针刺结合功能性电刺激治疗脑卒中后膝过伸临床疗效观察

目的观察脑卒中后膝过伸患者采取针刺结合功能性电刺激治疗的临床效果。方法将三亚市中医院及黑龙江中医药大学附属第二医院收治的99例脑卒中后膝过伸患者(2022年1月—2023年8月收治)纳入研究,采取随机数字表法将患者分为常规组(49例)与研究组(50例),常规组患者采取常规康复治疗,研究组患者在常规组患者治疗基础上结合针刺及功能性电刺激治疗,各组数据观察:膝过伸治疗效果、膝关节活动度(Range of motion, ROM)疗效、治疗前后膝过伸次数变化与10 m步行测试时间变化、功能性步行量表(functional ambulation category scale, FAC)评分变化、简式运动功能评分量表(Fugl-Meyer assessment, FMA)评分变化以及Berg量表(Berg balance scale, BBS)评分变化、步态空间参数(步频、步速、步幅)变化、测定伸肌及屈肌峰力矩评估治疗前后患者肌力水平变化、治疗前后C反应蛋白(C-reactive protein, CRP)、白介素-6(interleukin 6,IL-6)以及肿瘤坏死因子α(Tumor necrosis factorα,TNF-α)指标变化。结果研究组患者膝过伸治疗效果、膝关节ROM疗效均高于常规组(P<0.05);治疗后各组患者膝过伸次数均减少,10 m步行测试时间缩短,FAC评分、FMA评分、BBS评分、步态空间参数(步频、步速、步幅)、伸肌及屈肌峰力矩均改善,CRP、IL-6、TNF-α水平均下降,而研究组患者治疗后膝过伸次数少于常规组,10 m步行测试时间短于对照组,FAC、FMA评分、BBS评分、步态空间参数(步频、步速、步幅)、伸肌及屈肌峰力矩等指标优于常规组,CRP、IL-6、TNF-α水平低于常规组(P<0.05)。结论针刺结合功能性电刺激治疗脑卒中后膝过伸临床效果显著,患者症状改善,膝关节功能改善,值得应用。

减重步态训练联合膝关节控制对脑卒中后膝过伸患者的疗效

探讨减重步态训练联合膝关节控制对脑卒中后膝过伸患者的疗效。方法 选取康复医学科接诊治疗的脑卒中膝过伸患者30例,采用随机数表法分成对照组15例,实验组15例。对照组接受常规康复训练,实验组在接受常规训练的同时,增加减重步态训练及膝关节控制训练。治疗4周后,观察2组脑卒中膝过伸患者的各项相关指标。同时选取15例年龄、性别相匹配的健康受试者作为正常对照组,采集站立状态下足底压力数据。结果 三组患者各项指标存在统计学差异。结论 对于脑卒中后膝过伸患者,采用减重步态训练联合膝关节控制训练可减少膝过伸次数,有效提高患者步行平衡能力及下肢运动功能,改善足底压力参数,预防跌倒发生。

针灸结合倒走训练治疗脑卒中膝过伸患者的临床疗效观察

目的:观察和评价针灸结合倒走训练治疗对脑卒中膝过伸患者的临床疗效。方法:共纳入2020年1月~2021年8月就诊于本院脑卒中膝过伸患者120例,采用随机数字表法分为针灸治疗组、倒走训练组、针灸结合倒走训练组三组各40例。针灸治疗组采用单纯针灸治疗,穴位选取患侧内膝眼、外膝眼、血海、粱丘、阳陵泉、委中、足三里、悬钟;倒走训练组采用倒走训练法治疗;针灸结合倒走训练组采用针灸结合倒走训练法进行治疗。依据治疗前后的膝伸展角度观察临床有效率,于治疗前、治疗后测量膝关节伸展位活动度(ROM),以此评价临床疗效,并采用Holden功能性行走分类评分量表比较治疗前后及各组治疗方法对膝过伸患者行走功能的改善。结果:针灸治疗组、倒走训练组总有效率差异无统计学意义(P>0.05),针灸结合倒走训练组高于针灸治疗组(P<0.05)、倒走训练组(P<0.05)。治疗后,三组患者的膝关节ROM均较治疗前降低(P<0.05),且针灸结合倒走训练组治疗后的膝关节ROM显著低于针灸治疗组(P<0.05)、倒走训练组(P<0.05),但针灸治疗组、倒走训练组膝关节ROM差异无统计学意义(P>0.05)。治疗后,三组患者的Holden步行功能分级均较治疗前改善(P<0.05),且针灸结合倒走训练组治疗后的Holden步行功能分级显著优于针灸治疗组(P<0.05)、倒走训练组(P<0.05),但针灸治疗组、倒走训练组Holden步行功能分级差异无统计学意义(P>0.05)。结论:针灸结合倒走训练能够有效治疗脑卒中后膝过伸并能够改善脑卒中后膝过伸的膝关节ROM。

四肢联动康复踏车配合康复训练治疗脑卒中膝过伸疗效观察

目的：分析四肢联动康复踏车配合康复训练对脑卒中膝过伸患者的临床疗效。方法：收集我院在2年内收治的脑卒中膝过伸患者，数量40例，将其使用随机方法分为对照组和观察组，均为20例。对照组使用常规康复训练治疗，观察组在康复训练基础上配合四肢联动康复踏车治疗，比较2组临床疗效。结果：2组患者均取得一定效果，但观察组Fugl-Meyer肢体功能运动评分和Barthel指数均明显高于对照组，所有差异均显著（P〈0．05）。结论：在对脑卒中膝过伸患者实施临床治疗时，通过四肢联动康复踏车配合康复训练能取得明显更佳的治疗效果，有较高临床使用价值。

下肢康复踏车结合康复训练对脑卒中膝过伸患者的临床疗效观察

观察脑卒中膝过伸患者应用下肢康复踏车结合康复训练临床疗效。方法:对照组行康复训练,观察组联合下肢康复踏车。结果:观察组BBS评分(35.68±4.85)分,Fugl-Meyer评分为(21.05±3.05)分高于对照组,观察组Barthel指数为(64.59±3.74)分,SF-36评分(91.25±6.85)分高于对照组,观察组步态周期(1.60±0.20)s,左右摆动相偏差(5.01±2.71)%低于对照组,观察组步长偏差(7.26±3.15)cm,患侧髋关节屈伸度(29.84±7.15)°,患侧膝关节屈伸度(25.94±9.48)°高于对照组,观察组治疗满意度为97.37%高于对照组(P<0.05)。结论:针对脑卒中膝过伸患者,在接受康复治疗的基础上,配合下肢康复踏车,能够有效促进患者下肢功能恢复,可提升患者平衡能力,有利于帮助患者恢复日常生活水平,提高生活质量,改善步行质量,优化满意度。

中药熏洗结合推拿治疗轻中度膝骨关节炎的疗效观察

目的:探讨中药熏洗结合推拿治疗轻中度膝骨关节炎的临床疗效。方法:将90例轻中度膝骨关节炎患者随机分为治疗组、对照组Ⅰ及对照组Ⅱ,每组30例,治疗组予中药熏洗结合推拿治疗,对照组Ⅰ予中药熏洗治疗,对照组Ⅱ予推拿治疗,3组均以10 d为1个疗程,连续治疗2个疗程后评定疗效。结果:总有效率治疗组为90.0%,对照组Ⅰ为66.7%,对照组Ⅱ为63.3%,治疗组优于对照组Ⅰ及对照组Ⅱ,差异有统计学意义(P<0.05)。结论:中药熏洗和推拿治疗膝关节炎均有良好的疗效,且两者结合更有更明显的作用。

中国人腘动脉关节支类型的观察

本文为了提供与积累中国人的体质资料,观察了腘动脉分支类型数目和粗细的比较。本文材料之来源系供学员局解实习用之成人下肢共100侧,其中整尸41具82侧,单个下肢18侧。其中男性94侧,女性6侧。其侧别,左侧为52侧,右侧为48侧,由作者仔细解剖,并绘制简图作出记录。一、膝中动脉的分支类型:我们在100侧下肢中观察到膝中动脉并不限于一支,这是与一般记载不同之处。本文按其数目及发出部位,分为四型,现将其分支型分述如下。

天全川牛膝生产现状调查

川牛膝Cvathula officinalis Kuan.为四川著名道地栽培药材之一,具有逐瘀通经、通利关节、利尿通淋等功能,现代药理表明川牛膝所含的川牛膝多糖还具有抗肿瘤的作用.四川雅安市天全县是牛膝的主产区,故称天全川牛膝.天全牛膝栽培历史悠久,早在清朝咸丰八年<天全州志>中就有记载.天全牛膝以其品质好、质量优而驰名中外.为此,笔者专门对该产区进行了生产现状调查.

人类膝关节的研究

本文的研究对象是出生不满一个月的婴儿到80岁的老年人。对以每10岁作为一年龄组的15个下肢进行了研究。论文首先对成年人的膝最上动脉、膝上内侧外侧动脉、膝下内外侧动脉、胫前后返动脉,出生不满一个月的婴儿的一般血管、骺血液供应、骺板屏障、髌骨和青少年的血管基本结构进行了研究。其次对膝关节一些特殊部分的血管进行了研究,包括骨骼、滑膜。

前交叉韧带的应用解剖

在100侧成人尸体的膝部,对前交叉韧带进行了解剖学研究.多束性前交叉韧带分为前内束和后外束,其神经血管束沿束间的疏松结缔组织分布于其中,其主要血供来自膝中动脉支,在韧带周围形成血管滑膜鞘.保护和利用此鞘,以利受损韧带在修复时愈合。

足部自我保健按摩

我国足部自我保健按摩有悠久的历史,在各种延年益寿功法中均少不了足部的自我按摩和活动。在华佗“按摩神术十八法”中就有:大坐伸两脚,即以一脚向前虚掣,左右同”,“大坐伸两脚用当相手勾所伸脚着膝中以手按之”的补益延年之法。 我国民间有赤足踏豆子、石卵、沙子等锻炼方法,也有在睡前用冷水,后用热水交替泡足10～15分钟(泡水时双足互相摩擦)有良好的健身作用。以下对足部的自我保健按摩法作概括的介绍。

先天性梨状窝瘘一例报告

男,6岁,反复左颈前肿瘤两年,伴畏寒、发热。曾多次在当地医院以颈部脓肿切开引流及抗炎治疗,症状尚能缓解。体检:T37.4℃,左颈前、甲状软骨下可触及一质地较硬结节,约2cm×2cm×1cm,边界较清,可活动,轻压痛,不随吞咽上下活动。食管钡餐检查:钡剂通过顺畅,梨状窝对称,收缩功能良好。于左侧梨状窝底部可见一长约1.5cm的线状盲管向前下方走行,多次吞咽动作后充盈之盲管内造影剂未见排空。

利用Word 2013快速创建新公式

很多时候,我们需要重复使用某些特殊的公式,而这些公式在Word内置的公式列表并未提供,此时可以直接创建新公式,这里以Word 2013为例进行说明： 打开相关文档,如果使用的是Word 2013,那么必须是＊.docx格式,或者新建一个空白文档,切换到＂插入＂选项卡,直接单击＂符号＂功能组的＂公式＂按钮,注意不要点击下面的倒三角箭头,按照自己的实际需要手工输入公式。完成输入之后,点击公式右下角的倒三角箭头,此时会弹出图1所示的快捷菜单,选择＂另存为新公式＂,此时会弹出图2所示对话框,在这里可以更改公式的名称、类别说明,确认之后即可保存。以后,我们在需要使用上述公式时,就不需要重新手工输入,如图3所示,直接从公式下拉列表即可插入,是不是很方便？需要删除公式时,右击公式,选择＂整理和删除＂,在弹出的对话框确认之后即可删除。

四肢联动康复训练系统配合康复训练对脑卒中康复期膝过伸疗效的影响

目的:评价四肢联动康复配合康复训练对脑卒中膝过伸患者的临床影响,为脑卒中患者临床干预工作提供参考。方法:选择本院2017年6月~2018年8月收治处在康复阶段的脑卒中患者,总计82例。进行82例脑卒中患者康复方法随机分组,各41例。对照组41例脑卒中患者接受康复训练,观察组41例脑卒中患者接受康复训练配合四肢联动康复。对比对照组以及观察组脑卒中患者膝过伸纠正有效率以及干预期间患者肢体运动功能评分以及下肢运动功能评分改善情况。结果:观察组脑卒中患者膝过伸纠正有效率以及干预后指标评分明显高于对照组,P<0.05有统计学意义。结论:四肢联动康复加行康复训练可以促进脑卒中患者膝过伸纠正,从而提高患者肢体运动功能、下肢运动功能。

Comparative study of various internal fixation methods for treating patellar fractures by three-dimensional photoelasticity

Objective: To compare the biomechanical basis of 3 different internal fixation methods: nitinol patellar concentrator (NT-PC), tension band and wire circle in treating patellar fractures. Methods: The epoxy resin three dimensional photoelasticity patellar models were made by precise moulding, and were fixated by nitinol patellar concentrator (NT-PC), tension band and wire circle respectively. The patellar models with frozen stress stripes were put into the polarized light field and the stress distributions were compared. As for the model fixated by NT-PC, by dividing layer, photographing and tracing, we used the iterative method to calculate the stress value of every internal node of the epoxy resin patellar model, and the character of stress was analyzed. Results: An overall stress field was yielded when the patellar model was fixated by NT-PC, and the stripes were more than that of tension band model and wire circle model, which have only few stress stripes in the fixated layers. Further analysis indicated that there were continuous fixated stresses in the facies articularis and distal pole of patella, and the character of stresses produced by NT-PC were mainly in longitudinal direction, then in transverse direction. The shearing stresses were small. Conclusion: The initiative and continuous memorial stress of NT-PC and its overall stress distribution character are the essence of NT-PC distinguished with tension band and wire circle in treating patellar fractures. The stress character produced by NT-PC is good for the stability of fracture site and prompts fracture healing.

Influencing factors analysis of spontaneous knee joint osteoarthritis among middle aged and old aged pople in Xi'an

Objective:To explore the prevalence rate of knee joint osteoarthritis and its pathogenetic fea- tures among the middle-aged and old aged people in the urban and rural area of Xi'an.Methods:From May to October 2005,1538 Han nationality above 40 years in Xi'an were investigated according to strati- fied and cluster random sampling.The same questionnaire was delivered to subjects who had been given normotopia and lateral position radiographic examination in both knees.Excluded from etiological arthri- tis,some subjects with clinical symptoms and a radiographic grade (beyond Kellgren & Lawrence gradeⅡ) were finally diagnosed as spontaneous knee joint osteoarthritis.All analyses were performed with SPSS 13.0 and t test,U test.Single factor analysis and multiple logistic regression analysis were used to analyze dates.Results:The total prevalence of spontaneous knee joint osteoarthritis was 12.1% with 2.5% and 2.1% for right and left knees,respectively.The prevalence of knee joint osteoarthritis in wom- en was 2.5 times of that in men (17.2% vs 6.8%,P=0.000).the osteophyte prevalence in women was 2.3 times of that in men (26.5% vs 11.4%,P=0.000).The prevalence of knee joint osteoarthritis and osteophyte increased with the growth of age.So did the symptomatic knee,except for the age group of 56- 60 years and 66-70 years.The prevalence of symptomatic knee joint for urban area was significantly higher than that for rural area (56.3% vs 45.3%,P=0.003).In women,the prevalence of knee joint os- teoarthritis increased significantly with the increasing of body mass index,which had not been observed in men.Female and obesity are the risk factors for osteoarthritis,but bean and its products and meat could prevent the osteoarthritis.Conclusion:Old age,female and obesity serve as risk factors for knee joint os- teoarthritis.

Systematic evaluation and Meta-analysis of acupuncture and collaterals cupping therapy for Knee Osteoarthritis

Objective:In order to obtain the best treatment program for Knee Osteoarthritis(KOA),to alleviate the pain of patients with KOA,and to systematically evaluate the efficacy of acupuncture cupping therapy for KOA.Methods:we used computer to search the databases of CNKI(1989-2018.10),Wanfang(1989-2018.10),VIP(1989-2018.10),PubMed(1966-2018.10),EMbase(1986-2018.10)and Cochrane Library(the 3rd issue of 2018).And the literature quality was evaluated by Jadad scale.Results:A total of 19 eligible RCT studies were included,and a total of 2,088 patients participated in the eligible clinical study.Meta-analysis results showed that the total effective rate OR combination=2.85[OR=3.98,95%CI(2.98,5.32),P<0.00001].The results showed that the curative effect of acupuncture and collaterals cupping in the treatment of KOA was superior to other therapies.Conclusion:Acupuncture and cupping therapy of traditional Chinese medicine is effective and safe in treating KOA.Due to the impact of the original study on Meta-analysis results,more large samples and high-quality clinical trials are still needed to verify.

Treatment of Genual Osteoarthritis by Massotherapy

Genual osteoarthritis is a commonly-encountered affection in the middle-aged and oldpersons.The author has treated 65 cases of genualosteoarthritis with massotherapy in the past threeyears,with satisfactory therapeutic results reported asfollows.

CLINICAL OBSERVATION ON THE TREATMENT OF KNEE OSTEOARTHRITIS BY ACUPUNCTURE IN BA-HE TECHNIQUE

Objective: To observe the clinical therapeutic effect of Ba-He techniqu e of acupuncture in the treatment of knee osteoarthritis. Methods: A total of 90 cases of knee osteoarthritis were evenly randomized into Ba-He technique group (observation group) and common technique group (control group), with 45 cases in each group. Zusanli (足三里 ST 36), Heding (鹤顶 EX-LE 2) and Dubi (犊鼻 ST 35 ) were punctured respectively in Ba-He technique and common technique in the two gr oups. The therapeutic effects of the two groups were compared after one course o f treatment (10 sessions) in accordance with Japanese assessment criteria for kn ee-joint functions. Results: After treatment, among the 74 and 7 1 affected knees in the observation and control groups, the therapeutic effect was excellent in 42 (56.8%) and 26 (36.6%) knees, fine in 14 (18.9%) and 20 (28.2%), OK in 10 (13 .5%) and 11 (15.5%), and poor in 8 (10.8%) and 14 (19.7%) respectively. The ther apeutic effect of the observation group was significantly better than that of co ntrol group (P<0.01). Conclusion: The Ba- He technique of acupuncture applied to the above-mentioned three acupoints exerted remarkable therapeutic effect for k n ee osteoarthritis, which is obviously better than that of the common needling te chnique.

Clinical Effect of Acupuncture Treatment in 109 Cases of Knee Osteoarthritis

Knee Osteoarthritis, a retrograde disease, is mainly characterized by pain in the knee joints and limitation of the movement. It is a common and frequently occurring disease affecting the health and life quality of old people. In recent years, acupuncture treatment of knee osteoarthritis with satisfactory therapeutic results has been repeatedly reported,2-3, 5-6 but there has been few report on the observation of long-term therapeutic effects after treatment. With acupuncture as the main therapy, 109 cases of knee osteoarthritis were treated in this series. 91 cases with good therapeutic results were followed up for 6 months. A report is presented in the following.