RESUMO
Objective To investigate the efficacy of integrated traditional Chinese medicine (TCM) with Western medicine in treatment of diarrhea type irritable bowel syndrome (IBS-D) and its effect on serum inflammatory cytokine levels.Methods One hundred and sixty four IBS-D patients treated in Guangfu Hospital from July 2013 to August 2015 were randomly divided into study group and control group with 82 cases in each group.All patients received oral Saccharomyces boulardii 1.0 b.i.d, while patients in study group received additional Shuganjianpi decoction b.i.d for 4 weeks.The clinical efficacy was observed, serum IL-10, IFN-γ and TNF-α levels were measured in 2 groups.Results After treatment, the total score of clinical symptoms in study group was lower than that of control group [(5.71±1.41) vs.(11.70±2.88) points,t=16.707, P<0.01].Serum levels of IFN-γ, TNF-α in study group decreased significantly after treatment [IFN-γ (2.88±1.38) ng/L vs.(1.00±0.44) ng/L, t=11.609, P<0.01;TNF-α (41.26±5.29) ng/L vs.(24.13±3.27) ng/L,t=24.636, P<0.01], IL-10 significantly increased [(142.23±21.58) ng/L vs.(170.23±33.45) ng/L,t=6.291,P<0.01].The overall effective rate of study group was higher than that of control group, [87.50% (70/80) vs.68.75% (55/80), x2=8.228, P<0.01].After treatment, the quality of life scores in both groups were improved;but the improvement of diet, spirit, mood and sleep scores in study group were better than those in control group [(240±69) vs.(193±60), t=4.579, (316±74) vs.(230 ± 69), t=7.603, (297±62) vs.(228±59), t=7.211;(284±62) vs.(230±54), t=5.874, all P<0.01].Conclusion The efficacy of integrated traditional Chinese medicine with Western medicine in treatment of IBS-D is significantly better than that of Western medicine alone, which may be associated with its regulatory effect on the serum inflammatory cytokine levels.
RESUMO
Objective To systematically evaluate the safety and effectiveness of interventional uterine artery embolization (UAE) in treating symptomatic uterine fibroids by comparing it with surgical therapy. Methods Computer retrieval of the Cochrane Library, PubMed, EMbase, Web of Science, China National Knowledge Internet (CNKI), Wanfang data, etc. was conducted. The retrieval time was from the inception to July 2014. The academic papers that were related to the randomly controlled test (RCT) of UAE and surgical treatment for symptomatic uterine fibroids were collected, and the reference literatures were also searched for. Two reviewers screened the literatures according to the inclusion and exclusion criteria, the useful data were extracted and the qualities were evaluated. Meta-analysis was performed by using RevMan 5.2 software. Results A total of 6 RCTs were finally obtained, including 732 patients in total. Meta-analysis indicated that both the hospitalization time and recovery time in UAE group were shorter than those in surgery group. No significant differences in health -related quality of life, patient’s satisfaction, intra -operation complications, the recurrence rate and main complications within one year existed between UAE group and surgery group; while the differences in the incidence of minor complications within one year and the need of further intervention rate during 2 -5 years were statistically significant, the occurrence of these minor complications in UAE group being higher than that in the surgery group. The pregnancy rate and live-birth rate in UAE group were significantly lower than those in the surgery group. Conclusion Compared with surgery, UAE has many advantages, such as technically-safe, excellent therapeutic effect, simply-manipulated, easy-nursing, mini-invasive, quick-recovery and easily-accepted by patient, etc. although there is risk of receiving intervention treatment again. The influence of UAE on the fertility, the influence of different embolic agents on the therapeutic effect of UAE, and the effectiveness of UAE for multiple uterine fibroids need to be further studied.