寻常疣患者应用贴麻后火针剥除术对凋亡抑制基因Livin及细胞增殖相关基因表达的影响

目的探究寻常疣患者应用贴麻后火针剥除术对凋亡抑制基因Livin及细胞增殖相关基因表达的影响。方法便利抽样法选取符合要求的450例寻常疣患者,按随机数余数法分为A(贴麻后火针剥除术)、B(火针治疗)、C(液氮冷冻治疗)三组,每组150例,比较三组疗效;采用视觉模拟评分(VAS)评估三组治疗期间、治疗1 h、治疗3 h自觉疼痛程度的差别;治疗前后均留取寻常疣皮损组织,匀浆后测定凋亡抑制基因Livin、Survivin、XIAP及细胞增殖相关基因Cyclin D1、p16INK4、CDK6、E2F的变化;采用原位缺口末端标记(TUNEL)法检测细胞凋亡数目;并检测治疗前后巨噬细胞细胞炎症蛋白3α(MIP-3α)、肿瘤坏死因子-α(TNF-α)、白介素-1α(IL-1α)等促炎因子的变化;观察治疗不良反应发生情况。结果有效率对比:A组(96.67%)>B组(90.00%)>C组(79.33%),差异有统计学意义(P<0.05);A组疣体完全清除时间[(8.61±1.23)周]短于B、C组[(9.78±0.52)周、(10.63±0.41)周],B组又短于C组(P<0.05);A、C组治疗不同时间VAS评分相近,均低于B组(P<0.05);治疗8周,三组Livin、Survivin、XIAP、Cyclin D1、p16INK4、CDK6、E2F、MIP-3α、TNF-α、IL-1α均较同组治疗前降低(P<0.05),A组Livin、Survivin、XIAP、Cyclin D1、p16INK4、CDK6、E2F、MIP-3α、TNF-α、IL-1α基因相对表达量低于B、C组(P<0.05),B组又低于C组(P<0.05);A组细胞凋亡数目[(66.71±10.26)%、]高于B、C组[(56.52±6.79)%、(50.01±5.79)%],B组又高于C组(P<0.05);A组不良反应发生率(4.67%)低于B组(12.67%)(P<0.05)。结论贴麻后火针剥除术可通过抑制寻常疣患者皮损组织凋亡抑制基因及细胞增殖基因表达,促进细胞凋亡,抑制角质形成细胞增殖,控制疣体增生及局部炎症反应,优化疗效,减轻患者疼痛感,安全可行。

麻附辛中药穴位贴敷应用于骨折长期卧床阳虚证患者便秘的效果评估与研究

目的对中药穴位贴敷应用于骨折长期卧阳虚证患者的治疗效果进行研究与分析,制定专门的护理方案,改善患者的便秘症状。方法选取2017年1月至2017年6月于本院接受治疗的120例由骨折长期卧床引发便秘的阳虚证患者,将其平均分为对照组与观察组两组,每组患者各60例,遵循随机分配的分组原则。为对照组患者提供常规治疗与护理以及天枢穴位按摩,观察组患者在此基础上辅以中药穴位贴敷治疗,对比两组患者在便秘治疗有效率方面的差异。结果纳入本次实验研究范围的60例观察组患者在治疗总有效率方面明显优于对照组,P<0.05差异有统计学意义。结论为由骨折长期卧床引发便秘的阳虚证患者提供中药穴位贴敷治疗,结合常规的针对性护理,能够有效改善患者的便秘症状,提高患者的生活质量,临床价值值得推广。

点刺与麻蒌方贴敷联合西医治疗风热犯肺型儿童肺炎的疗效及其对呼吸道黏膜免疫的影响

目的:探讨点刺与麻蒌方贴敷联合西医治疗风热犯肺型儿童肺炎的疗效及其对呼吸道黏膜免疫的影响。方法:采用前瞻性研究方法收集2022年1月至2023年7月河北秦皇岛市中医医院收治的肺炎患儿86例,按随机数表法分为常规西医组和点刺联合贴敷组。其中,常规西医组43例患儿中,因服用其他药物脱落1例,最终纳入42例,给予西医常规治疗;点刺联合贴敷组43例患儿中,因难以配合脱落2例,最终纳入41例,在西医常规治疗的基础上联合点刺联合麻蒌方贴敷治疗。比较两组患儿临床疗效及治疗前后中医证候评分,记录肺部啰音消失时间、咳痰缓解时间、咳嗽缓解时间、发热消失时间、喘息缓解时间等,检测甲壳质酶40(YKL-40)、烟酰胺磷酸核糖基转移酶(NAMPT)、表面活性蛋白D(SP-D)、T淋巴细胞亚群CD4^(+)、CD8^(+)及唾液分泌型免疫球蛋白水平(sIgA)水平,并比较两组患儿不良反应发生情况。结果:点刺联合贴敷组患儿总有效率为97.56%,高于常规西医组的78.57%(P<0.05)。点刺联合贴敷组患儿发热恶风、痰稠色黄、微有汗出、呼吸急促、口渴欲饮、咽红、咳嗽评分低于常规西医组(P<0.05),肺部啰音消失时间、咳痰缓解时间、咳嗽缓解时间、发热消失时间、喘息缓解时间短于常规西医组(P<0.05)。点刺联合贴敷组患儿YKL-40、NAMPT、SP-D水平低于常规西医组,差异均有统计学意义(P<0.05)。点刺联合贴敷组患儿CD8^(+)水平低于常规西医组(P<0.05),CD4^(+)、sIgA水平高于常规西医组(P<0.05)。两组患儿不良反应发生率比较差异无统计学意义(P>0.05)。结论:点刺与麻蒌方贴敷联合西医治疗风热犯肺型肺炎患儿的临床疗效显著,可改善呼吸道黏膜免疫,抑制机体炎症,提高患儿肺功能。

黄麻贴辅助治疗小儿肺炎喘嗽痰热闭肺证50例临床观察

目的观察黄麻贴辅助治疗小儿肺炎喘嗽痰热闭肺证的临床疗效。方法选取2019年6月至2020年5月常熟市中医院儿科住院部肺炎喘嗽痰热闭肺证患儿100例,采用随机数字表法分为对照组和治疗组,各50例。对照组给予注射用头孢呋辛钠治疗,治疗组在对照组治疗方法的基础上联合黄麻贴贴敷治疗。2组均治疗7 d后统计临床疗效,患儿体温恢复正常时间,咳嗽、咳痰、气喘、肺部湿啰音消失时间以及治疗前后血常规、中性粒细胞占比、C-反应蛋白(CRP)水平变化和不良反应发生情况。结果治疗组总有效率为100%(50/50),显著高于对照组的94%(47/50),2组比较,差异有统计学意义(P<0.05)。治疗组体温恢复正常时间以及咳嗽、咳痰、气喘和肺部湿啰音消失时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,2组白细胞计数、中性粒细胞占比、CRP水平比较,差异均无统计学意义(P>0.05),具有可比性。治疗后,2组上述指标值均较同组治疗前显著降低(P<0.05),且治疗组降幅更显著,差异均有统计学意义(P<0.05)。治疗中,2组均未发生严重不良反应。结论黄麻贴辅助治疗小儿肺炎喘嗽痰热闭肺证疗效满意,可显著改善临床症状,且无严重不良反应发生,值得临床推广应用。

Effect of acupoint massage plus acupoint sticking therapy for the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery

Objective:To observe the effect of acupoint massage plus acupoint sticking therapy for the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery.Methods:A total of 120 patients undergoing nasal endoscopic surgery were included,and all patients were under trachea intubation and general anesthesia.The patients were randomized into an observation group and a control group,with 60 patients in each group.Patients in the control group received conventional anesthesia resuscitation,while patients in the observation group received acupoint massage plus acupoint sticking therapy on the basis of conventional anesthesia resuscitation.Changes in the heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed at three time points including the end of the surgery (TO),the removal of the tracheal tube (T1) and 10 min after the removal of the tracheal tube (T2).The awakening and tube removal time,choking cough and restlessness,and adverse reactions (dizziness,nausea and vomiting) in 24 h post-surgery period were compared.Results:At T1 and T2,the comparisons of HR,SBP and DBP between the two groups showed statistical significance (all P＜0.05).Intra-group comparisons showed that the HR,SBP and DBP of the control group at T1 and T2 were significant different from those at TO (all P＜0.05).There were significant differences in the awakening time and tube removal time between the two groups (both P＜0.05).The incidences of choking cough and restlessness were 8.3％ and 3.3％ respectively in the observation group,versus 53.3％ and 30.0％ in the control group,and the between-group comparisons showed statistical significance (both P＜0.05).The incidences of dizziness,nausea and vomiting in 24 h post-surgery period were 3.3％,5.0％ and 0.0％ respectively in the observation group,versus 43.3％,33.3％ and 25.0％ in the control group,and the between-group comparisons showed statistical significance (all P＜0.05).Conclusion:Acupoint massage plus acupoint sticking therapy can effectively regulate the stress reaction during postoperative anesthesia recovery period in patients undergoing nasal endoscopic surgery,and maintain a stable internal environment.

Clinical observation on acupoint sticking therapy plus electroacupuncture for treating peripheral facial paralysis

Objective:To observe the clinical effect of acupoint sticking therapy with Mian Tan Gao(facial paralysis paste)plus electroacupuncture(EA)for treating peripheral facial paralysis and its influence on patients'facial nerve functions,facial disability index and clinical symptoms and signs.Methods:A total of 96 peripheral facial paralysis patients were allocated into an observation group,a medicine group and an EA group by simple randomization,with 32 cases in each group.Patients in the medicine group were treated with oral mecobalamine and prednisone acetate;patients in the EA group were treated with EA on the basis of the medicine treatment;while patients in the observation group were treated with acupoint sticking therapy with Mian Tan Gao(facial paralysis paste)plus EA.After 4-week treatment,the clinical efficacy,the adverse events,and the scores of House-Brackmann(H-B)facial nerve function grading scale,visual analog scale(VAS),clinical symptoms and signs,and facial disability index(FDI)were compared.Results:After 4-week treatment,the total effective rate was 96.9%in the observation group,higher than 68.7%in the medicine group and 75.0%in the EA group(both P<0.05).After 4-week treatment,the scores of H-B grading scale,VAS and clinical symptoms and signs in the three groups dropped significantly compared with those before treatment,and the scores in the observation group were lower than those in the medicine group and EA group(all P<0.05).After 4-week treatment,the facial disability index-physical function(FDIP)in the FDI in the three groups increased significantly,with a higher value in the observation group compared with that in the medicine group and EA group(both P<0.05).The facial disability index-social function(FDIS)in the FDI dropped significantly,with a lower score in the observation group compared with that in the medicine group and EA group(both P<0.05).However,the comparisons of the items above between the medicine group and the EA group showed no statistical significance(all P>0.05).The between-group comparison of the adverse event across the three groups showed no statistical significance(P>0.05).Conclusion:Acupoint sticking therapy with Mian Tan Gao(facial paralysis paste)plus EA can decrease H-B grade,reduce pain severity and improve clinical symptoms and signs as well as the facial disability condition in peripheral facial paralysis patients.This method produced more significant efficacy compared with oral medicine and medicine plus EA.