神经生长因子联合高压氧对重型颅脑损伤患者促醒作用的临床观察

目的:探讨神经生长因子联合高压氧对重型颅脑损伤患者的促醒作用。方法:60例重型颅脑损伤昏迷患者按照随机数字表法分为观察组和对照组,每组30例。两组患者均接受常规治疗,观察组患者在此基础上使用神经生长因子联合高压氧。于治疗1个月后,比较两组患者GCS评分、GOS等级及清醒率和清醒时间。结果:治疗1个月后,两组患者GCS评分均较治疗前有不同程度改善,差异均有统计学意义(P0.05);其中以观察组患者改善更为明显,与对照组患者GCS评分比较差异有统计学意义(P0.05);观察组重型颅脑损伤患者GOS良好患者明显多于对照组,比较差异均有统计学意义(P0.05);观察组重型颅脑损伤患者的清醒率和清醒时间明显优于对照组,比较差异均有统计学意义(P0.05)。结论:神经生长因子联合高压氧可促进重型颅脑损伤患者神经功能的恢复,具有促醒及改善预后的作用。     

活血开窍醒神法治疗重型颅脑损伤昏迷的临床研究

目的:探讨活血开窍醒神法对重型颅脑损伤昏迷的临床疗效.方法:将105例重型颅脑损伤昏迷患者随机分为两组,对照组51例予西医常规治疗,治疗组54例在西医治疗基础上联合用醒脑静注射液、补阳还五汤加味中药及醒神开窍针刺促醒治疗,观察治疗1个月后意识好转和预后的情况.结果:治疗组预后恢复良好为87.03%,显著高于对照组68.62%(P＜0.05),两组病死率差异无统计学意义(P＞0.05).治疗组1月内清醒46例,对照组32例(P＜0.05).结论:活血开窍醒神法对重型颅脑损伤昏迷的促醒疗效明显高于单纯西医治疗.     

呼唤式护理在重型颅脑损伤昏迷期患者的应用

目的探讨呼唤式护理对重型颅脑损伤患者昏迷期的促醒作用及预后的影响。方法将64例重型颅脑损伤患者随机分为对照组与试验组。对照组（32例）行常规治疗护理;试验组（32例）在此基础上加用呼唤式治疗护理。于伤后不同时间段评定2组临床疗效、清醒率及清醒时间。结果2组临床疗效比较,差异有统计学意义（P〈0．05）,且试验组清醒率及清醒时间明显优于对照组（均P〈0．01）。结论将呼唤式护理应用于重型颅脑损伤昏迷期患者,能加速患者清醒,提高清醒率,改善预后。     

刺激性护理对重型颅脑损伤的促醒效果评价

目的分析刺激性护理对重型颅脑损伤的促醒效果。方法选取2013年12月至2015年12月济源市人民医院收治的104例重型颅脑损伤昏迷患者,随机分为对照组与研究组,各52例。对照组仅接受常规护理,研究组在常规护理基础上实施刺激性护理干预措施,观察两组患者昏迷转清醒情况并进行对比分析。结果研究组患者清醒率(86.5%)高于对照组(59.6%),清醒时间较对照组短,差异有统计学意义(P<0.05)。结论对于重型颅脑损伤患者,实施刺激性护理干预可促进患者尽快清醒,有助于改善患者预后,建议临床推广应用。     

高压氧对重型颅脑损伤昏迷患者促醒效果观察

目的探讨高压氧（HBO）对重型颅脑损伤昏迷患者促醒的临床效果。方法将2011年7月～2013年6月南京医科大学附属江宁医院神经外科住院的重型颅脑损伤后处于昏迷状态的60例患者,按照治疗方法分为对照组和观察组,每组各30例,对照组患者给予常规治疗,观察组患者在对照组的基础上加用HBO治疗。比较两组患者的清醒率、清醒时间及治疗前后的脑动脉血流速度。记录观察组患者HBO开始治疗时间、次数对临床疗效影响。结果对照组患者的清醒率为83-3％,明显低于观察组的96．7％;对照组患者的清醒时间明显长于对照组,差异有统计学意义（P〈0．05）。治疗后观察组患者的大脑前、中动脉的血流速度均优于对照组,差异有统计学意义（P〈0．05）。≤30d组及〉30～60d组分别与〉60d比较,差异均有统计学意义（P〈0．05）。治疗〈90次的效果相对较好,治疗90次以上仅有3例．无一例显效。结论重型颅脑损伤昏迷患者如无禁忌证,应尽早行HBO治疗,效果显著。     

早期应用纳洛酮治疗颅脑损伤昏迷近期疗效对比观察

目的: 探讨早期应用纳洛酮治疗颅脑损伤昏迷的近期疗效。方法: 将颅脑损伤昏迷87例随机分成纳洛酮治疗组(n=44)与对照组(n=43);观察两组患者近期5天清醒率、病死率,并进行统计学分析。结果: 治疗结束(5天)时纳洛酮治疗组清醒率(72.7%)较对照组高(51.2%)(P<0.05)。纳洛酮治疗组病死率(18.2%)较对照组(37.2%)低(P<0.05)。结论: 早期应用纳洛酮治疗颅脑损伤昏迷近期疗效显著,可以提高早期清醒率,降低病死率。     

针刺联合高压氧对重度颅脑损伤昏迷患者的促醒作用

目的观察针刺联合高压氧促醒重度颅脑损伤昏迷临床疗效。方法 50例颅脑损伤昏迷患者(GCS≤8分)随机等量分成治疗和对照组,二组均实施神经营养、预防癫痫、护胃、防止感染、促醒等常规治疗,治疗组在此基础上加用针刺和高压氧疗,每日1次,每10次为1疗程,观察治疗组与对照组患者苏醒程度和GCS预后评分。结果治疗组25例中,5分12例,4分6例,3分3例,2分5例。对照组25例中,5分7例,4分2例,3分4例,2分12例。治疗组和对照组治疗效果差异显著(P<0.05)。结论针灸配合高压氧治疗对颅脑损伤后昏迷患者有明显的促醒作用,值得推广。     

重型颅脑损伤昏迷患者采用刺激性护理干预对其促醒作用疗效观察

目的研究早期刺激性护理干预对创伤性重型颅脑损伤昏迷患者促醒作用疗效观察。方法将42例患者分成实验组和对照组并采取相应的护理干预措施并记录观察结果。结果两组患者在临床学治疗上差异具有统计学意义(P0.05),实验组病患比对照组病患情形时间更多(P0.01)。结论早期对创伤性重型颅脑损伤昏迷患者使用各种刺激性护理干预效果较明显,在一定程度上具有促醒作用。     

低温治疗与重型颅脑损伤术后患者神志恢复清醒时间

目的 探讨低温治疗与重型颅脑损伤术后患者神志恢复清醒时间之间的关系,进而了解低温在重型颅脑损伤术后患者治疗中的促醒作用. 方法回顾性分析2005年2月至2008年4月入住我科80例重症颅脑损伤术后患者的临床资料,其中接受低温及常温治疗者各40例,统计不同治疗方案作用下清醒患者的例数及其相应的促醒时间.结果 40例接受低温治疗患者中有25例神志恢复清醒,发病至恢复清醒时间为14-36天,平均23.08天;接受常温治疗的40例患者中有22例恢复清醒,发病至恢复清醒时间为15-50天,平均31.18天.两种治疗方案下清醒人数的差别无统计学意义(χ 2=0.464,P=0.650>0.05),但清醒时间差别具有统计学意义(t=2.728,P=0.009<0.05).结论 低温治疗可缩短重型颅脑损伤术后患者神志恢复清醒的时间,似乎对重型颅脑损伤术后患者具有促醒作用,但可能受限于样本量的大小,本实验未能得出低温治疗有助于逆转重型颅脑损伤术后患者昏迷状态的结论.     

针药结合促醒法治疗重型颅脑损伤后昏迷的临床研究

目的研究针药结合促醒法对重型颅脑损伤后昏迷患者的临床疗效。方法选取本院收治的重型颅脑损伤后昏迷患者80例,随机分为对照组和观察组,每组40例,对照组采用常规西医治疗,观察组在对照组基础上加用针药结合促醒法,比较2组治疗前后格拉斯哥昏迷评分(GCS)、格拉斯哥预后评分(GOS)、大脑中动脉(MCA)和颈内动脉(ICA)血流速度、脑脊液中5-羟色胺(5-TH)、多巴胺(DA)、去甲肾上腺素(NE)、乙酰胆碱(Ach)含量的变化。结果治疗后,观察组GCS评分和GOS评分均显著高于对照组(P0.05);2组MCA和ICA血流速度均显著低于治疗前(P0.05),且观察组降低程度优于对照组(P0.05);2组脑脊液5-TH含量均降低(P0.05),DA、NE、Ach含量均升高(P0.05),且观察组改善程度优于对照组(P0.05)。结论针药结合促醒法能改善重型颅脑损伤后昏迷患者脑血流速度和觉醒相关神经递质的释放,有明显促醒作用。     

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.     

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.     

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.