不同牵引重量对颈椎髓核内压力影响的研究

目的:通过测试不同牵引力量对颈椎标本髓核内压力的影响,探讨牵引对颈椎影响的机制。方法:利用生物力学材料实验机使用150N、200N、300N3种牵引力对6例新鲜人体颈椎标本进行力学加载,同时利用微型压力传感器测试加载过程中各节段髓核内压力的变化。结果:模拟头部重量及加载牵引力后均出现C5,6,C6,7髓核内压力高于C3,4,C4,5髓核内压力(P0.05),加载牵引力后所有标本髓核内压力均出现降低(P0.05)。结论:牵引通过增大颈椎椎间隙,降低外力对椎间盘髓核内的压力;同时在进行旋转手法时应配合适当的牵引力以增加旋转手法的安全性。     

静止中立位状态及加载模拟头部重量后对髓核内压力影响的研究

目的:通过测试颈椎标本在静止中立位及模拟头部重量后的髓核内压力,从而探讨颈椎髓核内压力的变化规律。方法:利用生物力学材料实验机及微型压力传感器测试新鲜人体颈椎标本在静止中立位及加载100N压力时的髓核内压力。结果:静止中立位及加载100N压力时,C3～4和C4～5节段髓核内压力比较无显著性差异(P0.05),C5～6和C6～7节段髓核内压力比较无显著性差异(P0.05);C5～6,C6～7高于C3～4,C4～5髓核内压力(P0.05);加载100N后所有节段髓核内压力均升高具有显著性差异(P0.05)。结论:正常人体下颈段髓核内压力高于上颈段髓核内压力,并且随外在负荷的增加而压力增加。     

经皮耳迷走神经刺激干预功能性消化不良模型大鼠的效应及机制研究

ObjectiveTo explore the effect and its possible mechanism of the intervention of transcutaneous auricular vagus nerve stimulation (taVNS) for the functional dyspepsia (FD) model rats.MethodsOf the 25 male SD rats, 6 rats were set as blank group, the other 19 rats were established to be the functional dyspepsia (FD) model by iodoacetamide intragastric administration, and 18 FD models were successfully established. The 18 model rats were randomly divided into a model group, a sham-taVNS group, and taVNS group, with 6 rats in each group. There was no intervention applied to the rats in the blank and model groups. Whereas, the rats in sham-taVNS group received stimulation to the rim of auricular concha of both sides, and those in taVNS group received stimulation to the cavity of auricular concha of both sides, for 30 min each time, once a day, 7 days in succession. After the intervention, the gastric sensitivity of the rats in each group under different pressure conditions in the stomach, the expressions of serum brain-gut peptide motilin (MTL), cholecystokinin (CCK), glucagon-likepeptide1 (GLP-1), and inflammatory factors IL-4, IL-10, and IL-1β were detected.Results(1) Gastric sensitivity: compared with the blank group, the gastric sensitivity of the model group was higher (P <0.05). Compared with the model group, the gastric sensitivity of the taVNS group was lower (P < 0.05). Compared with the sham-taVNS group, the gastric sensitivity of the taVNS group was lower (P <0.05).(2) Expression of brain-gut peptide: compared with the blank group, MTL was lower, CCK and GLP-1 were higher in the model group (all P <0.05). Compared with the model group, MTL was higher, CCK and GLP-1 were lower in the taVNS group (all P <0.05). Compared with the sham-taVNS group, CCK and GLP-1 were lower in the taVNS group (both P<0.05). (3)Expression of inflammatory factors: compared with the blank group, IL-4 and IL-10 were lower and IL-1β was higher in the model group (all P <0.05). Compared with the model group, IL-10 was higher and IL-1β was lower in the sham-taVNS group (all P <0.05), while IL-4 and IL-10 were higher and IL-1β was lower in the taVNS group (all P <0.05). Compared with the sham-taVNS group, IL-4 and IL-10 were higher and IL-1β was lower in the taVNS group (all P <0.05).ConclusionTaVNS can reduce the gastric sensitivity of FD model rats by peripheral anti-inflammatory action and regulating the abnormal secretion of brain-gut peptide.     

三棱火针加拔罐治疗腘窝囊肿30例

ObjectiveTo explore the therapeutic effect of the fire needling with the three-edged needle and the cupping on popliteal cyst.MethodsA total of 60 patients of popliteal cyst were divided into two groups, 30 cases in each one according to the random number table. In the fire needling group, the burnt-red three-edged needle was inserted to the deep layer of the cyst. After the fluid was squeezed out, the cupping was exerted. The treatment was given 1 to 2 times a week, for 4 weeks totally. In the western medication group, prednisolone acetate 25 mg was injected in the cyst capsule, once a week, for 4 weeks totally. The effective rate, recurrence rate and Rauschning–Lindgren grading were evaluated before and after treatment.ResultsThe total effective rate was 80.0% in the fire needling group and was 83.3% in the western medication group, without statistical significance in comparison (P > 0.05). The recurrence rate was 6.7% in the fire needling group and was 30% in the western medication group. The recurrence rate in the fire needling group was lower than that in the western medication group, indicating the statistical significance (P < 0.05). After treatment, Rauschning–Lindgren grade was different statistically as compared with that before treatment in either group (both P < 0.05). Rauschning–Lindgren grade was distributed in 0 to I in the fire needling group after treatment, which was different significantly as compared with the western medication group (P < 0.05).ConclusionThe combined treatment with the fire needling combined with cupping therapy achieves the satisfactory effect on popliteal cyst and the very low recurrence rate and it is easy in operation and deserves to be promoted in primary care.     

麻醉下手法松解配合关节镜技术治疗原发性冻结肩

目的：探讨麻醉下手法松解配合关节镜技术治疗原发性冻结肩的可行性及疗效。方法：2006年1月至2009年3月,原发性冻结肩僵硬期患者共34例,均经保守治疗无效,其中男20例,女14例;年龄43～62岁,平均（56±3.6）岁;病程9～13个月,平均11.3个月。全麻下先行盂肱关节、肩峰下间隙清理,再行麻醉下手法松解后镜下射频修整止血及进行针对性松解。术后第1天即开始行患肩主动、被动功能练习,术后所有患者得到随访,平均18.9个月（13～32个月）,对治疗前后患者疼痛、关节活动度Constant评分进行对比分析。结果：术后12个月患肩Constant疼痛评分（总分15分）为（13±1.58）分,较术前的疼痛评分（5±2.60）分降低（P〈0.01）。34例术后12个月Constant评分（86±11.20）分,比术前（27±2.40）分明显改善（P〈0.01）。结论：麻醉下手法松解配合关节镜技术治疗原发性冻结肩功能恢复快,具有疗效确切、微创、恢复快等特点。     

痛宁凝胶的成型工艺研究

目的：研究痛宁凝胶的成型工艺。方法：以凝胶的外观稠度、流动性、涂展难易程度为考察指标,筛选骨架材料及附加剂的种类与用量;采用HPLC法测定透皮试验中药物延胡索乙素的累积透过量作为指标,筛选透皮吸收促进剂的种类与用量。结果：痛宁凝胶基质配方为卡波姆2%,甘油10%,三乙醇胺2%,pH值在5.40～5.65之间。结论：痛宁凝胶成型工艺简单、性质稳定、透皮吸收较快。     

穴位埋线配合隔姜灸治疗周围性面瘫后遗症及其对表面肌电图的影响

ObjectiveTo explore the therapeutic effect of acupoint catgut embedding combined with ginger-separated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography (sEMG) can be an outcome to evaluate the effect of this disease.MethodsThirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine (TCM) differentiated syndromes. At the same time, the ginger-separated moxibustion was applied at Yīfēng (翳风 TE17) and Qiānzhèng (牵正 EX-HN16) of the affected side. The catgut embedding was applied once every 15 days, one time of treatment is of one course, and a total of three courses were given. The moxibustion would be taken after 5 days of catgut embedding each time, once every other day, 5 times as one course, a total of 3 courses are given. After treatment, the recovery of facial nerve functions was evaluated by House–Brackmann (H-B) facial nerve function evaluation grading system. Before and after treatment, the surface electromyography (sEMG) was used to detect the root-mean-square (RMS) of frontal muscles, cheek muscles, and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side.ResultsAfter 3 courses of treatment, 9 cases were cured, 22 cases were effective, and 4 cases were ineffective. The total effective rate was 88.6% (31/35). After treatment, the RMS of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side were 31.56±4.25, 34.13±4.28, and 7.46±1.53 respectively, significantly increased in comparing with 11.69±2.45, 12.98±3.34, and 2.62±1.41 respectively before treatment (all P<0.05). After treatment, the RMS ratios of frontal muscles, cheek muscles, and orbicularis oris muscles of the affected side and healthy side were 0.73±0.09, 0.71±0.11, and 0.68±0.08 respectively, greatly increased in comparing with 0.28±0.10, 0.27±0.08, and 0.22±0.09 respectively before treatment (all P<0.05).ConclusionAcupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions, and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.     

Clinical practice guideline of traditional medicine for primary osteoporosis

BACKGROUND Primary osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue,leading to enhanced bone fragility and a consequent increase in fracture risk. Primary osteoporosis is particularly common in senile persons and in postmenopausal women.It ranks the fifth of diseases in the modern society.There are about two billion patients with osteoporosis all over the     

A randomized placebo-controlled trial of traditional Chinese medicine as an add-on therapy to oral montelukast in the treatment of mild persistent asthma in children

ObjectivesTraditional Chinese medicine are commonly used for treatment of asthma. However, there are only very limited data about its efficacy in children. Therefore, we aimed to determine the efficacy of augmented Yu Ping Feng San (aYPFS) as an add-on to oral montelukast compared with montelukast alone for treatment of mild persistent asthma in children.DesignA single centre, placebo-controlled, double-blinded, randomized control trial was carried out. Participants with age 6–18 years who had mild persistent asthma were randomized according to random number list to receive either aYPFS plus montelukast for 24 weeks or placebo plus montelukast for 24 weeks. Primary outcome measure was lung function parameters. Secondary outcome measures were Asthma Control Test™ (ACT™) and Paediatric Allergic Disease Quality of Life Questionnaire (PADQLQ) scores, symptom-free days, short-acting β2-agonist use, use of rescue oral corticosteroids, days of hospitalization for asthma and number of emergency consultation with GPs or AED department.ResultsTwenty-eight participants were randomized to aYPFS group and twenty-nine to placebo group. There was no significant difference in baseline characteristics. There was significant improvement in ACT™ score in aYPFS group (up to 6.9% change from baseline) (p = 0.016) but not in the control group. There were no significant differences between groups in other primary and secondary outcome parameters. Dropout because of adverse effects is comparable in both groups.ConclusionTraditional Chinese medicine aYPFS as an add-on to montelukast improved symptoms of asthma control. Further studies with larger sample size are needed to evaluate its efficacy and safety in childhood asthma.