Observation on therapeutic effect of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation

Objective: To observe the clinical efficacy of acupuncture at abdomen acupoints plus tuina for lumbar intervertebral disc herniation (LIDH). Methods: A total of 70 patients with LIDH were randomized into an observation group and a control group, with 35 cases in each group. The observation group was treated with acupuncture at abdomen acupoints plus tuina, while the control group was treated only with tuina treatment. The clinical efficacy was observed after one course of treatment. Results: The cure rate and the total effective rate of the observation group were 83.3% and 96.7%, respectively. The cure rate and the total effective rate of the control group were 39.4% and 78.8%, respectively. There were significant differences in the cured rate and the total effective rate between the two groups (both P<0.05). There was no significant differenee in Japanese Orthopedic Association (JOA) score between the two groups before treatment (P>0.05). After treatment, the JOA scores of both groups in creased sign ifica ntly, and the in tra-group differe nces were statistically sign ifica nt (both P<0.05);the JOA score of the observation group was significantly higher than that of the control group (P<0.05). Conclusion: Acupuncture at abdomen acupoints plus tuina has a better therapeutic effect than tuina alone in the treatment of LIDH.

Observation on effects of moxibustion at abdominal acupoints for slow transit constipation due to yang deficiency of the spleen and kidney

Objective： To observe the clinical effects of moxibustion at abdominal acupoints for slow transit constipation（STC） due to yang deficiency of the spleen and kidney. Methods： A total of 52 cases with slow transit constipation in conformity with the inclusion criteria were selected and divided into a control group and an observation group according to their visit order and random digital table, 26 cases in each group. Patients in the control group received routine nursing guide. Besides the same routine nursing guide, patients in the observation group received moxibustion at the abdominal acupoints, once every day. The course of the treatment was 4 weeks in the two groups, and the 3-month follow-up was given after the course was finished, for comparing the clinical symptoms, results of colon transit tests, scores of depression/anxiety scale and nursing satisfaction. Results： The total effective rate was 92.3% in the observation group and 69.2% in the control group, with a significant difference between the two groups. After the treatment and during the follow-up checks, the scores of Chinese medical symptoms in the two groups were remarkably decreased than those before the treatment（all P〈0.01）; the scores of the observation group were obviously lower than those in the control group（all P〈0.01）. The discharge rates of the markers in the two groups were remarkably increased than those at the same time period before the treatment; moreover, the discharge rates of the markers at various time periods were remarkably better in the observation group than those in the control group（P〈0.01）. SDS and SAS scores were remarkably decreased after the treatment in the two groups（P〈0.01）. In comparison of SDS score between the two groups after the treatment, the difference was statistically significant（P〈0.01）. In comparison of SAS score between the two groups after the treatment, the difference was statistically significant（P〈0.05）. The nursing satisfaction was 96.2% in the observation group after the treatment, obviously better than that in the control group（73.1%）. The recurrence rate was 8.3% in the observation group, remarkably lower than that in the control group（33.3%）. Conclusion： Moxibustion at the abdominal acupoints plus routine nursing can remarkably improve the colon transit functions and anxious and depressive emotion in patients with STC, and the therapeutic effects are remarkable. Not only the clinical satisfaction is higher, but the recurrence rate is obviously lower than that of routine nursing.

SIMPLE OBESITY AND OBESITY HYPERLIPEMIA TREATED WITH OTOACUPOINT PELLET PRESSURE AND BODY ACUPUNCTURE

161 cases of simple obesity with or without hyperlipemia were treated by pellet pressure onauricular acupoints plus body acupuncture for 3 months in a single-blind experiment.Pa-tients on Capsulae Oiei Oenothera Erythrosepalae were taken as positive controls.Bodyweight,circumference of chest,abdomen,arms and legs,the appetite,sleep,bowelmovement,blood TC,TG and HDL-C were recorded for comparison.The results indicatedthat treatment in the auricular and body acupoint group was superior to treatment in thecontrol group.In the acupoint group body weight dropped by an average of 5.04 kg in84.55% of the patients,who also showed decreased appetite,blood TC and TG.

胸痛发作时床边即时检测心肌钙蛋白T诊断急性心肌梗死的价值

目的确定胸痛症状发作后不同时间间隔内,床边心肌肌钙蛋白T(point of care troponin-T testing,POCT-cTnT)对急性心肌梗死(acute myocardial infarction,AMI)的诊断性能,了解其在快速排除AMI方面的意义。方法这项回顾性研究包括了2019年1月至2022年12月期间出现胸痛症状的6024例患者。在入院时测量了POCT-cTnT和中心实验室cTnI水平。通过按时间窗口划分的受试者工作特征(receiver operating characteristics,ROC)分析,评估POCT-cTnT在诊断AMI时的准确性。结果总体而言,POCT-cTnT诊断AMI的AUC为0.826(95%CI:0.816~0.836),灵敏度和特异度分别为72.81%和86.26%。根据胸痛发作的时间进行区间分组(<3 h、3~6 h、6~12 h、12~24 h、24~72 h和≥72 h),6~12 h以后的分组AUC值分别为0.918、0.928、0.920和0.908,差异无统计学意义(P>0.05),均要高于6 h时以内的组(P<0.001);根据胸痛发作时间点进行分组,≥8 h组的AUC为0.921,阴性预测值(negative predictive value,NPV)98.1%和阴性似然比(negative likelihood ratio,-LR)0.11,其AUC高于≥3 h、≥2 h、≥1 h和overall组(P<0.05),而与≥4 h以后的各时间组相比,差异无统计学意义(P>0.05)。结论胸痛发作时间对单次检测POCT-cTnT诊断AMI的性能存在一定的影响,结合胸痛发作至就诊时间,可能提高其诊断或排除AMI的可靠性。在胸痛发作4 h后,单次POCT-cTnT检测能可靠地诊断或排除AMI;当胸痛发作8 h后,其诊断或排除AMI方面具有更高的可靠性。

穴位注射联合贴敷治疗腹腔镜术后胃肠功能紊乱的疗效观察及对胃肠黏膜损伤的影响

目的观察穴位注射足三里穴联合腹部穴位贴敷治疗腹腔镜术后胃肠功能紊乱的临床疗效及对患者胃肠黏膜损伤修复作用和创伤应激、胃泌素调节及血清生长素释放肽(Ghrelin)和胃动素(motilin,MTL)的影响。方法将128例腹腔镜术后胃肠功能紊乱患者按随机数字表法分为联合组和西医组,每组64例。西医组予西医常规治疗,联合组在西医常规治疗基础上予穴位注射足三里穴联合腹部穴位贴敷治疗。比较两组肠鸣音恢复时间、首次进食时间、肛门排气时间、排便时间和临床疗效,观察两组治疗前后中医证候积分、血清MTL、Ghrelin、胃泌素(gastrin,GAS)、二胺氧化酶(diamine oxidase,DAO)、D-乳酸(D-lactic acid,D-LA)、瓜氨酸、胃蛋白酶原Ⅱ、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、醛固酮和皮质醇水平的变化。结果联合组总有效率为96.9%,高于西医组的84.4%(P<0.05)。联合组治疗后肠鸣音恢复时间、首次进食时间、肛门排气时间、排便时间均较西医组短(P<0.05);联合组治疗后中医证候积分中疲乏无力、食欲不振、脘腹痞满、食物后痞满加重、大便溏稀和恶心呕吐的评分较西医组降低(P<0.05);联合组治疗后血清TNF-α、醛固酮、皮质醇、DAO、胃蛋白酶原Ⅱ和D-LA水平低于西医组(P<0.05);联合组治疗后血清MTL、Ghrelin、GAS和瓜氨酸水平高于西医组(P<0.05)。结论在西医常规治疗基础上,穴位注射足三里穴联合腹部穴位贴敷治疗腹腔镜术后胃肠功能紊乱可减少患者创伤应激反应,改善胃动力,促进胃肠黏膜损伤修复,缓解患者临床症状,提高临床疗效。

原络配穴法联合耳穴埋豆在胸痹心痛病中的应用效果

目的探讨原络配穴法联合耳穴埋豆在胸痹心痛病中的应用效果。方法选取2022年1月至12月九江市中医医院收治的100例胸痹心痛病患者作为研究对象,按随机数字表法分对照组(50例)及观察组(50例)。对照组采用耳穴埋豆治疗,观察组在对照组的基础上加用原络配穴法,两组均持续治疗4周。比较两组临床疗效、中医证候积分、心绞痛发作情况、心功能指标、生活质量。结果观察组总有效率高于对照组,观察组治疗后胸闷、胸痛、心悸、气短、神疲、乏力及总分低于对照组,差异有统计学意义(P<0.05);观察组治疗后心绞痛发作次数少于对照组,持续时间短于对照组,左室射血分数(LVEF)高于对照组,左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)低于对照组,西雅图心绞痛量表(SAQ)评分中各维度评分均高于对照组,差异有统计学意义(P<0.05)。结论原络配穴法联合耳穴埋豆可提高胸痹心痛病治疗效果,降低中医证候积分,减少心绞痛发作次数,改善患者生活质量。

术前ALB、FIB表达与手外伤软组织缺损患者皮瓣修复后皮瓣失活的相关性

目的:探讨白蛋白(Albumin,ALB)、纤维蛋白原(Fibrinogen,FIB)表达与手外伤软组织缺损患者皮瓣修复后皮瓣失活的关系。方法:选取2020年1月至2022年12月期间本院收治的手外伤软组织缺损患者96例作为观察组,另选取同期97名健康体检者设为健康对照组。分析比较观察组和健康对照组的ALB、FIB水平。所有患者均接受胸腹带蒂皮瓣修复术治疗,统计患者术后皮瓣存活情况,并根据术后皮瓣存活情况分为皮瓣存活组和皮瓣失活组。分析比较皮瓣存活组和皮瓣失活组ALB、FIB水平,并使用点二列相关性分析检验ALB、FIB表达与手外伤软组织缺损患者皮瓣修复后皮瓣失活的关系。结果:观察组ALB水平低于健康对照组,FIB水平高于健康对照组(P<0.05)。观察组有14例术后发生皮瓣失活,占比14.58%。皮瓣失活组ALB水平低于皮瓣存活组,FIB水平高于皮瓣存活组(P<0.05)。经点二列相关性分析发现,FIB水平与手外伤软组织缺损患者皮瓣修复后皮瓣失活呈正相关(r>0,P<0.05),ALB水平与手外伤软组织缺损患者皮瓣修复后皮瓣失活呈负相关(r<0,P<0.05)。结论:ALB、FIB表达与手外伤软组织缺损患者皮瓣修复后皮瓣失活相关,术前ALB低表达、FIB高表达会增加患者皮瓣修复后皮瓣失活的风险。

针刺联合医用臭氧注射治疗胸部肌筋膜疼痛综合征的临床研究

目的探讨针刺联合医用臭氧注射治疗胸部肌筋膜疼痛综合征的临床效果。方法选取2021年10月—2022年8月本院收治的64例胸部肌筋膜疼痛综合征患者为研究对象,将其随机分为试验组和对照组,每组32例。其中,对照组采用常规针刺治疗,试验组除常规针刺治疗外,加用医用臭氧疼痛触发点注射治疗,每周治疗1次,6次为一个疗程。在治疗前后分别使用视觉模拟评分量表(VAS)和健康调查简表(SF-36)两种量表来评估针刺联合医用臭氧注射治疗胸部肌筋膜疼痛综合征的疗效,并对比两组的差异。结果VAS评分、SF-36评分在治疗后均较治疗前有显著改善,组间差异有统计学意义(P<0.05)。试验组在治疗1个月、疗程结束当天及疗程结束后1个月,症状改善均明显优于对照组,组间差异有统计学意义(P<0.05)。结论针刺联合医用臭氧注射治疗在缓解胸部肌筋膜疼痛综合征患者疼痛、提高其生活质量方面均有效,优于单纯针刺治疗。

Therapeutic observation on tuina at head and abdomen for headache due to phlegm turbidity

Objective:To observe the clinical efficacy of tuina at head and abdomen for headache due to phlegm turbidity.Methods:A total of 56 patients with headache due to phlegm turbidity were randomized into a tuina group and a Chinese medicine group by the random number table,with 28 cases in each group.The tuina group was treated mainly with tuina at the head and abdomen,while the Chinese medicine group was treated with oral administration of Ban Xia Bai Zhu Tian Ma Tang(Pinellio,Atractylodes Mocrocepholo and Gastrodio Decoction).The course of treatment was 30 d.The scores of headache index,traditional Chinese medicine syndrome scale,and the therapeutic efficacy were observed.Results:There were 2 dropouts in each group during treatment.The total effective rate was 92.3%in the tuina group,significantly higher than 76.9%in the Chinese medicine group(P<0.05).The scores of headache index and traditional Chinese medicine syndrome scale in both groups decreased after treatment(both P<0.05),and scores in the tuina group were lower than those in the Chinese medicine group(both P<0.05).Conclusion:Tuina mainly at head and abdomen is effective in treating headache due to phlegm turbidity,and has a better effect than Ban Xia Bai Zhu Tian Ma Tang(Pinellia,Atractylodes Macrocephalo and Gastrodio Decoction).

腹部常用经穴针刺深度研究

目的 :为求得腹部主要常用经穴的安全针刺深度。方法 :取 51具较新鲜成年人尸体 ,其中男尸 2 1具 ,女尸 30具 ,定穴 ,冰冻后 ,用解剖学断面方法切割成穴位断面标本 ,等自然化冻后 ,测量穴位皮肤浅点至脏器深点间的距离 ,用统计学方法处理测量得到的数据。结果 :得到腹部

腹部电针治疗中风后便秘临床观察

目的:比较腹部电针和西药治疗中风后便秘的疗效差异。方法:将中风后便秘患者80例随机分为电针组和西药组,每组40例。电针组用电针刺激大横、腹结、天枢、水道等穴位,每日1次,每次30分钟;药物组口服西沙必利10 mg,每日3次。2组均治疗7天为一疗程,治疗2个疗程后根据临床症状积分进行疗效评价。结果:电针组总有效率为92.5%,明显优于药物组的72.5%(P<0.05)。2组患者治疗后临床症状积分较治疗前均明显降低(P<0.05),且电针组症状改善程度较药物组显著(P<0.05)。结论:腹部电针对于促进中风后便秘患者的胃肠蠕动、缓解便秘有肯定的临床疗效。

腹针治疗颈椎病临床随机对照研究

目的:比较腹针与传统针刺治疗颈椎病的临床疗效。方法:将62例颈型或神经根型颈椎病患者随机分为腹针组(观察组)32例,穴取中脘、关元等;传统针刺组(对照组)30例,穴取风池、颈夹脊等。以简化McGill疼痛询问量表(MPQ)及临床疗效为客观指标,比较两组第1次治疗后、疗程结束和3个月随访的疗效差异。结果:观察组有效率为100.0%,对照组为100.0%,两组比较,差异无显著性意义。两组治疗后和随访MPQ各项指标均较治疗前明显改善,观察组第1次治疗后与治疗前的疼痛分级指数(PRI)感觉分差值和第1次后、总疗程后和3个月随访与治疗前的PRI总分差值均较对照组明显改善(P<0.05)。结论:腹针能较好地缓解颈椎病患者的疼痛感觉,且有即时的缓解疼痛效果,但尚不能说其疗效优于传统针刺。

胸部危险穴位针刺安全深度的研究

随机抽样取５１具较新鲜成年人尸体，其中男尸２１具，女尸３０具，定穴、冰冻后，用解剖学断面方法切割，然后等化冻后，测量穴位皮肤浅点至引起危险的深点之间的距离，用统计学方法处理测量得到的数据。经研究，得到胸部２３个危险穴位引起危险的平均深度，并对胸部２３个危险穴位提出了针刺安全深度。

薄氏腹针治疗慢性荨麻疹近期疗效观察

目的:观察薄氏腹针治疗慢性荨麻疹的近期疗效和安全性。方法:将61例患者随机分为观察组31例和对照组30例,观察组以薄氏腹针治疗,对照组以西替利嗪片治疗,比较两组治疗后的效果。结果:观察组有效率80.7%,对照组有效率76.7%,两者均具有良好疗效,差异无显著性意义(P>0.05)。观察组无不良反应出现,对照组出现嗜睡、头痛、口干等不良反应。结论:薄氏腹针治疗慢性荨麻疹近期疗效与西替利嗪相当,但无抗组胺药物的不良反应,较为安全,是治疗慢性荨麻疹的理想方法之一。

胸腹部肿瘤放射治疗体位固定技术分析

目的:分析比较常用的3种胸腹部肿瘤体位固定技术,探寻最为理想的一种,从而提高肿瘤的控制率。方法:胸腹部肿瘤患者共134例,其中胸部肿瘤患者78例、腹部肿瘤患者56例,分别采用热塑膜、负压垫、负压垫+热塑膜进行体位固定,其中热塑膜40例、负压垫44例、负压垫+热塑膜50例,于5、10、15、20 d治疗前进行电子射野影像验证,记录体位偏移数据进行分析。结果:在误差>5 mm范围内,热塑膜固定组X、Y、Z轴分别偏移10%、13%、8%;负压垫固定组X、Y、Z轴分别偏移9%、10%、10%;负压垫+热塑膜固定组X、Y、Z轴分别偏移6%、5%、5%。结论:为提高放射治疗精度,在胸腹部肿瘤放射治疗时应采用负压垫+热塑膜固定技术。

“老十针”治疗慢性紧张型头痛的疗效观察

目的观察"老十针"治疗慢性紧张型头痛的临床疗效。方法将56例慢性紧张型头痛患者随机分为治疗组29例和对照组27例。治疗组以"老十针"为主穴针刺治疗,对照组予口服盐酸乙哌立松片。观察两组治疗前后疼痛程度、疼痛时间及发作频次的变化,并比较临床疗效。结果治疗组痊愈率为48.3%,对照组为33.3%,两组比较差异有统计学意义(P<0.05)。治疗后两组患者头痛程度、持续时间及发作频次均有明显改善(P<0.05),且治疗组头痛程度和发作频次改善优于对照组(P<0.05)。治疗组复发率为7.1%,低于对照组的22.2%(P<0.05)。结论 "老十针"治疗紧张型头痛有效。

胸腹部巨大淋巴结增生症的CT和MR诊断

目的 了解巨大淋巴结增生症的CT和MRI表现以及与病理改变的联系。材料与方法 搜集我院 8年间资料完整的 13例巨大淋巴结增生症 ,均经手术及病理证实。其中胸部 8例 ,腹部 5例。局限性 10例 ,弥漫性 3例。病理诊断为透明血管型 10例 ,浆细胞型 3例。 13例中 10例行CT平扫和增强扫描 ,6例行MRI检查 ,其中 3例同时作CT及MRI检查。MRI采用的序列为T1WI、T2 WI以及梯度回波快速增强扫描。结果 局限性肿块均大于 3cm ,最大为 6cm。弥漫性肿块大小不等 ,最大为 3 .5cm。肿块呈圆形、类圆形 ,部分伴有分叶 ,轮廓光滑。除 3例伴有钙化外 ,CT平扫均为等密度。增强后透明血管型均有明显强化 ,且持续时间较长 ;浆细胞型则呈轻～中度强化。MRSE序列T1WI肿块呈等信号 ,T2 WI呈高信号 ,并伴有扭曲扩张的流空小血管。Gd DTPA增强扫描表现与CT大致相仿。结论 巨大淋巴结增生症的CT和MRI表现与病理改变密切相关。

腹针治疗脑血管病后痉挛性瘫痪的疗效观察

目的:探讨治疗脑血管病后痉挛性瘫痪的最佳针刺组穴配方。方法:将60例脑血管病后痉挛性瘫痪的患者按入院先后随机分为腹针组及体针组各30例,均每周治疗5次,连续治疗3周观察疗效。结果:腹针组患者痉挛得到明显改善,相关指标有统计学意义,体针组患者痉挛也有改善,相关指标无统计学意义。两组疗效比较腹针组疗效优于体针组,差异有显著性意义。结论:腹针疗法治疗脑血管病后痉挛性瘫痪是一种安全有效的治疗方法。

改良式体位固定技术在胸腹部肿瘤放疗中的应用

目的:探讨两种不同体位固定技术对胸腹部肿瘤放疗重复摆位精度的影响。方法:60例需行放疗的胸腹部肿瘤患者按随机数字法分为对照组:翼形板+真空垫固定体位(30例);观察组:改良式体位固定技术即热塑体膜联合体板+真空垫组(30例)。所有患者首次放疗前行CBCT扫描,以后每周扫描一次,比较两组X轴(左右)、Y轴(头脚)和Z轴(腹背)方向的摆位误差值。结果:对照组X轴、Y轴和Z轴方向上摆位误差分别为(4.03±0.15)mm、(3.62±0.23)mm和(3.74±0.31)mm。观察组X轴、Y轴和Z轴方向上摆位误差分别为(3.91±0.29)mm、(3.54±0.34)mm和(2.86±0.20)mm。两组在Z轴方向的摆位误差比较差异具有统计学意义(P<0.05)。结论:改良式体位固定技术可以改善胸腹部肿瘤患者放疗时摆位的舒适度,利于体位的固定,提高患者治疗时摆位的重复性和精度。

经足三里穴位注射维生素B1对腹部手术后胃肠功能恢复的影响

目的探讨经足三里穴位注射维生素B1对腹部手术后胃肠功能恢复的影响。方法随机选择80例腹部手术后患者,分别经足三里穴位注射(实验组)和臀大肌肌肉注射(对照组)维生素B1,从术后肠鸣音恢复时间、肛门排气时间,腹胀、呕吐的发生率两方面来评价两组胃肠功能恢复情况。结果实验组术后肠鸣音恢复时间、肛门排气时间明显早于对照组,腹胀、呕吐的发生率低于对照组,胃肠功能完全恢复率高于对照组。结论经足三里穴位注射维生素B1能促进腹部手术后胃肠功能恢复。