目的基于脑肠轴理论观察针刺治疗卒中后抑郁的临床疗效。方法选取74例卒中后抑郁患者,根据随机数字表法分为试验组和对照组,每组37例。两组均采用常规西药治疗,对照组采用醒脑开窍针刺法治疗,试验组在对照组基础上联合基于脑肠轴理论取...目的基于脑肠轴理论观察针刺治疗卒中后抑郁的临床疗效。方法选取74例卒中后抑郁患者,根据随机数字表法分为试验组和对照组,每组37例。两组均采用常规西药治疗,对照组采用醒脑开窍针刺法治疗,试验组在对照组基础上联合基于脑肠轴理论取穴的电针治疗。比较两组临床疗效,观察两组治疗前后中医主症积分、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分和日常生活能力量表(activity of daily living,ADL)评分的变化,比较两组治疗前后血清胃泌素(gastrin,GAS)、生长抑素(somatostatin,SS)、5-羟色胺(5-hydroxytryptamin,5-HT)和脑源性神经生长因子(brain-derived neuotrophyic factor,BDNF)水平的变化。结果试验组抑郁总有效率和中医证候总有效率均高于对照组(P<0.05)。两组治疗后中医主症积分、HAMD评分和NIHSS评分均较同组治疗前降低(P<0.05),ADL评分较同组治疗前升高(P<0.05);试验组治疗后上述评分均优于对照组(P<0.05)。两组治疗后血清SS水平均降低(P<0.05),血清GAS、5-HT和BDNF水平均升高(P<0.05);且试验组治疗后血清SS水平低于对照组(P<0.05),血清GAS、5-HT和BDNF水平高于对照组(P<0.05)。结论在常规西药治疗基础上,醒脑开窍针刺法联合基于脑肠轴理论取穴的电针治疗可更好地缓解卒中后抑郁患者的临床症状,改善神经功能和日常生活能力,提高临床疗效,这可能与调节血清SS、GAS、5-HT和BDNF水平有关。展开更多
[目的]对中医外治法治疗妊娠期贝尔面瘫相关的临床研究进行归纳总结,以期为临床医师选择治疗方案提供参考。[方法]从建库起至2020年4月,以“妊娠”“孕妇”及“贝尔麻痹”“特发性面神经麻痹”“面神经炎”“面瘫”为关键词,检索知网、...[目的]对中医外治法治疗妊娠期贝尔面瘫相关的临床研究进行归纳总结,以期为临床医师选择治疗方案提供参考。[方法]从建库起至2020年4月,以“妊娠”“孕妇”及“贝尔麻痹”“特发性面神经麻痹”“面神经炎”“面瘫”为关键词,检索知网、万方、维普、中国生物医学文献数据库、Pubmed、Web of Science、Embase数据库,筛选中医外治法治疗妊娠期贝尔面瘫的相关文献,从介入时机、治疗方式、选穴等方面进行分析。[结果]共检索到中医外治法治疗孕妇贝尔面瘫的相关文献50篇,其中中文文献46篇,英文文献4篇。应用于妊娠期贝尔面瘫的中医特色外治法以针刺、灸法为主。针刺手法宜轻宜浅,取穴以面部三阳经穴为主,注意穴位禁忌;重视灸法的应用,艾灸方式以温针灸或悬起灸为主,施灸部位局部以翳风穴、下关穴最为常见,亦可选择督脉神道穴,在热敏感区治疗可显著提高疗效。推拿、闪罐常作为辅助疗法与针刺联合应用。各种疗法均可早期介入,临床未见严重不良反应报道。[结论]以针灸为主的中医外治法治疗妊娠期贝尔面瘫疗效肯定,安全性好,可作为临床首选疗法。未来还需要更高质量的临床研究来进一步证实各疗法的临床疗效,并探究提高疗效的最佳方案。展开更多
OBJECTIVE: To use evidence-based medicine to explore the efficacy of acupoint application(AA) for allergic rhinitis(AR) at different time points and its safety. METHODS: We searched 7 databases(Pub Med, Cochrane, Emba...OBJECTIVE: To use evidence-based medicine to explore the efficacy of acupoint application(AA) for allergic rhinitis(AR) at different time points and its safety. METHODS: We searched 7 databases(Pub Med, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, and China Biology Medicine disc) as well as the international clinical trial registration platform from January 2010 to March 2020 for randomized controlled trials(RCTs) comparing the efficacy of AA versus placebo, Western Medicine or other alternative therapies on AR. Risk of bias was assessed according to the Cochrane handbook, and statistical analysis was performed using Rev Man 5.3. Outcomes included the total effective rate, recurrence rate, total nasal symptom score(TNSS), visual analogue scale(VAS), quality of life measured by the Rhinitis Quality of Life Questionnaire(RQLQ) or Short Form-36(SF-36), adverse events, and biomarkers including immunoglobulin E(Ig E), peripheral blood eosinophil count(EOS), interleukin-4(IL-4), and interferon gamma(INF-γ). RESULTS: Twenty-eight RCTs involving 3282 participants were included. The short-term and long-term efficacy of AA was significantly better than placebo, including better total effective rate [RR: 3.05, 95%CI(1.84, 5.07), after treatment;RR: 9.29, 95%CI(2.57, 33.66), at 6 months], lower recurrence rate [RR: 0.55, 95%CI(0.45, 0.66), at 6 months;RR: 0.65, 95%CI(0.57, 0.74), at 1 year], lower TNSS [MD:-3.09, 95%CI(-3.58,-2.61), after treatment], and lower RQLQ [MD:-14.79, 95%CI(-21.49,-8.10), after treatment;MD:-11.92, 95%CI(-17.40,-6.45), at 4-6 months]. Compared with Western Medicine, AA had better long-term total effective rate [RR: 1.33, 95%CI(1.05, 1.69), at 3 months;RR: 1.49, 95%CI 1.22 to 1.81, at 1 year) and lower recurrence rate [RR: 0.48, 95%CI(0.39, 0.58), at 6 months;RR: 0.45, 95%CI(0.33, 0.60), at 1 year]. AA had better long-term total effective rate versus acupuncture [RR: 2.06, 95% CI(1.28, 3.31), at 1 year] or oral Chinese medicine [RR: 1.21, 95% CI(1.09, 1.34), ≥ 6 months]. Both AA and Western Medicine can reduce serum levels of Ig E, EOS, and IL-4 after treatment. The main adverse event of AA was local skin reaction without systemic side effects. CONCLUSIONS: The short-term(within one month) and long-term(at 3 months, 6 months and 1 year) efficacy of acupoint application on AR was better than that of placebo. The long-term efficacy of acupoint application was superior to that of Western Medicine(at 3 months, 6 months and 1 year), oral Chinese medicine(at more than 6 months) and acupuncture(at 1 year). AA can reduce serum Ig E, EOS, and IL-4 level of AR patients in a short run. Acupoint application is safe, but severe skin reactions can reduce patient compliance.展开更多
文摘目的基于脑肠轴理论观察针刺治疗卒中后抑郁的临床疗效。方法选取74例卒中后抑郁患者,根据随机数字表法分为试验组和对照组,每组37例。两组均采用常规西药治疗,对照组采用醒脑开窍针刺法治疗,试验组在对照组基础上联合基于脑肠轴理论取穴的电针治疗。比较两组临床疗效,观察两组治疗前后中医主症积分、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分和日常生活能力量表(activity of daily living,ADL)评分的变化,比较两组治疗前后血清胃泌素(gastrin,GAS)、生长抑素(somatostatin,SS)、5-羟色胺(5-hydroxytryptamin,5-HT)和脑源性神经生长因子(brain-derived neuotrophyic factor,BDNF)水平的变化。结果试验组抑郁总有效率和中医证候总有效率均高于对照组(P<0.05)。两组治疗后中医主症积分、HAMD评分和NIHSS评分均较同组治疗前降低(P<0.05),ADL评分较同组治疗前升高(P<0.05);试验组治疗后上述评分均优于对照组(P<0.05)。两组治疗后血清SS水平均降低(P<0.05),血清GAS、5-HT和BDNF水平均升高(P<0.05);且试验组治疗后血清SS水平低于对照组(P<0.05),血清GAS、5-HT和BDNF水平高于对照组(P<0.05)。结论在常规西药治疗基础上,醒脑开窍针刺法联合基于脑肠轴理论取穴的电针治疗可更好地缓解卒中后抑郁患者的临床症状,改善神经功能和日常生活能力,提高临床疗效,这可能与调节血清SS、GAS、5-HT和BDNF水平有关。
文摘[目的]对中医外治法治疗妊娠期贝尔面瘫相关的临床研究进行归纳总结,以期为临床医师选择治疗方案提供参考。[方法]从建库起至2020年4月,以“妊娠”“孕妇”及“贝尔麻痹”“特发性面神经麻痹”“面神经炎”“面瘫”为关键词,检索知网、万方、维普、中国生物医学文献数据库、Pubmed、Web of Science、Embase数据库,筛选中医外治法治疗妊娠期贝尔面瘫的相关文献,从介入时机、治疗方式、选穴等方面进行分析。[结果]共检索到中医外治法治疗孕妇贝尔面瘫的相关文献50篇,其中中文文献46篇,英文文献4篇。应用于妊娠期贝尔面瘫的中医特色外治法以针刺、灸法为主。针刺手法宜轻宜浅,取穴以面部三阳经穴为主,注意穴位禁忌;重视灸法的应用,艾灸方式以温针灸或悬起灸为主,施灸部位局部以翳风穴、下关穴最为常见,亦可选择督脉神道穴,在热敏感区治疗可显著提高疗效。推拿、闪罐常作为辅助疗法与针刺联合应用。各种疗法均可早期介入,临床未见严重不良反应报道。[结论]以针灸为主的中医外治法治疗妊娠期贝尔面瘫疗效肯定,安全性好,可作为临床首选疗法。未来还需要更高质量的临床研究来进一步证实各疗法的临床疗效,并探究提高疗效的最佳方案。
基金Supported by the Key Science and Technology Projects of Zhejiang Province:Research and Application of Key Techniques for Prevention and Treatment of Allergic Diseases of the Respiratory Tract by Summer Treatment of Winter Disease of Acupoint Application (No. 2014C03046-2)。
文摘OBJECTIVE: To use evidence-based medicine to explore the efficacy of acupoint application(AA) for allergic rhinitis(AR) at different time points and its safety. METHODS: We searched 7 databases(Pub Med, Cochrane, Embase, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, and China Biology Medicine disc) as well as the international clinical trial registration platform from January 2010 to March 2020 for randomized controlled trials(RCTs) comparing the efficacy of AA versus placebo, Western Medicine or other alternative therapies on AR. Risk of bias was assessed according to the Cochrane handbook, and statistical analysis was performed using Rev Man 5.3. Outcomes included the total effective rate, recurrence rate, total nasal symptom score(TNSS), visual analogue scale(VAS), quality of life measured by the Rhinitis Quality of Life Questionnaire(RQLQ) or Short Form-36(SF-36), adverse events, and biomarkers including immunoglobulin E(Ig E), peripheral blood eosinophil count(EOS), interleukin-4(IL-4), and interferon gamma(INF-γ). RESULTS: Twenty-eight RCTs involving 3282 participants were included. The short-term and long-term efficacy of AA was significantly better than placebo, including better total effective rate [RR: 3.05, 95%CI(1.84, 5.07), after treatment;RR: 9.29, 95%CI(2.57, 33.66), at 6 months], lower recurrence rate [RR: 0.55, 95%CI(0.45, 0.66), at 6 months;RR: 0.65, 95%CI(0.57, 0.74), at 1 year], lower TNSS [MD:-3.09, 95%CI(-3.58,-2.61), after treatment], and lower RQLQ [MD:-14.79, 95%CI(-21.49,-8.10), after treatment;MD:-11.92, 95%CI(-17.40,-6.45), at 4-6 months]. Compared with Western Medicine, AA had better long-term total effective rate [RR: 1.33, 95%CI(1.05, 1.69), at 3 months;RR: 1.49, 95%CI 1.22 to 1.81, at 1 year) and lower recurrence rate [RR: 0.48, 95%CI(0.39, 0.58), at 6 months;RR: 0.45, 95%CI(0.33, 0.60), at 1 year]. AA had better long-term total effective rate versus acupuncture [RR: 2.06, 95% CI(1.28, 3.31), at 1 year] or oral Chinese medicine [RR: 1.21, 95% CI(1.09, 1.34), ≥ 6 months]. Both AA and Western Medicine can reduce serum levels of Ig E, EOS, and IL-4 after treatment. The main adverse event of AA was local skin reaction without systemic side effects. CONCLUSIONS: The short-term(within one month) and long-term(at 3 months, 6 months and 1 year) efficacy of acupoint application on AR was better than that of placebo. The long-term efficacy of acupoint application was superior to that of Western Medicine(at 3 months, 6 months and 1 year), oral Chinese medicine(at more than 6 months) and acupuncture(at 1 year). AA can reduce serum Ig E, EOS, and IL-4 level of AR patients in a short run. Acupoint application is safe, but severe skin reactions can reduce patient compliance.
