藏医涂擦疗法对血瘫(脑溢血)病康复期的临床观察

探究藏医涂擦疗法对血瘫(脑溢血)病康复期的临床疗效。方法 所有病例患者均纳入自2021年初至2023年中后,共计选取20例病患进入数据局统计将,纳入患者将以不同的治疗方针进行组别划分,并各以10例执行数据对比,区分对照及观察两组,分别提供基本药物治疗和藏医擦涂治疗,对比两组患者治疗后的临床疗效、神经功能缺失评分、上下肢运动功能评分、生活自理能力评分、满意度评分以及不良反应发生率。结果 在接受相应治疗内容下可见,通过选用藏医擦涂治疗的患者,治疗后的效果明显更高,在改善患者神经功能方面,藏医学擦涂治疗也更能体现相对于常规药物治疗更高的治疗效果,治疗后患者的运动功能以及生活水平方面均可取得显著的提升。患者可对治疗后的整体疗效保持较高的满意程度,且藏医擦涂治疗的患者在接受治疗后所产生的不良反应更少。结论 通过在血瘫患者的病症治疗中以藏医涂擦疗法对患者进行治疗,对比常规的降压药物治疗更具使用优势,患者于接受该疗法下的临床疗效更高,在恢复患者受损神经方面具有显著的使用效果,患者可于持续接受治疗下改善自身运动功能以及生活水平,对治疗整体满意度较高,且用药后具有较高的安全性,使用和推广价值良好。

血瘫病(脑出血)藏西医结合治疗疗效评价

目的:评价血瘫病(脑出血)诊疗方案的临床疗效和安全性,为进一步优化诊疗方案奠定基础。方法:42例患者进行藏成药一个疗程的治疗(28天),对治疗前后的疗效进行比较,观察患者的症候、体征、肝功、肾功、心电图,头颅CT等指标。结果:治疗后,患者的症候、体征、头颅CT指标具有明显的改善,具有统计学意义(P<0.01)。治疗前后肝功、肾功未见明显异常,无显著性差异。结论:血瘫病的藏成药诊疗方案临床疗效确切,值得推广应用。

藏医涂擦疗法对血瘫(脑溢血)病康复期的临床观察

脑溢血是由长期过多饮食热性富有营养的食品,如肉、血、油脂等,起居行止受水晶、阳光等强光线的照射等因素使血压升高,脑动脉硬化、颅内血管畸形等,常因用力、突然站立或突然剧烈出力,情绪激动等异常行为使身体的血、隆失去平衡而发病。藏医名＂萨＂病。1分型按照藏医《四部医典》中记载的＂隆、赤巴、培根＂病（各类病均属藏医隆、赤巴、培根功能紊乱所致）的具体临床症状与典型病例相结合,进行诊断、分类。

临床路径管理下的低血钾型周期性瘫痪40例诊治分析

目的探讨低血钾型周期性瘫痪的临床特点并对其临床路径的实施情况进行分析。方法对神经内科病房收治的40例低钾周瘫患者的临床特点、临床路径实施情况、诊治经过和费用等进行分析。结果本组40例患者中继发于甲状腺功能亢进症者18例,22例(57.5%)发作有明确的诱因,均行电解质和心电图检查,其中血钾<2.0mmol/L者17例(42.5%),2.0～3.0mmol/L者19例(47.5%),>3.0mmol/L者仅4例(10.0%);ECG检查异常者17例(42.5%)。本组患者中进入临床路径管理者共36例(90.0%),40例患者均在心电监护下予补钾治疗后治愈,平均住院日为(3.3±1.9)d,平均住院费用为(1503.3±811.7)元。结论低血钾型周期性瘫痪临床路径的开展实施,既能保证系统全面的病因学搜索,又能安全、有效、及时地救治患者,值得临床推广。

针灸配合通心络胶囊联合西药治疗气虚血瘀络阻型面瘫多中心随机平行对照研究

[目的]观察针灸配合通心络胶囊联合西药治疗气虚血瘀络阻型面瘫疗效。[方法]使用随机平行对照方法,将60例住院及门诊患者按就诊顺序编号方法随机分为两组,均西药对症治疗。对照组30例针刺治疗(患侧阳白、鱼腰、丝竹空、太阳、颧骼、下关、地仓、颊车、四白、迎香、完骨、豁风等穴,配风池、合谷、关元、气海)手法用补,得气后留针30min,每10min行针1次。1周内前5d,1次/d,休息2d,连续治疗4周。治疗组30例通心络胶囊口服,4粒/次,3次/d,连续服用4周;针灸治疗同对照组。观测临床症状、Portmann简易评分。均4周为1疗程,连续治疗1疗程,随访180d,判定疗效。[结果]治疗组痊愈16例,显效9例,有效3例,无效2例,总有效率93.33%。对照组痊愈10例,显效7例,有效6例,无效7例,总有效率76.67%。痊愈显效率治疗组优于对照组(P<0.05);平均痊愈时间治疗组优于对照组(P<0.05);周围性面瘫症状总积分改善治疗组优于对照组(P<0.05)。[结论]针灸配合通心络胶囊联合西药治疗气虚血瘀络阻型面瘫疗效满意,提高痊愈、显效比例,缩短治疗时间。

引气归元针法配合经筋刺法治疗气虚血瘀型面瘫病的临床应用体会

明确引气归元针法配合经筋刺法治疗气虚血瘀型面瘫病的应用优势。 方法:随机将 60 例气虚血瘀型面瘫病的患者分为对照组(30 例,应用传统针刺)、观察组(30 例,应用引气归元针法配合经筋刺法),最后进行对比分析。 结果:观察组患者治疗优良率更高,相比呈 P<0.05。 结论:对于气虚血瘀型面瘫病的患者应用引气归元针法配合经筋刺法,效果确切。

偏瘫通络汤联合针刺治疗缺血性中风偏瘫(气虚血瘀)随机平行对照研究

[目的]观察偏瘫通络汤联合针刺治疗缺血性中风偏瘫(气虚血瘀)疗效。[方法]使用随机平行对照方法,将120例住院患者按病志号抽签随机分两组。对照组30例抗血小板聚集,调脂、稳定斑块,营养神经,调控血压等对症处理。治疗组30例针刺(风池、灵骨),30min/次,1次/d;偏瘫通络汤(黄芪、当归、桃仁、红花、赤芍、地龙炒、川芎、水蛭烫、土鳖虫、白花蛇、乌梢蛇),1剂/d,水煎400m L,分两次服,200m L/次。连续治疗28d为1疗程。观测临床症状、日常生活功能评分、运动功能评分、神经功能缺损评分、全血高切黏度、全血低切黏度、血浆黏度、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床治愈13例,显效27例,有效18例,无效2例,总有效率96.70%;对照组临床治愈8例,显效20例,有效12例,无效20例,总有效率66.70%;治疗组疗效优于对照组(P<0.05)。日常生活功能评分、运动功能评分、神经功能缺损评分两组均有明显改善(P<0.05),治疗组改善优于对照组(P<0.05);全血高切黏度、全血低切黏度、血浆黏度两组均有明显降低(P<0.05),治疗组降低优于对照组(P<0.05)。[结论]偏瘫通络汤联合针刺治疗缺血性中风偏瘫(气虚血瘀),疗效满意,无严重不良反应,值得推广。

玫果口服液治疗高脂血症临床研究

目的:观察玫果口服液治疗高脂 血症(气滞血瘀证)的临床疗效。方法:将 患者70例随机分为两组,治疗组予玫果口 服液,对照组予山玫胶囊。结果:治疗高 脂血症综合疗效,治疗组优于对照组。结 论:玫果口服液治疗高脂血症有效。

临床护理路径在低血钾型周期性瘫痪患者护理中的应用

目的了解临床护理路径在低血钾型周期性瘫痪患者护理中的应用情况.方法：2010年4月1日至2012年5月30日间我科共收治40例低血钾型周期性瘫痪患者,其中有36例进入临床护理路径.结果：进入临床护理路径能显著降低住院总费用,缩短平均住院日（P〈0.05）,同时获得更高的健康教育知晓率,提高患者满意度.结论：临床护理路径在低血钾型周期性瘫痪患者中的实施取得了-定的成效,值得推广.

人工流产术后的保养和证治

随着社会的进步、改革开放的进一步发展,现在有很多的青年夫妇由于工作、学习、进修、出国、生活条件等原因,不想过早要孩子。由于避孕失败而怀了孕,或者由于种种原因而致未婚先孕等等,目前最普遍的补救方法是实施人工流产。

Effect of Electroacupuncture on Platelet-derived Growth Factor and the Ultrastructure of Mitochondria in Rats with Diabetic Gastroparesis

Objective To observe the effect of electroacupuncture(EA)at the pressure points Zu San Li(ST36),San Yin Jiao(SP6)and Liang Men(ST21)on platelet-derived growth factor(PDGF)and the ultrastructure of mitochondria in rats with diabetic gastroparesis(DGP).Methods Sixty Sprague Dawley(SD)rats were randomly separated into a normal control group(NC,n=10)and a modeling group(n=50).Rats in the modeling group received an injection of 2%streptozotocin(STZ)and a high-fat and highglucose diet for eight weeks to establish a DGP rat model.At the same time,blood glucose and a general symptom score were recorded every week.After modeling,30 successfully modeled rats were randomly separated into the following groups:the DGP group(n=10),the EA group(n=10)and the metoclopramide(MP)group(n=10).After three weeks of intervention,the gastrointestinal propulsive rate was measured by measuring the optical density(OD).The concentration of Ca2+was determined by fluorescence immunoassay,and levels of serum insulin(INS)and PDGF were determined by ELISA.The ultrastructure of mitochondria was observed with transmission electron microscopy.Results(1)After intervention,levels of blood glucose and the general symptom score were greatly decreased in the EA group compared to the DGP group(P<0.01).Compared with the DGP group,the gastric emptying rate and the intestinal propulsive rate of the EA group was significantly improved(P<0.01),and there was no statistically significant difference between the EA and the NC groups.(2)Compared with the NC group,the levels of INS in the DGP group markedly decreased(P<0.05),but there was no significant difference of INS levels between the EA and the MP roups.(3)Compared with the DGP group,theconcentration of Ca2+in the EA and the MP groups significantly increased(P<0.01,P<0.05,respectively).(4)Compared with the NC group,the average OD of PDGF in the DGP group was significantly higher(P<0.01).Compared with the DGP group,levels of PDGF in the EA group increased significantly(P<0.01).(5)There were abundant mitochondria with a clear structure and complete cristae in the NC group.However,in the DGP group,mitochondria were severely swollen,partly vacuolated,and cristae were either fractured,absent,or shortened.In the EA group,mitochondria were slightly swollen,with clear cristae.Conclusions Electroacupuncture at the points Zu San Li(ST36),San Yin Jiao(SP6)and Liang Men(ST21)may improve gastric motility in DGP by up-regulating the amount of PDGF and improving the ultrastructure of mitochondria.

Acupuncture Treatment of Facial Paralysis Caused by Craniocerebral Trauma in 50 Cases

Cooperating with doctors in the Department of Brain Surgery, the author have treated 50 cases of facial paralysis caused by craniocerebral trauma in recent 3 years. The results are reported as follows.

CLINICAL OBSERVATION ON SCALP ACUPUNCTURE TREATMENT OF WINDSTROKE-CAUSED DYSPHAGIA-DYSPHONIA SYNDRONE

Objective: To observe the therapeutic effect of scalp acupuncture on cerebral blood flow in pseudobulbar paralysis patients for analyzing mechanisms of scalp acupuncture in the treatment of wind stroke. Methods: A total of 38 inpatients (26 males and 12 females) were treated with electroacupuncture (EA) of scalp point Dingzhongxian (MS 5), Dingnie Houxiexian (MS 7), Dingpangxian II (MS 9) and Dingnie Qianxiexian (MS 6). Before and after acupuncture treatment, clinical symptoms of dysphagia and dysphonia were compared, and the mean blood flow speed (MBFS) values of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) detected by using Doppler blood flow meter. Results: Following two courses (4 weeks) of scalp acupuncture treatment, of the 38 cases, 23 had their dysphagia and dysphonia cured (60.5%), 10 (25.3%) had remarkable improvement, 3(7.9%) experienced improvement and 2 (5.3%) had no apparent changes. Simultaneously, MBFS of ACA, MCA and PCA increased significantly in comparison with that of pre treatment (P<0.01). Additionally, results also showed that scalp acupuncture could stabilize the blood circulation between both hemispheres of the brain. Conclusion: Scalp acupuncture has a fairly good therapeutic effect in improving stroke caused dysphagia and dysphonia and in facilitating cerebral blood flow.

INFLUENCE OF DIFFERENT NEEDLE-RETAINING DURATION ON CEREBRAL HEMODYNAMICS OF CEREBRAL PARALYSIS CHILDREN

Objective: To investigate the effects of different needle-retaining duration on cerebral hemodynamics in cerebral paralysis (CP) children. Methods: A total of 20 cases of CP children were subjected into this study. Changes of systolic peak value (Vs), blood flow velocity at the end-diastolic phase (Ved), mean velocity (Vm), pulsation index (PI) and resistance index (RI) of the cerebral hemodynamics before and after performing JIN’s Three-Needling Therapy with the needles retained for 30 min (group A) and 5 min (group B) were observed by using transcranial Doppler ultrasonography (TCD). Results: After acupuncture, the blood flow in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was accelerated, and the resistance of blood vessels decreased. The effect of needle-retaining-30 min was better than that of needle-retaining-5 min. Conclusion: In treating cerebral paralysis by using JIN’s Three-Needling Therapy, sufficient stimulation provided by needle remaining is an important factor for achieving satisfactory therapeutic effects.

Observation on the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke

Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divided into an acupuncture rehabilitation group （33 cases） and a routine treatment group （27 cases）. Both two groups received rehabilitation exercise, acupuncture rehabilitation group was treated with scalp acupuncture and body acupuncture, and in body acupuncture, Pishu（脾俞 BL 20）, Weishu （胃俞 BE 21）, Zusanli （足三里 ST 36）, Fenglong （丰隆 ST 40）, Xuehai （血海 SP 10）, and accompanying points according to the symptoms were selected; in scalp acupuncture, Baihui （百会 GV 20）, Sishencong （四神聪EX-HN 1）, motor area, vascular dilation and constriction area were selected. Routine treatment group was treated with western drugs, including dehydration with mannitol to reduce intracranial pressure, control blood pressure, and brain cell protective agent was given, triamcinolone acetate solution for shoulder pain or cortisone acetate solution for blocking treatment. The treatment was given once a day, four weeks were one course, and four courses were given in all. The hemorheological indices and the clinical effect of two groups were compared. Results The effective rate of acupuncture rehabilitation group was 90.9% （30/33）, better than that of 70.4% （19/27） in routine treatment group （P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment became lowered than those before the treatment in acupuncture rehabilitation group （all P〈0.05）; whole blood viscosity and plasma viscosity after the treatment was also lowered than those before the treatment in routine treatment group （both P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment in acupuncture rehabilitation group were obviously lowered than those of routine treatment group （all P〈0.05）. Conclusion With good therapeutic effect and better efficacy than routine medical treatment, scalp acupuncture and body acupuncture in combination with rehabilitation exercise can improve the movement, sensation and hemorheology of extremities of patients with hemiplegia and shoulder pain after stroke.

Observation on Therapeutic Effect of Acupucnture plus Rehabilitation for Hemiplegia Following Stroke

Objective： To observe the therapeutic effect of acupuncture plus rehabilitation on hemiplegia following stroke. Methods： Ninety-six patients with hemiplegia due to stroke were randomly allocated into two groups. The treatment group （50 cases） was treated with acupuncture plus rehabilitation, and the control group （46 cases） was treated with rehabilitation. Results： The total effective rate was 92.0% in the treatment group and 76.1% in the control group. There was a statistical difference in the effects between the two groups （P〈0.05）. Conclusion： Acupuncture plus rehabilitation is a perfect method for hemiplegia following stroke. It is especially effective in improving the function of limbs, relieving the spasm and improving the activity of daily life.

Effects of acupuncture combined with Brunnstrom staging on upper-limb motor function,cerebral arterial blood flow velocity,and brain function remodeling after stroke

Objective:To explore the effects of acupuncture combined with Brunnstrom staging on upper-limb motor function,cerebral arterial blood flow velocity,and brain function remodeling after stroke.Methods:A total of 77 patients after stroke were selected between January 2017 and December 2019 to perform a prospective study.All cases were divided into an observation group and a control group by the random number table method.Both groups were treated with conventional symptomatic treatment for stroke and functional exercise according to the Brunnstrom staging.The observation group was treated with additional acupuncture treatment based on the Brunnstrom staging therapy.The therapeutic efficacy was evaluated after six-week treatment.The traditional Chinese medicine(TCM)symptom scores of dizziness,headache,limb numbness,and language disorders before and after the treatment in the two groups were compared.According to the Fugl-Meyer motor function assessment(FMA),the upper-limb motor function before and after the treatment was compared.And the average systolic blood flow velocity of the anterior cerebral artery(ACA),middle cerebral artery(MCA),and posterior cerebral artery(PCA)in the two groups before and after the treatment were compared.According to the modified Edinburgh-Scandinavia stroke scale(MESSS),the nerve function before and after the treatment was compared.Results:The total effective rate of the observation group was 94.9%,significantly higher than 79.0%of the control group(P<0.05).After the treatment,the TCM symptom scores of dizziness,headache,limb numbness,and language disorders in both groups decreased,and the scores in the observation group were all significantly lower than those in the control group(P<0.05).The FMA score of upper limbs in both groups increased,and the score in the observation group was significantly higher than that in the control group(P<0.05).The average systolic blood flow velocities of the ACA,MCA and PCA in both groups increased,and were significantly higher in the observation group than in the control group(P<0.05).The MESSS score in both groups decreased,and the score in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Acupuncture combined with Brunnstrom staging is effective for patients after stroke.It can effectively improve the upper-limb motor function and cerebral artery blood flow velocity,promote brain function remodeling,and restore nerve function.

Effects of acupuncture plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy

Objective To observe the clinical efficacy of acupuncture plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy,and analyze the effects on lower limb motor function,intelligence development level,immune function and cerebral hemodynamics.Methods A total of 42 children with spastic cerebral palsy were selected as the observation objects,and enrolled into the observation group.Another 42 cases treated in the same period were selected as the control group.Both groups received MOTOmed intelligent motor training,and the observation group was given additional acupuncture therapy,and the control group was given additional conventional rehabilitation treatment.After 2 consecutive treatment courses,the psychomotor development index(PDI)and mental development index(MDI)of Children’s Developmental Center of China(CDCC)scale,the scores of gross motor function measure(GMFM)scale and modified Ashworth scale(MAS),and the changes in CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were observed.The peak systolic velocity(PSV)and mean flow velocity(MFV)of the anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)were observed and measured.The clinical efficacy was evaluated.Results Compared with the same group before treatment,the scores of GMFM,PDI and MDI,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+),PSV and MFV levels of ACA,MCA and PCA in both groups were significantly increased after treatment(all P<0.05),while the CD8^(+)level had no significant change(both P>0.05).After treatment,the total effective rate of lower limb spasm in the observation group was 90.5%,significantly higher than 71.4%in the control group(P<0.05).The scores of GMFM,PDI and MDI,the levels of CD3^(+)and CD4^(+),PSV and MFV,and the levels of ACA,MCA and PCA in the observation group were all significantly higher than those in the control group(all P<0.05).There were no significant differences in the CD8^(+)level and CD4^(+)/CD8^(+)between the groups(all P>0.05).Conclusion Acupuncture plus MOTOmed intelligent motor training has a better clinical efficacy than conventional rehabilitation plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy,and is also superior in improving lower limb motor function and the level of intellectual development.And the mechanism may be related to the improvement of cerebral hemodynamics.

Therapeutic efficacy of acupuncture plus Tuina for spastic cerebral palsy and discussion of its mechanism

Objective To discuss the effects of acupuncture plus Tuina(Chinese therapeutic massage)in intervening the mental development,motor function,cerebral hemodynamics,and muscle tone in kids with spastic cerebral palsy(CP).Methods A retrospective analysis was conducted on 87 kids with spastic CP.They were divided into a control group and an observation group based on their original treatment plan.Kids in the control group received symptomatic treatment,motor development therapy,and Tuina treatment.The observation group was additionally given acupuncture treatment.One month was taken as a treatment course.After six courses,the efficacy,change in muscle tone,mental development,gross motor function,fine motor function,and the systolic velocity(Vs),mean velocity(Vm),and pulsatility index(PI)of the anterior cerebral artery(ACA),middle cerebral artery(MCA),and posterior cerebral artery(PCA)were compared between the two groups.Results After treatment,the muscle tone score dropped in both groups(P<0.05)and was significantly lower in the observation group than in the control group(P<0.05).The observation group achieved more significant efficacy than the control group(P<0.05).After the intervention,the mental development index(MDI),psychomotor development index(PDI),gross motor function measure(GMFM)score,and fine motor function measure(FMFM)score all increased in both groups(P<0.05)and were notably higher in the observation group than in the control group(P<0.05).After treatment,the Vs and Vm of the ACA,MCA,and PCA were markedly higher in the observation group than in the control group(P<0.05),and the observation group was significantly lower than the control group comparing the PI of the ACA,MCA,and PCA(P<0.05).Conclusion Based on the symptomatic treatment and motor development therapy,Tuina and acupuncture treatment can effectively treat spastic CP children,manifesting as reducing muscle tone,boosting mental development,and improving motor function and cerebral hemodynamics.