针刺分娩镇痛的临床试验研究

[目的]研究针刺分娩镇痛的作用机制。[方法]以Keele标尺图评级法及视觉模拟评分法(V RS)疼痛分级法作为针刺分娩镇痛效果评定方法,并通过记录产妇产程等来观察针刺对母婴的影响,通过观察针刺前后及相应时间产妇外周血中β-内啡肽(β-EP)及5-羟色胺(5-H T)浓度变化,探讨该方法的镇痛机制。[结果]针刺能有效减轻第一产程分娩疼痛,与自然分娩对照组相比有显著性差异(P<0.05),对母婴无不良影响且能缩短产程。该方法能明显提高产妇外周血中β-EP及5-H T浓度。[结论]以针刺作为分娩镇痛手段,具有操作方便、安全,镇痛效果可靠,无副作用等优点,其镇痛效果可能是通过中枢镇痛系统与对子宫的直接作用共同实现的。     

普消痛在镇痛分娩中的效果观察

目的 探讨普消痛镇痛分娩的效果反对产程、母婴的影响。方法 以普消痛进行镇痛分娩的400例产妇为观察组，未行镇痛分娩的406例产妇作为对照组，比较两组的疼痛程度、产程时间、分娩方式、产后出血、胎儿窘迫、新生几窒息及不良反应。结果 观察组镇痛效果明显，且第一产程活跃期、总产程明显短于对照组，差异有显著性（P〈0．05）。两组分娩方式、产后出血量、胎儿窘迫和新生儿窒息发生率比较，无显著性差异（P〉0．05）。结论 普消痛用于镇痛分娩，效果可靠．对母婴无不良影响，是一种既能解除分娩疼痛又能保障母婴安全的方法，值得推广应用。     

针刺辅助硬膜外麻醉对分娩镇痛的可行性研究

目的研究针刺相应穴位辅助硬膜外分娩镇痛的效果。方法选取100例初产妇,排除难产因素和硬膜外穿刺禁忌,随机双盲法分为2组,A组为硬膜外自控镇痛（PCEA）组;B组为针刺复合PCEA组。记录2组疼痛评分、产程等各项指标,并检测不同时间点血β-内啡肽和5-羟色胺（5-HT）水平的变化。结果镇痛后（宫口开10 cm）血5-HT、血β-内啡肽和疼痛评分较镇痛前（宫口开3 cm）均降低（P < 0.05~P < 0.01）;镇痛后,B组血5-HT和疼痛评分较A组低（P < 0.01）,β-内啡肽在2组间差异无统计学意义（P>0.05）。A组的活跃期时间、第二产程时间及出血量均高于B组（P < 0.01）,第三产程时间A组低于B组（P < 0.01）。2组间剖宫产率、产钳率和新生儿评分差异均无统计学意义（P>0.05）。结论针刺复合PCEA辅助硬膜外分娩镇痛安全、有效。     

腰麻复合硬膜外阻滞和笑气吸入用于无痛分娩的效果评估

目的腰麻复合硬膜外阻滞(CSEA)和笑气吸入无痛分娩的效果评估.方法90名足月初产孕妇随机分为实验组Ⅰ、实验组Ⅱ及对照组,前两组孕妇宫口开至3 cm后,分别行CSEA及笑气吸入分娩镇痛,监测镇痛效果、产程各指标及测定β-内啡肽(β-EP).结果实验组镇痛效果好于对照组,而实验组Ⅰ镇痛效果好于实验组Ⅱ.实验组Ⅰ活跃期短于对照组活跃期,实验组Ⅱ潜伏期后各产程均短于对照组.实验组Ⅰ与Ⅱ各产程无明显差异.宫缩强度、产钳率、剖宫产率、产后出血,胎儿窘迫、新生儿Apgar评分,三组无显著性差异.三组产妇β-EP浓度时均高于产后.产时β-EP实验组Ⅰ最低,实验组Ⅱ与对照组无差异;而产后β-EP实验组Ⅱ最高.结论CSEA及笑气吸入用于分娩镇痛,能缓解产痛,缩短产程,不影响产程中各因素.β-EP在分娩应激状态下升高,产后显著下降,提示β-EP参与分娩镇痛.     

硬膜外阻滞麻醉用于无痛分娩的临床观察

【目的】探讨分娩镇痛的效果及对产程、母婴状况的影响。【方法】采用ＰＣＥＡ泵硬膜外腔给药用于分娩镇痛,观察产程时间,分娩方式,产后出血,胎儿宫内窘迫及新生儿窒息情况。【结果】观察组和对照组产程比较、两组分娩方式比较有显性差异（Ｐ＜０．０１）;两组胎儿宫内窘迫,新生儿窒息及产后出血发生率比较,无显性差异（Ｐ＜０．０５）。【结论】ＰＣＥＡ泵用于持续硬膜外腔给药镇痛,疼痛阻滞完善,加强了产程的进展,降     

联合阻滞麻醉用于分娩镇痛对母婴影响因素分析

为探讨分娩镇痛对产程，母婴影响，采用蛛网膜下腔（脊麻）硬膜外腔联合阻滞麻醉（CSEA）方法，用于分娩镇痛产妇100例作为观察组，随机抽取同期未采用CSEA方法分娩产妇100例为对照组，分别观察镇痛效果，不良反应及对产程时间，分娩方式，产后出血，新生儿窒息及产后恢复的影响。结果两组间各产程时间无明显差异，但活跃期比较有差异（P＜0．05）。两组分娩方式及新生儿窒息及产后出血皆无差异。实施分娩镇痛时机对分娩结局有明显差异（P＜0．01）。结论：CESA分娩镇痛法起效快，疼痛阻滞完善，副反应少，母婴安全。     

促肾上腺皮质激素和5=羟色胺在疼痛与针刺镇痛中的作用

早有报道:应激有一定消除疼痛的作用,给动物注射促肾上腺皮质激素(ACTH)能加强针刺镇痛的效果。ACTH、β-内啡肽(β-EP)与5-羟色胺(5-HT)等在针刺镇痛中都有重要作用。本文先用连续     

非药物分娩镇痛的应用现状及研究进展

【摘要】 分娩疼痛是一种内脏性疼痛,是导致围产期母婴不良妊娠结局的原因之一,其强度及镇痛措施的效果与产妇的生理因素、心理因素及社会因素相关。非药物分娩镇痛措施为产妇提供心理支持和生理调节技术以达到分娩镇痛、促进自然分娩的目的。其对产程及母婴影响小、安全性高、依从性好、经济易行,适用范围广,有利于促进产程进展,减少产科和麻醉干预措施,改善妊娠结局。本文就国内外常用的非药物分娩镇痛方法的应用现状及研究进展进行综述。     

硬膜外麻醉分娩镇痛临床观察

目的观察硬膜外微泵用于分娩镇痛的效果及对产程的影响，探讨小剂量麻醉复合物的分娩镇痛作用。方法采用低浓度的布比卡因与芬太尼硬膜外微泵持续给药对120例产妇进行分娩镇痛（作为观察组）与同期未干预的产妇150例相对照，用视觉模拟疼痛评分进行疼痛分级，观察记录孕妇三个产程所用的时间及胎儿的健康情况，比较两组的镇痛效果，产程时间。结果观察组的阵痛强度明显低于对照组（“P〈0.05”），观察组的第一产程缩短。结论硬膜外麻醉用于分娩镇痛效果可靠，对母婴未发现不良影响。     

镇痛分娩800例临床分析

目的探讨镇痛分娩的临床效果,观察对产程、分娩方式和母婴的影响。方法选择我院2009年1月-2013年4月要求实施镇痛分娩的住院待产妇800例作为观察组,选择同期未要求实施镇痛分娩进行自然分娩的待产妇800例作为对照组,对两组产妇各产程时间、剖宫产率、产后出血量及新生儿窒息率等方面进行比较分析。结果观察组产妇第一产程时间和剖宫产率明显低于对照组,差异有统计学意义（P〈0.05）;第二产程、第三产程、产后出血量和新生儿窒息率情况两组相比较,差异无统计学意义（P〉0.05）。结论镇痛分娩能减轻产妇疼痛,增加其自然分娩信心,缩短产程,降低剖宫产率,且对母婴无不良影响。     

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.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

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<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.