适宜吸痰联合针灸电针刺激促醒在重度颅脑损伤合并意识障碍气管切开患者中的应用

目的分析适宜吸痰联合针灸电针刺激促醒在重度颅脑损伤合并意识障碍气管切开患者中的应用效果及对GCS评分的影响。方法将2017年1月—2019年3月入住山东省德州市中医院神经外科54例重度颅脑损伤合并意识障碍气管切开患者随机分为对照组和观察组,各27例。对照组给予常规吸痰保持气道通畅+药物治疗,观察组给予适宜吸痰联合针灸电针刺激促醒+药物治疗。比较两组患者吸痰间隔时间和气道黏膜损伤情况、意识变化情况。结果痰鸣音改善方面,对照组(1.67±0.55)分与观察组(1.70±0.67)分比较,差异无统计学意义(t=-0.220,P=0.830>0.05);吸痰间隔时间方面,相比于对照组(48.33±11.19)min,观察组(61.70±10.42)min优势显著(t=-4.540,P=0.000<0.05);对照组气道黏膜损伤发生率22.22%,观察组3.70%,后者优势显著,差异有统计学意义(χ~2=4.100,P=0.040<0.05);入院42 d时,对照组与观察组比较,对照组与观察组GCS评分差异有统计学意义(t=-3.020,P=0.000<0.05)。结论适宜吸痰不仅能达到有效吸痰,同时吸痰间隔时间较长,对气道黏膜损伤小,针灸电针刺激对促进意识障碍患者脑功能的恢复具有一定效果,可以改善患者的意识状态,促进患者意识恢复,改善咳痰无力状况。

Treatment of Early-stage Adhesive Shoulder Periarthritis with Transcutaneous Electric Stimulation on Acupoints

Objective： To observe the therapeutic effects of transcutaneous electric acupoint stimulation on early-stage adhesive shoulder periarthritis. Methods： by using the research approach of evidence-based medicine such as multi-center, large sample and randomization, the 163 cases of early-stage adhesive shoulder periarthritis were treated with transcutaneous electric point stimulation and electric acupuncture respectively to observe the therapeutic effect of transcutaneous electric acupoint stimulation and compare its effect with electric acupuncture. Results and Conclusion： The total effective rate of transcutaneous electric point stimulation on early-stage adhesive shoulder periarthritis reached 96.5%, showing no significant difference with the electric acupuncture group; the transcutaneous electric acupoint stimulation could not only relieve pain, but also improve the shoulder joint movement. As a result, the transcutaneous electric acupoint stimulation is an easy and more effective therapy for shoulder periarthritis.

Clinical observation on regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina for cerebral infarction

Objective：To observe the clinical effect of regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina for cerebral infarction. Methods：A total of 61 eligible cases with cerebral infarction were treated with regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina, once a day, 12 d for a course. There was a 3-day interval between two courses. These cases were treated for 3 courses. Before treatment, the infarction severity was graded using neurological deficit score. The score changes and correlation between infarction severity and therapeutic efficacy were evaluated after 1, 2 and 3 courses of treatment. Results：Before treatment, the neurological deficit score was （18.65±3.28）, versus （13.63±3.91）, （9.53±3.22） and （5.57±3.97） respectively after 1, 2 and 3 courses of treatment. When the third course was completed, 4 cases obtained almost full recovery, 33 cases obtained marked effect, 18 cases obtained improvement and 6 cases had no effect. The total effective rate was 90.2%. Conclusion：Regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina can substantially improve limb function in patients with hemiplegia due to cerebral infarction.

Effects of Different Acupuncture Stimulations on NO Content in Acupoint Areas

Objective:To study the effects of different acupuncture stimulation on nitric oxide(NO) content in acupoint areas.Methods:The experiment was performed in 47 healthy volunteers providing informed consents.Both males and females were included in each group:11 cases in electro-acupuncture group,13 cases in manual-acupuncture group,16 cases in warm-moxibustion group,and 7 cases in control group.Stimulations were given at Jianshi(PC 5) of the Pericardium Meridian and Chengshan(BL 57) of the Bladder Meridian with manual-acupuncture,electro-acupuncture and warm-moxibustion respectively.NO was collected from Ximen(PC 4) and Chengjin(BL 56) areas on the ipsilateral meridians,and the content was detected.Results:The content of NO in the warm-moxibustion group was higher than that in the electro-acupuncture group,the content in electro-acupuncture group was higher than that in the manual acupuncture group(P<0.05) . Conclusion:All the three stimulations can raise NO levels on acupoint areas significantly,and the effect moxibustion is superior to that of electro-acupuncture and manual acupuncture.