热敏灸与温针灸治疗肩背部肌筋膜疼痛综合征的随机对照研究

目的评价热敏灸与温针灸治疗肩背部肌筋膜疼痛综合征的临床疗效。方法选择我院2016年5月～2018年5月康复科收治的肩背部肌筋膜疼痛综合征患者117例为本次研究对象,按照随机数字表法分为对照组58例与观察组59例。对照组采取温针灸疗法,观察组采取热敏灸疗法,对比两组患者疼痛改善情况及复发情况。结果治疗前两组患者PRI、PPI、VAS积分值比较差异无统计学意义(P0.05),治疗后两组积分值明显优于治疗前,差异有统计学意义(P0.05),治疗后两组间积分值比较无统计学意义(P0.05);两组间治疗有效率比较差异无统计学意义(P0.05),观察组复发率(3.39%)明显低于对照组(15.52%),差异有统计学意义(P0.05)。结论热敏灸与温针灸治疗肩背部肌筋膜疼痛综合征疗效显著、确切,但热敏灸短期复发率较低,说明其短期疗效显著,值得临床应用与推广。     

热敏灸配合针刺治疗下腰痛临床观察

目的观察热敏灸配合针刺治疗下腰痛的临床疗效。方法将60例腰痛患者随机分为热敏灸组和温和灸组各30例,两组均针刺大肠俞、肾俞、委中、阿是穴,并根据患者证型不同进行腧穴配伍。热敏灸组选取1～2个热敏点行热敏灸,温和灸组选取压痛点使用艾灸盒进行温和灸。统计治疗前后患者视觉模拟评分(VAS)、改进汉化Oswestry功能障碍指数(ODI)、汉译RMDQ量表和总体疗效,以及出现热敏灸感的次数和效应种类。结果治疗前两组VAS、ODI、RMDQ评分比较差异无统计学意义(P0.05);治疗后两组总有效率比较差异无统计学意义(P0.05),热敏灸组治愈率高于温和灸组(P0.05);治疗后两组VAS均降低(P0.05),热敏灸组VAS低于温和灸组(P0.05);治疗第2周、第4周后ODI、RMDQ量表评分较治疗前显著下降(P0.05),热敏灸组ODI、RMDQ量表评分显著低于温和灸组(P0.05)。6种热敏灸感中扩热最常见,且热敏灸感出现的次数随治疗而变化。结论热敏灸和温和灸结合针刺均能有效改善腰痛和腰部功能障碍,热敏灸结合针刺疗效更优。热敏灸感因人因时不同,临床中需辨证施灸。     

小针刀联合推拿治疗慢性腰肌劳损的临床效果

目的观察小针刀联合推拿治疗慢性腰肌劳损的临床效果。方法选择2018年1月至2019年2月于广州医科大学附属顺德医院就诊的148例慢性腰肌劳损患者,采用随机数表法分为对照组和观察组,各74例。给予两组患者双氯芬酸钠缓释胶囊治疗。在此基础上,对照组接受推拿治疗,观察组在对照组基础上联合小针刀治疗。比较两组疗效,治疗前后视觉模拟评分量表(VAS)评分、Oswestry功能障碍指数问卷表(ODI)评分。结果观察组治疗总有效率为91.8%,高于对照组的79.7%,差异有统计学意义(P<0.05)。治疗后,两组VAS评分均较治疗前降低,且观察组VAS评分低于对照组,ODI 10个方面评分均较治疗前降低,且观察组ODI 10个方面评分均低于对照组,差异有统计学意义(均P<0.05)。结论小针刀联合推拿治疗慢性腰肌劳损效果显著,可减轻患者疼痛,增强腰部功能。     

热敏灸辅助配合渐进式康复训练在卒中后上肢痉挛中的应用效果

目的 评价热敏灸辅助配合渐进式康复训练在卒中后上肢痉挛中的应用效果。方法 选择2017年2月～2019年5月我院康复科收治的80例卒中后上肢痉挛患者为研究对象,根据患者在院病床尾号单双号不同原则将其分为对照组与观察组两组,每组40例。对照组(单号)开展渐进式康复训练,观察组(双号)在对照组基础上辅助热敏灸治疗,比较两组患者改良Ashworth评分(MAS)、简化Fugl-Meyer运动功能(FMA)评分、改良Barthel指数(MBI)及临床治疗效果。结果 治疗前两组患者MAS评级情况差异无统计学意义(P0.05),治疗后两组患者评级比较差异有统计学意义(P0.05),观察组优于对照组;治疗前两组患者FMA、MBI评分比较,差异无统计学意义(P0.05),治疗后两组患者评分与治疗前比较,差异有统计学意义(P0.05);治疗后观察组评分明显高于对照组,差异有统计学意义(P0.05);观察组治疗总有效率92.50%,明显高于对照组的75.00%,差异有统计学意义(P0.05)。结论 热敏灸配合渐进式康复训练在卒中后上肢痉挛患者中应用,可有效改善患者上肢痉挛程度,提升上肢运动功能与日常生活能力,值得应用与推广。     

莫沙必利分散片联合热敏灸治疗功能性消化不良的临床效果研究

目的:分析莫沙必利分散片联合热敏灸治疗功能性消化不良的临床效果,以及对患者各项症候评分的改善情况。方法:将80例功能性消化不良的患者随机分为2组。两组均给予莫沙必利分散片进行治疗,在此基础上,观察组40例联合采用热敏灸治疗。治疗后观察两组临床效果、症候评分、血浆胃动素(MTL)水平和胃泌素(GAS)水平。结果:观察组治疗有效率为90.00%,对照组为70.00%。观察组治疗有效率明显高于对照组(P0.05)。治疗后2组患者各项症候评分、MTL水平以及GAS水平均有改善,与治疗前相比,差异有统计学意义(P0.01);治疗后2组比较,差异也有统计学意义(P0.01)。结论:莫沙必利分散片联合热敏灸治疗功能性消化不良的临床效果显著,症状改善明显。     

热敏灸联合正骨推拿治疗腰椎间盘突出症患者的疗效分析

目的 探讨热敏灸联合正骨推拿对腰椎间盘突出症患者腰椎功能及疼痛评分的影响.方法 选取本单位2018年2月至2019年8月治疗的76例腰椎间盘突出症患者,按随机数字表法分为两组,各38例.对照组采用正骨推拿法治疗,观察组在对照组基础上行热敏灸疗法,比较两组临床疗效、腰椎功能、疼痛程度.结果 治疗20 d后,观察组治疗总有效率为94.74％,高于对照组的78.95％,差异有统计学意义(P<0.05).治疗20 d后,两组JOA评分均高于治疗前,VAS评分均低于治疗前,且观察组评分变化幅度大于对照组,差异有统计学意义(P<0.05).结论 热敏灸联合正骨推拿治疗腰椎间盘突出症疗效显著,可改善患者腰椎功能,降低疼痛程度.     

三伏天“热敏灸”治疗老年慢性支气管炎的效果及对生活质量的影响

目的:分析研讨三伏天"热敏灸"治疗老年慢性支气管炎的效果及对生活质量的影响。方法:随机从本院2016年4月-2018年11月收治的老年慢性支气管炎患者中选取80例,按照治疗方式不同分为研究组与对照组,各40例。研究组接受三伏天"热敏灸"治疗,对照组接受三伏天天灸疗法治疗。观察比较两组治疗效果与生活质量。结果:研究组治疗总有效率(95.00%)高于对照组(65.00%),差异有统计学意义(P0.05)。研究组治疗后咳嗽、咳痰、气促情况均优于对照组(P0.05)。治疗前两组各项生活质量评分比较,差异均无统计学意义(P0.05),治疗后研究组各项生活质量评分均低于对照组(P0.05)。结论:老年慢性支气管炎接受三伏天"热敏灸"治疗,疗效明显,改善其生活质量的作用更突出。     

热敏灸结合中药离子透入治疗慢性盆腔炎临床研究

目的探讨热敏灸结合中药离子透入治疗慢性盆腔炎临床疗效。方法选取我院2014年10月至2016年3月门诊治疗的慢性盆腔炎患者120例,按照随机对照原则,将患者分为观察组和对照组,每组各60例,对照组患者单纯给予热敏灸治疗,而观察组在对照组的基础上给予中药离子透入治疗,对比分析两组的临床疗效、治疗前后中医证候积分及盆腔积液量情况。结果:观察组有效率为100%,对照组总有效率为86.6%,两组比较差异具有统计学意义(P0.05);与治疗前相比,两组治疗后中医证候积分均有所改善,但观察组优于对照组,差异具有统计学意义(P0.05);治疗后观察组盆腔积液量减少程度优于对照组,差异具有统计学意义(P0.05)。结论热敏灸结合中药离子透入治疗慢性盆腔炎临床疗效确切,值得临床借鉴。     

热敏灸结合中药灌肠治疗慢性盆腔炎疗效研究

【目的】观察热敏灸结合中药灌肠治疗慢性盆腔炎的临床疗效。【方法】将80例慢性盆腔炎患者随机分为观察组和对照组各40例。观察组给予热敏灸结合中药灌肠治疗,对照组给予针刺结合中药灌肠治疗,观察2组临床疗效及治疗前后症状的恢复情况。【结果】(1)治疗2个疗程后,观察组的总有效率为92.31%,对照组为81.08%,观察组疗效优于对照组,2组比较差异有统计学意义(P0.05)。(2)治疗2个疗程后,2组患者的小腹疼痛、腰骶胀痛、带下量多等症状积分均显著改善,与治疗前比较差异均有统计学意义(P0.05);且观察组的改善作用优于对照组,差异均有统计学意义(P0.05)。【结论】热敏灸结合中药灌肠治疗慢性盆腔炎患者,效果满意,其疗效优于针刺结合中药灌肠治疗。     

平衡火罐疗法联合三伏天督灸对围绝经期阳虚体质的影响

目的:观察平衡火罐疗法联合三伏天督脉灸对围绝经期阳虚体质的影响。方法:将60例围绝经期阳虚体质患者按随机数字表法分为对照组和治疗组,每组30例。对照组采用三伏天督脉灸疗法治疗,治疗组采取平衡火罐疗法联合三伏天督脉灸治疗。两组患者均治疗2个月。观察两组患者阳虚体质条目评分、生活质量评分和临床疗效。结果:治疗后,治疗组阳虚体质条目评分明显低于对照组,世界卫生组织生活质量简表(quality of life-BREF,QOL-BREF)各指标评分明显高于对照组,差异均有统计学意义(P0.01)。治疗组有效率为90.00%,明显优于对照组的66.67%,差异有统计学意义(P0.05)。结论:平衡火罐联合三伏天督脉灸对围绝经期阳虚体质患者效果显著。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.