针刺配合自血疗法治疗过敏性鼻炎的临床效果

目的观察针刺配合自血疗法治疗过敏性鼻炎的临床效果。方法选取福建医科大学附属龙岩第一医院2020年9月—2022年9月收治的40例过敏性鼻炎患者,随机数字表法分为两组,各20例。对照组采用常规针刺治疗,观察组加用自血穴位注射。比较临床疗效,两组患者在治疗前后的症状积分,统计患者症状明显减轻及消失时间。结果治疗后,两组症状积分较治疗前下降,观察组症状积分下降程度优于对照组(P<0.05)。观察组治疗后流涕、喷嚏、鼻塞症状明显减轻及消失时间均更短(P<0.05)。观察组总有效率为95.00%,高于对照组的65.00%(P<0.05)。结论针刺配合自血疗法治疗过敏性鼻炎疗效显著,可有效缓解症状,缩短患者流涕、喷嚏、鼻塞等持续时间。

针刺结合雷火灸治疗面肌痉挛疗效观察

目的:观察针刺结合雷火灸治疗面肌痉挛的临床疗效。方法:34例随机分为治疗组16例和对照组18例,治疗组予针刺结合雷火灸治疗,对照组单用针刺治疗。结果:总有效率治疗组高于对照组(P<0.01)。结论:针刺结合雷火灸治疗面肌痉挛效果较好。

挂针为主结合TDP照射治疗面肌痉挛疗效观察

目的:观察挂针结合TDP照射治疗面肌痉挛的临床疗效观察。方法:40例随机分成治疗组22例及对照组18例,治疗组采用挂针结合TDP照射治疗,对照组用普通针刺治疗。结果:总有效率治疗组高于对照组(P<0.01)。结论:挂针结合TDP照射治疗面肌痉挛疗效优于普通针刺。

雷火灸配合针刺治疗膝关节骨性关节炎40例临床观察

目的:观察雷火灸配合针刺治疗膝关节骨性关节炎的临床疗效。方法:选取膝关节骨性关节炎患者80例为研究对象,按照随机数字表法分为雷火灸配合针刺组和玻璃酸钠组各40例,玻璃酸钠组以玻璃酸钠关节腔内注射治疗,雷火灸配合针刺组采用雷火灸配合针刺治疗,比较两组临床疗效。结果:雷火灸配合针刺组总有效率为100.0%,高于玻璃酸钠组的82.5%,差异具有统计学意义(P﹤0.05);雷火灸配合针刺组治疗后的数字量表评分以及功能状态评分均低于玻璃酸钠组,差异具有统计学意义(P﹤0.05)。结论:雷火灸配合针刺治疗膝关节骨性关节炎疗效较好,可有效缓解疼痛及改善膝关节功能。

腹针配合艾灸治疗慢性盆腔炎50例

目的:观察腹针配合艾灸治疗慢性盆腔炎的临床疗效。方法:50例用腹针配合艾灸治疗。结果:治愈10例,显效12例,有效22例,无效6例,总有效率88.00%。治疗后中医症候积分、疼痛分值明显降低,CD4^+、CD4^+/CD8^+明显升高,CD8^+、CRP明显降低(P<0.05)。结论:腹针配合艾灸治疗慢性盆腔炎临床疗效确切,可缓解临床症状和疼痛,改善外周血T细胞亚群水平。

醒脑开窍配合通调督脉法治疗小儿脑性瘫痪临床研究

目的:观察醒脑开窍配合通调督脉法治疗小儿脑性瘫痪的临床疗效。方法:20例小儿脑性瘫痪患者予醒脑开窍配合通调督脉法治疗作为治疗组,对照组15例采用常规治疗,分析治疗前、后脑电图变化及临床疗效。结果:醒脑开窍配合通调督脉法组同治疗前及对照组相比,脑电图正常者增多,临床总有效率显著提高。结论:醒脑开窍配合通调督脉法治疗小儿脑性瘫痪能够明显改善患者脑电图情况,并有增强疗效的作用。

电针结合艾灸治疗寒湿凝滞型盆腔炎临床研究

目的:研究电针结合艾灸治疗寒湿凝滞型盆腔炎的临床效果。方法:将83例寒湿凝滞型盆腔炎患者随机分为西医常规组(n=41)和中医疗法组(n=42);西医常规组患者采用甲硝唑、左氧氟沙星等药物常规治疗,中医疗法组患者采用电针结合艾灸治疗。观察比较两组患者总有效率、6个月复发率及治疗前后患者血清TNF-α、IL-10水平、C反应蛋白等指标。结果:中医疗法组患者总有效率明显高于西医常规组,差异具有统计学意义(P<0.05);中医疗法组患者6个月复发率明显低于西医常规组,差异具有统计学意义(P<0.05)。治疗前两组血清TNF-α、IL-10水平、C反应蛋白无明显差异(P>0.05);治疗后,中医疗法组患者血清TNF-α、IL-10水平、C反应蛋白等指标改善明显优于西医常规组,差异具有统计学意义(P<0.05)。结论:电针结合艾灸治疗寒湿凝滞型盆腔炎疗效确切,可有效降低机体炎症水平及复发率,值得临床推广应用。

结合头颅DTI成像技术探讨针灸干预脑卒中后吞咽功能障碍临床研究

目的:利用头颅DTI成像技术探讨针灸治疗卒中后吞咽障碍的有效性及特异性。方法:根据诊断标准选取34例吞咽障碍患者,所有患者均给予神经内科常规治疗及针灸治疗,每次针灸留针30min;每天治疗1次,每周5次,3周为1个疗程,连续治疗2个疗程,治疗3周、6周后进行吞咽功能评估及头颅DTI检测。结果:治疗3周、6周后,吞咽功能障碍评分、吞咽造影及FA值有显著性差异(P<0.05)。针刺治疗对脑半球吞咽困难的改善尤为明显(P<0.05)。其次,治疗内囊、基底节和间脑。脑干和小脑半球前后变化不大。结论:结合头颅DTI成像技术和VFSS评估,针刺可改善吞咽困难。针刺对单侧大脑半球梗塞所致吞咽困难具有特异性。FA值可作为评价吞咽困难恢复的客观指标。

医学院在校大学生志愿服务于养老院现状调查

目的:了解在校医学生志愿服务于养老院的行为现状,分析存在的问题,并进一步促进和完善在校医学生志愿服务工作提供依据.方法:釆用两个自制调查问卷,分别对三所海南养老院的老人及海南某医学院校钓护理专业、临床专业和中医专业的学生进行调查。结果:调查发现医学生去养老院频率过少,对志愿服务活动认识不足以及志愿服务组织不完善等问题.结论:医学院校应加强对志愿服务的重视,加大对志愿服务的宣传力度以及提高对志愿服务组织的管理.

颈四针治疗神经根型颈椎病的临床疗效分析

目的 探讨颈四针治疗神经根型颈椎病的临床疗效。方法 随机选择2020年1月-2021年12月在福建医科大学附属龙岩第一医院就诊的神经根型颈椎病患者60例为研究对象,根据不同治疗方法分成两组,即观察组和对照组(各30例)。对照组患者采用推拿法治疗,观察组患者在对照组的基础上采用颈四针治疗,比较两组患者的临床疗效、疼痛情况、日常生活活动能力和颈椎障碍指数。结果 对照组总有效率为70.00%,低于观察组的93.33%,差异有统计学意义(χ^(2)=5.455,P=0.020)。治疗后,观察组疼痛视觉模拟量表(VAS)疼痛评分、颈椎障碍指数(NDI)评分均低于对照组,Barthel指数高于对照组,差异有统计学意义(P<0.05)。结论 采用颈四针治疗神经根型颈椎病可缓解患者症状,改善颈椎功能和日常生活活动能力,临床治疗效果较显著。

基于弥散张量成像技术探讨针刺对脑梗死后吞咽障碍患者神经重塑的研究

ObjectiveTo investigate the clinical effect of acupuncture among patients with dysphagia after cerebral infarction, and the nerve remodeling of acupuncture using diffusion tensor imaging.MethodsOne hundred and twenty patients with dysphagia after cerebral infarction were randomly assigned to either acupuncture group or sham-acupuncture group with a 1:1 ratio. All patients received usual care and swallowing function training of neurology department. Additionally, acupuncture was applied at Sìshéncōng (四神聪EX-HN1), Băihuì (百会GV20), Tàiyáng (太阳EX-HN5), Fēngchí (风池GB20) and Shésānzhēn (舌三针three-tongue needling points, Extra) in acupuncture group. The needles were retained for 30 min each time, and five times a week for three weeks as a course of treatment. Two courses of treatments were required in total. In sham-acupuncture group, the blunt needles were put into the needle sleeve, and the top of needle was fixed on the skin. During treatment the blunt needle tip only had slight contact with the skin without any penetration. The blunt needle tips were placed on EX-HN1, GV20, EX-HN5, GB20 and three-tongue needling points, respectively. The duration of treatment in sham-acupuncture group was the same as that in acupuncture group. Before and after treatment, all patients underwent Kubota water swallowing test to evaluate the clinical effect. Using diffusion tensor image (DTI), the nerve remodeling was detected.ResultsClinical effect: After treatment and assessed by water swallowing test, there were 38 cases of normal swallowing function in acupuncture group, higher than 15 cases in sham-acupuncture group (P < 0.05). Nerve remodeling: (1) apparent diffusion coefficient (ADC): before treatment, ADC in acupuncture group and sham acupuncture group were 1.76 ± 0.45 mm/s and 1.68 ± 0.51 mm/s, respectively. After treatment, ADC were 0.66 ± 0.15 mm/s and 0.74 ± 0.11 mm/s, respectively. The difference in ADC had no statistical significance between two groups after treatment (P > 0.05);(2) fractional anisotropy (FA): after treatment, FA of acupuncture group was 0.57 ± 0.06, which was significantly higher than that of sham-acupuncture group (P < 0.05);(3) observation of different infarct lesions: after treatment, ADC of temporal lobe infarction in acupuncture group was (0.57 ± 0.11) mm/s, lower than 0.82 ± 0.24 mm/s of sham acupuncture group, while FA in acupuncture group was 0.61 ± 0.07, higher than 0.45 ± 0.10 in sham-acupuncture group, both with statistical significance (both P < 0.05). Regarding the changes of FA maps for temporal lobe infarction before and after treatment, the transverse bundles of the white matter fibers increased remarkably in infarct lesions and on the healthy side of temporal lobe.ConclusionAcupuncture could improve the swallowing function of patients with dysphagia after cerebral infarction. It reduced ADC and increased FA, especially among patients with temporal lobe infarction after treatment. Acupuncture may have a remodeling effect on transverse cortical fibers after temporal lobe infarction.

通过弥散张量成像技术观察利咽通窍针法治疗脑卒中后吞咽障碍的临床研究

目的:利用头颅弥散张量成像(DTI)技术观察利咽通窍针法治疗脑卒中后吞咽障碍的临床疗效。方法:60例脑卒中后吞咽障碍患者根据随机数字表法随机分为利咽通窍针法组及神经内科组,每组30例。神经内科组予神经内科常规治疗及吞咽康复训练,利咽通窍针法组在神经内科组治疗的基础上针刺四神聪、百会、双侧太阳、双侧风池、舌三针,其中四神聪、双侧风池及舌三针接电针治疗仪,每次留针30 min,均每天治疗1次,每周5次,3周为1个疗程,治疗2个疗程。治疗后进行吞咽功能评估及头颅DTI检测。结果:治疗后,两组患者吞咽功能均有一定程度的改善,利咽通窍针法组优于神经内科组(P<0.05);两组患者口腔期、咽喉期、食管期的透视吞咽功能检查(VFSS)评分较治疗前均有明显提高(P<0.05),其中,利咽通窍针法组咽喉期VFSS评分升高较神经内科组更为明显(P<0.05);两组各向异性分数(FA)值较治疗前均增大(P<0.05),其中利咽通窍针法组大于神经内科组(P<0.05)。结论:利咽通窍针法能改善吞咽困难,可能与针刺刺激相关腧穴的信号使大脑皮质重塑,提高梗死区域的FA值有关。

Relieving throat and opening orifice acupuncture therapy for the post-stroke dysphagia

Objectives: To observe the effectiveness of acupuncture therapy for relieving throat and opening orifice on dysphagia due to different brain infarct sites.Methods: According to the random number table, 128 patients with post-stroke dysphagia were divided into group A(63 cases, intervention with deglutition training and acupuncture) and group B(65 cases,intervention with simple deglutition training). The conventional treatment and deglutition rehabilitation training in neurology department were used in the two groups. In group B, according to patient's condition, the rehabilitation trainings, such as respiration and neck movement range were used selectively.In group A, on the base of deglutition training, acupuncture therapy for relieving throat and opening orifice was supplemented. The acupoints included Sìshéncōng(四神聪EX HN 1),Bāihuì(百会GV 20), Tàiyang(太阳EX-HN5) bilateral, Fēngchi(风池GB 20) bilateral and Shésānzhēn(舌三针).Electrostimulator was attached on EX-HN 1, bilateral GB 20 and Shesanzhen(舌三针). Needles were retained for 30 min in each treatment. The treatment was given once a day, 5 treatments a week and the treatment for 3 weeks as 1 course. After 6 weeks of treatment, the deglutition ability scale developed by Fujishima Ichiro was adopted to determine the therapeutic effects and observe the score increase for dysphagia related to brain infarct sites before and after treatment.Results: In assessment after 6-week treatment, the improvements of deglutition ability were different corresponding to different brain infarct sites in group A. Specially, the improvements in the patients with dysphagia related to cerebral hemisphere infarction in group A were better than group B(8.68 ±1.12 vs7.32 ±0.91, P<0.05), followed by the improvements in the patients with dysphagia related to internal capsule/basal ganglia/diencephalon infarction(6.53 ±0.65 vs 6.36 ±0.84, P>0.05). Regarding the therapeutic effects in comparison of the two groups, the total effective rates in dysphagia related to cerebral hemisphere infarction were different between the two groups significantly(96.67% vs 82.75%, P< 0.05), as well as in the patients related to internal capsule/basal ganglia/diencephalon infarction(88.89% vs 66.67%,P<0.05). The therapeutic effects were not different in the patients related to cerebral stem and cerebella infarction between the two groups(P>0.05).Conclusion: The acupuncture therapy for relieving throat and opening orifice combined with deglutition training achieves the satisfactory therapeutic effects on dysphagia induced by cortical infarction in stroke.However, a large sample and multicentral clinical trial with this therapy is needed for a further argument so that this therapy is likely promoted in clinical practice in future.