Osteoarthritis index (WOMAC), pain and swelling, index of severity of osteoarthritis (ISOA), local signs of knee joint and cold-dampness obstruction syndrome were scored, and the score of quality of life were discussed by arthritis impact measurement scale 2 (AIMS2-SF). And levels of interleukin-1 beta (IL-1β), IL-17, tumor necrosis factor-alpha (TNF-α), substance P (SP) and calcitonin gene-related peptide (CGRP) were detected. Result: The clinical efficacy in observation group was better than that in control group (Z=2.131, PPPβ, IL-17, TNF-α, SP and CGRP were higher than those in control group (PConclusion: Modified Zhenwutang combined with Zhengji technique can relieve clinical symptoms of patients with cold-dampness arthralgia syndrome caused by knee osteoarthritis (KOA) at episode, ameliorate joint function to improve patients' quality of life, reduce the expression of proinflammatory factors and neuropeptides in synovial fluid, so as to inhibit the inflammatory response and controlling clinical symptoms.
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Objective To investigate the relationship between white matter lesions(WML) and cognitive impairment in migraine with and without aura.Methods 56 migraine without aura patients (MwoA group),22 migraine with aura patients(MA group) and 30 normal controls were recruited.All of them were performed head MRI examination and were evaluated by operational definitions of ARWMC and Mattis Dementia Ratiing Scale(DRS),and compare among three groups,discuss the relationship between WML and cognitive impairment.Results (1) Compared with control group,the occurrence rate of WML in MA group was significantly higher(40.9％ vs 13.3％,x2=22.74,P＜0.01).The OD-ARWMC score was significantly higher in both MA and MwoA groups((0.73±l.12) vs (0.13±0.35),t=2.76,P＜0.01;(0.36±0.67) vs (0.13±0.35),t=1.75,P＜0.05).Compared with MwoA group,the occurrence rate of WML and the OD-ARWMC score of MA group was significantly higher(t=22.80,P＜0.01;t=1.79,P＜0.05).(2) During the attack period,the DRS total scale and its 5 factors (attention,initiation/perseveration,concept formation,construction and memory) were significantly lower in both MwoA and MA group(P＜0.05 or 0.01) than control group,while the DRS total scale and its two factors (attention,concept formation) of MA group were significantly lower than that of MwoA group (P＜ 0.01).During the intermission period,the concept formation and memory scale in MA group was significantly lower than control group(P＜0.05),only memory factor in MwoA group was significantly lower than control group(P＜0.05),while the initiation/perseveration factor scale of MA group was significantly lower than MwoA group(P＜0.05).(3) There Was a negative correlation between OD-ARWMC scale and the total DRS scale as well as its three factors (attention,concept formation,memory)during attack period in MA group(r=-0.584,P＜0.01;r=-0.465,P＜0.05;r=-0.558,P＜0.01;r=-0.439,P＜0.05).There was a negative correlation between OD-ARWMC scale and the total DRS scale as well as concept formation factor during attack period in MwoA group (r=-0.328,P＜ 0.05;r =-0.276,P＜ 0.05).Conclusion Migraine patients may have white matter lesions and cognitive impairment,especially in MA patients and during attack period.
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Aim] To summarize and introduce the clinical experience of Chang Qing in the treatment of refractory asthma. [Method] To analyze the clinical experience and academic views of Chang Qing in the treatment of refractory asthma from the perspective of etiology and pathogenesis; and to discuss his basic prescription compatibility and flexible drug-applying characteristics. [Result] According to Chang Qing's clinical experience, while addressing the symptoms, treating the root is badly needed. He insists that in the period of acute exacerbation the adjustment of traditional Chinese medicine dosage should be used to rapidly bring the asthma under control until the symptoms disappear or obviously ease, then nourishing spleen and kidney to reduce the relapse of asthma. [Conclusion] In the aspect of treating the refractory asthma, Chang Qing has got rich clinical experience and effective. methods to relieve the asthma,his clinical dialectic thinking and the originality of prescription are greatly worth learning.