Health Care Seeking Behaviour and Predictors of Combined Orthodox and Traditional Health Care Utilization among Households in Communities in Owerri, Imo State, Nigeria

Background: Health care seeking behaviour is a complex, dynamic and multidimensional process that involves a sequence of remedial actions that are influenced by the interaction between the individual, household and community with the intention of addressing perceived ill health. Objective: To determine health care seeking attitude and behaviour and the predictors of combined orthodox and traditional health care use among households in communities in Owerri, Imo State. Nigeria. Methods: A cross sectional design that used a multistage random sampling technique to select 500 participants from households in two communities in Owerri, Imo State. Data was collected using a pretested, semi structured questionnaire. Descriptive analyses were done with frequencies and summary statistics. Chi square statistics were computed to determine significant relationships and binary logistic regression was used to determine predictors of combined use. P was set at 0.05 significance level. Results: The results revealed that, while just more than half of the respondents (56.4%) had a moderate to good level of overall knowledge of health care, almost all of the respondents (96.2%) also had a moderate to good level of overall positive attitude towards seeking health care;with less than one third (29.4%) using combined orthodox and traditional health care treatments. It further revealed that, respondents who were female, traders and from households of polygamous families were significantly more likely to use combined orthodox and traditional health care treatments (p < 0.05) while those with a tertiary level of education, from households with a professional as head, having private water closet toilets and earning a monthly income of more than 50,000 Naira ($140) were significantly less likely to use combined orthodox and traditional health care treatments (p < 0.05). Conclusion: There is a need to be more sensitive to the realities of the combined use of orthodox and traditional treatments, as its use will be difficult to prevent because this behaviour is rooted in the traditional and cultural belief system of our societies.

meta-analysis of randomized controlled trials of combined treatment with DGSN and western medicine on diabetic peripheral neuropathy

Objective:To systematically study the clinical effects of combined treatment with Dang gui si ni tang(DGSN)and western medicine(WM)on diabetic peripheral neuropathy.Methods:Seven databases,including Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical Database(CBM),Wanfang full-text database,VIP Database for Chinese Technical Periodicals,MEDLINE,PubMed,Embase,were retrieved.Related references about randomized controlled trials on the combination of DGSN and WM on diabetic peripheral neuropathy published during January 2012 up to now(recent 5 years)were reviewed.Related grey literatures were also reviewed according to the selected articles.RevMan5.3 software was used to analyze the publish bias,and to compare the total clinical effects of the combination of DGSN and WM with WM alone.Results:Ultimately,19 randomized controlled trials with 1690 patients were incorporated.The results of meta-analysis showed that combined treatment of diabetic peripheral neuropathy with DGSN and WM showed better general efficacy compared with control group,with a statistically significant difference(P<0.05).The results of study showed homogeneity(P=0.94>0.05).The general efficacy of combined treatment with DGSN and WM was significantly higher than that of control group(P<0.00001,OR=3.98,95%CI:3.01~5.27).Conclusion:Compared with treatment with WM alone,combined treatment of diabetic peripheral neuropathy with DGSN and WM is more effective.Meanwhile,due to the limited literature samples and low quality of literatures,large samples and high quality of multi-center randomized controlled double-blind trials are needed to verify these results.

Clinical Observation of Integrated Traditional Chinese and Western Medicine in the Treatment of Chronic Ulcerative Rectitis

Objective:To observe and compare whether the combination of traditional Chinese and Western medicine can achieve more satisfactory results in the treatment of patients with chronic ulcerative rectitis(UR).Methods:70 cases of chronic ulcerative rectitis were selected in all hospitals of our hospital for comparison.Observation and control were set up.The number of people was the same,but there were differences in methods.The control group retained enema,and the observation group was treated with traditional Chinese medicine.Rectal mucosa scores after different treatments were compared to evaluate the effect of intervention.Results:It was found that the observation group scored lower(P<0.05),and the effect was better.Conclusion:For the treatment of patients with chronic ulcerative rectitis,the combination of traditional Chinese and Western medicine will help to promote the prognosis of the disease,improve the problem of ulcer,promote the improvement of gastrointestinal function and bring a more positive impact.

Clinical Effect of Integrated Traditional Chinese and Western Medicine on Diabetic Peripheral Neuropathy

Objective:Patients with diabetic peripheral neuropathy were treated with integrated traditional Chinese and western medicine,and the final results were observed.Methods:70 patients with such symptoms were randomly divided into two groups.The number of people is the same,and the treatment methods are different.The control group uses western medicine,while the observation group uses traditional Chinese medicine to evaluate the treatment effect.Results:After treatment,the effective rate of the observation group was(P<0.05),indicating that the treatment effect was significantly better.Conclusion:Patients with clinical diabetic peripheral neuropathy treated with routine nutrition and nerve repair,and with Chinese medicine,the effect is more satisfactory,and the effect is positive,so as to promote the optimization of their health.

Combined Treatment of Advanced Primary Hepatocellular Carcinoma with Traditional Chinese Medicine and Western Medicine

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阿尔茨海默病不同治疗方式研究新进展

阿尔茨海默病(Alzheimer’s disease,AD)是一种复杂的、起病隐秘的、病因不明的、缺乏特异性诊断方式的神经退行性病变。面对与日俱增的患病率,却缺乏有效的治疗方式。中医药治疗方式具有多层次、多靶点、多通路的独特优势,中西医结合方式的互补,非药物疗法的辅助,干细胞疗法、新的分子药物、抗体及蛋白疫苗、γ感官刺激等新颖的实验阶段新疗法等方式治疗AD。本文综述近年来的不同治疗方式治疗AD研究新进展,旨在为临床上治疗AD提供新思路、新方法及参考价值。

中西医结合治疗高脂血症性急性胰腺炎的研究进展

高脂血症性急性胰腺炎(hyperlipidemia in acute pancreatitis,HTG-AP)是由血清甘油三酯升高引起的急性胰腺炎,临床以保守治疗为主,除西医常规治疗以外,传统中医药治疗具有显著疗效,大柴胡汤、大承气汤等化裁被临床广泛应用,且联合中药外治法治疗,效果更佳。目前,中外学者从不同靶点探究HTG-AP的治疗。文章从靶向治疗、炎症机制及肠道菌群等方面介绍HTG-AP中西医治疗的研究进展。

中西医结合内外合治输卵管阻塞性不孕的随机对照多中心临床研究

目的 观察中西医结合内外合治综合方案治疗输卵管阻塞性不孕(TOI)患者的临床疗效。方法 收集2022年3月至2023年3月期间,就诊于成都中医药大学附属医院、重庆市中医院、四川省第二中医医院妇科门诊并确诊为输卵管通而不畅导致的TOI患者为研究对象,共189例。通过中心分层随机方法将患者随机分为研究组(n=90)与对照组(n=99),研究组采用中西医结合三联疗法(中药口服+中药保留灌肠+永磁旋振治疗仪)治疗,对照组采用中医二联疗法(中药口服+中药保留灌肠)治疗,连续治疗12周,观察两组患者治疗各时间节点的中医证候评分变化情况及疗效,比较治疗结束后的输卵管疏通率,并随访其治疗结束后1年内的妊娠情况。结果 两组患者的年龄、病程、不孕症类型、输卵管通畅情况等基本资料比较均无显著性差异(P>0.05)。两组患者治疗第4周、第8周、第12周的中医证候评分均较治疗前显著下降(P<0.05),且治疗第12周研究组的中医证候评分显著低于对照组(P<0.05)。治疗结束后,研究组患者的中医证候疗效总有效率(91.11%vs.80.81%)、输卵管疏通率(68.16%vs.50.25%)、妊娠率(38.89%vs.23.23%)、宫内妊娠率(36.67%vs.17.17%)均显著高于对照组(P<0.05),两组患者的异位妊娠率比较无显著性差异(P>0.05)。结论 中西医结合内外合治综合方案能有效改善输卵管通而不畅导致的TOI患者的中医证候,提高输卵管疏通率、妊娠率、宫内妊娠率,同时缩短妊娠时间,临床上值得推广应用。

中西医结合治疗膀胱癌的研究进展

膀胱癌(bladder cancer,BC)是一种在全球影响广泛的常见且危险的疾病。西医和中医各自对膀胱癌有其独特的理解、诊断方法和治疗方法。概述西医和中医对膀胱癌的流行病学、统计学、诊断和治疗方面的认识。此外,还探讨了中西医结合治疗膀胱癌的方法,包括中医在手术治疗、化疗、放疗、靶向治疗、免疫治疗以及其他西医治疗中的应用。最后,讨论了中医对膀胱癌的循证和临床研究,包括单一化合物、提取物、方剂和专利药物的应用。

中西医结合肿瘤“病-期-机-证-靶”诊疗新模式的构建

中医和西医是两种独立的医学体系和诊疗模式,在强调肿瘤综合治疗的现今,探索并构建一种中西医结合肿瘤诊疗新模式意义重大。传统中医治疗肿瘤重视整体观、治未病,具有整体调节机体、实现带瘤生存、预防复发转移等优势,但在现代医学背景下,其面临诊断不明确、治疗不精准、疗效不确切、机制不清楚等难题。为了切实提高肿瘤治疗的临床疗效,该文基于传统中医的特色和优势,结合现代医学研究成果,提出“病-期-机-证-靶”的诊疗思路,初步构建中西医结合肿瘤诊疗新模式,以期实现中西医优势互补、协同增效。

基于“动静结合”理论探讨中医治疗儿童肱骨髁上骨折的优势

“动静结合”是中医骨伤科治疗疾病的重要指导原则。肱骨髁上骨折是儿童最为常见的肘关节骨折,其并发症多,康复治疗缺乏一定的规范,容易出现肘关节功能障碍等严重后果。根据临床实践及文献阅读,从“动静结合的理论溯源”“儿童肱骨髁上骨折的治疗现状及困境”“动静结合的思想内涵与科学论证”“动静结合在临床中的具体应用“”动静结合理论在儿童肱骨髁上骨折治疗中的优势”5个方面探讨基于“动静结合”理论下中医药治疗儿童肱骨髁上骨折的优势,以期丰富中医“动静结合”思想内涵,为中医药治疗儿童肱骨髁上骨折提供理论基础。

单纯艾灸及艾灸联合疗法治疗膝骨关节病的研究进展

膝骨关节病是骨关节退行性疾病,主要症状为关节疼痛、积液、肿胀、畸形、运动受限、功能障碍等。临床膝骨关节病患者多接受西医保守治疗,但服用西药的长期疗效欠满意,手术治疗亦存在诸多缺点。艾灸作为中医传统外治法,用于治疗膝骨关节病有满意疗效。笔者通过检索相关文献,从单纯艾灸治疗和艾灸联合其他中医外治法治疗两方面,综述艾灸治疗膝骨关节病的临床研究进展,以期提供更多临床治疗膝骨关节病的治疗思路,提示更多临床研究中医外治法治疗膝骨关节病的方向。

白芥子“以消为补”治疗妇科疾病的古今应用探析

[目的]探析白芥子的药用功效及在妇科疾病中的应用价值,为现代妇科疾病的治疗提供参考借鉴。[方法]通过查阅古籍经典、文献资料及临床侍诊,总结白芥子的药用功效及在古今中医妇科临床治疗中的巧妙应用。[结果]白芥子化痰之功胜,能“安五脏”,入血分可痰瘀并治,辛温行散能助排卵,同时外用“引赤发泡”可促进透皮吸收。在妇科临床应用中,可妙治多囊卵巢综合征(polycystic ovary syndrome,PCOS)、豁痰通络治不孕、辛散开闭通闭经、内外同治调痛经、消肿散结除痞块。[结论]临床应用白芥子能以消为补、消补结合,通过灵活组方及加减配伍,在妇科疾病诊疗中可使功倍效增。

温建民教授中西医结合微创治疗拇外翻学术思想总结

阐述温建民教授中西医结合微创治疗拇外翻的学术思想。温老师治疗拇外翻的核心思想来源于中医的阴阳理论、筋骨理论及天人合一的整体观念,在此基础上凝练出“筋骨并重”“动静结合”及“内外兼治”3条治疗大法,涵盖了微创截骨手法整复、裹帘法外固定、中药内服外用、中西医结合康复调护4个操作环节。温老师传承经典,融贯中西,从中西医结合的角度贡献了“筋”与“骨”伤病的独家治疗经验和学术思想。

非小细胞肺癌免疫检查点抑制剂相关性肺炎研究进展及中西医结合治疗

免疫检查点抑制剂(ICIs)主要包括细胞毒性T淋巴细胞抗原4(CTLA-4)抑制剂和程序性细胞死亡蛋白1/配体1(PD-1/PD-L1)抑制剂,为非小细胞肺癌(NSCLC)患者带来显著的治疗效益。但是,在增强机体抗肿瘤免疫反应的同时,ICIs产生免疫相关不良事件(irAEs),包括免疫检查点抑制剂相关性肺炎(CIP)。虽然CIP临床发病率较低,但在一些严重病例中可能导致免疫治疗的延迟或终止,甚至危害生命。本文拟从CIP的临床表现、病理特征、生物学机制、易感人群、诊断与鉴别诊断以及中西医结合治疗等角度进行总结,以期更加清晰地认识CIP。

中医药治疗斑秃研究进展

斑秃是一种较为常见的非瘢痕性炎症性脱发,禀赋不足气血空虚、饮食不节湿热内蕴、情志失调瘀阻脉络、腠理不固风袭巅顶等皆可导致斑秃的发生,其病性属本虚标实。本病可从肝肾不足、气血亏虚、血虚风燥、血热动风、肝郁血瘀、湿热蕴蒸6个证型辨治。现从辨证论治、专方治疗、中成药治疗、针药并用以及中西医结合治疗角度概括中医药治疗斑秃的研究进展,以期为临床治疗斑秃提供思路。

中药封包结合西药治疗对气滞血瘀证腰椎间盘突出症的疗效

目的探讨中药封包结合西药治疗对腰椎间盘突出症(气滞血瘀证)的临床效果。方法本研究共纳入125例腰椎间盘突出症患者,所有病例均来源于安阳市中医院,选取时间为2021年9月至2023年9月,根据治疗方法将患者分为对照组(62例,常规西药治疗)和研究组(63例,中药封包结合西药治疗)。对比2组患者治疗后前后中医证候积分、视觉模拟疼痛量表(VAS)评分、Oswestry功能障碍指数(ODI)量表、日本骨科协会下腰痛评估问卷(JOA)评分,治疗前后各项血清学指标以及2组患者不良反应发生情况。结果治疗后2组患者各项中医证候积分较治疗前降低,研究组患者上述评分较对照组低(t=7.734、10.168、7.884、8.912,P均<0.01);治疗后2组患者VAS评分、ODI评分均较治疗前下降,研究组患者上述评分较对照组低,治疗后2组患者J0A评分较治疗前上升,研究组较对照组高(t=10.368、10.398、4.219,均P<0.01);治疗后2组患者血清前列腺素E2(PCE2)、肿瘤坏死因子-α(TNF-α)、转化生长因子β_(1)(TGF-β_(1))、重组人基质金属蛋白酶3(MMP-3)水平均较治疗前下降,研究组患者上述指标均较对照组低,而治疗后2组患者β-内啡肽(β-EP)水平较治疗前上升,研究组较对照组高(t=30.026、10.895、9.446、6.665,13.012,P均<0.01);2组患者不良反应总发生率比较,差异无统计学意义(χ^(2)=0.088,P>0.05)。结论腰椎间盘突出症(气滞血瘀证)的治疗中采用中药封包联合常规西药治疗,可有效缓解临床症状,减轻疼痛程度与炎症反应,促进腰椎功能的恢复,并有助于腰椎纤维化程度好转,且安全性良好。

白虎汤加减联合亚胺培南西司他丁治疗老年重症肺炎的效果和用药安全性

目的 探究老年重症肺炎患者采用白虎汤加减联合亚胺培南西司他丁治疗的临床效果。方法 选取2021年1—12月海阳市中医医院收治80例老年重症肺炎患者为研究对象,按治疗方案不同,分为对照组和中医组,各40例。对照组采用亚胺培南西司他丁治疗,中医组在对照组治疗的基础上加用白虎汤。对比分析两组患者的治疗有效率、血清炎症因子(白细胞介素-6、C反应蛋白)、生化指标(白细胞计数、中性粒细胞百分比、血小板计数)、不良反应发生率。结果 中医组治疗有效率为97.50%(39/40),高于对照组的为80.00%(32/40),差异有统计学意义(χ^(2)=9.202,P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。治疗后,中医组白细胞介素-6、C反应蛋白、白细胞计数、中性粒细胞百分比、血小板计数水平均优于对照组,差异有统计学意义(P均<0.05)。结论 白虎汤加减联合亚胺培南西司他丁治疗老年重症肺炎患者,可快速消除疾病症状,且不会产生严重不良反应。

地塞米松联合加味桑白皮汤治疗急性呼吸窘迫综合征30例临床分析

目的 探讨中西医结合治疗急性呼吸窘迫综合征的应用价值。方法 选择2019年1月至2023年12月兴化市人民医院接诊的30例急性呼吸窘迫综合征患者为研究对象,采用随机数字表法分为对照组和观察组。对照组采用西药地塞米松治疗,观察组采用地塞米松联合加味桑白皮汤的治疗方式。对比两组患者的治疗有效率,接受治疗之后两组患者的呼吸频率、氧合指数、肿瘤坏死因子-α、白细胞介素-6、ICU停留时间、住院时间、机械通气时间等。结果 观察组患者治疗有效率高于对照组(P <0.05)。观察组患者的呼吸频率以及氧合指数比对照组高,肿瘤坏死因子-α以及白细胞介素-6指标比对照组低(P <0.05)。观察组患者ICU停留时间、机械通气时间以及总体住院时间均比对照组少(P <0.05)。结论 治疗急性呼吸窘迫综合征患者过程中应用中西结合治疗方式能使得患者的治疗有效率有较大幅度的提升,呼吸频率、氧合指数均有所提高,肿瘤坏死因子-α、白细胞介素-6均有较大幅度的下降,而从患者恢复指标的情况来看,观察组患者的ICU停留时间、机械通气时间、住院时间均有所减少。

马脑震荡的诊断与治疗

脑震荡及脑挫伤,是由于钝性暴力物作用于颅骨或头部受大力撞击引起的脑神经全面损伤的一种急性疾病,军马多发。随着社会生产力水平的不断进步,马的功能属性由役用转变为休闲骑乘,现阶段马脑震荡的病例并不多见。本文介绍了一例调教训练操作不慎,撞击引起的马脑震荡的诊断和中西医结合治疗,为该病的预防和治疗提供一定参考。