关键词： 半夏泻心汤   胃肠疾病   治疗效果  

摘要： 目的:分析并研究半夏泻心汤在胃肠疾病当中的治疗效果.方法:选择我院在2014年10月到2015年10月收治的70例胃肠疾病患者作为研究对象,将所有患者划分为观察组和对照组,每组各有35例患者,对照组患者配合常规的治疗方法进行治疗,观察组患者给药半夏泻心汤,比较两组患者的治疗效果.结果:观察组患者的治疗有效率明显高于对照组,且观察组患者的满意度高于对照组,P<0.05,差异明显,具有统计学意义.结论:临床上对于胃肠疾病患者,在对患者进行治疗的时候采用半夏泻心汤进行治疗能够取得更好的治疗效果,促进患者的恢复,值得在临床上推广使用.

关键词： 疼痛   肛肠术   护理干预   混合痔外剥内扎术  

摘要： 目的肛肠疾病的疼痛护理对术后换药效果的影响观察。方法选择收治的60例肛肠手术病人给予探讨,平均分组,参考组选择一般护理干预;实验组选择疼痛护理干预,对比两组的临床成效。结果经过分析,实验组远远强于参考组,差异较大,具有临床对比价值。结论针对肛肠手术病人选择疼痛护理干预,能够显著缓解焦虑情绪,减轻疼痛,增强满意度,具有良好的治疗成效。

关键词： Cytomegalovirus   inflammatory bowel disease   biopsy   immunosuppression  

摘要： Background Patients with inflammatory bowel disease (IBD) are often immunosuppressed and are at risk for reactivation of latent cytomegalovirus (CMV) infection. We examined the diagnostic yield from colon biopsies in IBD patients with suspected CMV infection. Methods Patients above 18 years of age who underwent testing for CMV on colon biopsies between January 1st, 2012, and December 31st, 2015, were identified from a pathology data base. A positive CMV result was included only if testing included both hematoxylin/eosin staining and immunohistochemistry from two or more biopsy samples. Results One hundred twenty-five patients met the inclusion criteria. Of these, 99 had a diagnosis of IBD: 30 with Crohn's disease, 63 with ulcerative colitis, and 6 with indeterminate colitis. As regards treatment, 21.2% of the patients had biologic therapy alone, 13.1% received immunomodulators, and 11.1% were treated with combined biologic and immunomodulator therapy within 3 months of the colon biopsy. In addition, 32.3% of the patients were on steroids. Of the 99 IBD patients, only 1 had biopsy-proven CMV colitis. Conclusion The yield from colon biopsies with hematoxylin/eosin staining and immunohistochemistry to test for CMV in IBD flare is very low. Further multicenter studies with large numbers of patients are needed to compare all testing modalities in the same cohort of patients. This may help identify which subgroup of IBD patients are likely to benefit from specific modalities of CMV testing, with potential cost-saving implications.

摘要： [This corrects the article DOI: 10.1155/2013/862312.].

关键词： FOOD habits -- Evaluation   BIOCHEMICAL markers   FRUIT   INFLAMMATORY bowel diseases   INGESTION   MEDICAL care -- Evaluation   OUTCOME assessment (Medical care)   VEGETABLES   DESCRIPTIVE statistics  

摘要： The impact of dietary behaviors on health outcomes in youth with inflammatory bowel disease (IBD) is unclear. The present study examined dietary behaviors and their association with biomedical factors in youth with IBD. Eighty-six newly diagnosed youth (mean age=12.6) were included in analyses. Biomedical factors included disease activity and inflammatory markers. Despite adequate total caloric intake, estimated nutrient and fruit and vegetable intakes were below recommended levels. There was a significant negative association between vegetable intake and C-Reactive Protein (p=0.04). Results suggest that dietary behaviors play an important role in IBD health outcomes.

关键词： 胶囊内镜   小肠镜   诊断   Meta分析  

摘要： 目的:小肠位于消化道的中段,是消化管道中最长的一段,成人全长平均5-7米,因为其特殊的解剖学部位及结构特点,传统的检查手段很难对小肠疾病做出有效的诊断及治疗。近年来,随着胶囊内镜和小肠镜的开展与普及,小肠疾病的检出率有了很大的提升。胶囊内镜能动态、清晰地显示小肠腔内的病变,且具有无痛、安全等优点。而小肠镜对病变的观察则更为清晰,发现病变后可以取活检及做内镜下治疗。但小肠镜需要结合经口、经肛两种进镜方式才能观察到整个小肠,对于患者来说痛苦较大。目前,胶囊内镜和小肠镜对小肠疾病的诊断均有较好的效果,但二者各有优缺点,近年来,众学者对这两种方式对小肠疾病的检出率做了深入的研究,但报道结果并不一致,故本文通过对2002-2016年以来有关胶囊内镜与小肠镜对小肠疾病的诊断的研究进行Meta分析,比较两种方法对小肠疾病的诊断价值,用以评估小肠疾病患者的最优检查方案。方法:从Pubmed、Embase、Cochrane Library和CNKI中检索比较胶囊内镜和小肠镜对小肠疾病阳性检出率的研究。纳入文献需满足以下标准:(1)所入选的文献在国内外杂志公开发表,包括前瞻性或回顾性研究(全文或摘要)。(2)入选病例均经胃镜、结肠镜等传统检查除外其他疾病后疑诊为小肠疾病者。(3)各研究中,入选的患者需先后行胶囊内镜和小肠镜检查,即在同一批患者中进行这2种检查,得以在相同条件下对两种方法进行比较。所得数据采用Revman5.3进行Meta分析。对各项研究中二者的阳性检出率的OR(odds ratio,比值比)进行Meta分析,经异质性检验后采用随机效应模型进行统计分析。结果:根据纳入标准,纳入29项研究,共2256名患者,胶囊内镜共检出病灶1422例,小肠镜共检出病灶1398例。数据分析结果发现,比较胶囊内镜和小肠镜对小肠疾病的阳性检出率差异无统计学意义(随机效应模型,OR=1.13,95%CI:0.91-1.41,P=0.27)。由于部分腹痛、腹泻患者可能是功能性胃肠道疾病所致,将影响到胶囊内镜和小肠镜诊断小肠疾病敏感性的评估,所以我们对所纳入的文献进行亚组分析,共16篇摘要或全文纳入胶囊内镜和小肠镜对不明原因消化道出血阳性检出率的Meta分析。亚组分析结果表明,胶囊内镜和小肠镜对不明原因消化道出血的阳性检出率差异无统计学意义(随机效应模型,OR=1.08,95%CI:0.75-1.54,P=0.68)。结论:胶囊内镜和小肠镜在小肠疾病和不明原因消化道出血中的诊断率无显著差异。胶囊内镜可作为疑诊小肠疾病患者的首选检查方式,根据胶囊内镜的检查结果再决定小肠镜的入路及进一步的内镜治疗方案。小肠镜在某些病变,如息肉、肿瘤、憩室的诊断率比胶囊内镜高,且小肠镜具有行病理活检、内镜下治疗的优势是胶囊内镜所不能替代的,故胶囊内镜阳性检查后的小肠镜往往是必需的。

关键词： inflammatory bowel disease   Crohn's disease   health-related quality of life   anxiety   depression   stress  

摘要： Purpose: Many patients with inflammatory bowel disease (IBD) have impaired health-related quality of life (HRQOL). The influence of psychological and economic factors on HRQOL has not been fully elucidated in IBD. Therefore, we aimed to identify the predictors of HRQOL in an IBD cohort. Patients and methods: This was a cross-sectional cohort study of patients presenting to our tertiary IBD center. HRQOL was measured using the 36-item Short Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Perceived stress and perceived social support were also assessed by standardized scales. Demographic, socioeconomic and clinical data were obtained from a prespecified questionnaire and patients' medical records. Univariate analyses and multiple regression analysis were performed to identify predictors of HRQOL. Results: A total of 242 IBD patients were recruited, and the questionnaire return rate was 90.5% (219/ 242). The prevalence rates of anxiety and depression were 24.7% and 17.4%, respectively. In all, 30.6% of the patients spent over half of their income to cover medical costs. Multivariate analysis revealed that anxiety symptoms (P<0.001), active disease (P<0.001) and higher medical expenditures (P=0.001) were strong and independent predictors of reduced HRQOL. Conclusion: Psychological factors and costs of medical care strongly impair HRQOL in IBD, independent of the disease activity. Psychological counseling and socioeconomic support programs should be considered for integration into the management of IBD patients.

关键词： Inflammatory bowel disease   ulcerative colitis   probiotics   microbiota  

摘要： Inflammatory bowel disease (IBD) generally comprises Crohn's disease (CD) and ulcerative colitis (UC), and their main characteristic is the intestinal mucosa inflammation. Although its origin is not yet fully known, there is growing evidence related to genetics, intestinal microbiota composition, and the immune system factors such as precursors for the initiation and progression of intestinal conditions. The use of certain probiotic microorganisms has been touted as a possible and promising therapeutic approach in reducing the risk of inflammatory bowel disease, specifically ulcerative colitis. Several mechanisms have been proposed to explain the benefits of probiotics, indicating that some bacterial strains are able to positively modulate the intestinal microbiota and the immune system, and to produce metabolites with antiinflammatory properties. The aim of this paper is to bring together the various results and information, based on scientific evidence, that are related to probiotics and inflammatory bowel disease, emphasizing the possible mechanisms involved in this action.

关键词： 消化内科   幽门螺杆菌感染现状   胃肠疾病相关性  

摘要： 幽门螺杆菌是一种多见于胃部感染的螺杆状细菌,它是在1983年由两位澳洲学者从胃病患者的胃黏膜中分离并且培养成功的,可以说幽门螺旋杆菌的发现使医学界对于消化系统的疾病研究获得了飞跃性的进展,因为当前很多临床证据已经表明幽门螺旋杆菌在多种消化系统疾病中具有重要作用,本文就幽门螺旋杆菌的患者感染情况进行分析,并对该致病菌的消化道疾病相关性进行研究。

关键词： AMBULATORY electrocardiography   CARDIOVASCULAR diseases   ECHOCARDIOGRAPHY   CROHN'S disease   HEART atrium   HEART beat   HEART conduction system   INFLAMMATORY bowel diseases   T-test (Statistics)   ULCERATIVE colitis   BRUGADA syndrome   DISEASE remission   DATA analysis software   DESCRIPTIVE statistics   DISEASE complications  

摘要： Objectives. Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases (IBD) with unclear underlying aetiologies. Severe cardiac arrhythmias have been emphasised in a few studies on adult IBD patients. This study aimed to investigate the alteration of the P-wave and QT interval dispersion parameters to assess the risk of atrial conduction and ventricular repolarisation abnormalities in pediatric IBD patients. Patients and Methods. Thirty-six IBD patients in remission (UC: 20, CD: 16) aged 3-18 years and 36 age- and sex-matched control patients were enrolled in the study. Twelve-lead electrocardiograms were used to determine durations of P-wave, QT, and corrected QT (QTc) interval dispersion. Transthoracic echocardiograms and 24-hour rhythm Holter recordings were obtained for both groups. Results. The P-wave dispersion, QT dispersion, and QTc interval dispersion (Pdisp, QTdisp, and QTcdisp) were significantly longer in the patient group. The mean values of Pminimum, Pmaximum, and QTcminimum were significantly different between the two groups. The echocardiography and Holter monitoring results were not significantly different between the groups. Furthermore, no differences in these parameters were detected between the CD and UC groups. Conclusion. Results suggest that paediatric IBD patients may carry potential risks for serious atrial and ventricular arrhythmias over time even during remission.