特色光刺激双眼对人体植物神经功能的影响

目的 探讨植物神经功能紊乱相关疾病的治疗，研究特色光刺激双眼对本病的影响及治疗作用。方法 回顾性总结分析采用视窗光导治疗仪治疗偏头痛、眩晕症、失眠症、神经衰弱和原发性高血压共805例(男302例，女503例)的临床资料。结果 平均治疗时间为20．6min／次，平均治疗次数6．25次／例。临床治愈率66．5％，有效率84．5％。结论 采用特色光刺激双眼，可以相对提高副交感神经系统的兴奋性，拮抗交感神经，达到缓解和治疗植物神经功能紊乱相关疾病的目的。     

帕罗西汀治疗植物神经功能紊乱症的疗效观察

目的：探讨抗抑郁药帕罗西汀治疗植物神经功能紊乱症的疗效和适应证。方法：将50例植物神经功能紊乱患者分成两组，综合组给予帕罗西丁治疗（赛乐特20-40mg／d），对照组给予传统的单纯内科治疗（谷维素、安定等），两组均配合支持性心理治疗，治疗期为4周。于治疗前、后分别进行焦虑自评量表（SAS）、抑郁自评量表（SDS）、90项症状自评量表（Scl-90）及植物神经功能紊乱症状评分。结果：50例植物神经功能紊乱患者中60％存在焦虑症状，53％存在抑郁症状。植物神经功能紊乱患者的SAS、SDS及Scl-90的部分因子评分均明显高于常模，差异具有显著性（P〈0.05）。治疗4周后综合组SAS、SDS及植物神经功能紊乱症状评分明显低于对照组，差异具有显著性（P〈0.05）。有情绪障碍的植物神经功能紊乱患者经抗抑郁治疗后植物神经功能紊乱症状减分综合组明显大于对照组，差异具有显著性（P〈0．05）；无情绪障碍的植物神经功能紊乱患者经两种疗法后其植物神经功能紊乱症状减分差异无显著性（P〉0．05）。结论：植物神经功能紊乱患者普遍存在情绪问题，抗抑郁剂适合治疗有情绪障碍的植物神经功能紊乱患者，既能改善情绪症状又能改善植物神经功能紊乱症状     

牡蛎散加味治疗焦虑症伴严重植物神经功能紊乱

1例焦虑症伴严重植物神经功能紊乱患者采用心理疗法及抗抑郁药治疗对植物神经功能紊乱疗效不佳,改用牡蛎散加味治疗27d痊愈。     

老年抑郁症误诊17例临床分析

目的 探讨老年抑郁症的临床特征、误诊原因,为提高基层医院医生对老年抑郁症的识别率提供依据.方法 对17例老年抑郁症患者的临床资料进行回顾性分析.结果 17例抑郁症病例中,误诊为消化系统疾病23.53%,心血管疾病11.76%,神经系统疾病17.65%,泌尿生殖系统疾病17.65%,植物神经功能紊乱11.76%,代谢疾病11.76%,其他5.88%.结论 提高基层医院医生对老年抑郁症的认识和重视程度,是减少误诊的关键.     

牡蛎散加味治疗焦虑症伴严重植物神经功能紊乱

1例焦虑症伴严重植物神经功能紊乱患采用心理疗法及抗抑郁药治疗对植物神经功能紊乱疗效不佳，改用牡蛎散加味治疗27d痊愈。     

经皮电刺激治疗颞下颌关节紊乱

目的 :观察经皮电刺激(TENS)治疗颞下颌关节紊乱疗效。方法 :采用TENS及He -Ne激光 (对照组 )治疗颞下颌关节紊乱 ,两组分别为70颞/67例和70颞/68例。结果 :TENS组及对照组治疗前后总痊愈显效率及有效率分别为88.6 %、97.1 %和82.9 %、95.7 % ,经统计学处理 ,差异均无显著性意义 ( P >0.05)。疗程10次以内的患者 ,TENS组45例 (46颞下颌关节 ) ,对照组41颞/40例 ,痊愈显效率分别为89.1 %和70.7 %(P<0.05) ,平均治疗次数分别为(5.4±2.0)和(6.7±2.0)(P<0.05) ,两组相比均有显著性差异。结论 :TENS可有效治疗颞下颌关节紊乱 ,见效较He -Ne激光快。     

高电位治疗仪改善血液透析患者植物神经功能紊乱的效果及安全性

血液透析可调节尿毒症症状,提高患者的生活质量。但血液透析在改善患者尿毒症症状的同时,也容易引起植物神经功能紊乱。为了改善因血液透析引起的植物神经功能紊乱症状,进一步提高血液透析患者的生活质量,选择了既能调整植物神经功能,又无任何毒副作用的高电位治疗仪对18例有血液透析综合征的患者进行疗效及安全性观察,结果痊愈2例,显效6例,有效8例,无效2例,总有效率89%。说明高电位治疗仪确能改善血液透析引起的植物神经功能紊乱临床症状,且十分安全。     

脊髓损伤后植物神经反射异常的临床特点及防治措施

植物神经反射异常是一种多见于T6及以上脊髓损伤人群中的急性病症,慢性脊髓损伤患者中发病率较高,常由损伤平面以下部位刺激诱发。突然的血压升高是主要的临床症状,未经处理的高血压可引起心脑血管意外甚至死亡。植物神经功能紊乱的发病机制可能与脊上调节功能障碍、发生神经可塑性变化以及相关受体发生变化有关。目前治疗及预防措施主要有去除诱因、体位调节及药物治疗。     

糖尿病人植物神经功能与心源性猝死

43例糖尿病人,按心率变异<100±20ms或R-R差大于50ms率<3%或24小时最低心率>60次/分判断植物神经功能,其中23例符合糖尿病伴植物神经病变.三年随访结果:23例中猝死8例.无植物神经病变者死亡2例.显示糖尿病伴植物神经病变是疾病晚期表现,短期内猝死率高,抗交感神经治疗是防止猝死的重要方法.     

导痰汤治疗卒中后抑郁症临床观察

目的:观察导痰汤治疗脑卒中后抑郁症的临床疗效及其不良反应。方法:70例患者随机分为2组,治疗组35例应用导痰汤为主加减治疗,对照组予氟西汀治疗,30d为1个疗程。结果:2组间疗效比较,差别无统计学意义;2组间肠胃道不适症状、植物神经功能紊乱,组间比较差异均有统计意义(P<0.05),治疗组明显优于对照组。结论:导痰汤治疗脑卒中后抑郁症与目前公认的氟西汀临床疗效相当,但肠胃道不适症状、植物神经功能紊乱症状等不良反应发生率明显降低。     

骶神经电刺激治疗顽固性排尿功能障碍

目的观察骶神经电刺激(sacral nerve stimulafion,SNS)治疗顽固性排尿功能障碍的临床效果.方法对1例确诊为顽固性排尿功能患者行骶3孔神经电刺激治疗.结果电刺激治疗8 d后及拔除电极后第1,4,8周,B超测定剩余尿量为0,尿失禁、尿频、尿急等临床症状均明显改善,每次排尿量正常.结论骶神经电刺激能有效地治疗顽固性排尿功能障碍.     

Facilitation of ganglionic transmission by sulpiride: evidence for an inhibitory role of dopamine in the canine sympathetic ganglion

Effects of the (R) and (S) enantiomers of sulpiride, a potent dopamine (DA) antagonist, on ganglionic transmission were studied in anesthetized dogs. The pre- and postganglionic nerves of cardiac sympathetic ganglia were stimulated electrically, and heart rate was monitored as a measure of ganglionic transmission and sympathetic nerve activity. The heart rate was free from influence of the central nervous system. (R)- And (S)-sulpiride injected i.a. close to the blood supply of the ganglia did not alter basal heart rate, but facilitated ganglionic transmission as demonstrated by an increase in the tachycardia induced by preganglionic nerve stimulation. The (R) enantiomer was 4 times more active than the (S) enantiomer in this respect. Neither enantiomer affected the tachycardia induced by postganglionic nerve stimulation. Norepinephrine and DA injected i.a. caused inhibition of the tachycardia induced by preganglionic nerve stimulation. The inhibitory effect of both catecholamines was antagonized by the sulpiride enantiomers (R)-sulpiride was about 4-fold more potent than (S)-sulpiride in antagonizing DA, whereas (S)-sulpiride was more active against norepinephrine. The sulpiride enantiomers affected neither the tachycardia induced by i.a. administration of acetylcholine nor the bradycardia induced by vagal nerve stimulation. Thus, cholinesterase inhibition and ganglionic stimulation were excluded. These data are, therefore, consistent with the hypothesis that the facilitatory action of the sulpiride enantiomers is related to the antagonism of catecholamines. Positive correlation between the activity of the (R) enantiomer to facilitate ganglionic transmission and to antagonize DA suggests that DA is a physiologically released catecholamine modulating transmission in the cardiac sympathetic ganglia of the dog.     

Clinical features of gastrointestinal diseases in patients with primary mitral prolapse

Whether patients with mitral prolapse (MP) have specific features in the course of their gastrointestinal diseases (GD) was studied in 420 MP patients with various GD. Echocardiography and examination of the vegetative status were conducted in all the patients. On demand, esophagogastroduodenoscopy, ultrasonic investigation of the abdominal organs, multistage fraction duodenal intubation were made. The findings evidence of more severe course of GD in MP patients. This manifests in early onset, severe pain and dispeptic syndromes, marked mucosal inflammation and is explained by dysfunction of the vegetative nervous system and generalized dysplasia of the connective tissue.     

Role of grandaxin in the treatment of functional gastrointestinal diseases

AIM: To assess efficacy of grandaxine in correction of anxiety syndrome and vegetative dysfunction in patients with gastrointestinal diseases. MATERIAL AND METHODS: The trial included 59 patients with functional gastrointestinal, emotional and vegetative disorders who failed standard therapy. 43 patients of the test group received standard therapy in combination with grandaxine. RESULTS: Anxiety (Spilberg-Khanin scale), vegetative dysfunction (Vein scale) reduced in 90% of the patients of the test group more significantly than in the control group. Intestinal passage in patients with irritable colon syndrome improved also. CONCLUSION: A pronounced role of psychovegetative disorders was confirmed in development of functional gastrointestinal disorders. Grandaxine proved efficient in correction of such disorders irrespective of location of the pathology and prevalent tonicity of the autonomic nervous system.     

经骶3神经根和膀胱区的功能性磁刺激治疗排尿功能障碍8例

背景功能性磁刺激具有安全、无创、无副作用等优点,目前已逐步用于中枢神经传导、疲劳恢复、骨愈合、神经疾病治疗及脑功能研究等各方面.目的观察功能性磁刺激治疗排尿功能障碍的疗效.设计对排尿功能障碍患者,采用经骶3神经根和膀胱区的功能性磁刺激治疗,纵向观察. 单位华中科技大学同济医学院附属同济医院康复医学科.对象于2003-06/2004-06在华中科技大学同济医学院附属同济医院泌尿外科就诊的8例排尿功能障碍患者,其中有3例为腰骶椎隐性脊柱裂;4例为尿频尿急综合征,上述7例病例均经长期系统的药物治疗,效果不明显.1例为自闭症及先天性巨结肠术后.方法对8例排尿功能障碍患者,采用Dantec公司(丹麦)生产的MagLite型磁刺激仪,经骶3神经根和膀胱区的功能性磁刺激治疗,2次/d,5 d/周,4～8周1个疗程.治疗前、后采用因排尿的症状而影响生活质量评分(0～6级评分,分值越低生活质量越高)和国际下尿路综合征症状评分进行疗效评价(0～5级评分,分值越低疗效越好).主要观察指标①治疗前后排尿次数、平均尿量及单次最大排尿量的改变.②治疗前后生活质量评分和国际下尿路综合征症状评分的变化.结果所有8例患者经泌尿外科明确诊断为排尿功能障碍,均接受功能性磁刺激治疗,并完成所有评定.①7例难治性尿频尿急综合征患者症状有显著改善,日排尿次数显著减少,平均排尿量增加,尿急程度减轻,其中3例达到完全康复,1例患者无效.②8例患者治疗前国际下尿路综合征症状评分的总分为273分,治疗后为52分;治疗前因排尿症状而影响生活质量的总分为44分,治疗后为11分.结论功能性磁刺激可以部分改善难治性膀胱排尿功能障碍患者的临床症状,从而提高患者的生活质量.     

Neurovegetativum, Blockaden und manuelle Medizin

The ubiquitous distribution of the vegetative nervous system (VNS), the functions of which control all acts in the body, e.g. in the situation of being in homeostasis or homeodynamics, as well as in the case of diseases, makes the diagnostic and therapeutic access to the VNS possible and supports healing in combination with manual medicine and neurotherapy. The definition of a disease or rather a blockade of the spinal column or another joint is basically determined by the stimulus response of the VNS, which can disrupt the balance between the sympathetic and parasympathetic nervous systems depending on the duration and intensity of the stimulus and for this reason can lead to a disorder of an organ or a whole organ system. If a stimulus or irritation lasts long enough and overloads the corresponding regulation mechanism between the sympathetic and parasympathetic nervous systems it will lead to a manifestation of the disease or rather to blockade of the respective region of distribution depending on the predominance of one vegetative branch or the other. Because of the well-developed network of the stimulation conduction system the stimulus could have happened anywhere. The response is not necessarily only at the place where the stimulus occurred and it can also be expected to have occurred somewhere else. Permanent stress (irritation of the sympathetic nervous system) causes a constant reduction of the blood circulation to various organs, back muscles, ligaments and bones. This will lead to organic diseases in the future which can persist even long after the stress situation has passed.     

Neurophysiological characterization of postherniotomy pain

Inguinal herniotomy is one of the most frequent surgical procedures and chronic pain affecting everyday activities is reported in approximately 10% of patients. However, the neurophysiological changes and underlying pathophysiological mechanisms of postherniotomy pain are not known in detail, thereby precluding advances in treatment strategies and prophylaxis. Therefore, we examined forty-six patients reporting moderate to severe postherniotomy pain affecting daily activities for more than a year postoperatively, and compared them with a control group of patients without pain 1 yr postoperatively. A quantitative sensory testing protocol was used, assessing sensory dysfunction type, location and severity. We assessed the protocol test-retest variability using data from healthy control subjects. All patients (pain and pain-free) had signs of nerve damage, seen as sensory dysfunction. Detection thresholds for tactile and warmth stimulation were significantly increased while cold detection and pressure pain detection thresholds were significantly decreased in pain patients compared to controls. Repetitive punctuate and brush stimulation resulted in significantly more frequent and intense pain on the painful side than on the unaffected side in pain patients, and was not observed in controls. Our findings showed large and small fiber dysfunction in both pain and pain-free patients but more profound in pain patients and with signs of central sensitization (abnormal temporal summation). The specific finding of reduced pain detection threshold over the external inguinal annulus is consistent with damage to the cutaneous innervation territory of nervous structures in the inguinal region. The correspondence between pain location and sensory disturbance suggests that the pain is neuropathic in nature. Whether the underlying pathophysiological mechanisms are related to direct intraoperative nerve injury or nerve injury due to an inflammatory mesh response remains to be determined.     

Complex regional pain syndromes

Complex regional pain syndromes (CRPS) (formerly reflex sympathetic dystrophy and causalgia) are neuropathic pain conditions that are initiated by an extremity trauma or peripheral nerve lesion. Clinical definition and scientific understanding of CRPS are still evolving; however, both the clinical picture and therapeutic options are significantly influenced by a dysfunction of the sympathetic nervous system. Recent investigations suggest functional central abnormalities and a peripheral inflammatory component in the pathophysiology of CRPS. Interdisciplinary treatment includes physical, pharmacologic, and invasive interventional therapy, as well as stimulation techniques.     

电刺激小脑顶核对脑梗死患者神经功能恢复的疗效观察

SinceJanuary２００１，wehavetreated３６cerebralinfarctionpatientswithcerebralcirculationfunctiontreatmentdevicemadebyshanghairenhemedicalequipmentcompany（CVFT－０１０Mtype）andgaingoodeffects，reportasfollow．１Subjectandmethod１．１SubjectAllthese７１patientswerein－patientsofourde－partment，whofitthecriterionpassedbythe４th．Nationalcerebralvasculardiseaseacademicconference犤１犦．Thesepatientswerediag－nosedbycerebralCTorMRIscan．Inthese７１patients，３６casestreatedbycerebralcircul…     

干细胞移植:神经系统疾病治疗的新策略

目的干细胞特别是神经干细胞移植治疗神经系统疾病在动物实验中已得到了证实,这为临床神经系统疾病的治疗尤其是其功能的恢复带来了新的希望.近年来有关干细胞及神经干细胞在神经系统疾病研究中的成果较多,从不同的效果及其机制方面提出了干细胞及神经干细胞在神经系统再生修复过程中的假说理论并进行了相关的临床验证.资料来源应用计算机检索Medline数据库1997-01/2003-08期间的文章,检索词为stem cell,neural stem cell,bone marrow stromal cell,stroke,ischemiciniury,nervous system disease,neurotrophicfactor"分别组合进行检索,限定文章语言种类为英文.同时检索万方数据库2003-01/2004-12期间的相关文章,检索词干细胞,神经干细胞,骨髓基质细胞,卒中,缺血性脑损伤,神经营养因子,限定文章语言种类为中文.资料选择对资料进行初筛,选出与研究关系密切的文献.纳入标准研究对象为动物或人,包括干细胞及神经干细胞的基础与临床研究内容.重点选取与缺血性神经损伤相关的文献.资料提炼共收集到文献72篇,其中与本研究关系密切的文献14篇,间接相关的文献10篇,排除重复性文献8篇,共16篇文献用于资料的综述.资料综合对于选取的文献进行阅读、归纳和综合.结果显示神经干细胞在脑血管病、脑和脊髓损伤、变性病以及周围神经病方面均有较高的治疗价值和效果.结论干细胞及神经干细胞在神经系统疾病疾病中具有促进分化、神经营养、神经替代等多种积极作用,在神经系统疾病的治疗中具有广阔的前景.