交感神经型颈椎病按节段角度牵引正骨82例

颈椎病交感神经型发病率不算高,但给患者带来较大的痛苦.2011年以来,笔者采用按节段角度牵引正骨治疗交感神经型颈椎病82例,疗效显著.

按章备课方法在环境科学导论教学中的应用

按章备课方法是针对传统的按节备课方法的不足提出的 ,即根据授课总学时数、教学重点和能够找到的教学材料将教材重新组合 ,分为若干章 (专题 )讲授。经过《环境科学导论》课的多次使用 。

戴源《鼓琴八则》中技法原则的现代阐释

戴源《鼓琴八则》中所载的“调气”“炼骨”“按节”“取音”四项技法原则,在一般意义上涵蕴着器乐演奏技法运用的基本原理。采用哲学阐释学的方法,通过转换性的创构,可以实现其理论话语与当代钢琴演奏艺术理论话语的对应阐释,并能够形成中国传统音乐表演美学特色的理论话语,对当代钢琴演奏艺术的实践具有一定的指导意义和借鉴价值。

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACPUNCTURE COMBINED WITH MASSAGE FOR CERVICAL SPONDYLOSIS OF VERTEBRAL ARTERIAL TYPE BY USING TRANCRANIAL DOPPLYER ULTRASONOGRAPHY

To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type （CSVAT） patients. Methods： In the present study, methods of evidence-based medicine, triple-centers, single-blindness, randomization and control were used. A total of 100 cases of CSVAT patients were randomized into acupuncture plus massage （acu-massage） group （n = 38）, acupuncture group （n = 32） and massage group （n = 30）. Acupoints used were Fengchi （风池, GB 20）, cervical Jiaji （颈夹脊 EX-B 2）, Baihui （百会 GV 20）, and the methods of massage used were kneading-rolling, adhesion-separating and acupoint-digital pressing, topical digital pressing and rubbing, traction-extending and mild palm-rubbing. The treatment was conducted once daily, with 7 sessions being a therapeutic course and continuously for 2 courses. Changes of peak velocity （Vp）, end-diastolic velocity （Vd）, mean velocity （Vm） of blood flow of the vertebral artery （VA） and basilar artery （BA）, etc were detected before and after the treatment by using transcranial Doppler （TCD） ultrasonography. Resuits： After the treatment, the abnormally low Vp of both VA and BA in acu-massage, acupuncture and massage groups, Vm of VA in acu-massage and acupuncture groups, Vm of BA in acu-massage and massage groups, and Vd of VA and BA in the 3 groups all increased significantly in comparison with their own pretreatment（ P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group in the 3 indexes were significantly superior to those of acupuncture group and/or massage group （P 〈0.05, 0.01 ）. The abnormally increased Vp of VA in acu-massage and acupuncture groups, Vm of VA in the 3 groups, and Vd of VA in acu-massage and massage groups decreased obviously after the treatment in comparison with their own pretreatment （P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group were significantly superior to those of acupuncture and/or massage group in the 3 indexes of VA （P〈0.05, 0.01）. In addition, the abnormally increased Vp, Vm and Vd of BA in the 3 groups showed a similar tendency. No significant differences between acupuncture and massage groups in 3 indexes （ P 〉0.05）. Conclusion： The therapeutic effects of acupuncture plus massage is significantly superior to those of simple acupuncture and simple massage therapies in improving abnormal blood dynamics of vertebral and basilar arteries in CSVAT patients.

MULTI-CENTER RANDOMIZED CONTROLLED TRIALS OF COMBINED TREATMENT OF VERTEBRAL ARTERY TYPE CERVICAL SPONDYLOSIS WITH ACUPUNCTURE AND MASSAGE

Objective.To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis （VACS）. Methods： In the present study, triple-center, single-blind, randomized and control methods were adopted. Qualified subjects were randomly assigned to three groups： acupuncture-massage （acu-mas） group, acupuncture group, and massage group （60 subjects in each group）. Bilateral Fengchi （风池 GB 20）, Jiaji （夹脊 EX-B 2, C4-7） and Baihui （百会 GV 20） ware punctured in combination with massage at the neck-shoulder and back region. The treatment was conducted once daily, 14 times altogether. Results. After treatment, of the 60 cases in each of acu-mas, acupuncture and massage groups, 28, 11 and 13 were cured, 13, 20 and 17 markedly effective, 12, 14 and 16 effective, and 7, 15 and 14 ineffective, with the total effective rates being 88.3%, 75.0% and 76.7% respectively. The therapeutic effect of acu-mas group was significantly superior to that of simple acupuncture and massage groups （P〈 0.05）. The scores of clinical symptoms and signs in 3 groups all declined significantly after treatment （ P〈 0.01 ）, and the score of symptoms of acu-mas was markedly lower than those of acupuncture and massage groups （P〈 0.05）. No significant differences were found among 3 groups in the score of clinical signs and between acupuncture and massage groups in the score of clinical symptoms （P〉0.05）. The time for producing therapeutic effects in acu-mas group was significantly shorter than those of acupuncture and massage groups （P〈0.01, 0.05）, meanng a faster of aou-mas group in producing clinical effect. No adverse events ware found in all the 3 groups. Conclusion： Acupuncture and massage are effective and safe in the treatment of VACS, and the therapeutic effect of acupuncture combined with massage is superior to that of simple acupuncture and simple massage therapy.

“按(案)”词义考

"按"的本义是动词"手往下按"。"案"通"按"。"按酒"即"下酒",就是使酒下肚,也就是喝酒。能使酒顺利下肚的一定是好的菜肴,所以"按酒"也作名词,谓下酒菜,这是"按"的本义用法。"按"由具体动作转为泛指动词,多表示执持义,构成"按歌"、"按曲"、"按辔"、"按节"等双音词,分别表示奏乐演唱和执辔驾车等。"按"的抽象义多表示依照、执行,构成"按据"、"按法"等双音词,表示依照或执法等。

Observation on therapeutic effects of electroacupuncture combined with massage at points on gonarthrosis in 80 cases

Objective To observe clinical therapeutic effects of integrative acupuncture therapy on gonarthrosis. Methods One hundred and sixty cases of gonarthrosis were randomly divided into two groups （80 cases in each group） ： an observation group treated by electroacupuncture （EA） plus massage at points and a control group treated with conventional medicine. Results In the observation group, the cured rate was 57.50%, and the effective rate was 88.75%. In the control group, the cured rate was 36.25%, and the effective rate was 73.75%. The differences between the two groups in the cured rate and the total effective rate were of significance （X^2-test, P〈0. 01, P〈0.05）. Conclusion EA combined with massage at points is definitely effective in treating gonarthrosis.

Clinical Efficacy Evaluation on Electroacupuncture for Osteoarthritis and Observation on Biomechanical Indexes

Objective： To observe the clinical efficacy of electroacupuncture for knee osteoarthritis （KOA）. Method： Forty KOA cases were randomized into an electroacupuncture and a tuina group （20 cases in each group） by their visit order. The therapeutic efficacy was evaluated by the WOMAC osteoarthritis index obtained prior to the treatment, and 2 or 4 weeks afterwards. In addition, the gait prior to the treatment and afterwards were tested by a gait analyzer. Results： The WOMAC scale revealed that after 4 weeks of treatment, cases in both groups got significant improvement （P〈0.01 in both electroacupuncture and tuina group） in pain relief, stiffness improvement and management of daily activities; cases in the electroacupuncture group showed a better result after 2 weeks of treatment, coupled with a better result than tuina group in managing daily activities and pain relief after 4-week treatment, however, there was no significant difference between the two groups in stiffness improvement. Cases in the electroacupuncture group also showed a significant improvement （P 〈0.05） in step length, stride length, step speed and walking cycles after the treatment, but no significant difference in the Q angle. Conclusion： Electroacupuncture has better effect for knee osteoarthritis than tuina, and it can also improve the gait performance of the patients.

Therapeutic Effect Observation on Combined Tuina and Chinese Medicinal Fumigation for Knee Osteoarthritis

Objective： To observe the clinical efficacy of combined tuina and Chinese medicinal fumigation for knee osteoarthritis. Methods： The 147 cases were randomly allocated into a treatment group of 76 cases and a control group of 71 cases. Combined tuina and fumigation were employed in the treatment group, versus combined oral GU Ci Ning capsule and external application of plasters in the control group. The therapeutic effect was observed after 2 courses of treatment. Results： The total effective rate of the treatment group was 98.7%, versus 84.5% in the control group, indicating a significant difference （P〈0.01）. Conclusion： Combined tuina and Chinese medicinal fumigation has exact effect for knee osteoarthritis.

Therapeutic Efficacy of Tuina in Treating 48 Cases with Knee Osteoarthritis

Objective: To observe the clinical efficacy of tuina in treating knee osteoarthritis(KOA). Methods: Forty-eight cases with KOA who met the inclusion criteria were enrolled and received tuina therapy. Visual analogue scale(VAS) was used to evaluate pain degree. VAS, range of motion(ROM) and Lysholm score were observed before and after intervention to evaluate the clinical efficacy. Results: After treatment, VAS score, ROM and Lysholm score were significantly improved, and the total effective rate was 87.5%. Conclusion: The therapeutic efficacy of tuina in treating KOA was reliable.

Effect of Chinese massage(Tui Na) on isokinetic muscle strength in patients with knee osteoarthritis

OBJECTIVE: Chinese massage(Tui Na) is one of the most popular Traditional Chinese Medicine remedies for knee osteoarthritis(OA). Several studies have subjectively evaluated the effect of Chinese massage on knee OA through self-assessment questionnaires; however, very few studies have objectively assessed the effect by measuring knee muscle strength. The purpose of this study was to assess the efficacy of Chinese massage in improving knee extensor and flexor muscle strength in patients with knee OA.METHODS: Thirty patients with knee OA received Chinese massage therapy three times per week for 2 weeks. Patients completed pre- and post-treatment Visual Analogue Scale(VAS) pain questionnaires, and pre- and post-treatment knee muscle strength was evaluated using the Biodex Multi-Joint System 3. Isokinetic muscle strength measurements were performed at 60 degrees/s and 180 degrees/s. The peak torque(PT), peak torque/body weight(PT/BW), total work(TW), average power(AP), hamstring/quadriceps(H/Q), and range of motion(ROM) values were recorded separately for flexors and extensors.RESULTS: Chinese massage therapy significantly improved knee pain as assessed by the VAS in patients with knee OA(P < 0.05). Post-treatment values were significantly greater than pre-treatment values in the extensor muscles for PT(right P =0.013, left P = 0.001), PT/BW(right P = 0.008, left P =0.001) and TW(right P = 0.036, left P = 0.004) at 60 degrees/s. The AP increased significantly after treatment in the flexor muscles in the right knee(P =0.009) and the extensor muscles in the left knee(P = 0.001). There were no significant differences in pre- and post-treatment ROM and H/Q at 60 degrees/s and 180 degrees/s.CONCLUSION: Chinese massage therapy decreased pain and may improve extensor muscle strength in patients with knee OA, but does not appear to improve ROM.

Treatment of Scapulohumeral Periarthritis by Needling Tiaokou （ST 38） plus Tuina

To treat 30 cases of scapulohumeral periarthritis by needling Tiaokou（ST 38） plus Tuina, which compared with treating 28 cases of scapulohumeral periarthritis by only needling Tiaokou（ST 38）. The total effective rate were 96.7% and 92.8%respectively.

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.

Clinical research on the short-term efficacy of massaging quadriceps for knee osteoarthritis

Objective： To observe the short-term efficacy of massaging quadriceps on knee osteoarthritis （KOA）. Methods： Totally 30 KOA patients were enrolled and treated mainly with massaging quadriceps, 20 min for each session, once a day, 2 weeks as a treatment course, and for 2 courses in total. After treatment, the changes of visual analogue scale （VAS） and Western Ontario and McMaster Universities osteoarthritis index （WOMAC） were observed. Result： The VAS and WOMAC scores dropped after treatment, with a statistically significant difference （P〈0.01）. After a course of treatment, the recovery rate was 33.3% and the total effective rate was 86.7%; after 2 courses, the recovery rate was 60.0% and the total effect rate was 96.7%. Conclusion： Massaging quadriceps can alleviate pain, improve the function of knee joint, and produce a significant short-term efficacy in treating KOA.

Therapeutic observation of warm needling moxibustion plus tuina for knee osteoarthritis due to cold-dampness blocking collaterals

Objective： To observe the clinical efficacy of warm needling moxibustion plus tuina in treating knee osteoarthritis （KOA） due to cold-dampness blocking collaterals. Methods： Forty-eight KOA patients were randomized into 2 groups by their visiting sequence, 24 cases in each group. The treatment group was intervened by warm needling moxibustion plus tuina, while the control group was treated with acupuncture plus tuina. The two groups were both treated once a day, 30 min for each session, 10 d as a treatment course, totally for 3 treatment courses. The visual analogue scale （VAS） and Lysholm knee scoring scale （LKSS） were observed before and after the treatment to evaluate the clinical efficacy. Results： After 3 treatment courses, the VAS and LKSS scores were significantly changed in the two groups （P〈0.01）, and the between-group differences were also statistically significant （P〈0.01）. The markedly-effective rate was 83.3% in the treatment group versus 66.7% in the control group, and the difference was statistically significant （P〈0.05）. Conclusion： Warm needling moxibustion plus tuina can produce a more significant efficacy than acupuncture plus tuina in treating KOA due to cold-dampness blocking collaterals.

Clinical observation on acupoint pressure therapy plus electroacupuncture for post-traumatic knee osteoarthritis

Objective： To investigate the clinical efficacy of Zhang＇s acupoint pressure therapy plus electroacupuncture（EA） in treating post-traumatic knee osteoarthritis.Methods： A total of 98 eligible patients with post-traumatic knee osteoarthritis were divided into group A and B by the random number table, 49 cases in each group. Group A was intervened by Zhang＇s acupoint pressure therapy plus EA; group B was given medicinal fumigation. The clinical efficacies of the two groups were compared. Results： The markedly effective rate of group A was significantly higher than that of group B. Conclusion： Zhang＇s acupoint pressure therapy plus EA can produce a satisfactory clinical efficacy in treating post-traumatic knee osteoarthritis, and is worth promotion.

Therapeutic efficacy observation of warm needling moxibustion plus Tuina for knee osteoarthritis

Objective To observe the clinical efficacy of warm needling moxibustion plus Tuina(Chinese therapeutic massage)for knee osteoarthritis(KOA).Methods A total of 60 patients with KOA were randomized into an observation group and a control group by the random number table,with 30 cases in each group.The control group was treated with warm needling moxibustion,and the observation group was treated with additional Tuina treatment.The treatments were performed once every other day,for a total of 10 times.The visual analog scale(VAS)and Western Ontario and McMaster Universities osteoarthritis index(WOMAC)were scored before and after treatment,and the surface electromyography(sEMG)signals of quadriceps femoris were collected.Results The total effective rate of the control group was 76.7%,and that of the observation group was 90.0%.The difference between the two groups was statistically significant(P<0.05).The WOMAC and VAS scores in both groups after treatment were improved,and the integrated electromyography(iEMG)and median frequency(MF)of quadriceps femoris were increased.The intra-group differences were statistically significant(P<0.05).After treatment,the WOMAC and VAS scores in the observation group were lower than those in the control group,and the differences between the two groups were statistically significant(P<0.05).The improvement of quadriceps femoris function in the observation group was more notable than that in the control group,and the iEMG value and MF were significantly higher than those in the control group(P<0.05).Conclusion Warming needling moxibustion plus Tuina can effectively relieve the pain in patients with KOA,improve their daily activity function,and increase the sEMG signals of the quadriceps femoris.

Clinical Observation on Treatment of Degenerative Knee Osteoarthritis with Warming Needle plus Tuina

Objective： To study the therapeutic effect of wanning needle plus tuina for degenerative knee osteoarthritis. Method： Randomize 120 cases into a treatment group and a control group, 60 cases in each group by the visiting sequence, and then apply warming needle plus tuina for the cases in the treatment group and articular cavity injection of Sodium Hyaluronate for the cases in the control group. Results： The total effective rates in the treatment group and control group were 93.3% and 83.3% respectively, showing a significant difference （P〈0.05）. Conclusion： Wanning needle plus tuina works well on degenerative knee osteoarthritis.

Clinical Observation on Tuina Therapy for Cervicogenic Headache

Objective： To observe the clinical effects of tuina therapy for cervicogenic headache. Methods： Fifty-four cases were randomized allocated into tuina group and medicine group, 27 cases in each group. The patients in the tuina group treated with tuina therapy, and the patients in the medicine group take ibuprofen orally. The headache degree （Visual Analogue Scale, VAS）, frequency of headache occurrence and the neck disability index （NDI） were compared 2 weeks pre-treatment and 2 weeks post-treatment. Results： Before treatment, there were no significant differences in the headache VAS, frequency and NDI between the two groups. After treatment, headache VAS, frequency and NDI were significantly decreased, and there were statistical differences between the tuina group and the medicine group （P 〈 0.01）. Conclusion： Tuina therapy is more effective for treating cervicogenic headache than routine dose of ibuprofen.

Clinical Observation on Treatment of Knee Osteoarthritis by Acupuncture and Tuina Therapy

Objective： To observe the effect of acupuncture and Chinese tuina manipulation therapy in treating knee osteoarthritis, and analyze the alteration of musculus quadriceps femoris strength. Methods： A total of 80 patients were randomly assigned to a treatment group receiving acupuncture combined Chinese tuina manipulation therapy （n=40） and a control group receiving Fenbid treatment （n=40）, curative effective score, Lequene ＆ Mery assessment tests, and isokinetic evaluation were recorded before and after the treatment course. Results： The total effective rate was 90.0 % in the treatment group and 87.5% in the control group, without a significant difference between the two groups. Lequene ＆ Mery assessment tests had no significant change. Musculus quadriceps femoris isokinetic evaluation improved significantly after the treatment course in the two groups （/9〈0.05）, and there was a significant difference between the two groups （P〈0.05）. Conclusion： Acupuncture combined with tuina manipulation therapy and Fenbid treatment both can reduce knee pain and joint disability in the short term, though no improvement was shown in the severity of the disease. Acupuncture combined with tuina manipulation therapy is better than Fenbid in improving the strength, total work and explosive force of the musculus quadriceps femoris.