Rapid rehabilitation technique with integrated traditional Chinese and Western medicine promotes postoperative gastrointestinal function recovery

BACKGROUND During the perioperative period, the characteristic therapy of traditional Chinese medicine is effective in improving postoperative rehabilitation. In large-scale hospitals practicing traditional Chinese medicine, there is accumulating experience related to the promotion of fast recovery in the perioperative period.AIM To evaluate the efficacy and safety of Yikou-Sizi powder hot compress on Shenque acupuncture point combined with rapid rehabilitation technique.METHODS This prospective, multicenter, randomized, controlled study included two groups: Treatment group and control group. The patients in the treatment group and control group received Yikou-Sizi powder hot compress on Shenque acupuncture point combined with rapid rehabilitation technique and routine treatment, respectively. Clinical observation regarding postoperative recovery of gastrointestinal function was performed, including the times to first passage of flatus, first defecation, and first normal bowel sounds. The comparison between groups was conducted through descriptive analysis, χ~2, t, F, and rank-sum tests.RESULTS There was a statistically significant difference in the time to postoperative first defecation between the treatment and control group(87.16 ± 32.09 vs 109.79 ±40.25 h, respectively;P < 0.05). Similarly, the time to initial recovery of bowel sounds in the treatment group was significantly shorter than that in the control group(61.17 ± 26.75 vs 79.19 ± 33.35 h, respectively;P < 0.05). However, there was no statistically significant difference in the time to initial exhaust between the treatment and control groups(51.54 ± 23.66 vs 62.24 ± 25.95 h, respectively;P >0.05). The hospitalization expenses for the two groups of patients were 62283.45 ±12413.90 and 62059.42 ± 11350.51 yuan, respectively. Although the cost of hospitalization was decreased in the control group, the difference was not statistically significant(P > 0.05). This clinical trial was safe without reports of any adverse reaction or event.CONCLUSION The rapid rehabilitation technique with integrated traditional Chinese and Western medicine promotes the recovery of postoperative gastrointestinal function and is significantly better than standard approach for patients after colorectal surgery.

Research on Combined Rehabilitation Method and Its Mechanism of Traditional Chinese Medicine Daoyin Technique with Biofeedback Technique

Objective: To study an anti resistance active exercise training method which is consistent with the principle of “transcendental goal power” to promote the plasticity change of central nervous system (CNS) in order to recover the motor function after CNS injury, observe its clinical effect and explore its mechanism. Methods: The potential of CNS was induced by six-step Daoyin technique of Chinese medicine, and the potential signal was received in real time by bio-electrical signal receiving equipment and displayed in curve form. Combined with the Operant conditioning biofeedback technique, targeted guidance was given to patients to continuously enhance the action muscle signal intensity and weaken the antagonistic muscle signal intensity, so that the motor program was gradually re-established. Sixty-four patients with hemiplegic elbow dysfunction of old cerebral infarction who had been trained but could not be improved further and had a history of more than 1 year were treated for one course, 90 times and 45 minutes each time. Lovett, Elbow Rom, Fugl-Meyer, program signal intensity and proportion were evaluated before and after treatment. The data were analyzed statistically. Before and after treatment, Lovett MMT, ROM of elbow joint, Fugl Meyer, motor program signal intensity and proportion were assessed, and the data were statistically analyzed. Results: After treatment and before treatment, there was a significant difference between the functional evaluation data (P < 0.01). The function of elbow joint was improved;this is the result of reconstructing the motor program on the basis of developing the potential of CNS by means of the “transcendental goal power” mechanism of the method. There was no recurrence after 6 months of follow-up. Conclusion: The Chinese Medicine Daoyin feedback rehabilitation technique is an effective method to improve elbow joint function of hemiplegia patients with cerebral infarction.

Research progress of traditional Chinese medicine nursing techniques for the management of postoperative complications in mixed hemorrhoids

Mixed hemorrhoids,especially ring-shaped mixed hemorrhoid,is still a headache for anorectal surgeons due to its post-operative complications.In recent years,clinicians have been studying and exploring to avoid and alleviate these complications.In the Chinese medicine industry,the application of traditional Chinese medicine nursing technology has good and unique effect in prevent local pain,perianal edema,promote wound healing,relieve urinary retention,improve constipation,relieve anxiety,and so on.This article summarized the evidences of investigated the role of traditional Chinese medicine nursing technique in preventing and treating mixed hemorrhoid so that practitioners can make decision based on the best available evidences.

CLINICAL STUDY ON IRRADIATION COMBINED WITH TRADITIONAL CHINESE MEDICINE IN THE TREATMENT OF LARGE PRIMARY LIVER CANCER

This paper resports the response of inoperable primary liver cancer to whole liver irradiation(WLI)by movingstrip technique(MST)during the period from 1980- 1988.The results showed that WLI by MST gave good response in this malignancy.The 5-year survival after treatment was 30.83% and median survival 25.8 months.The analysis of prognostic factors indicated that the higher the midplane tissue dose(mTD),the longer the survival(P<0.001),and that the survival of those patients tumor diameter was>8 to<13 cm and/or tumor volume>50% to <75% of liver volume was longer than that of there with tumor diameter of≥13 cm and/or tumor volume≥75% of the liver volume(P<0. 001 ).Traditional Chinese medicine is an indispensable therapy during the period of WLI by MST.Both clinical and experimental studies suggest that WLI by MST can enhance the therapeutic effect.

Study of Controlling Acute Hemorrhage from Esophageal Varices Rupture with Technique of Traditional Chinese Medicine

Objective: To find a method for inducing Chinese drugs to adhere to the esophageal mucosa to control bleeding from ruptured esophageal varices.Methods: The site and time that the Chinese drugs adhere to esophageal mucosa were observed in 30 healthy volunteers under the specific condition of standing and lying posture. Seventy episodes bled with ruptured esophageal varices patients (treated group 36 episodes in 25 patients and control group 34 episodes in 27 patients) suffering from cirrhosis of liver were treated by the technique of drug adhesion.Results: (1) The adhesion of Chinese hemostatie drugs remained in the lower segment of esophagus for more than 15 minutes in lying posture, longer than that in standing posture (P < 0.01). (2) The effectiveness of controlling bleeding esophageal varices had no significant difference between the balloon tamponade and adhesion of Chinese hemostatie drugs (P >0. 05).Conclusion: This drug adhesion technique provides a new approach to control hemorrhage from ruptured esophageal Variees.

Recent Advances in the Study of Ancient Books on Traditional Chinese Medicine

The ancient books on traditional Chinese medicine(TCM) are the source of knowledge for TCM physicians. Therapeutic principles and therapeutic methods for healing many diseases are recorded in these ancient TCM books, providing a huge number of references for modern TCM physicians on conducting diagnosis and administering treatment for different diseases. The ancient TCM books can be dated back thousands of years, and this vast knowledge is recorded in different medical books in the form of text. However, it is difficult to systematically assimilate much information in ancient TCM books. At present, many researchers are applying advanced analytical techniques to analyze the text data in the ancient TCM books. Advanced techniques that have been applied include database construction, cognitive linguistic analysis, fuzzy logic, data mining, and artificial intelligence(AI) technology. There are different characteristics in these advanced analytical techniques. In this study, we comprehensively review recent advances in these techniques applied to the study of ancient TCM books. Furthermore, as AI technology is increasingly utilized in the medical field as well as in the study of ancient TCM books, we also review the application of AI technology to the study of ancient TCM books.

中医适宜技术联合盆底肌肉训练治疗产后压力性尿失禁临床观察

目的 对产后压力性尿失禁患者进行中医适宜技术干预治疗,并观察效果。方法 将60例患者随机分为治疗组和训练组,并对其进行相应治疗,观察2组1 h尿垫试验结果、Sandvik尿失禁指数和国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)评分改善情况,以及临床疗效。结果 治疗后,治疗组1 h尿垫试验结果、Sandvik尿失禁指数和ICI-Q-SF评分改善均优于训练组。治疗结束时,治疗组总有效率为86.7%(26/30),高于对照组的63.3%(19/30)(P<0.05)。6个月随访时治疗组总有效率86.7%(26/30)亦高于对照组的56.7%(17/30)(P<0.05)。结论 在产后女性中,压力性尿失禁的发生是值得关注的问题。将中医适宜技术与凯格尔训练联用干预产后压力性尿失禁达到巩固、延长疗效的目的。

疼痛专科护士中医疼痛管理培训知识体系的构建研究

目的构建疼痛专科护士中医疼痛管理培训知识体系,为中国疼痛护理人才中医疼痛管理培训提供参考。方法以核心能力理论为指导,通过文献研究和半结构式访谈构建中医疼痛管理培训知识体系初稿,2024年1月—2月采用德尔菲法对17名专家进行2轮函询。结果2轮函询的积极系数分别为100%和94.12%,权威系数均为0.899,肯德尔和谐系数为0.406~0.606(均p<0.001)。最终形成包括5个一级指标、12个二级指标和35个三级指标的疼痛专科护士中医疼痛管理培训知识体系。结论构建的疼痛专科护士中医疼痛管理培训知识体系具有科学性、可靠性,可为中国疼痛护理人才规范化、同质化的中医疼痛管理培训提供指导和借鉴。

浅析天津中药炮制技术的形成、发展与特色

天津中药饮片炮制起源于明代,成于清代,独具地方特色。为了传承与发扬天津中药炮制特色,文章通过整理文献书籍和《天津中药饮片炮制规范》2022版,分析了天津中药炮制技术的形成、发展与特色。天津中药炮制优选道地药材;修治与软化药材技术多样;切制技术兼容并蓄;辅料使用丰富多彩,重用醋与黄酒,善用甘草水炮制解毒;炮炙技术丰富,醋煮技术独具特色,通过比较《中国药典》2020版与其他地方中药材与饮片标准,挖掘出一些特色炮制品种。经过本文的挖掘与分析,可以为天津中药炮制的继承、发展与推广提供参考。

多角度对比中药熏蒸联合睑板腺按摩治疗MGD性干眼临床疗效观察

目的:从多角度对比中药熏蒸和睑板腺按摩治疗MGD性干眼患者临床疗效观察。方法:选择2023年5月~2023年11月在我院就诊的120例MGD性干眼患者采用随机数字表将患者按照1∶1∶1∶1比例随机分为ABCD四个组。其中A组采用先热敷再进行睑板腺按摩,B组采用先睑板腺按摩再进行热敷,C组采取先中药熏蒸再进行睑板腺按摩,D组采取先睑板腺按摩再进行中药熏蒸。四组均进行热敷或中药熏蒸隔日一次,睑板腺按摩每周一次的干预,四周为1个疗程,共干预1个疗程。对四组患者从患者干眼相关评价指标、睑板腺功能相关评价指标、OSDI评分及患者疼痛评分进行观察比较。结果:A组的干眼相关评价指标(BUT、Schirmer I)、睑板腺功能相关评价指标、OSDI评分均优于B组(P<0.05),疼痛评分低于B组(P<0.05);C组的干眼相关评价指标(BUT、Schirmer I)、睑板腺功能相关评价指标、OSDI评分均优于D组(P<0.05),疼痛评分低于D组(P<0.05);A组与C组相比较,C组的干眼相关评价指标(BUT、Schirmer I)、OSDI评分均优于A组(P<0.05),睑板腺功能相关评价指标及疼痛评分无差异(P>0.05)。结论:先进行中药熏蒸再进行睑板腺按摩治疗MGD性干眼,有利于患者症状改善,减轻患者的疼痛,提高患者的治疗效果。

中医护理技术应用创新现状与思考

中医护理技术应用创新是中医护理传承创新的重要要素,也是中医护理优势专科建设的重要抓手。聚焦人民群众日益增长的多元化护理服务需求,积极开展中医护理技术创新研究,进一步改善患者临床结局具有重要的意义。通过梳理中医护理技术应用创新现状,客观分析影响因素,发现中医护理技术应用创新的广度和深度尚需进一步提升,可通过深化专科建设提升守正创新能力,期待中医护理学科在新时代下能取得跨越式发展。

吴氏理筋手法结合J型针刀治疗术后肘关节僵硬的临床研究

目的 探讨吴氏理筋手法结合J型针刀治疗术后肘关节僵硬的临床应用价值。方法 选取江西省南昌市洪都中医院康复科2020年6月—2021年6月收治的60例术后肘关节僵硬患者,以单盲随机法分为对照组(关节松动术)与治疗组(吴氏理筋手法结合J型针刀),各30例。治疗4周后,比较两组Mayo肘关节功能评分(MEPS)与视觉模拟量表(VAS)评分,同时对疗效开展评估。结果 治疗后,与对照组相比,治疗组MEPS评分较高,而VAS评分较低(P<0.05);且治疗组总有效率为100.00%(30/30),明显高于对照组的83.33%(25/30)(P<0.05)。结论 吴氏理筋手法结合J型针刀治疗术后肘关节僵硬患者,能实现肘关节功能的恢复,并减轻患者疼痛,效果确切,具有较高的推广价值。

中药贴敷联合推拿手法对肺炎喘嗽患儿肺功能及症状消失时间的影响

目的本研究旨在探讨中药贴敷联合推拿手法对肺炎喘嗽患儿肺功能及症状消失时间的影响。方法选取2020年4月-2021年6月在我院诊治的102例肺炎患儿为研究对象,按随机数字表法分为对照组和研究组,各51例。观察治疗前后2组中医证候积分、肺功能及免疫功能,统计临床疗效及症状消失时间。结果治疗前,2组患儿发热、咯痰黄稠、咳嗽、气喘息粗、喉中痰鸣、鼻翼煽动、口渴、烦躁、瞬时流量(PEF25)、最高呼气峰流速(PEF)、第1秒最大呼气量(FEV_(1))、肺活量(FVC)、IgG、IgM、IgA水平比较,差异无统计学意义(P>0.05);治疗后,2组患儿发热、咯痰黄稠、咳嗽、气喘息粗、喉中痰鸣、鼻翼煽动、口渴、烦躁评分均较治疗前降低,PEF25、PEF、FEV_(1)、FVC、IgG、IgM、IgA水平较治疗前明显升高,与对照组相比,研究组患儿发热、咯痰黄稠、咳嗽、气喘息粗、喉中痰鸣、鼻翼煽动、口渴、烦躁评分更低,发烧,咳嗽,咳痰,肺部湿罗音都会在较短的时间内消失,PEF25、PEF、FEV_(1)、FVC、IgG、IgM、IgA水平更高,差异具有统计学意义(P<0.05)。结论中药贴敷联合推拿手法可改善肺炎喘嗽患儿肺功能,缩短症状消失时间,降低住院时间,促使患儿康复,疗效显著。

铜绿假单胞菌耐药机制及治疗技术研究新进展

铜绿假单胞菌(PA)是最常见的条件致病菌之一,严重危害人类的健康。随着广谱抗生素的大量应用,导致多重耐药菌株的出现,从而使治疗更加棘手。研究发现,免疫力低下的人群容易诱发PA的感染,随着临床耐药PA检出率的增加及抗生素的治疗效果减弱,部分患者的生活质量及预后受到很大影响。PA的感染难以控制的原因是复杂的耐药机制,其中包括生物膜的形成、孔蛋白的介导作用、外排泵以及抗菌灭活酶的产生等。由于抗生素的应用不能有效控制PA的感染,所以针对耐药机制在药物治疗方面进行研究,其中包括外排泵抑制剂、抗生素佐剂、相关灭活酶抑制剂、外膜透化剂。此外,噬菌体疗法、中药疗法、一氧化氮疗法及纳米技术等特殊治疗也展现出良好的治疗效果,疫苗领域及增强自身免疫力也是未来预防PA感染的重要研究方向。因此,研究PA的耐药机制及治疗技术对PA感染的预防和治疗具有深远的意义。

名中医邓素玲运用“三宝合璧”法治疗颈性眩晕

邓素玲教授认为颈性眩晕与肝、脾、肾三脏密切相关,同时伴有筋伤骨错与气血失和,在治疗颈性眩晕时始终坚持“筋骨并重、内外兼治、动静结合、医患合作”的治疗方针,采用中药、正骨、挑治三宝合璧的治疗方法,内服中药调理脏腑,外以理筋正骨迅速解除颈椎内部压力,使得筋骨平调,眩晕自止,毫针挑治刺激皮部,振奋气血,临床疗效颇丰。总结邓素玲教授治疗颈性眩晕经验,为本病提出新的治疗方案,以改善患者生活质量。

基于缓释微胶囊技术中草药纺织品的研究进展

微胶囊技术是一种近年来得到广泛研究和应用的先进技术,可以将药物、香料、保健品等有效成分封装在微小颗粒中,以达到缓慢释放的效果。微胶囊技术广泛应用于中草药纺织品中,可以缓释中药有效成分,达到更加持久的疗效。对微胶囊的定义和概念进行了介绍,并对中草药纺织品中常用的微胶囊芯材和壁材种类进行分析总结。此外,还重点关注了微胶囊制备方法及其在中草药纺织品中的应用研究进展。

中医叙事医学临床实践路径的构建

目的构建中医叙事医学临床实践路径,以期为临床一线提供中医叙事医学临床实践指导。方法运用现实性文献综述及名义群体法,系统整理中医古籍和名医医案中的人文关怀实践,构建中医叙事医学临床实践路径及细则初稿。随后,邀请多领域专家通过名义群体法论证,在深入探讨并经过集体投票表决后,确定了各项操作模块及其细则、配套工具,从而完成了整个实践路径的构建。结果形成了一套完整的中医叙事医学临床实践路径,它涵盖了“诊疗开启”“交流病情”“诊断及解释”“共同决策”“诊疗结束”“反思总结”6个核心模块,并附有详尽的操作细则及配套工具。结论中医叙事医学临床实践路径将中医学的人文精神特质、叙事医学的核心理念、心理学的沟通技巧相融合,为医务工作者提供了一份既具备规范化、流程化,又兼顾操作灵活性的实践指导,助力于医患双方在诊疗全过程中更好地沟通、共情以及共同决策。

耳穴贴压技术在泌尿系统结石患者中应用的证据图分析

目的 通过证据图分析方法系统梳理耳穴贴压技术在泌尿系统结石患者中应用的干预性研究,以了解该领域证据分布情况及研究存在的问题。方法 系统检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Cochrane Library、CINAHL complete、Web of Science、Elsevier Science Direct、Embase等中英文数据库,筛选与耳穴贴压技术在泌尿系统结石患者中应用相关的研究,检索时限为数据库建库至2024年6月。分析纳入文献的发文量趋势、文献类型、文献内样本量、干预措施、选穴分布、结局指标及文献方法学质量。结果 本研究共纳入79篇文献,包含随机对照研究65篇,类实验性研究5篇,不清楚分组依据的研究9篇。总体发文量呈上升趋势,平均样本量为103.37例,最常选用的耳穴为肾、输尿管、交感、神门、膀胱等,关注较多的结局指标为临床疗效、疼痛缓解情况及结石排出情况等,总体纳入文献的方法学质量不高。结论 耳穴贴压技术在泌尿系统结石患者中的应用具有一定优势,穴位及结局指标的选择具有多样性,但多数研究在设计的科学性、干预措施的个性化及结局指标的测量与分析等方面存在不足,未来有待开展科学严谨的大样本、多中心的随机对照研究,为耳穴贴压技术在泌尿系统结石患者中的应用提供高质量的循证依据。

1例宫颈癌术后双下肢淋巴水肿患者的中医特色护理体会

本文总结1例宫颈癌术后双下肢淋巴水肿患者的中医特色护理经验。基于辨证分型,在完善护理评估、用药指导等常规护理的基础上,采用穴位贴敷、刺络拔罐等中医特色护理措施,,积极改善微循环,加强皮肤护理,减轻患者水肿程度,促进患者日常活动能力恢复。

基于数据挖掘探讨中医药在辅助生殖技术中的分期应用

目的:基于数据挖掘技术整合分析名医名家临证应用中医药配合辅助生殖技术(assisted reproductive technology,ART)的各期方药分布规律。方法:计算机系统检索中国知网、维普中文科技期刊数据库、万方数据库和中国生物医学文献数据库中名医名家临证应用中医药配合ART的相关文献,建立文献分析数据库进行整合归纳,获得其中药物分布规律。结果:本研究纳入合格文献共112篇,涉及名家36人。降调期药物共获得总类别13种,相关药物77味,累计出现频次224次,频率较高者为“补虚药”(55.94%)、“活血化瘀药”(10.89%)、“清热药”(6.44%)、“收涩药”(5.45%)、“利水渗湿药”(5.45%)等;促排期药物共获得总类别13种,相关药物92味,累计出现频次398次,频率较高者为“补虚药”(61.34%)、“活血化瘀药”(8.68%)、“收涩药”(8.40%)、“清热药”(5.88%)、“利水渗湿药”(5.32%)等;移植期药物共获得总类别14种,相关药物70味,累计出现频次372次,频率较高者为“补虚药”(68.78%)、“祛风湿药”(5.80%)、“活血化瘀药”(5.52%)等;确认妊娠后用药物共获得总类别11种,相关药物47味,累计出现频次182次,频率较高者为“补虚药”(59.88%)、“祛风湿药”(9.30%)、“清热药”(7.56%)、“收涩药”(5.23%)等。四期用药关联分析显示降调期分析得18组药物组合,促排期分析得14组药物组合,移植期分析得41组药物组合,确认妊娠后分析得22组药物组合。四期用药聚类分析结果显示降调期得到核心药物组:党参-甘草-白术-黄芪-酸枣仁、菟丝子-枸杞子-熟地黄-当归-香附、熟地黄-白芍-阿胶-菟丝子-生地黄;促排期得到核心药物组:菟丝子-熟地黄-山药-枸杞子-桑椹、菟丝子-熟地黄-当归-枸杞子-丹参、熟地黄-山茱萸-山药-菟丝子-生地黄;移植期得到核心药物组:白术-续断-桑寄生-党参-菟丝子、桑寄生-菟丝子-续断-黄芩-阿胶、当归-菟丝子-甘草-山药-巴戟天;确认妊娠后得到核心药物组:白术-黄芪-甘草-党参-续断、菟丝子-续断-白术-桑寄生-阿胶、白术-续断-甘草-苎麻根-杜仲。结论:“补虚药”是四期主要应用的药物种类,药物主要归肝肾脾经,“以补为主,攻补兼施,性以温平,味以甘苦”是四期用药的共同特点,临床应根据四期不同特点进行相应的遣方用药以提高疗效,降调期以防气血躁动为主;促排期应以补肾精为主,同时应加用少量温阳药物,在补肾的同时应涩促结合,防止肾精过耗;移植期与胚胎着床后中药的功效主要在于“稳固胎元”,应注重补养母体气血。