国内音乐疗法对肿瘤患者抑郁症状干预效果的Meta分析

目的 评价音乐疗法对肿瘤患者抑郁症状的干预效果.方法 采用计算机检索万方、维普、中国知网和中国生物医学文献数据库,按纳入与排除标准选择文献,按Jadad量表评价文献质量,最后提取数据进行定性描述和Meta分析.结果 共纳入19个随机对照试验(RCT),包括1 680例肿瘤患者.音乐治疗效果的抑郁自评量表(SDS)评分是-1.223(-1.655,-0.791),试验组比对照组得分低;汉密尔顿抑郁量表(HAMD)评分是-1.128(-2.504,0.247),但两组差异无统计学意义(P＞0.05).Meta分析异质性比较高,亚组分析异质性无改善,且存在发表偏倚.结论 音乐治疗可以缓解肿瘤患者的抑郁症状,但需更多证据来证实音乐治疗的效果.     

中医药疗法治疗艾滋病合并抑郁症的系统评价与Meta分析

目的系统评价中医药疗法治疗艾滋病合并抑郁症的疗效与安全性。方法检索包括中国知网、万方数据库、维普数据库、Sinomed、PubMed、Cochrane Library、EMbase、Web of Science建库以来至2020年2月收录的有关于中医药疗法治疗艾滋病合并抑郁症的随机对照试验,并对其进行筛选和资料提取。采用Cochrane协作网“偏倚风险”评价工具对纳入试验进行方法学质量评价,使用RevMan 5.3对研究数据进行合并分析。结果共纳入6篇随机对照试验文献,涉及451例患者。Meta分析结果显示,中药方剂联合心理干预较单纯心理疗法明显降低抑郁患者的汉密顿抑郁量表(HAMD)评分(MD-2.06,95%CI-3.24,-0.87;Z=3.4,P<0.01);温针灸联合逍遥散较帕罗西汀可显著降低抑郁患者HAMD评分(MD-4.68,95%CI-6.11,-3.25;Z=6.41,P<0.001)。结论低质量证据显示,使用温针灸联合中药方剂等纯中医疗法,在改善患者抑郁状态、提高患者生活质量方面可能有优势。但由于纳入文献质量不高,该结论需要更多大样本、多中心、高质量的随机对照试验加以验证,为艾滋病合并抑郁症的临床治疗提供更加可靠的证据。     

黛力新联合乌灵胶囊治疗脑卒中后抑郁的Meta分析*

目的系统评价黛力新联合乌灵胶囊治疗卒中后抑郁的安全性和有效性。方法检索PubMed，CNKI，VIP和Wan Fang Data。搜集黛力新联合乌灵胶囊治疗治疗卒中后抑郁的随机对照试验（截止时间为2017年9月）。根据统一的排除及纳入标 准，2名研究员独立挑选文献、提取研讨资料、评价文献品质分析采用RevMan5.3软件。结果纳入16篇RCTs，涉及1299例卒 中后抑郁患者（试验组653例，对照组646例）。Meta分析结果：试验组治疗卒中后抑郁的总有效率比黛力新组高 15%（P<0.05）；1周治疗后2组汉密顿抑郁量表（HAMD）评分无差异（P>0.05），2、4、6、8周后试验组对降低卒中后抑郁 患者的HAMD评分均优于对照组（P<0.05）；4、8、12周后试验组对提高卒中后抑郁Barthel指数（BI）均优于对照组 （P<0.05）；4、6、8周后美国国立卫生研究院卒中量表（NIHSS）评分优于对照组（P<0.05）；试验组治疗卒中后抑郁的 不良反应发生率比黛力新组低34%（P<0.05）。结论黛力新联合乌灵胶囊改善卒中后抑郁患者的日常生活能力、神经功能、 抑郁症状优于对照组，且副作用更小。     

中医手法治疗颈型颈椎病随机对照试验的质量评价研究

背景 中医手法是治疗颈型颈椎病的重要手段。随着研究的不断发展，大量中医手法治疗颈型颈椎病的随机对照试验已经发表，但质量水平参差不齐，限制了中医手法的推广和高质量临床证据的产生。 目的 评价目前中医手法治疗颈型颈椎病随机对照试验的文献质量。 方法 计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统、PubMed、Embase和Cochrane Library数据库中手法治疗颈型颈椎病的随机对照试验，检索时限为建库至2021年6月。由2名研究者完成文献筛选和资料提取。采用物理治疗证据数据库（PEDro）量表、Cochrane偏倚风险评估工具、临床试验报告标准（CONSORT）声明2010版及附加指标评价纳入文献的质量。 结果 共纳入81篇文献，其中2006—2014年共发表文献28篇，年平均发表3.11篇；2015—2021年共发表文献53篇，年平均发表7.57篇。文献质量评价结果显示，PEDro量表总分≥7分的高质量文献仅7篇（8.6%）。Cochrane偏倚风险评估工具显示，高偏倚风险文献所占比例最少，低偏倚风险文献次之，大部分条目因为报告信息不全，评分偏倚风险不确定。CONSORT声明2010版评价结果显示，纳入文献的文题和摘要、方法、结果、讨论、其他信息部分报告率不足。附加指标中采用多中心、伦理审批、干预措施质量控制、志谢报告率低。 结论 目前中医手法治疗颈型颈椎病随机对照试验的文献质量普遍偏低，建议今后研究者参照PEDro量表、Cochrane偏倚风险评估工具、CONSORT声明对中医手法治疗颈型颈椎病的随机对照试验进行规范性报告。     

护理干预对老年抑郁症患者应对方式的影响

目的探讨护理干预对老年抑郁症患者应对方式的作用效果。方法将100例老年抑郁症患者随机分为试验组和观察组,2组均接受抗抑郁药的治疗及常规护理,试验组在此基础上实施综合护理干预。采用抑郁自评量表（SDS）和汉密尔顿抑郁量表（HAMD）评分进行评估。结果试验组SDS、HAMD评分治疗后较治疗前明显改善（P〈0.01）,组间治疗后比较,试验组疗效优于对照组（P〈0.05）。结论对于老年抑郁症患者采用综合性的护理干预有能缓解其抑郁症状,提高生活质量。     

靳三针治疗中风后抑郁症系统评价及Meta分析

目的:评价靳三针疗法治疗中风后抑郁症的临床疗效及研究现状。方法:系统检索中国生物医学文献数据库(CBM)、万方数据库、PubMed、Cochrane Library和Springer、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP),搜集靳三针疗法治疗中风后抑郁症的随机对照试验(RCT),由2名评价员经过文献的筛选、资料提取、评价其特征及偏倚风险后,使用RevMan5.3进行Meta分析。结果:共纳入10个RCT,包括581例患者。经分析,靳三针对有效率、抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD),差异有统计学意义[OR=3.03,95%CI(1.75,5.26),P0.0001;MD=-2.05,95%CI(-2.79,-1.31),P0.00001;MD=-2.05,95%CI(-2.79,-1.31),P0.00001]。结论:Meta分析结果表明,相对于对照组,靳三针治疗中风后抑郁症的疗效结果存在明显优势。由于本系统评价纳入研究质量较低,极可能存在偏倚,影响了结果的论证强度,需要进行多中心、大样本的随机对照双盲试验证实。     

合理情绪疗法对乳腺癌患者术前焦虑抑郁心理的影响

目的：分析合理情绪疗法对乳腺癌患者术前焦虑抑郁心理的影响。方法：将42例乳腺癌患者分为干预组与对照组,干预组应用合理情绪疗法进行健康教育,对照组行一般健康教育,采用汉密顿焦虑量表（HAMD）和汉密顿抑郁量表（HAMA）进行干预前后得分评定。结果：干预组与对照组干预前后HAMA、HAMD评分比较,差异有显著性（P〈0.01）。结论：应用合理情绪疗法理论对手术前乳腺癌患者进行健康教育,可显著改善其焦虑抑郁心理,利于手术顺利进行。     

综合干预对老年痴呆患者家庭照顾者抑郁情绪改善的系统评价

目的 系统评价综合干预对老年痴呆患者家庭照顾者抑郁情绪的干预效果。方法 计算机检索PubMed、中文生物医学文献数据库（CBM）及中国知网（CNKI）、万方等全文数据库,检索时限为建库至2014年12月。纳入文献中试验组对老年痴呆患者照顾者实施综合干预,即健康教育+心理治疗+技能训练、健康教育+心理治疗或者健康教育+技能训练;对照组只做一般护理教育或空白对照。采用RevMan 5.3软件对两组抑郁情绪改善情况进行分析。结果 共纳入10篇随机对照试验,769例患者,其中试验组385例,对照组384例。纳入的10篇文献中,均把抑郁状况作为主要的结局指标,但评估方法不同,本研究只对使用抑郁自评量表（SDS）的7篇文献进行了合并分析。实施干预措施3、6、9、12个月后,试验组SDS评分均低于对照组,差异有统计学意义〔SMD=-0.76,95%CI（-1.49,-0.03）,P=0.04;SMD=-0.65,95%CI（-0.85,-0.46）,P＜0.01;SMD=-0.73,95%CI（-1.02,-0.44）,P＜0.01;SMD=-0.80,95%CI（-1.08,-0.53）,P＜0.01〕。敏感性分析结果显示,实施干预措施3个月后,试验组和对照组SDS评分比较,差异无统计学意义〔SMD=-0.69,95%CI（-1.90,0.53）,P=0.27〕,与原结果不一致,稳定性较差。漏斗图显示,散点左右分布不对称,提示存在发表偏倚。结论 综合干预措施可以改善老年痴呆患者家庭照顾者的抑郁情绪,但由于受纳入文献质量和数量的限制,有待开展更多高质量、多中心研究加以验证。     

中医药治疗胃癌前病变临床随机对照试验二十年文献质量评价

目的:评价近二十年中医药治疗胃癌前病变临床随机对照试验（RCT的方法学质量，为提升该疾病临床研究质量提供参考。方法:检索2001年1月—2021年12月中国知网、万方数据、维普网、PubMed和Embase中收录的中医药治疗胃癌前病变的临床RCT文献，经过筛选、信息提取，构建数据库，基于2010版CONSORT声明、Cochrane偏倚风险评估量表及与疾病相关附加评价指标对临床试验设计进行评价及分析。结果:共纳入840篇文献。根据Cochrane偏倚风险评估量表，随机方法应用为高偏倚风险占5.95%；分配方案隐藏风险为不确定者占98.93%；患者或试验者施盲的风险不确定为98.69%；结果评估者施盲的风险不确定为100.00%；结果数据完整性高风险占2.86%；选择性报告的风险不确定为98.45%。CONSORT声明评价报告质量结果显示，100.00%RCT文献报告了引言、目标和干预措施等8个条目；36.79%的文献交代了随机序列产生方法，但仅有27.62%的文献交代了实施随机方案的人员，1.07%的文献隐藏了分配方案，1.31%的文献采用盲法；36.67%的文献报告了不良反应；没有文...     

认知行为护理干预对改善首发抑郁症患者抑郁情绪的影响

目的 探讨认知行为护理干预对改善首发抑郁症患者抑郁情绪的效果.方法 将65例首发抑郁症患者随机分为对照组和干预组,对照组采用常规护理措施,干预组增加认知行为护理措施,各组在入组前和治疗护理第4周,分别采用汉密顿抑郁量表（HAMD）、汉密顿焦虑量表（HAMA）进行效果评价.结果 治疗护理4周后,对照组HAMD评分为（18.97±2.21）分,HAMA评分为（12.09-2.75）分;干预组HAMD评分为（14.94±3.46）分,HAMA评分为（10.30±2.54）分,两组之间差异有统计学意义（P＜0.01）.结论 认知行为护理干预能显著改善首发抑郁症患者的抑郁情绪,提高生活质量,对抑郁症患者的治疗有一定的临床应用价值.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.