目的:观察中西医结合综合治疗重症急性胆源性胰腺炎(SABP)的效果。方法:回顾性分析四川大学华西医院2004年1月至2007年8月收治的85例SABP患者在给予禁食、胃肠减压、补液、预防及治疗感染、维持内环境、营养支持、抑制胃肠和胰液的分泌治疗的基础上给予中药柴芩承气汤经口入或保留灌肠导泻,观察这些患者的治疗效果。结果:85例SABP患者经过中西医结合内科保守治疗后58名痊愈,14例患者症状缓解出院。5例患者死亡,8例患者治疗无效,无效率为15.3%,死亡率为5.9%。结论:中西医结合方法治疗SABP患者可明显提高治疗效果及降低死亡率。
ObjectiveTo construct a prediction model of diabetics distal symmetric polyneuropathy (DSPN) based on neural network algorithm and the characteristic data of traditional Chinese medicine and Western medicine. MethodsFrom the inpatients with diabetes in the First Affiliated Hospital of Anhui University of Chinese Medicine from 2017 to 2022, 4 071 cases with complete data were selected. The early warning model of DSPN was established by using neural network, and 49 indicators including general epidemiological data, laboratory examination, signs and symptoms of traditional Chinese medicine were included to analyze the potential risk factors of DSPN, and the weight values of variable features were sorted. Validation was performed using ten-fold crossover, and the model was measured by accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and AUC value. ResultsThe mean duration of diabetes in the DSPN group was about 4 years longer than that in the non-DSPN group (P<0.001). Compared with non-DSPN patients, DSPN patients had a significantly higher proportion of Chinese medicine symptoms and signs such as numbness of limb, limb pain, dizziness and palpitations, fatigue, thirst with desire to drink, dry mouth and throat, blurred vision, frequent urination, slow reaction, dull complexion, purple tongue, thready pulse and hesitant pulse (P<0.001). In this study, the DSPN neural network prediction model was established by integrating traditional Chinese and Western medicine feature data. The AUC of the model was 0.945 3, the accuracy was 87.68%, the sensitivity was 73.9%, the specificity was 92.7%, the positive predictive value was 78.7%, and the negative predictive value was 90.72%. ConclusionThe fusion of Chinese and Western medicine characteristic data has great clinical value for early diagnosis, and the established model has high accuracy and diagnostic efficacy, which can provide practical tools for DSPN screening and diagnosis in diabetic population.
Acute pancreatitis is a common surgical acute abdomen in clinical practice. With the development of minimally invasive technology, more and more treatment methods are being applied to acute pancreatitis, especially for severe acute pancreatitis and acute biliary pancreatitis. At present, the efficacy of integrated traditional Chinese and Western medicine in the treatment of acute pancreatitis has been widely recognized. In terms of minimally invasive diagnosis and treatment of acute pancreatitis, the “SELECT” concept of integrated traditional Chinese and Western medicine minimally invasive diagnosis and treatment has emerged. Based on the severity and etiology of acute pancreatitis, the optimal combination of multiple endoscope (Spyglass, encoscopic retrograde cholangiopancreatography, laparoscopy, endoscopic ultrasound, choledochoscopy) is selected, and combined with traditional Chinese medicine treatment. With a patient-centered approach, we have achieved minimally invasive, individualized, and precise treatment of acute pancreatitis through the integration of traditional Chinese and Western medicine.
Objective To compare the effectiveness of integrated traditional Chinese medicine (TCM) with Western medicine and Western medicine alone for acute episodes of withdrawal in alcoholism. Methods According to the criteria of alcohol dependence and acute alcochol withdrawal syndrome of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) , 62 consecutive patients were divided into two groups: 31 patients with odd numbers were allocated to the treatment group (4 patients were excluded because they left hospital early), 31 patients with even numbers were allocated to the control group. According to the four diagnostic methods of TCM, all patients in the treatment group were further divided into 4 types. The treatment group received valium, tiopronin, transfusion therapy and herbs (potion per day). The control group received the same therapy as the treatment group did but without oral herbs. Results Liver function, especially the difference between before and after treatment of GOT and γ-GT,the treatment group showed more improvement than the control group (P=0.046 and 0.001). The scores of anxiety and depression test, especially the HAMD, the treatment group showed more improvement than the control group (t=3.165, P=0.003). The treatment group used significantly less time than the control group (P=0.01), but no statistically significant difference was seen in the dosage of valium between the two groups (P=0.434). Conclusions The efficacy of integrated TCM with Western medicine is better than Western medicine alone for acute episodes of withdrawal in alcoholism.
The research background, way of thinking, research contents and methods of a united research project - "The Clinical Research on the Treatment of SARS with Integrated Traditional and Western Medicine" were reviewed. The latest research achievements on the treatment of SARS with integrated traditional and western medicine and the difficult points in the research were discussed. Furthermore, some tentative ideas were put forward to further the research. The conclusion was drawn that the principles of evidence-based medicine and the research scheme of multi-centered, prospective and randomized controlled trials, as well as the standard statistical and analyzing methods are the best way to assess the effectiveness and safety of treating SARS with integrated traditional and western medicine.
ObjectiveTo systematically review the methods of clinical practice guidelines for integration traditional Chinese medicine (TCM) and western medicine (WM), in order to benefit the integration of TCM and WM in the future. MethodsThe PubMed, Web of Science, CNKI, WanFang Data,VIP databases, Yimaitong website, National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE) were electronically searched to collect clinical practice guidelines of integrated TCM and WM. The search time limit was from the inception of the database to July 2022. Two researchers independently screened the literature, extracted data, and then, descriptive analysis was performed using qualitative methods. ResultsA total of 54 guidelines were included. There were 25 guidelines that adopted the "combination of disease and syndrome" model of integrated TCM and WM, among which 20 adopted the "combination of disease period and syndrome" model, and the number of these guidelines increased with the time sequence. Among the 26 guidelines that provide ideas for the integration of TCM and WM, 22 guidelines clarify the relationship between the application of TCM and WM, among which 5 guidelines have A grade of quality evaluation, and a total of 61 articles were extracted to clarify the relationship between TCM and WM. ConclusionAt the present stage, the recommendations of TCM and WM in most guidelines of integrated TCM and WM are still independent of each other, and there is no special thinking and research on how to integrate TCM and WM evidence organically to generate recommendations with important guiding value for actual diagnosis and treatment, which is difficult to truly guide clinical practice.
Objective To explore the procedure options in the treatment for acute plasma cell mastitis with minimal compromise to breast appearance. Methods The clinical data of 19 cases diagnosed as acute plasma cell mastitis from 2007 to 2010 were analyzed retrospectively. All the patients were adopted the same protocol as the combination of traditional Chinese medicine，abscess drainage at the proper moment，and the excision of focal mass after the acute inflammatory response diminish. Results The duration from taking traditional Chinese medicine to lumpectomy in all the patients were from 63 d to 97d，and the average time was 78d. Seven cases were treated with antibiotic before lumpectomy and 12 cases were treated with abscess drainage，and all the patients were cured satisfactorily. All the patients were followed up for 24-48 months with an average 36 months， there was no recurrence，and the shape of the treated breast remained consistent with the contralateral side，with the natural shape and smooth skin，and an undetectable thready mammary areola incision left. Conclusion The combination of traditional Chinese and Western medicine could treat acute plasma cell mastitis efficiently and with an advantage of minimal compromise to breast appearance.