置管对侧偏头法在PICC患者置管中的应用

目的探讨置管对侧偏头法对PICC患者导管异位和舒适度的影响。方法采用便利抽样法,选择2018年1月至2019年12月长治市人民医院肝胆外科需留置PICC的住院患者作为研究对象。2018年1—12月收治的患者作为对照组,2019年1—12月收治的患者作为试验组,每组174例。对照组采用传统偏头法送管,试验组采用置管对侧偏头法送管。比较2组患者一次性送管成功率、导管异位发生率、并发症发生率及置管时舒适度。结果试验组一次性送管成功率、导管异位发生率分别为97.1%(169/174)、1.2%(2/174),对照组分别为91.4%(159/174)、7.5%(13/174),差异有统计学意义(χ^(2)=5.30、8.43,均P<0.05)。生存曲线分析显示,试验组导管相关性血栓、导管相关性血流感染发生率均明显低于对照组,差异有统计学意义(χ^(2)=15.23、8.76,均P<0.05)。试验组置管时舒适度问卷评分为(15.00±2.19)分,明显低于对照组的(16.86±1.88)分,差异有统计学意义(t=8.49,P<0.05)。结论采用置管对侧偏头法,可提高一次性送管成功率,降低导管异位发生率,并减少置管过程中患者的不适感。

超声引导下三种防止PICC导管异位于颈内静脉的方式效果比较研究

目的研究防止PICC导管异位于颈内静脉的有效方法。方法选取2017年1~6月本院拟行PICC置管患者为研究对象,随机分为三组,每组100例。甲组在送管时采用指压法合并传统转颈法,乙组采用指压法,丙组采用传统转颈法。置管后比较三组患者导管的异位率。结果三组穿刺后甲组首次颈部静脉异位率最低,三组差异有统计学意义(P<0.05)。结论指压法合并传统转颈法(甲组)比指压法和传统偏头法更能有效预防PICC导管端位于颈内静脉,值得临床推广。

新生儿PICC中送管体位改良对导管异位的影响研究

目的探究新生儿经外周中心静脉置管(PICC)中送管体位改良对导管异位的影响。方法62例行PICC的新生儿,按照随机抽样法分为对照组和实验组,各31例。对照组行常规偏头法置管,实验组行改良体位不偏头法置管。对比两组置管成功率及平均穿刺时间;导管尖端易位率及非计划拔管率。结果实验组置管成功率96.8%高于对照组的80.6%,平均穿刺时间(8.00±1.21)min短于对照组的(12.00±2.71)min,差异均有统计学意义(P<0.05)。实验组导管尖端易位率3.2%、非计划拔管率3.2%均低于对照组的22.6%、19.4%,差异有统计学意义(P<0.05)。结论较之于常规偏头法置管,改良体位不偏头法置管能显著提高置管成功率,缩短导管留置期间平均穿刺时间,降低导管尖端易位率以及非计划拔管率,具有较大的临床价值,值得在临床推广与普及。

STUDY ON THE ATTACK CONTROL ACTION OF ELECTRO-ACUPUNC-TURE ON T■IYANG(太阳EX-HN5)FOR MIGRAINE DUE TO HYPERAC-TIVITY OF LIVER YANG:RANDOMIED CONTROLED TRIAL

Objective To discuss the difference of electro-acupuncture and drug in controlling the attack of migraine due to hyperactivity of liver yang. Methods Three-centered random control method was used, and 300 qualified cases were randomly divided into treatment group （146 cases according to the design） and control group （140 cases）, which were respectively treated with electro-acupuncture and drugs （Compound Aminopyrine Phenacetin Tablets, Ergotamine Caffeine Tablets, Diazepam Tablets）, and observed the overall effect and scores of headache, accompanying symptoms, psychological and social adaptability scores, life quality scores, TCM symptoms scores and follow-up results before and after the treatment. Results In treatment group, the successful rate of attack control was 47.3 %, the improvement rate was 73.3 %, and the total effectiveness was 90.4 %, the clinical control rate and improvement were much superior to control group （the clinical control rate 35.7 %, improvement 61.4 %, the total effectiveness 85. 7 % ）, P〈0. 01, the difference in effect was mainly reflected in patients with moderate severity; the total scores of TCM syndrome after the treatment was obviously significant or very obviously significant（ P〈0. 05, P〈0. 01 ）, but the headache scores between two groups was not obviously significant（P〉0.05）, the difference in accompanying symptoms was significant（ P〈0. 01 ） ;the long term attack control action in two groups was not satisfactory, the recurrence was similar （P〉0. 05） ,the severity of headache in recurrence cases of treatment group was alleviated and superior to control group（ P 〈 0. 01 ）, the occurrence of headache after the treatment is much less than that before the treatment and the situation after 2 months was superior to control group （P〈0. 01 ）. Sleepiness and redness of face in some patients which were seen in control group weren＇t seen in treatment group. Conclusion Electro-acupuncture on Tàiyáng （太阳 EX-HN5） can control the attack of migraine due to hyperactivity of liver yang, and it has advantages in improving the accompanying symptoms and reducing the toxic and side effects of western drugs.

Treatment of Migraine with Acupuncture at Points Pertaining to the Liver and Gallbladder Channels

In studying the syndrome of yang-hyperactivity, we found that most migraine patients were with hyperactivity of the liver-yang, stagnation of the liver-qiand blood stasis, and stagnation of the liverqi and deficiency of the spleen. To evaluate the needling effects on migraine and to approach its mechanism, we have launched a study in 207 cases since 1997. The results were satisfactory and reported as follows.

Clinical Records for Acupuncture Treatment of Migraine

Migraine, characterized by periodic attacks that hampers the quality of the daily life, is an obstinate symptom complex commonly seen in the clinic. In contrast with the poor effects obtained in Western medicine, acupuncture is a safe and effective treatment for migraine. The following are the clinical records for acupuncture treatment of migraine in the recent 5 years.

两种 PICC 置管方法在消化科住院患者中的应用效果比较

目的：探讨两种PICC置管方法（偏头法置管与举臂靠头法置管）在消化科住院患者中的应用效果。方法选取我院行PICC置管的消化科住院患者146例，随机分为对照组和观察组，每组73例。采用视觉模拟评分法（ VAS）评定患者的舒适度，比较两组患者的置管情况、并发症情况、满意度情况。结果观察组患者舒适度明显好于对照组（ P＜0．05），患者并发症发生率明显低于对照组（ P＜0．05），患者一次置管成功率、满意度均明显高于对照组（ P＜0．05）。结论消化科住院患者行PICC置管时，举臂靠头法置管优于偏头法置管，可显著提高患者的舒适度和满意度，并发症少且安全性高。

不同颈部静脉阻断法预防PICC置管导管异位的价值比较

目的探讨不同颈部静脉阻断法预防经外周静脉置入中心静脉导管(PICC)异位的价值比较,为临床护理操作方法改进提供依据。方法选取2016年1月至2017年1月于该院行PICC置管患者286例为研究对象,按随机数表法随机分为观察组和对照组,各143例。对照组患者在置管时采取传统偏头法同时助手可辅以指压法进行颈部静脉阻断,观察组患者则采用按压器法阻断颈部静脉,比较两组患者置管时间、导管总异位率、颈部静脉异位率及患者护理满意度,并作统计学分析。结果观察组患者首次穿刺成功率显著高于对照组患者,差异有统计学意义(P<0.05);观察组患者PICC置管总异位率及颈部静脉异位率均显著低于对照组,差异有统计学意义(均P<0-05);观察组患者护理满意度显著高于对照组,差异有统计学意义(P<0.05)。结论用按压器法阻断颈部静脉可显著降低PICC置管时导管异位率,提升患者护理满意度,值得临床推广。

Clinical efficacy of opposing needling in the treatment of migraine with the symptom of ascendant hyperactivity of liver yang and its effect on NO level in plasma of patients

Objective To observe the clinical efficacy of opposing needling for the treatment of migraine with the symptom of hyperactivity of liver yang type and its effect on NO level in plasma of patients. Methods Atotal of 60 migraine patients with the symptom of hyperactivity of liver yang who met the inclusive criteria were randomly divided into a opposing needling group （group A） and a routine acupuncture group （group B） by using SPSS 15.0 software according to the registration order with 30 patients in each group. Patients in group A were treated with opposing needling. Taich6ng （太冲 LR 3）, Zhongzhu （中渚 TE 3）, ZOlfnqi （足临泣 GB 41） and QiOxu （丘墟 GB 40） in the uninjured side were selected. After deqi, reducing method was used. Then Taixi （太溪 KI 3） in the uninjured side was selected. After deqi, rein forcing method was used. Needles were retained for 30 rain. Patients in group B were treated with routine acupuncture. Local Ash point, Sishncong （ 四神聪EX-HN1）, Yifeng （翳风 TE 17）, Fengchi （风池 GB 20）, Sizhukong （丝竹空 TE 23）, Shuaigu （率谷GB 8）, Hegu （合谷 LI 4） and LiEque （列缺 LU 7） were selected. After puncturing, reducing method was used routinely and needles were retained for 30 rain. After 2 weeks treatment, migraine specific quality of life questionnaire （MSQ）, visual analogue scale （VAS） and nitric oxide （NO） level in plasma of patients in two groups were observed. Results After treatment, the MSQ, VAS and NO of two groups were significantly improved compared with those before treatment. After treatment, score of MSQ functional limitation was 73.41±10.22 in group A and 60.95 ± 10.15 in group B; the score of MSQ dysfunction was 86.11 ±8.22 in group A and 75.45±8.34 in group B; score of MSQ emotion was 80.51±10.16 in group A and 75.01± 10.20 in group B. The improvements of group A were superior to those of group B, and the differences were all statistically significant （all P〈0.05）. After treatment, the VAS score was 0.93 ± 1.25 in group A and 2.17± 1.70 in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. After treatment, blood plasma NO level was （42.15 ± 16.15） μmol/L in group A and （62.76±15.17） μmol/L in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. Overall response rate was 86.7% （26/30） in group A and 53.3% （16/30） in group B, and the difference between two groups was statistically significant （P〈0.05）. Conclusion Opposing needling is an effective method for the treatment of migraine with the symptom of hyperactivity of liver yong. Its mechanism is to regulate the generation of NO in migraine patients, and improve the relaxation and contraction of cerebral vascular smooth muscle, so as to adjust the cerebral circulation.

Clinical Observations on the Treatment of Migraine by Acupuncture plus Auricular Plaster Therapy

Objective： To investigate the clinical efficacy of acupuncture plus auricular plaster therapy for treating migraine. Methods： One hundred and fifty migraine patients were randomly allocated to an observation group （n=90） and a control group （n=60）. The observation group were treated by acupuncture plus auricular plaster therapy based on syndrome differentiation and the control group, by oral administration of Flunarizine. The curative effects were compared between the two groups. Results： The total efficacy rate was 94.4% in the observation group and higher than in the control group （73.3%）. The recovery rate was 87.8% in the observation group and higher than in the control group （55.0%）. There were significant differences between the two groups （both P〈0.01）. The curative effect was significantly better in the observation group than in the control group. Conclusion： Clinically, acupuncture plus auricular plaster therapy based on syndrome differentiation has a good effect on migraine.

Clinical Observation on Treatment of Migraine with Acupuncture

Objective： To study the effect of puncturing points Taiyang （Ex-HN 5）, Jiaosun （TE 20）, Qiuxu （GB 40） and Shenmai （BL 62） on migraine. Methods： The 120 cases in the treatment group were treated with routine acupuncture therapy, while the 40 cases in the control group were treated with Ergotamine and Caffeine Tablet, and then the therapeutic effect and recovery time of the two groups were compared. Results： The recovery rate of the treatment group was 90.0%, which is higher than 70.0% of the control group （P〈 0.01）. The total effective rate of the treatment group was 100%, which is better than 92.5% of the control group （P 〈 0.05）, The therapeutic effect of the treatment group was significantly better than the control group and the treatment group needed shorter treatment period （P 〈 0.05）. Conclusions： Acupuncture has higher recovery rate and total effective rate as well as shorter treatment period than oral ergotamine and caffeine tablets, which indicated that acupuncture is superior to the routinely-administered oral western tablets in treating migraine.

Clinical observation on acupuncture at points of Shaoyang meridians plus moving cupping on the neck and shoulder for migraine

Objective： To observe the efficacy of acupuncture at points of Shaoyang meridians plus moving cupping on neck and shoulder for migraine. Methods： A total of 64 migraine cases were randomly allocated into an observation group and a control group, 32 cases in each group. Random number table method was used in allocation. Acupuncture at points of Shaoyang meridians and cupping on neck and shoulder were used for cases in the observation group, which contain acupuncture 5 times a week and cupping once a week. Oral flunarizine hydrochloride capsules were used for cases in the control group, 10 mg for each dose, 1 dose a day. 2 weeks constitutes a course of treatment. The patients were treated for two courses of treatment in both groups. After that, the changes of visual analogue scale （VAS） and the migraine disability assessment questionnaire （MIDAS） were observed, as well as the clinical efficacy. Results： The total effective rate and recovery and marked effective rate in the observation group were 93.8% and 71.0% respectively, versus 78.1% and 43.8% in the control group, showing statistical significant differences （both P〈O.05）. There were significant decreases in VAS and MIDAS scores after treatments in both groups （both P〈O.05）. VAS and MIDAS scores in the observation group were significantly different from those in the control group （both P〈0.05）. Conclusion： Combining acupuncture at points of Shaoyang meridians and cupping on neck and shoulder can relieve headache and reduce influence of migraine on life. It can produce a better efficacy than oral flunarizine hydrochloride capsules in treating migraine patients.

Treatment of 30 Cases of Migraine by Mind-regulating Acupuncture

Objective： To observe the clinical effects of needling acupoints Shenting（GV 24）, Neiguan（PC 6） and Sanyinjiao（SP 6） in the treatment of migraine. Methods： Thirty cases of Germen patients with migraine were treated mainly by Shenting（GV 24）, bilateral Neiguan（PC 6） and Sanyinjiao（SP 6）, as well as bilateral Hegu（LI 4） and Taichong（LR 3）, Touwei（ST 8）, Yangbai（GB 14）, Cuanzhu（BL 2）, Sizhukong（TE 23）, Shuaigu（GB 8） and Sibai（ST 2） in the affected side of head, auricular Sympathetic （MA-AH 7）, Er Shenmen （MA-TF 1）, Heart （MA- IC） and Endocrine （MA-IC 3）; another 28 cases were treated by routine acupuncture. The clinical results and immediate pain relieving effects were observed. Results. The total effective rate was 90.0% in treatment group and 75.0% in control group, X^2= 4.57, P 〈 0.05; the 24 hour pain-relieving effects were obviously better in treatment group than that in control group, X^2= 10.11, P〈 0.01. Conclusion： Needling Shenting（GV 24）, Neiguan （PC 6） and San yinjiao（SP 6） has better effects than routine acupuncture in the treatment of migraine.

Clinical Observation on Acupuncture for Migraine

Objective： To observe the clinical efficacy of acupuncture treatment for migraine. Methods： Forty cases were randomly allocated to a treatment group and a control group, 20 cases in each group. Cases in the treatment group were treated with acupuncture, while cases in the control group were treated with oral Sibelium. After that, the changes of cerebral blood flow were observed before and after treatment. Results： There was significant difference in clinical efficacies between two groups （P〈0.05）. There were also significant differences in arterial blood flow velocities of before and after treatment. Acupuncture can produce substantial differences （P〈0.05） in blood flow velocities of vertebral artery （VA）, middle cerebral artery （MCA） and anterior cerebral artery （ACA） during an increased flow rate. It can also produce statistical differences in blood flow velocities of VA during a decreased flow rate （P〈0.05）. Conclusion： Acupuncture can effectively alleviate the pain of migraine sufferers and exert a two-way regulation on the cerebral blood flow.

Effect of Pricking Blood Therapy on Behavior and Gene Expression in a Rat Model of Migraine

Objective： To investigate the effect of pricking blood therapy on behavior and brainstem c-los and c-jun gene expression in migraine rats. Methods： A rat model of migraine was made with nitroglycerol. The rats were treated by pricking blood. Rat behavior was observed. Brainstem c-fos and c-jun gene expression was examined by immunohistochemistry. Results： Ear redness improved significantly, the number of head scratchings decreased obviously （P〈0.05） and c-fos and c-jun expression was reduced markedly （P〈0.01） in the treatment group after pricking blood compared with the model group and the blank group. Conclusion： Pricking blood treatment can improve behavior indices and reduce c-fos and c-jun positive expression in migraine rats.

The observation on different effectiveness between the embedding needle therapy and medication in the preventative treatment of chronic migraine

Objective: To evaluate the therapeutic effects of the embedding needle therapy in the preventative treatment of chronic migraine.Methods: A total of 36 patients with chronic migraine were divided into an embedding needle therapy group and a flunarizine group according to random number table, 18 cases in each group. In the embedding needle therapy group, the thumb-tack needles were used at Sizhúkōng(丝竹空TE 23), Hànyàn(颔厌GB 4), Wángǔ(完骨GB 12) and Cuánzhú(攒竹BL 2) and the needles were embedded for 24 h. The embedding needle therapy was given three times a week. In the flunarizine group, flunarizine was prescribed, 10 mg a day. Separately, at the end of the 4-week treatment and in 4 weeks of the follow-up, the number of days of headache attack per month(days/month) and the headache duration(hours/month)in the cases with moderate to severe headache were observed in the two groups.Results: The number of days of headache attack in the cases with moderate to severe headache was reduced after treatment as compared with the number before treatment in the two groups. The headache duration was reduced obviously after treatment in the cases of moderate to severe headache in the two groups. In the 4-week follow-up, all the indexes were still reduced as compared with the indexes before treatment, indicating the significant differences in the two groups(both P < 0.05). In the embedding needle therapy group, at the end of the 4-week treatment and in 4 weeks of the follow-up, the number of days of headache attack per month was(8.1 ± 2.4) days and(7.2 ± 1.6) days separately, which were significant difference as compared with(9.7 ± 2.3) days and(8.9 ± 1.4) days in the flunarizine group(both P < 0.05). Regarding the headache duration, at the end of the 4-week treatment and in 4 weeks of the follow-up, it was(105.6 ± 10.5) h/month and(92.1 ± 7.2) h/month respectively in the embedding needle therapy group, indicating the significant differences as compared with(135.4 ± 8.9) h and(116.1 ± 8.2) h in the flunarizine group respectively(both P < 0.05).Conclusion: The 4-week treatment with the embedding needle therapy obviously reduces the number of days of headache attack and the headache duration, presents the preventative effects in the patients with chronic migraine.

Clinical efficacy of Chifeng Yingyuan manipulation for migraine and its effects on endothelin and nitric oxide

Objective To observe clinical efficacy of Ch/J：eng Yingyuan manipulation for migraine and its effects on endothelin （ET） and nitric oxide （NO）. Methods One hundred and seventeen cases were randomly divided into a treatment group （59 cases） and a control group （58 cases）. The Chifeng Yingyuan manipulation was applied in the treatment group while oral administration of flunarizine hydrochloride capsules was applied in the control group for consecutive 4 weeks. Before and after the treatment, the clinical efficacy and migraine score in both groups were compared; radioimmunoassay was used to test level of ET while nitrate reductase method was for level of NO. Results Compared between two groups, the total effective rate was 91.5% in the treatment group, which was superior to 70.7% in the control group （P〈0.05）. After the treatment, the migraine scores were both significantly decreased in two groups （P〈0.05, P〈0.01）, which was more obvious in the treatment group （P〈0.05）. The level of ET and NO was significantly changed after treatment （P〈0.05, P〈0.01）. Compared between two groups, the improvement of ET and NO in the treatment group was better than that in the control group （both P〈0.05）. Conclusion The Chifeng Yingyuan manipulation has positive effect on migraine without any adverse reaction, which could maintain cerebrovascular vasomotor function by regulating level of ET and NO in the plasma.

Clinical Observations on Acupuncture Treatment of 68 Migraine Patients

Objective To investigate the curative effect of points Fengchi（GB 20）, Tianzhu（BL 10） and Wangu （GB 12） on migraine. Methods. A treatment group of 68 patients received acupuncture of bilateral points Fengchi（GB 20）, Tianzhu（BL 10） and Wangu（GB 12） and a control group of 40 patients took orally Nimodipine and Oryzanol. The curative effect was evaluated in both groups after two courses of treatment. Results： The total efficacy rate was 92.7% and 72.5% and the control rate was 45.6% and 22.5%, respectively, in the two groups. Conclusion： Acupuncture is significantly more effective than Western medicine in treating migraine.

Clinical study on nape cluster acupuncture for 50 cases of migraine

To observe the clinical efficacy of nape cluster acupuncture in treating migraine. Methods： Fifty patients with confirmed diagnosis of migraine were intervened by using nape cluster acupuncture, and were evaluated at the outset and after 2-month treatment by the short-form of McGill pain questionnaire （SP-MPQ） and self-rating depression scale （SDS）. Results： After treatment, the number of positive words, sensory pain rating index （S-PRI）, affective pain rating index （A-PRI）, total pain rating index （T-PRI）, visual analogue scale （VAS）, and present pain intensity （PPI） were significantly changed （P〈0.01）; the SDS score was （56.42＋8.12） points before treatment versus （41.08＋5.73） points after treatment, and the difference was statistically significant （P〈0.01）. The total effective rate was 86.0%; the therapeutic efficacy of the patients with a shorter disease duration was superior to that of the patients with a longer one （P〈0.05）; the efficacy of mild-moderate migraine was superior to that of severe one （P〈0.01）; the total effective rate of patients without depression was higher than that with depression, but without a significant difference in comparing the therapeutic efficacy （P〈0.05）. Conclusion： Nape cluster acupuncture is effective in treating migraine, significantly improving headache and depression.