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.

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.

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.

Effect of Chinese Medicines on the Subretinal Fluid Absorption after Operation for Retinal Detachment

Purpose:To determine the effects of traditional Chinese medicines on subretinal fluld absorption after Operation for retinal detachment.Mehods:Among100eyes with operations fo retinal detachment without drainage of fluid,there were 50eyes in traditional Chinese medicine treatment group and 50eyes in the control group.and there were no significant difference between the two groups in age,myopia and retinal detachment area.We observed the time for the absorption of subretinal fluid and visual acuity improvement aftr the opera-tions for retinal detachment.Results;he result showed that the average time for the absorption of subretinal fluid was14.5days in the traditional Chinese medicine treatment group,21.7days in the control group and the visual acuity was better in the former than in the latter.Conclusions:The taditional Chinese medicine treatment could increase the ab-sorption of subretional fluid,the mechanisms of which may be that Chinese medicines regulated and impved the general blood circulation and local eye blood criculation and the function of blood-retinal barrier so that they increase the out-ward osmotic suction forces of the pigment epithelium.

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

目的:观察中医护理对促进腹部手术后患者胃肠功能恢复的临床疗效。方法:选取我院普外科2013年6月至2014年6月收治的行腹部手术的患者148例,随机分为观察组和对照组,每组各74例,对照组给予常规护理,观察组在对照组常规护理基础上加用指针、针刺联合外敷腹部治疗,每日2次,7天为一疗程。结果:观察组肠鸣音恢复时间、首次肛门排气排便时间、住院天数均少于对照组,两组比较,差异有统计学意义(P<0.05);术后的腹痛腹胀、恶心呕吐及便秘等并发症的发生率观察组均明显低于对照组,差异有统计学意义(P<0.05)。结论:在常规护理基础上,实施中医特色护理,可有效促进胃肠功能恢复,减少并发症的发生,缩短住院时间,提高临床疗效。

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.

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。

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。

经皮穴位电刺激联合中医情志干预对腹腔镜直肠癌根治术患者免疫功能和心理应激的影响

【目的】评价经皮穴位电刺激(TEAS)联合中医情志干预对腹腔镜直肠癌根治术患者免疫功能和心理应激的影响。【方法】将100例住院拟行腹腔镜直肠癌根治术治疗的患者随机分为A、B、C、D 4组,每组各25例。A组给予麻醉前TEAS 30 min,B组给予持续TEAS至手术结束,C组给予麻醉前TEAS 30 min+中医情志干预,D组给予持续TEAS至手术结束+中医情志干预,其中,TEAS取穴足三里(双侧)、三阴交(双侧)、百会、内关(双侧)。观察各组围术期指标以及术前与术后3 d免疫功能指标、Th1/Th2细胞分子机制、心理应激反应指标的变化情况,并比较各组的不良反应发生情况。【结果】(1)围术期指标方面,4组患者的手术时间、出血量、输液量比较,差异均无统计学意义(P>0.05);D组的舒芬太尼用量、瑞芬太尼用量、术后苏醒时间、术后24 h痛觉模拟量表(VAS)评分均低于A组、B组、C组(P<0.05),而B组、C组的上述指标均低于A组(P<0.05)。(2)免疫功能指标方面,D组术后3 d的T淋巴细胞亚群CD3+、CD4+及自然杀伤(NK)细胞水平均高于A组、B组、C组(P<0.05),而B组、C组的上述指标均高于A组(P<0.05)。(3)Th1/Th2细胞分子机制方面,D组术后3 d的血清白细胞介素2(IL-2)、γ干扰素(IFN-γ)水平均高于A组、B组、C组(P<0.05),血清白细胞介素10(IL-10)水平均低于A组、B组、C组(P<0.05),而B组、C组的血清IL-2、IFN-γ水平均高于A组(P<0.05),血清IL-10水平均低于A组(P<0.05)。(4)心理应激反应指标方面,D组术后3 d的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均低于A组、B组、C组(P<0.05),而B组、C组的上述评分均低于A组(P<0.05)。(5)不良反应方面,A组出现1例恶心呕吐,B组出现2例恶心呕吐、1例头晕,C组无不良反应,D组出现1例恶心呕吐,不良反应发生率分别为4.0%(1/25)、12.0%(3/25)、0.0%(0/25)、4.0%(1/25),组间比较,差异无统计学意义(χ2=0.400,P=0.527)。【结论】针对腹腔镜直肠癌根治术患者,TEAS联合中医情志干预可有效调节患者围术期免疫功能,减轻应激反应,缓解患者紧张焦虑状态,同时可产生一定的镇痛作用,减少阿片类药物用量,提高患者围术期舒适度及手术耐受水平。

Clinical Application of Fast-Track Surgery with Chinese Medicine Treatment in the Devascularization Operation for Cirrhotic Portal Hypertension

Objective： To investigate the clinical effect of fast-track surgery combined with Chinese medicine treatment in devascularization operation for cirrhotic esophageal varices. Methods： Seventy-two patients with cirrhotic esophageal varices were selected from January 2009 to June 2013, and randomly assigned to a conventional group and a fast-track group （fast-track surgery combined with Chinese medicine treatment） using a randomized digital table, 36 cases in each group. Operation and anesthesia recovery time, postoperative hospitalization and quality of life were recorded and compared between groups during the perioperative period. Results： Compared with the conventional group, the fast-track group had longer operation time （253.6±46.4 min vs. 220.6±51.0 min） and anesthesia recovery time （50.5 ± 15.9 rain vs. 23.5± 9.6 min; P〈0.01）; less bleeding （311.3±46.8 mL vs. 356.2 ± 57.5 mL; P〈0.01） and less transfusion （1932.3 ± 106.9 mL vs. 2045.6 ± 115.4 mL; P〈0.01）; as well as faster recovery of gastrointestinal function, shorter postoperative hospitalization and higher quality of life. There were no serious postoperative complications and no further bleeding occurred. Conclusion： Fast-track surgery combined with Chinese medicine treatment is a safe and feasible approach to accelerate the recovery of patients with cirrhotic portal hypertension in perioperative period of devascularization operation.

陈氏清肝解毒汤治疗肝经郁热型带状疱疹临床观察

目的:观察陈氏清肝解毒汤治疗肝经郁热型带状疱疹的临床效果。方法:选择上海市中医医院治未病科2020年1月~2022年12月带状疱疹患者75例进行研究,随机将其分为两组,其中对照组(n=37)接受盐酸伐昔洛韦片+甲钴胺片+炉甘石洗剂治疗,治疗组(n=38)加用陈氏清肝解毒汤,均实施为期10d治疗。观察两组10d治疗结束后的临床治疗效果;对比治疗前后的症状量化评分;对比治疗前,治疗后3d, 7d, 10d疼痛情况(VAS)评分;对比水疱停止增加时间、病灶结痂时间和脱痂时间;对比治疗前后血清水痘-带状疱疹病毒IgM抗体(VZV-IgM);对比不良反应情况;对比治疗后3个月带状疱疹后遗神经痛(PHN)的发生率。结果:治疗组10d治疗结束后临床疗效总有效率为90.32%,且高于对照组80.00%(P<0.05);10d药物治疗完成后,治疗组症状量化评分低于对照组(P<0.05);治疗后7d, 10d,治疗组疼痛低于优于对照组(P<0.05);与对照组相比,治疗组患者经药物治疗后水疱未增多、病灶结痂及脱痂时间均较低(P<0.05)。10d药物治疗完成后,治疗组患者VZV-IgM低于对照组(P<0.05);两组不良反应发生率相同(P>0.05)。治疗组治疗后3个月PHN发生率低于对照组(P<0.05)。结论:陈氏清肝解毒汤加入西药治疗后,不仅能有效改善肝经郁热型带状疱疹患者临床疗效,同时对病程缩短、疼痛减轻及减少PHN发生均有积极作用。

简单型先心病围术期中西医结合加速康复临床护理路径的构建及应用效果评价

目的构建简单型先心病围术期中西医结合加速康复外科(CMERAS)临床护理路径(CNP)并应用,探讨其对患儿术后康复的影响。方法选取2021年1月-2022年12月在我院行体外循环手术的90例简单型先心病患儿作为研究对象,采用随机数字表法分为对照组和观察组,每组45例。对照组实施小儿心脏外科常规护理;观察组严格按照构建的简单型先心病围术期CMERAS CNP实施护理。比较2组患儿术后康复情况、并发症发生率及护理满意度。结果观察组患儿的机械通气时间、尿管及引流管留置时间、首次下床活动时间、ICU治疗时间及住院天数明显短于/早于对照组(P<0.05);观察组患儿术后并发症总发生率明显低于对照组,差异有统计学意义(P<0.05);观察组满意度明显提高(P<0.05)。结论CMERAS CNP应用于简单型先心病围术期,可规范加速康复外科的护理行为,促进患儿早日康复,改善患儿结局,提高满意度,社会效益好,值得在临床上推广应用。

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。

基于微信-问卷星的形成性评价在中医外科学教学中的应用

目的探讨基于微信-问卷星的形成性评价在中医外科学教学中的应用效果。方法选择扬州大学中西医临床医学专业2015级、2017级和2018级本科学生作为研究对象,实验组2017级和2018级采用微信-问卷星平台的形成性评价、问卷调查、学生访谈,对照组2015级沿用传统终结性评价。结果实验组期末平均成绩和及格率均高于对照组,实验组期末考试优良率[81.48%(22/27)、87.50%(21/24))]明显优于对照组[61.76%(21/34)],且差异具有统计学意义(P<0.05)。结论借助微信-问卷星开展中医外科学形成性评价的教学实践,可以显著提高教学效果,值得在中医其他学科推广应用。

基于立德树人 守正创新 人文关怀的中医外科临床带教思政教育融入探索——以乳腺疾病为例

结合中医外科学课程特点,将思政教育融入课程教学以及临床带教中,以专业知识为载体,结合立德树人,守正创新,人文关怀设计教学内容和形式,在临床带教中融入思政教育。以乳腺疾病为例,基于思政理念,通过课堂内外、典型病案及借助模型教具等多种教学模式,以乳腺疾病的“点”带动中医外科学的“面”,提高学生职业责任感和自豪感,培养学生良好的专业素养。

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。

中西医结合甲状腺外科发展现状与思考

手术是治疗甲状腺癌、甲状腺腺瘤、结节性甲状腺肿等疾病的主要方式。甲状腺疾病在中医学中被称为“瘿病”,中医以整体观、辨证论治思想通过内治及外治多种途径治疗瘿病,优势独特、效果显著。中西医结合甲状腺外科是在甲状腺手术全流程管理中倡导中西医结合、多学科协作的理念,实现中西医取长补短、优势互补。本文通过文献回顾的方式梳理、总结了中医药方法在甲状腺疾病围手术期及术后随访诊疗中的应用,分析中西医结合甲状腺外科的发展现状,同时对未来工作进行展望与建议,希望对外科、中医科、麻醉科、护理等多学科临床医护人员、科研工作者、医院管理工作者有所帮助。

新时代背景下的中医外科学课程融入思政教学体会

党的十九大确立了习近平新时代中国特色社会主义思想的指导地位,并在新时代背景下,对当代大学生人生观及专业素养的培养提出了新的要求。中医学课程的教学通过医德、仁术等方面的教育,在提升学生道德修养、增强民族自信心、开拓奉献精神方面都起着极为重要的作用。中医外科学在理论传授、实践技能锻炼、临床教学方面具有独特的思政教学特点,能将习近平新时代背景与课程思政紧密结合。通过课堂授课、技能培训、临床实习等教学过程,更加全面、系统、直观地用习近平新时代中国特色社会主义思想武装中医学专业大学生头脑,培养有理想、有本领、有担当的新时代中医人。