Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery

BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

Therapeutic Effect of Integrated Traditional Chinese and Western Medicine on Anal Pruritus After Anorectal Surgery

Objective:To explore the therapeutic effect of integrated traditional Chinese and western medicine on anal pruritus after anorectal surgery.Methods:Ninety-eight patients with anal pruritus after anorectal surgery in our hospital were selected as the research subjects.They were divided into two groups,the control group(50 cases)and the study group(48 cases),according to the treatment plan.The control group was under a simple western medicine treatment plan,while the study group was under an integrated traditional Chinese and western medicine treatment plan.The overall efficacy,severity of anal pruritus,time to eliminate clinical symptoms,and anxiety and depression scores of the two groups of patients under different treatment plans were compared.Results:After two weeks of treatment,the total effective rate of the study group was 95.83%,which was significantly higher than that of the control group(82.00%,P<0.05).After 7 and 14 days of treatment,the anal pruritus scores improved significantly in both the groups,but the study group was superior to the control group,with statistical difference(P<0.01).The time of disappearance of skin itching and skin damage in the study group was shorter than that in the control group.After 14 days of treatment,the anxiety and depression scores of both groups were lower than those after 7 days of treatment;however,there was statistical difference between the two groups(P<0.01).Conclusion:In the clinical treatment of anorectal postoperative diseases,such as anal pruritus,the combination of traditional Chinese and western medicine can significantly improve the symptoms of pruritus,shorten the time of disappearance of clinical symptoms,improve depression and anxiety,and create a positive clinical application value in promoting the rehabilitation of patients and improving their quality of life.

Fast-track program vs traditional care in surgery for gastric cancer

AIM:To systematically review the evidence for the effectiveness of fast-track program vs traditional care in laparoscopic or open surgery for gastric cancer.METHODS:PubMed,Embase and the Cochrane library databases were electronically searched for published studies between January 1995 and April 2013,and only randomized trials were included.The references of relevant studies were manually searched for further studies that may have been missed.Search terms included"gastric cancer","fast track"and"enhanced recovery".Five outcome variables were considered most suitable for analysis:postoperative hospital stay,medical cost,duration to first flatus,C-reactive protein(CRP)level and complications.Postoperative hospital stay was calculated from the date of operation to the date of discharge.Fixed effects model was used for meta-analysis.RESULTS:Compared with traditional care,fasttrack program could significantly decrease the postoperative hospital stay[weighted mean difference(WMD)=-1.19,95%CI:-1.79--0.60,P=0.0001,fixed model],duration to first flatus(WMD=-6.82,95%CI:-11.51--2.13,P=0.004),medical costs(WMD=-2590,95%CI:-4054--1126,P=0.001),and the level of CRP(WMD=-17.78,95%CI:-32.22--3.35,P=0.0001)in laparoscopic surgery for gastric cancer.In open surgery for gastric cancer,fast-track program could also significantly decrease the postoperative hospital stay(WMD=-1.99,95%CI:-2.09--1.89,P=0.0001),duration to first flatus(WMD=-12.0,95%CI:-18.89--5.11,P=0.001),medical cost(WMD=-3674,95%CI:-5025--2323,P=0.0001),and the level of CRP(WMD=-27.34,95%CI:-35.42--19.26,P=0.0001).Furthermore,fast-track program did not significantly increase the incidence of complication(RR=1.39,95%CI:0.77-2.51,P=0.27,for laparoscopic surgery;and RR=1.52,95%CI:0.90-2.56,P=0.12,for open surgery).CONCLUSION:Our overall results suggested that compared with traditional care,fast-track program could result in shorter postoperative hospital stay,less medical costs,and lower level of CRP,with no more complications occurring in both laparoscopic and open surgery for gastric cancer.

New direction for surgery:Super minimally invasive surgery

The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm because of its lesser invasiveness.However,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients post-operation.Thus,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS.

Comparison of clinical outcomes and postoperative recovery between two open heart surgeries:minimally invasive right subaxillary vertical thoracomy and traditional median sternotomy

Objective: To compare the clinical outcomes of minimally invasive right subaxillary vertical thoracotomy and traditional median stemotomy through right atrium in treatment of common congenital heart diseases. Methods: Clinical data of 59 cases of common congenital heart diseases treated with minimally invasive right axillary vertical thoracotomy from May, 2011 to February, 2013 and 77 cases of same diseases with traditional median stemotomy in the past three years were retrospectively analyzed, including atrial septal defect, membranous ventricular septal defect and partial endocardial cushion defect. The results were compared from the two groups, including the time for operation and cardiopulmonary bypass, amount of blood transfusion, postoperative drainage, ventilation time, hospital stay, and prognosis. Results: No severe complications happened in both groups, like deaths or secondary surgery caused by bleeding. No significant differences were in CPB time and postoperative ventilator time between groups (P>0.05), while for all of the operative time, the length of incision, postoperative drainage and hospital stay, minimally invasive right axillary vertical thoracotomy was superior to median stemotomy, with statistically significant differences (P<0.05). In six month followup after operation, no complications of residual deformity and pericardial effusion were found in both groups by doing echocardiography, but mild pectus carinatum was found in 8 patients in the traditional median sternotomy group (traditional group), whereas patients in another group were well recovered. Conclusions: Minimally invasive right subaxillary vertical thoracotomy for common congenital heart diseases is as safe as traditional median stemotomy, without the increasing incidence of postoperative complications. Additionally, compared with traditional median stemotomy, minimally - invasive right subaxillary vertical thoracotomy is better in the aspects of hidden incision, appearance, and postoperative recovery.

Effects of Traditional Chinese Medicine Five-element Music Combined with Acupoint Application on Perioperative Sleep Quality in Patients Undergoing Joint Replacement Surgery

OBJECTIVE: To explore the effects of traditional Chinese medicine(TCM) five-element music combined with acupoint application on perioperative sleep quality in patients undergoing joint replacement surgery. METHODS: In this study, a total of 122 patients with joint replacement surgery in Beijing Jishuitan Hospital were targeted from 2015 to 2018. All patients were grouped by random number table method. Among them, 61 patients with routine nursing were included in the control group. On this basis, the other 61 patients with acupoint application and TCM five-element music therapy were included as the observation group. 2 weeks later, the Pittsburgh Sleep Quality Index(PSQI) was used to evaluate sleep quality in all patients. The sleep improvement of the 2 groups was evaluated, and the patient was assessed for anxiety and depression, and the curative efficacy was evaluated. RESULTS: After 2 weeks of nursing, the PSQI of the patients improved significantly. The PSQI of the observation group was only 6.6 ± 2.4, and the control group decreased to 9.9 ± 2.7. The observation group was better than the control group, and the difference was statistically significant(P < 0.05). Comparing the 2 groups, the anxiety score of the observation group decreased to 4.8 ± 1.6, which was significantly lower than that of 6.9 ± 2.2 in the control group. The depression score of the observation group decreased to 4.6 ± 1.3, which was significantly lower than that of 6.8 ± 2.3 in the control group. In the control group, the negative emotion scores after nursing were better than those before nursing, and the difference was statistically significant(P < 0.05). Comparing the 2 groups, the effective rate of sleep improvement in the observation group was 96.6%, and the cure rate was as high as 49.1%. The control group was 82.0%, and the cure rate was 18.0%. The observation group was better than the control group, and the difference was statistically significant(P < 0.05). CONCLUSION: The combination of TCM five-element music with acupoint application can improve the perioperative sleep quality of patients undergoing joint replacement surgery, and it can help patients to relieve negative emotions. It is worth promoting.

Clinical Effect of Fuming-Washing with Traditional Chinese Medicine after Anorectal Surgery

Objective:To observe the effect of fuming-washing with traditional Chinese medicine(TCM)after anorectal surgery.Methods:116 cases of patients with surgical operation were selected in the anorectal department of our hospital,which is Shenzhen Bao'an Hospital of Traditional Chinese Medicine,Shenzhen.According to the different postoperative adjuvant treatment methods implemented by patients,they were divided into two groups under the premise of equal number of patients.Among them,58 cases of patients with traditional Chinese medicine(TCM)fuming-washing treatment were divided into study group,and patients with hip bath treatment with potassium permanganate solution were divided into common group.The efficacy of adjuvant therapy was observed.Results:The observation and analysis showed that the actual effect of TCM adjuvant therapy was more prominent,and the difference between groups was more significant(P<0.05).Conclusion:The effect of traditional Chinese medicine adjuvant therapy is more significant than that of chemical method,which can help patients achieve better postoperative recovery effect.We should popularize this treatment in time for patients after surgery,and improve the prognosis of patients.

Treatment of refractory diabetic gastroparesis: Western medicine and traditional Chinese medicine therapies

Refractory diabetic gastroparesis(DGP),a disorder that occurs in both type 1 and type 2 diabetics,is associated with severe symptoms,such as nausea and vomiting,and results in an economic burden on the health care system.In this article,the basic characteristics of refractory DGP are reviewed,followed by a discussion of therapeutic modalities,which encompasses the definitions and clinical manifestations,pathogenesis,diagnosis,and therapeutic efficacy evaluation of refractory DGP.The diagnostic standards assumed in this study are those set forth in the published literature due to the absence of recognized diagnosis criteria that have been assessed by an international organization.The therapeutic modalities for refractory DGP are as follows:drug therapy,nutritional support,gastricelectrical stimulation,pyloric botulinum toxin injection,endoscopic or surgical therapy,and traditional Chinese treatment.The therapeutic modalities may be used alone or in combination.The use of traditional Chinese treatments is prevalent in China.The effectiveness of these therapies appears to be supported by preliminary evidence and clinical experience,although the mechanisms that underlie these effects will require further research.The purpose of this article is to explore the potential of combined Western and traditional Chinese medicine treatment methods for improved patient outcomes in refractory DGP.

Combined effect of Traditional Chinese Medicine decoction and low-molecular-weight heparin calcium on the postoperative deep venous thrombosis in patients with lower limb fracture

OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fracture.METHODS: Totally 86 hospitalized patients with DVT after surgery of lower limb fracture between September 2012 and January 2015 were recruited and randomly divided into control group and observation group, 43 cases in each group. The patients in the control group were treated with subcutaneous injection of low-molecular-weight heparin calcium, and those in the observation group were additionally given Danshen Injection and TCM decoction. The differences between two groups in occurrence rate, medication time, therapeutic effects,recurrence rate of thrombosis, activated partial thromboplastin time(APTT), and prothrombin time(PT) were compared.RESULTS: The occurrence rate of DVT in observation group(4.65%, 2/43) was lower than that in control group(27.91%,12/43)(P<0.05). The medication time of observation group was(6.15±2.94) d, shorter than(9.76±3.12) d in the control group(P<0.05). In observation group, 2 cases of DVT were cured(2/2); in the control group, 9 cases presented therapeutic effects and the total effective rate was 75.00%(9/12). The improvement of APTT and PT in the observation group was better than that in the control group(P<0.05).CONCLUSION: Integrative TCM decoction plus low-molecularweight heparin calcium is superior to applicaton of low-molecularweight heparin calcium alone in reducing and treating DVT in the postoperative patients with lower limb fracture.

Extreme Obesity Treated with Integrated Traditional Chinese and Western Medicine and Construction of an Innovative Obesity Diagnosis and Treatment Model: A Case Report

Background:The incidence of obesity is increasing each year,and is often accompanied by multi-system metabolic disorders,typically chronic diseases and multi-disease superposition disease states.Metabolic surgery is an important treatment option for patients with extreme obesity;however,surgical difficulties and perioperative complications are more serious in these patients.Therefore,there is an urgent need for a new comprehensive diagnosis and treatment model to reduce the weight of patients prior to surgery,subsequently reducing the risks of surgery.Case summary:This model combines traditional Chinese medicine(TCM),external TCM treatment,and health management with western technique of metabolic surgery.Obesity is recognized and treated by multidisciplinary,multi-channel,and multi-means,constituting an innovative diagnosis and treatment model of obesity in integrated traditional Chinese and Western medicine.The application of this model in the treatment of a patient with extreme obesity having multiple systemic diseases is described herein.Conclusion:The integrated traditional Chinese and Western medicine obesity diagnosis and treatment model can be used for precise syndrome differentiation,individualized treatment,and follow-up management of patients with extreme obesity,with strong scalability and significant clinical efficacy.

Clinical observation of traditional Chinese medicine nursing on recovery of gastrointestinal function in patients after abdominal operation

Objective: To observe the clinical effect of traditional Chinese medicine nursing on the recovery of gastrointestinal function after abdominal operation. Methods: A total of 148 patients undergoing abdominal surgery from June 2013 to June 2014 in our hospital were randomly divided into observation group and control group, 74 cases in each group. The control group received routine nursing and the observation group was treated with the pointer, acupuncture and external application of abdominal treatment on the basis of routine nursing, which is 2 times a day,7 days for a course of treatment. Results: The recovery time of bowel sound, the first anal exhaust defecation time the in the observation group and the hospital day was less than the control group. With the comparison of two groups, the difference between the two groups was statistically significant (P < 0.05). The incidence of abdominal pain, abdominal distension, nausea, vomiting and constipation in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: On the basis of routine nursing, the implementation of traditional Chinese medicine characteristic nursing can effectively promote the recovery of gastrointestinal function, reduce the occurrence of complications, shorten the length of stay and improve the clinical effect.

基于大黄散穴位贴敷的中西医结合便秘防治护理在肛肠术后的应用观察

目的比较对肛肠术后患者采取大黄散穴位贴敷的中西医结合护理与传统一般护理对预防便秘的疗效差异。方法回顾性研究2021年1月至2022年2月福建中医药大学附属人民医院肛肠科150例肛肠手术后患者预防便秘的方法,按照治疗方式不同分为大黄散穴位贴敷观察组和传统对照组,每组各75例。观察组在一般护理方法基础上采用大黄散穴位贴敷治疗,对照组采用一般护理方法。比较干预前后两组患者排便积分、Bristol大便性状分型、便秘发生情况、便秘相关不良事件发生等情况。结果干预前,两组患者排便积分对比差异无统计学意义(P=0.987)。干预后,观察组患者排便积分低于对照组(P=0.034);与对照组相比,观察组患者大便性状改善,便秘发生率降低,灌肠率降低,腹痛减少,肠道出血比例降低,肛门疼痛减少,预防便秘的总有效率高于对照组(均P<0.05)。结论肛肠术后患者采用大黄散穴位贴敷的中西医结合护理的便秘防护护理,与传统一般护理方法比较,能更好改善患者便秘情况。

中医适宜技术在骨外科术后气虚血瘀证患者快速康复的应用研究

目的观察中医适宜技术在骨外科术后气虚血瘀证患者快速康复中的应用,为中医特色护理提供一定参考。方法本次研究对骨外科接受手术治疗的120例骨折患者进行观察,顺利完成手术,术后“四诊”辨证分型,确定“气虚血瘀证”。随后使用红与绿随机摸球的方式,将患者分入2个临床组别。对照组60例,予以系统护理;在此基础上,观察组60例,予以中医适宜技术。术前及术后1周对视觉模拟评分(VAS)、匹兹堡睡眠指数(PSQI)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评估,对比2组术后胃肠功能恢复及并发症。结果干预后2组VAS评分、PSQI评分、SAS评分和SDS评分低于干预前(P<0.05);干预后观察组VAS评分、PSQI评分、SAS评分和SDS评分低于对照组(P<0.05)。对照组的首次排气时间、首次排便时间、首次进食时间和住院时间高于观察组,有统计意义(P<0.05)。对照组的总并发症率15.00%高于观察组3.33%,有统计意义(P<0.05)。结论中医适宜技术对于骨外科术后气虚血瘀证患者具有快速康复的效果,有助于缩短恢复时间,提高睡眠质量和情绪状态,减轻术后疼痛及并发症。

基于应用型人才培养的中医外科学本科教学方法探讨

中医外科学是中医学的重要组成部分之一,具有很强的应用性、实践性。随着时代发展和社会要求,患者的医疗需求及对医疗质量的要求日渐提高。同时疾病治疗复杂化和疾病谱的改变,对广大中医药事业技术人员的专业素养提出更高的要求,培养符合中医药事业发展的应用型人才已是刻不容缓的任务。通过探讨不同的本科教学模式,突出中医外科特色教学,建立全面可行的应用型人才培养模式,培养新型应用型中医外科人才,为中医外科医疗事业提供人才保障。此文将从应用型人才培养目标、中医外科学教学现状、教学模式及考核体系等方面进行探讨,探索中医外科学本科应用型人才的培养模式,提升本科生医学知识储备、临床实践技能水平、人文素质及科研能力等综合能力,提高教学质量,培养合格人才。

中医外科人文传承推进中西医结合外科学课程思政教学的探索与实践

院校教育与师承教育相融合是中医药大学高等教育研究的热点议题,中医人文传承是中医师承教育的一部分,传统中医外科人文传承有兼容开放、务实求真、重视外治的特色。本文拟在岭南中医外科学术流派研究及中医师承研究的基础上,挖掘中医外科人文传承内涵,通过对岭南中医外科医家及传人的访谈,研读医家现存著述,整理其中具有高尚医德、影响医术传承的人文故事,建立中医外科人文传承相关的课程思政史料库,丰富中西医结合外科学课程思政建设的内容。本文归纳阐述了中医外科人文传承参与中西医结合外科学课程思政建设的意义及内涵,并详细论述中医外科人文传承元素参与课程思政建设的融入路径、融入点和融入载体,并对融入成效评价进行初步探索,为中医院校临床教学的课程思政建设提供思路。

关节镜微创治疗与传统手术治疗跟骨骨折的临床疗效比较

目的探讨关节镜微创治疗与传统手术治疗跟骨骨折的临床疗效。方法选择2018年3月—2023年3月在四川省什邡市人民医院就诊治疗的41例跟骨SandersⅡ、Ⅲ型骨折患者,按术式不同分为传统组(n=21)与关节镜组(n=20)。比较2组患者手术时间、术中出血量、切口长度、骨折愈合时间和Maryland足功能评分、美国足踝矫形外科协会(American orthopedic foot and ankle society,AOFAS)足功能评分及临床治疗有效率和并发症发生率。结果关节镜组手术时间、术中出血量、切口长度、骨折愈合时间均小于传统组(P<0.05)。2组患者术后AOFAS、Maryland足功能评分均较术前升高,与术前比较差异有统计学意义(P<0.05)。术后3个月,关节镜组AOFAS、Maryland足功能评分高于传统组,差异有统计学意义(P<0.05)。关节镜组治疗总有效率和并发症发生率分别为95.00%、5.00%,与对照组的61.90%、38.10%比较,差异有统计学意义(P<0.05)。结论关节镜辅助治疗跟骨SandersⅡ、Ⅲ型骨折较传统手术治疗创伤小,促进足部功能的恢复好,并发症发生率低,临床治疗效果好,对提高跟骨骨折的治疗效率有非常积极的影响。

基于OBE理念的中医外科学皮肤病单元临床见习模式研究

目的:在中医外科学皮肤病单元临床见习教学中引入OBE理念,分析基于OBE理念的中医外科学皮肤病单元临床见习模式教学改革实践效果。方法:把中医外科学皮肤病单元临床见习的学生以单双周为单位分为两组。双周组为对照组,采用传统教学模式,单周组为试验组,采用OBE教学模式,通过期末考试成绩和问卷调查的结果,反映两种教学模式下学生的学习效果。结果:试验组学员期末考试成绩及问卷调查满意度均优于对照组(P<0.05)。结论:以OBE教学模式进行临床见习模式的教学改革,可以充分利用教学资源,缩短课堂教学时间,提升学生自学能力,具有一定创新性及应用价值,为探索中医教学改革提供了一种新模式。

完全腹腔镜回肠造口还纳术与传统回肠造口还纳术的对比研究

目的探讨并分析完全腹腔镜回肠造口还纳术与传统回肠造口还纳术的临床应用效果。方法选取2020年12月—2022年12月本院收治的80例行回肠单腔造口还纳术的患者为研究对象,并将患者分为完全腹腔镜组(n=40)以及传统开腹组(n=40),对比两组患者的术后相关指标及两组患者术后30d死亡率以及并发症的发生率。结果完全腹腔镜组患者的手术时间显著长于传统开腹组,住院时间短于传统开腹组,腹腔镜内粘连松解率高于传统开腹组,再住院率低于传统开腹组,组间差异有统计学意义(P<0.05);完全腹腔镜组患者的术中出血量与传统开腹组相比,组间差异无统计学意义(P>0.05);两组患者术后30d均未出现死亡病例;与传统开腹组相比,完全腹腔镜组术后30d内并发症的总发生率较低,组间差异有统计学意义(P<0.05)。结论完全腹腔镜回肠造口还纳术与传统回肠造口还纳术相比较,手术效果更为理想,能够有效保证患者的手术安全性,值得在临床中进一步推广应用。

基于三要素之课程思政在中医外科学混合教学中的应用

“课程思政”是中国现代社会主义建设下教育发展的产物,符合中国社会主义新时代教育发展的规律。中医学具有融入思政教育的天然优势。中医外科学是中医学专业的主干课程,是重要的临床专业课。作者团队在中医外科学的教学中,除传统的课堂教学与临床实践教学外,还进行了基于在线开放课程的线上线下混合式教学,且围绕教师、教书育人、学生三要素,具体实施课程思政探索。