复合针法治疗膝骨关节炎的临床观察简

目的：观察复合针刺法治疗膝骨关节炎的疗效。方法对200例膝骨关节炎患者运用复合针法进行治疗,采用视觉模拟评分法（VAS）、西安大略和麦马斯特大学骨关节炎指数可视化量表（WOMAC）进行评分,观察患者VAS评分、WOMAC评分治疗前后的变化及临床疗效。结果患者治疗后VAS评分、WOMAC评分均较治疗前降低。200例中痊愈64例,占32%;显效112例,占56%;有效20例,占10%;无效4例,占2%。结论复合针法治疗膝骨关节炎具有较好的疗效。     

双醋瑞因结合股四头肌锻炼改善中老年膝骨关节炎症状疗效观察

目的:探讨双醋瑞因联合股四头肌锻炼对中老年膝骨关节炎的疗效。方法: 将60例膝骨关节炎患者随机分入双醋瑞因组（A组）、双醋瑞因联合股四头肌功能锻炼组（B组）、双氯芬酸钠组（C组）和双氯芬酸钠联合股四头肌功能锻炼组（D组）,治疗前,治疗4周,8周的WOMAC及VAS评分比较。结果: 治疗4周及8周后患者的WOMAC关节炎指数及VAS评分与治疗前相比有明显改善(P<0.05);治疗8周后与治疗4周后相比,WOMAC关节炎指数及VAS评分进一步降低(P<0.05),且以B组为甚,A组次之;Likert评分中B组治疗后效果显著(P<0.01),A组与C组与D组两组间比较差异均无统计学意义(P>0.05),但B组与D组患者患肢的股四头肌肌力明显增强。结论: 双醋瑞因联合股四头肌锻炼能有增强膝骨关节炎患者的股四头肌肌力,有效缓解关节疼痛等症状,改善关节功能。     

富血小板血浆治疗膝骨关节炎的疗效分析

目的：探讨富血小板血浆（PRP）治疗膝骨关节炎的临床疗效。方法：选取2017年10月—2019年6月因膝骨关节炎于本院接受住院治疗的患者,根据性别和年龄进行病例配对分组,分为PRP组和对照组各43例,根据Kellgren?Lawrence（K?L）分级评估膝骨关节炎严重程度。所有患者均行关节镜清理术,PRP组患者在关节镜手术结束前向关节腔内注射PRP,对照组仅行单纯关节镜清理术治疗,两组患者治疗后均采取相同的康复锻炼计划。评估并记录治疗前、治疗后1、3、6和12个月时患者的视觉模拟疼痛评分（VAS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）,分析临床疗效,观察并记录随访过程中的不良反应发生情况。结果：所有患者均完成了至少12个月的随访。PRP组和对照组治疗后各个时间点的VAS及WOMAC评分均显著低于治疗前（P＜0.05）。PRP组的VAS及WOMAC评分在治疗后1、3个月时显著低于对照组（P＜0.05）,而在治疗后6、12个月时两组患者疗效无显著差异。K?L分级2级的患者使用PRP后6个月内的VAS及WOMAC评分显著低于对照组（P＜0.05）,而在12个月时与对照组疗效无显著差异。K?L分级3级的患者仅在治疗后1个月时VAS及WOMAC评分显著低于对照组（P＜0.05）,而在3个月后与对照组疗效无显著差异。结论：使用PRP可以改善膝骨关节炎患者的疼痛症状,恢复膝关节功能,但持续时间有限。低K?L分级的膝骨关节炎患者疗效持续时间更长。     

调神针法对膝骨关节炎患者疼痛及功能的影响

目的:探讨调神针法治疗膝骨关节炎的临床疗效。方法:回顾性分析我院2017年1月～2019年6月期间收治且疗程及随访完整的176例膝骨关节炎患者。按照治疗方法不同分为调神针法组和常规治疗组,调神针法组77例,在关节松动术结合运动训练的基础上加调神针法治疗,常规治疗组99例,予关节松动术结合运动训练,然后对比分析两组治疗前与治疗后2周的VAS评分、WOMAC指数。结果:两组患者的性别、年龄以及治疗前的VAS评分、WOMAC指数评分没有显著性差异(P0.05)。两组患者治疗后的VAS评分、WOMC指数较治疗前改善,差异有统计学意义(P0.05)。调神针法组治疗后2周的VAS评分、WOMAC指数改善程度优于常规治疗组(P0.05)。结论:调神针法组治疗膝骨关节炎能快速缓解疼痛,改善患者生活活动能力,疗效确切,适合临床推广应用。     

膝痹汤及舒膝散治疗膝关节退行性骨关节炎的分析

目的:探讨膝痹汤及舒膝散治疗膝关节退行性骨关节炎的疗效。方法:收集我院膝关节退行性骨关节炎的患者,分为:研究组(治疗方案为膝痹汤联合舒膝散)和对照组(治疗方案为膝痹汤)。对比(1)两组治疗前后膝关节退行性骨关节炎中医证候评分。(2)两组治疗前后VAS及WOMAC评分。结果:两组治疗前膝关节退行性骨关节炎中医证候评分、VAS及WOMAC评分比较无差异(P0.05);两组治疗后膝关节退行性骨关节炎中医证候评分、VAS及WOMAC评分比较有差异(P0.05)。结论:膝痹汤及舒膝散治疗膝关节退行性骨关节炎的疗效肯定,值得临床推广。     

消瘀接骨散联合运动训练治疗气滞血瘀型膝骨关节炎疗效观察

目的 观察消瘀接骨散和运动训练联合治疗对气滞血瘀型膝骨关节炎（knee osteoarthritis,KOA）的临床疗效。方法 将62例KOA患者随机分为研究组和对照组,每组31例。两组患者治疗期间均口服氨基葡萄糖,对照组另行患膝股四头肌运动训练,研究组在行患膝股四头肌运动训练的同时外敷消瘀接骨散,治疗周期为2周。分别观察和比较3个时间点（治疗前、治疗后2周和随访第6周）两组患者疼痛视觉模拟量表（visual analogue scale,VAS）评分、西安大略和麦克马斯特大学骨关节炎指数（Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC）,观察两组临床疗效。结果 与治疗前比较,治疗2周后、随访第6周两组VAS评分、WOMAC总评分均明显减少（P<0.05）。两组治疗2周后VAS评分、WOMAC总评分比较,差异均有统计学意义（P<0.05）。随访第6周两组VAS评分比较,差异无统计学意义（P＞0.05）;WOMAC总评分比较,差异有统计学意义（P<0.05）。两组临床疗效分布比较,差异有统计学意义（P<0.05）。结论 消瘀接骨散结合运动训练对KOA的疼痛及关节功能障碍疗效确切。     

运动疗法配合肌效贴治疗膝骨关节炎疗效观察

目的 观察运动疗法配合肌效贴治疗膝骨关节炎（knee osteoarthritis,KOA）的疗效。方法 选取2019年1月至2021年12月就诊于阿克苏地区第一人民医院康复科的61例KOA患者作为研究对象,随机分为试验组30例、对照组31例。对照组采用针灸推拿治疗,试验组在对照组的基础上采用运动疗法配合肌效贴治疗,治疗2个疗程,比较两组患者治疗前、治疗1周后、治疗2周后的临床症状评分、视觉模拟量表（visual analogue scale,VAS）评分、西安大略麦克马斯特大学骨关节炎指数（Western Ontario and McMaster University osteoarthritis index,WOMAC）评分、Lysholm膝关节评分。结果 两组患者治疗后的临床症状评分、VAS评分、WOMAC评分、Lysholm评分比较,差异有统计学意义（P<0.05）;且随着治疗时间的延长,试验组患者的临床症状评分、VAS评分、WOMAC评分降低幅度大于对照组,Lysholm评分升高幅度大于对照组（P<0.05）;试验组的总有效率为90.00%,对照组的总有效率74.19%,两组比较差异有统计学意义（P<0.05）。结论 运动疗法结合肌效贴治疗膝骨关节炎可显著降低临床症状评分、VAS 评分、WOMAC 评分,增加Lysholm评分,在改善患者的临床症状、膝关节功能和疼痛方面优于针灸推拿治疗。     

消瘀接骨散外敷治疗早中期膝骨关节炎30例临床研究

目的 观察消瘀接骨散外敷治疗早中期膝骨关节炎的临床疗效。方法 将60例膝骨关节炎患者随机分成观察组（外敷消瘀接骨散）和对照组（口服塞来昔布胶囊）,每组30例。治疗2周后连续随访12周,比较两组临床疗效,观察治疗前后血沉（erythrocyte sedimentation rate, ESR）、碱性磷酸酶（alkaline phosphatase, ALP）、高敏C-反应蛋白（hypersensitive C-reactive protein,hs-CRP）、血小板（platelet,PLT）及疼痛视觉模拟评分（visual analogue scale,VAS）、西安大略和麦克马斯特大学骨关节炎指数（Western Ontario McMaster University Osteoarthritis Index, WOMAC）、骨关节炎的严重程度指数（Lequesne MG）、膝关节活动度变化情况。结果 观察组临床疗效优于对照组,但两组临床疗效的分布比较,差异无统计学意义（P＞0.05）。观察组治疗后hs-CRP、ALP、PLT较治疗前显著降低,差异均有统计学意义（P＜0.05）;观察组PLT降低值显著大于对照组（P＜0.05）。两组患者治疗后WOMAC、VAS、Lequesne MG评分均较治疗前显著降低（P＜0.05）,膝关节活动度较治疗前显著增加（P＜0.05）;与治疗2周末比较,两组患者随访时WOMAC、VAS、Lequesne MG评分均无明显变化（P＞0.05）,但膝关节活动度显著增加（P＜0.05）。治疗2周末和随访时,观察组患者WOMAC、VAS、Lequesne MG评分显著低于对照组（P＜0.05）;治疗2周末,观察组患者膝关节活动度显著大于对照组（P＜0.05）;随访时,两组患者膝关节活动度比较,差异无统计学意义（P＞0.05）。结论 消瘀接骨散外敷治疗轻中度膝骨关节炎可显著改善临床症状和膝关节功能,提高患者生活质量。     

玻璃酸钠关节腔内注射联合冲击波治疗膝骨关节炎的临床疗效观察

目的 观察玻璃酸钠关节腔内注射联合冲击波治疗膝骨关节炎的临床疗效。方法 选取2016年3月～2018年5月于我院就诊的126例膝骨关节炎患者,按随机数字表随机分为治疗组63例和对照组63例,对照组采用单纯玻璃酸钠腔内注射治疗,治疗组采用玻璃酸钠关节腔注射联合冲击波治疗,疗程均为5周,分别在干预前及干预5周后采用疼痛视觉模拟评分(Visual analog scale,VAS)、西安大略麦克马斯特大学膝骨关节炎指数可视化量表(Western Ontario and McMaster Universities,WOMAC)及形态学(Lequesne)指数评分对两组进行评定。结果 干预后,治疗组VAS、WOMAC指数及Lequesne指数评分显著优于对照组(P0.05)。结论 玻璃酸钠关节腔注射联合冲击波治疗膝骨关节炎具有较好的临床疗效。     

黄附姜贴敷治疗膝骨关节炎（寒湿证）的临床研究

目的 观察黄附姜贴敷治疗膝骨关节炎的临床效果。方法 将我院120例膝骨关节炎患者随机分为对照组与观察组各60例,对照组采用洛索洛芬片治疗,观察组使用洛索洛芬片联合黄附姜贴敷治疗。比较两组疗效,治疗前后视觉模拟疼痛评分(VAS)、WOMAC骨关节炎指数评分(WOMAC)、膝关节红外热成像低温区直径、血清白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平。结果 治疗后,观察组临床总有效率高于对照组(P<0.05);两组VAS、WOMAC评分低于治疗前(P<0.05),观察组VAS、WOMAC评分低于对照组(P<0.05);两组膝关节红外热成像低温区直径、IL-1β及TNF-α水平低于治疗前(P<0.05),观察组膝关节红外热成像低温区直径、IL-1β及TNF-α水平低于对照组(P<0.05)。结论 黄附姜贴敷治疗能够减轻膝骨关节炎(寒湿证)的临床症状,降低VAS评分、WOMAC评分,缩小膝骨关节红外热成像低温区直径,降低IL-1β、TNF-α水平,对膝骨关节炎的功能恢复有促进作用。     

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…     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…