脑外伤后人格改变评定量表的编制与信效度分析

目的 编制脑外伤后人格改变评定量表,并制定条目的 评分细则,确定不同程度人格改变的等级划界分,为脑外伤后人格改变的客观评估提供标准化评定工具.方法 根据器质性人格改变的基本概念、诊断标准及临床特征.结合临床实践经验,编制脑外伤后人格改变评定量表及评分细则,对相关被试进行初试、修改及条日筛选后,再用于排除了伪装等(有影响评定结果)的脑外伤后精神伤残鉴定案例.结果 (1)量表总分对无人格改变、轻度人格改变、中度人格改变及重度人格改变划界分分别为≤6分、7～14分、15～21分、≥22分.(2)全量表的Cronnbach's α仅系数为0.876,Guttman分半信度为0.847,重测相关在0.972,评分者相关在0.965以上.(3)与专家诊断比较,对有无人格改变的评定特异性96.9%,灵敏度99.4%,总准确率97.9%.结论 编制的脑外伤后人格改变评定量表符合心理测量学的基本要求,能为脑外伤后有人格改变的伤残鉴定案例提供量化的客观依据.     

复方樟柳碱注射液治疗半面痉挛的疗效观察

目的观察复方樟柳碱注射液治疗半面痉挛的疗效。方法对20例半面痉挛患者行复方樟柳碱注射液患侧颞浅动脉旁皮下注射。结果 20例中显效17例,无效3例。结论复方樟柳碱局部注射简便易行、安全有效,无明显副作用,可作为治疗半面痉挛的治疗方法之一。     

Clinical Study on Electro-acupuncture Treatment for 30 Cases ofMental Depression

To observe the clinical therapeutic effects of electro-acupuncture therapy for mental depression, 30 cases were treated by electro-acupuncture on Baihui (GV20), Yintang (EX-HN3) and the differential points.Maprotiline was used in the control group of 31 cases. After the treatment, the scores in HAMD for both groups were found to be obviously decreased as compared with those before the treatment (P＜0.01),without significant between-group differences (P＞0.05). The total effective rate in the treatment group was 96.7%, and that of the control group was 90.3%, showing no significant between-group differences (P＞0.05). After the treatment, the two groups all showed obvious decrease in the TCM symptomatic integrals (P＜0.01), with significant between-group differences (P＜0.05), the integral of the treatment group showing obvious superiority to that of the control group. And the decrease of the Asberg scores testing the side effect of antidepressants of the treatment group was obviously superior to that of the control group. After the treatment, the cortisol (CORT) content and the endothelin-1 (ET-1) content of the two groups were all obviously decreased (P＜0.01), and basically turned to normal, without significant between-group differences (P＞0.05). Conclusion: Electro-acupuncture therapy can produce the same clinical therapeutic effect as that produced by the tetracyclic drug maprotiline, giving less side effect and better symptomatic improvement.     

颅脑外伤后器质性人格改变的临床分析

目的探讨颅脑外伤后器质性人格改变的发生率、症状特点及其相关因素。方法以脑外伤后进行工伤精神伤残鉴定的患者为研究对象,在治疗终结后,根据中国精神疾病分类与诊断标准(CCMD-3)对这些伤者的器质性人格改变情况进行诊断,并依据诊断标准中所罗列的人格改变症状表现,进行评分及统计分析。结果诊断为脑外伤后器质性人格改变者22例,占脑外伤工伤鉴定案例的19%。各临床症状的出现率为:易激惹72.7%;意志缺乏72.7%;孤僻退缩59.1%;缺乏亲密人际关系和情感平淡分别为54.5%;情绪不稳50.0%;自我中心和冲动性行为分别为45.5%;情感幼稚27.3%;情感脆弱、固执、偏执多疑、欲望增强分别为22.7%;言语粘滞、欣快、伦理道德观念减弱分别为13.6%。结论颅脑外伤后器质性人格改变发生率较高,应引起临床医师的重视。     

夹脊穴刺法刍议

活血化瘀治愈疑难发热病两则梁贻俊主治中日友好医院（北京１０００２９）游云整理北京护国寺中医院（北京１１００３５）梁贻俊教授，业医执教４０余年，临床经验丰富，疑难之证，往往应手取效。现举因瘀致热病案２例，以飨同道。此２例瘀血发热的辨证关键在于因其症而辨...     

辨证服药与灌肠治疗溃疡性结肠炎69例

对69例溃疡性结肠炎患者,采用中医辨证分型与灌肠并用治疗,结果总有效率为95％。揭示该法为目前治疗慢性结肠炎的较为理想而有效的方法。     

深刺肓俞穴治疗小儿腹泻

于1975年8月～11月在河南医疗队时,运用针灸疗法治疗80余例小儿腹泻(消化不良、肠炎、痢疾),经1～3次针灸治疗痊愈。现将治疗方法与体会简介如下: 一、治疗方法主穴肓俞(脐中旁开0.5寸)     

精神障碍患者社会功能缺损评定量表的信效度分析

目的 检测精神障碍患者社会功能缺损评定量表(SSFD-MD)的信度和效度.方法 对1003例精神残疾鉴定患者施测,其中100例患者相隔1个月进行重测,并由2名熟悉SSFD-MD评分细则的评定人背对背测评.对其中300例同时实测社会功能缺陷筛选量表(SDSS)、住院精神病人社会功能评定量表(SSPI)、精神功能大体评定昔表(GAF)、简明精神病评定量表(BPRS)、世界卫生组织残疾评定量表Ⅱ(WHO-DASⅡ)、成人智残评定量表(ARSMD)及锥体外系副反应量表(RSESE).结果 ①信度:全量表总分及各分量表的Cronbach's α系数均大于0.90;各分量表及总分重测一致性在0.67～0.83之间;评分者信度在0.87～0.97之间.②效度:各分量表间的相关系数在0.46～0.74之间,各分量表与总分的相关系数在0.73～0.87之间,均具有显著性(P＜0.01);经方差最大化正交旋转后全量表提取5个主成分,累计解释的总变异为82.25%.SSFD-MD与SDSS、SSPI及GAF呈高度相关,分别为0.71,0.72和0.78;与BPRS、WHO-DASⅡ及成人智残评定量表呈中度相关,r分别为0.62,0.50与0.46;与锥体外系副反应量表(RSE-SE)呈低度相关(0.22),均差异具有显著性(P＜0.01).结论 SSFD-MD编制符合心理测量学的基本要求,具有良好的信度和效度.

Abstract：

Objective To test the reliability and validity of the rating scale of social function deficit due to mental disorders (SSFD-MD). Methods 1003 cases with mental disability evaluation were tested by SSFDMD. At sametime, 100 cases of 1003 cases were test-retested and back to back tested by two examiners. 300 cases of 1003 cases also were tested by social disability screening schedule( SDSS),scale of social function for psychosis inpatients(SSPI),global assessment function(GAF) ,the brief psychiatric rating scale(BPRS) ,WH0 disability assessment scale Ⅱ (WHO-DASⅡ ), adult rating scale of mentally disabled ( ARSMD) and rating scale for extrapyramidal side effects (RSESE). Results ①The Cronbach's α coefficients of the total score and all dimensions of SSFD-MD were more than 0.90. The test-retest reliability ranged from 0.67～0. 83 ,and the scorer reliability were 0. 87～0.97. ②The correlations between item scores ranged from 0.46 ～0.74(P＜0.01). The correlations between the factor scores and the total scores ranged from 0.73～0.87(P＜0.01). To extract five full-scale principal components after orthogonal rotation to maximize variance,the cumulative total variance explained was 82.25%.There were highly correlations between SSFD-MD and SDSS.SSPI and GAF,respectively ( r = 0. 71,0.72 and 0. 78). There were moderate correlations between SSFD-MD and BPRS WHO-DAS II ARSMD,respectively(0.62,0. 50 and 0.46). There was a low correlations between SSFD-MD and RSESE ( r = 0.22) ,but all correlations were significant(P＜0.01). Conclusion SSFD-MD has acceptable psychometrics properties on reliability and validity.     

记忆测验中故意答错行为的事件相关电位变化

目的 研究记忆测验中的故意答错行为的事件相关电位(ERP)变化.方法 用二项必选数字记忆测验程序编制ERP范式,20名在校学生在主动答对、故意答错和被动答错三种情况下完成试验任务.结果 ①三种试验条件下的反应时由短至长依次为:主动答对(681±21)ms、故意答错(741±25)ms和被动答错(946±31)ms,各组间差异具有显著性(F=115.73,P=0.000).②所采集的ERP波形中,N2(160～200ms)和P2(200～300ms)成分在故意答错及被动答错条件下的波幅高于主动答对情况;其中N2成分的波幅在三种条件下差异有显著性(F=6.896,P＜0.01),分别为:主动答对(-0.376±0.58)μV、故意答错(4.31±0.58)μV及被动答错(1.77±0.82)μV.结论 事件相关电位的某些指标对识别记忆测验中的故意答错行为有参考价值.     

天灸对实验性骨质疏松的影响

目的：旨在探讨天灸防治骨质疏松症的作用机制。方法：采用卵巢切除所致的骨质疏松大鼠为模型,通过对大鼠骨密度及血清E2,骨钙素（BGP）,Ca,P碱性磷酸酶（AKP）等指标检测,结果：天灸外治可刺激成骨细胞的活性,增加骨形成,同时通过对体内激素的调整,在一定程度上抑制骨吸收,从而有效地防止骨量丢失,增强骨骼抵抗外力的能力,结论：天灸与钙的联合应用并正确掌握治疗时机是防治骨质疏松症的关键所在。