头针强刺激治疗顽固性呃逆疗效观察

目的观察头针强刺激联合口服呃逆汤治疗顽固性呃逆的临床疗效。方法将100例顽固性呃逆患者采用随机数字表法分为治疗组和对照组,每组50例。两组患者在口服呃逆汤基础上,治疗组采用头针胃区和胸腔区,进行强刺激;对照组采用电针治疗。观察对比两组患者的起效时间以及症状频率评分。结果 1个疗程结束后,治疗组痊愈率为42%,愈显率为66%,总有效率为78%;对照组痊愈率为24%,愈显率为40%,总有效率为68%,两组痊愈率与愈显率比较差异均有统计学意义(P<0.05),两组总有效率比较差异无统计学意义(P>0.05)。2个疗程结束后,治疗组痊愈率为68%,愈显率为78%,总有效率为88%;对照组痊愈率为40%,愈显率为60%,总有效率为74%,两组痊愈率比较差异有统计学意义(P<0.05),两组愈显率和总有效率比较差异无统计学意义(P>0.05)。1个疗程后和2个疗程后,治疗组呃逆症状频率评分与对照组比较差异有统计学意义(P<0.05),治疗组起效时间为2～5 h,对照组起效时间5～8 h。结论头针强刺激治疗顽固性呃逆总有效率与电针治疗无明显差异,但痊愈率明显优于电针治疗,起效快,可以减少呃逆次数,缓解呃逆伴随症状。

麻醉下四步手法松解联合超声针刀和药物注射治疗肩凝症的临床研究

目的观察麻醉下四步手法松解联合超声针刀和药物注射治疗肩凝症的临床效果。方法将84例肩凝症患者随机分为观察组(采用麻醉下四步手法松解联合超声针刀和药物注射治疗)和对照组(采用麻醉下四步手法松解联合药物注射治疗),每组42例。两组患者均每周治疗1次,连续治疗2周。在治疗前、治疗1周后、治疗2周后、治疗结束后2周随访时,比较两组患者疼痛视觉模拟(VAS)评分、Constant-Murley(CMC)肩关节功能评分,评定两组综合疗效。结果观察组治疗后治愈率高于对照组(P<0.05);两组患者治疗后VAS评分均较本组治疗前降低,且观察组低于对照组(P<0.05),两组患者治疗后CMC肩关节功能评分均较本组治疗前升高,且观察组高于对照组(P<0.05)。两组均未发生明显不良反应。结论采用麻醉下四步手法松解联合超声针刀和药物注射治疗肩凝症,与麻醉下手法松解联合药物注射治疗相比,能够更好地缓解疼痛、改善肩关节功能,提高综合疗效,且相对精准安全,具有临床应用价值。

Therapeutic observation of arthrolysis under brachial plexus anesthesia for adhesivecapsulitis of the shoulder

Objective:To objectively evaluate the short-term and long-term efficacies of arthrolysis under brachial plexus anesthesia in treating adhesive capsulitis of the shoulder(ACS).Methods:One hundred patients diagnosed with ACS were divided into two groups using the random number method.The two groups both received same active rehabilitation exercises.Besides,55 cases in the treatment group were given one session of arthrolysis under brachial plexus anesthesia,and 45 cases in the control group were given tuina treatment.Changes in the visual analog scale(VAS)score,Melle score and pressure pain index were observed I month and 3 months after treatment.The therapeutic efficacies were also compared.Results:The total effective rate was 96.4%at the 1-month follow-up and 96.4%at the 3-month follow-up in the treatment group.The total effective rate was 33.3%at the 1-month follow-up and 28.9%at the 3-month follow-up in the control group.There were significant differences between the two groups comparing the total effective rate at the two time points(both P<0.05).The scores of VAS,Melle and pressure pain were significantly different at the 1-month and 3-month follow-ups from those before treatment in the treatment group(all P<0.05);the three scores did not show significant differences at the 1-month and 3-month follow-ups compared with those before treatment in the control group(all P>0.05).Conclusion:Based on the active rehabilitation exercises,one session of arthrolysis under brachial plexus anesthesia can release the adhesion and restore the range of motion and function of shoulder joint in ACS patients.It is superior to rehabilitation exercises plus tuina treatment comparing both short-term and long-term efficacies.

Acupuncture combined with herb decoction for intractable hiccup

Objective To observe the efficacy of scalp acupuncture combined with oral administration of ènì Tāng（呃逆汤, Hiccup Decoction） for treatment of intractable hiccup. Methods One hundred patients with intractable hiccup were divided into treatment group（acupuncture combined with herb decoction group） and control group（western medicine group） according to the random number table method with 50 patients in each group. In treatment group, scalp acupuncture was conducted in the gastric area and thoracic area of patients, and Hiccup Decoction was taken orally. In control group, anisodamine（654-2） was injected intramuscularly in the dosage of l0 mg. The treatment was conducted for once a day in each group, and treatment for three consecutive times was needed. The number of times and the frequency of hiccup were observed after each treatment, and the results were compared. The standard of therapeutic effectiveness was evaluated by the number of hiccups decreased. Results In treatment group, the total cure rate was 54%, and the total effective rate was 84%, in control group, the total cure rate was 32%, and the total effective rate was 66%. According to the comparison between the two groups in the cure rate and total effective rate, the differences were statistically significant（both P〈0.05）. After the first treatment, there was no statistical difference according to the comparison between the two groups in the cure rate and total effective rate（both P〈0.05）, after the second treatment, the differences were statistically significant according to the comparison between the two groups in the cure rate and total effective rate（both P〈0.05）, and the efficacy in treatment group was obviously superior to that in control group, after the third treatment, there was no statistical difference according to the comparison between the two groups in the cure rate and total effective rate（both P〈0.05）. Conclusion In the one course of treatment, the efficacy of acupuncture combined with herb decoction for treatment of intractable hiccup was obviously superior to that of intramuscular injection with anisodamine. The therapeutic effect of intramuscular injection with anisodamine for treatment of intractable hiccup was the best at the first treatment, and the therapeutic effect of acupuncture combined with herb decoction was the best at the second treatment.

Effect of Electroacupuncture Combined with Tuina on Lumbar Muscle Tone in Patients with Acute Lumbar Sprain

Objective: To observe the clinical effect of electroacupuncture(EA)combined with tuina on acute lumbar sprain and lumbar muscle tone before and after treatment. Methods: A total of 130 acute lumbar sprain cases were randomly allocated into an observation group and a control group, 65 in each group. Cases in the observation group were treated with EA combined with tuina, whereas cases in the control group were treated with Diclofenac Sodium Dual Release Enteric-coated capsules. The muscle tones in two groups were tested before and after treatment. Results: The recovery rate and overall response rate in the observation group were 66.2% and 93.8% respectively, versus 56.9% and 87.7% in the control group, showing no between-group statistical significances(P>0.05). After treatment, the force-displacement area under curve(AUC) in both groups showed a significance difference(P<0.05). Conclusion: Both EA combined with tuina and aforementioned oral medication have remarkable effects for acute lumbar sprain, and the former can better improve the lumbar muscle tone in patients with acute lumbar sprain.