针刀治疗腕管综合征的病例对照研究

目的:研究针刀治疗腕管综合征的疗效。方法:2014年7月至2016年12月,60例门诊收治的腕管综合征患者分为两组,针刀治疗组(治疗组)和支具药物组(对照组),每组30例。治疗组男8例,女22例;平均年龄(49.38±7.43)岁。对照组男7例,女23例;平均年龄(50.23±8.71)岁。治疗前两组患者的年龄、性别、病程、感觉神经传导速度(SCV)、感觉神经动作电位波幅(SNAP)、运动传导末端潜伏期(DML)差异无统计学意义。治疗组患者采用针刀治疗1~2次;对照组患者口服塞来昔布、维生素B1、维生素B12,并采用支具固定;疗程结束后观察两组患者SCV、SNAP、DML变化。结果:两组患者治疗后,SCV分别为(48.63±7.33)、(41.24±6.15)m/s,SNAP分别为(9.89±3.71)、(8.22±2.19)m/s,DML分别为(5.11±2.28)、(6.13±2.23)m/s,均较治疗前改善,且治疗组优于对照组。结论:针刀疗法可以减轻患者症状,具有可行性,适合在临床中推广使用。

针药并用治疗视神经萎缩疗效观察

目的观察针药并用治疗视神经萎缩的临床疗效。方法 64例视神经萎缩患者88只眼,随机分为治疗组(33例46只眼)和药物组(31例42只眼)。药物组予以口服复方银杏胶囊、甲钴胺治疗,治疗组在药物组治疗的基础上联合针刺治疗。观察两组治疗前后视野MD值和视觉诱发电位(P-VEP)值变化,并比较两组临床疗效。结果治疗组总有效率为87.0%,对照组为59.5%,两组比较差异有统计学意义(P<0.05)。两组治疗后视野MD值和P-VEP值与治疗前比较,差异有统计学意义(P<0.05)。两组治疗后视野MD值和P-VEP值比较,差异有统计学意义(P<0.05)。结论针药并用可以改善视神经萎缩患者的视野和视觉诱发电位,效果显著。

电针治疗气阴两虚型干眼症的疗效观察

目的:观察电针治疗对气阴两虚型干眼症患者的影响。方法:将60例该型患者随机分为治疗组和对照组各30例,治疗组采用电针治疗,对照组采用人工泪液治疗,观察各组治疗前后基础泪液分泌试验、泪膜破裂时间、眼部症状评分及中医证候评分的变化情况并比较2组临床疗效。结果:治疗组治疗后基础泪液分泌试验左眼和右眼均显著高于对照组(P<0.01),治疗组泪膜破裂时间左眼和右眼也显著高于对照组(P<0.01)。治疗组治疗后眼部症状评分低于对照组,差异有统计学意义(P<0.05);治疗组总有效率86.7%,对照组13.3%,2组总有效率比较差异有统计学意义(P<0.05)。结论:电针治疗气阴两虚型干眼症可以促进泪液分泌并改善泪膜稳定性,缓解患者眼部干涩感、异物感、视疲劳等不适症状。

绝骨穴的文献研究探微

绝骨穴又名悬钟、髓会,是足少阳胆经的第39个穴位,为八会穴之髓会。本文分析整理绝骨穴在古代文献中的记载,明晰该穴位的穴名渊源、定位及循经、穴性特点、主治应用规律以及刺法灸法和禁忌。总结可知绝骨穴具有疏肝利胆、舒筋活络、补肾壮骨、益髓健脑的功效,古代和现代多运用该穴治疗内、外、妇、儿、五官科多种疾病,临床应用范围十分广泛。整理和分析古代文献中的相关记载对于拓宽绝骨穴的临床运用思路大有益处,为临床应用和穴位实质的科学研究提供更多的参考依据。

艾灸通过调控NLRP3炎性小体缓解5-氟尿嘧啶诱导的大鼠化疗性肠黏膜炎的实验研究

目的:探讨艾灸通过调控核苷酸结合寡聚化结构域样受体3(NLRP3)缓解5-氟尿嘧啶(5-FU)诱导的化疗性肠黏膜炎的作用机制。方法:将30只SD大鼠随机分为正常组、模型组和艾灸组,每组10只,造模前7 d对艾灸组行艾灸处理,模型组与艾灸组采用单次腹腔注射5-FU造模,造模完成后,艾灸组继续行艾灸处理,正常组与模型组常规饲养,观察各组大鼠一般情况,检测血清中IL-1β、TNF-α、NLRP3含量,观察结肠组织病理改变,检测结肠组织NLRP3 mRNA表达水平,以及NLRP3组成相关蛋白及IL-1β的表达。结果:腹腔注射5-FU后,模型组体质量和摄食量下降明显,肠黏膜形态不规则,损伤严重,肠绒毛变短融合,上皮细胞排列紊乱。与模型组比较,艾灸组体质量增长、血便、摄食量均有不同程度改善,疾病活动指数评分显著低于模型组。艾灸组血清中IL-1β、TNF-α、NLRP3含量均显著低于模型组(P<0.05或P<0.01);艾灸组结肠组织中NLRP3炎性小体组成部分NLRP3、Caspase-1、ASC蛋白及IL-1β表达显著低于模型组(P<0.05)。结论:艾灸可通过抑制NLRP3炎性小体改善5-FU诱导的大鼠化疗性肠黏膜炎症状。

青藏高原东南部径流特征的空间规律及控制因子研究

采用青藏高原东南部的水文气象资料,对比分析了该地区23个(区间)流域的年径流深、集中度与集中期、基流系数、退水系数等径流特征及其空间分布规律,并进一步研究了这些径流特征的控制因子。结果表明:该地区径流特征的空间分布规律为年径流深从东南(700~1300 mm)向西北(<400 mm)递减,而集中度则呈相反的空间格局(从<0.44增加到>0.59);退水系数及基流系数,在低海拔地区随高程增大而增大(分别为0.55~0.69、0.51~0.73),但在高海拔地区则随高程增大而减小(0.74~0.42、0.79~0.63)。本研究发现,青藏东南径流特征空间规律的控制因子,具有显著的区域分异:在低海拔流域(平均高程<3000 m),降水是径流特征的主要影响因子;而在高海拔流域(平均高程>3000 m),仅径流深和集中度受降水控制,其他特征则主要受温度、冻土、地形等条件的共同影响。可见,由于青藏高原东南部降水和冻土对气候变化敏感,该地区水资源时空分布格局将面临很大的不确定性,对此应予以充分重视。

清代日记中影响患者就医心理及行为的因素分析

通过系统梳理纳入的8部清代日记(《翁心存日记》《恽毓鼎澄斋日记》《朱峙三日记》《管庭芬日记》《寻乐堂日录》《慎宜轩日记》《郭嵩焘日记》《王文韶日记》)中所蕴含的医患关系素材,剖析医患沟通和"熟、誉、病、经"等影响患者就医心理的5种因素,阐述就医心理对患者择医、延医及轻重病情下就医行为的影响,形成"因素-心理-行为"的作用机制,明确良性医患沟通对缓和医患矛盾的重要性。

rherapeutic efficacy observation on acupuncture for persistent allergic rhinitis

Objective： To observe the clinical effect of acupuncture for persistent allergic rhinitis （PAR）. Methods： A total of 154 PAR patients were randomized into a treatment group and a control group, 78 cases in the treatment group received acupuncture at meridian points, while 76 cases in the control group received acupuncture at non-meridian points. The treatment was done every other day, 3 times a week for a total 4 weeks. The total nasal symptom score （TNSS）, the total non-nasal symptom score （TNNSS） and the rhinoconjunctivitis quality of life questionnaire （RO, LQ） were measured before the treatment and after 2 weeks and 4 weeks of treatment, as well as 1 month and 3 months after the treatment to compare the clinical effect between the two groups. Results： After 4 weeks of treatment, the total effective rate in the treatment group was 92.3%, versus 76.3% in the control group, showing a statistically significant difference （P〈0.05）. Intra-group comparisons of TNSS, TNNSS and R0.L0. scores after 4 weeks of treatment showed statistically significant differences （all P〈0.05）. Between-group comparisons of TNSS, TNNSS and RQLQ score after 4 weeks of treatment and in follow-up visits showed statistically significant differences （all P〈0.05）. Conclusion： Acupuncture is effective for PAR, and acupuncture at meridian points can produce a better effect than acupuncture at non-meridian points.

Warm needling moxibustion plus functional exercises for knee osteoarthritis

Objective： To observe the clinical efficacy of warm needling moxibustion plus functional exercises in treating knee osteoarthritis（KOA）. Methods： Totally 108 eligible KOA patients were intervened by warm needling moxibustion plus functional exercises. The warm needling moxibustion was given 3 times a week, successively for 4 weeks. The visual analogue scale（VAS） was adopted to evaluate the pain intensity of the knee joint. After 4-week treatment, the change of VAS score, range of motion（ROM） of knee, and Lysholm score were observed, and the clinical efficacy was also estimated. Results： After treatment, the VAS score dropped obviously, and the ROM and Lysholm score increased markedly; the total effective rate was 83.3%. Conclusion： Warm needling moxibustion plus functional exercises is effective in treating KOA, as it can relieve the knee joint pain and improve the joint motion.

Clinical observation on warm needling moxibustion for erectile dysfunction

Objective： To observe the therapeutic effect of warm needling moxibustion for erectile dysfunction （ED）. Methods： A total of 46 eligible ED patients were randomized into a treatment group （n=24） and a control group （n=22）. The treatment group was intervened by warm needling moxibustion while the control group by conventional acupuncture treatment, for a total of 4 courses. The therapeutic effect was evaluated by the international index of erectile function 5 （IIEF-5）. Results： After 4 courses of treatment, the overall effective rate was 91.3% in the treatment group （23 completed）, versus 75.0% in the control group （20 completed）, with a significant difference （P〈0.05）. After the treatment, the change of IIEF-5 score in the treatment group was significantly different from that in the control group （P〈0.05）. Conclusion： Warm needling moxibustion can produce a more significant efficacy than conventional acupuncture in the treatment of ED.

Clinical progress on moxibustion in preventing and treating adverse effects of surgery or chemoradiotherapy for breast cancer

Breast cancer has the highest incidence rate among all women＇s malignant tumors worldwide.Surgery,radiotherapy and chemotherapy are three major treatments,while most patients showed adverse effects or complications during or after the treatment,including lymphedema,gastrointestinal reactions and leukopenia,which cause severe impact on patients＇ recovery and quality of life.Moxibustion has been used and certified to alleviate adverse effects of surgery or chemoradiotherapy for breast cancer.We have summarized literatures in recent years and suggest more systematic research in the future for the underlying mechanism.

Clinical study of optimizing acupoint combining in treatment of bronchial asthma with acupoint application

Objective:To observe the therapeutic efficacy of acupoint application at different groups of acupoints in treating bronchial asthma in remission stage.Methods:A total of 120 patients with bronchial asthma in remission stage were recruited and divided by the random number table method into acupoint application group 1,acupoint application group 2 and acupoint application group 3,with 40 cases in each group.In all the three groups,Tiantu(CV 22),Dazhui(GV 14)and Feishu(BL 13)were selected,with Dingchuan(EX-B 1)added in acupoint application group 1,Shenshu(BL 23)added in acupoint application group 2,and Gaohuang(BL 43)added in acupoint application group 3.Before intervention,one month and 3 months after intervention,clinical symptoms,peak expiratory flow(PEF)and forced expiratory volume in 1 second percentage of predicted value(FEV1%)of the three groups were observed,and their clinical efficacies were evaluated.Results:Comparing the therapeutic efficacy regarding traditional Chinese medicine symptoms and signs,after 1-month treatment,the total effective rate was 87.5%in acupoint application group 1,versus 62.5%in acupoint application group 2 and 55.0%in acupoint application group 3,and the between-group differences were statistically significant.After 3-month treatment,the total effective rate was 95.0%in acupoint application group 1,versus 70.0%in acupoint application group 2 and 65.0%in acupoint application group 3,and the between-group differences were statistically significant.After intervention,the three groups all showed significant improvements in pulmonary function with statistical significance;among the three groups,the improvement in acupoint application group 1 was more significant than that in the other two groups.Conclusion:Tiantu(CV 22),Dazhui(GV 14)and Feishu(BL 13)as basic prescription plus Dingchuan(EX-B 1)can improve symptoms of bronchial asthma in remission stage,and it works better in improving pulmonary function than the basic prescription plus Shenshu(BL 23)or Gaohuang(BL 43).