Improved symptoms of complex regional pain syndrome after novel lymphatic treatment and interdisciplinary pain management

IntroductionComplex regional pain syndrome (CRPS) is a pain syndrome with no singular mechanism and no specific cure. The aim of this case report is to study the impact of Lymphatic Enhancement Technology (LET) treatment on CRPS-related symptoms.MethodsA 51 year-old female presented with a chief complaint of severe, refractory ankle pain and CRPS related to a tibial and fibular fracture sustained three years earlier. The patient completed twelve cognitive behavioral therapy sessions over a 4-week period, and eleven physical therapy sessions over a four-month period, six of which utilized LET.ResultsPain and swelling were largely unchanged with interdisciplinary treatment before the introduction of LET. A within-session change of 37.5% in pain intensity and 87.5% in ankle girth was observed immediately after the first application of LET. Three months after beginning LET treatment, the patient maintained a 43.8% improvement in pain intensity and 100% improvement in measurements of lower extremity girth and ankle range of motion. No side effects or adverse events were associated with the LET treatment.ConclusionSwelling, pain, and mobility loss are common symptoms and features of CRPS. LET is a novel, non-invasive treatment that appears to be quite safe and effective for improving pain, swelling, and mobility loss related to CRPS.     

针刺推拿结合治疗原发性不安腿综合征疗效观察

目的:观察针刺推拿结合疗法治疗原发性不安腿综合征的临床疗效。方法:将100例原发性不安腿综合征患者随机分为针推组(51例)和针刺组(49例),针推组采用针刺推拿结合疗法,针刺组采用单纯针刺疗法,以不安腿综合征的严重程度评定量表IRLS及生活质量评定量表RLSQOL、MOS睡眠量表评分为观察指标。结果:两种疗法均能显著降低IRLS评分[(8.34±4.16)VS(11.25±4.35)],明显提高RLSQOL评分[(83.10±7.76)VS(68.26±7.82)],且两组相比均有显著性差异(P<0.001);两组MOS-SS评分的变化则是睡眠障碍[(29.35±12.65)VS(40.27±12.43),P<0.001]、日间嗜睡[(24.74±11.65)VS(30.16±11.21),P<0.01]及睡眠指数Ⅱ[(27.36±12.67)VS(38.22±12.45),P<0.01]评分降低,睡眠数量[(6.36±1.32)VS(5.53±1.34),P<0.01]及睡眠充足[(53.72±13.25)VS(41.83±13.46),P<0.001]评分增加。结论:针刺推拿结合疗法、针刺疗法治疗原发性不安腿综合征疗效肯定,既能有效减轻或控制不安腿本身症状,又能明显改善与其相关联的睡眠障碍,从而有效提高患者的生活质量,且针刺推拿结合的疗效明显优于单纯针刺法,尤其在改善患者睡眠方面具有明显的优势,值得推广应用。     

从《金匮要略》探讨痛风“代谢-炎症-免疫”发病机制

痛风是一种单钠尿酸盐沉积所致的晶体相关性关节病,与嘌呤代谢紊乱及(或)尿酸排泄减少所致的高尿酸血症直接相关,属于代谢性风湿病范畴。然近几年研究显示痛风的发病同时与炎症和免疫相关。笔者主要从中医经典——《金匮要略》对痛风的辨证治疗来探讨其对痛风"代谢-炎症-免疫"发病机制的指导作用,以此发挥中西交融的优势,最终为痛风的治疗提供新的思路。     

CINV的中西医临床防治研究

化疗相关性恶心呕吐（CINV）的防治是肿瘤疾病治疗过程中亟待解决的重点难题,其严重影响患者的生活质量及化疗进程,进而影响治疗效果。近年来,虽然现代医学对该病的研究取得巨大进展,但仍存在一定的不足,而中医联合干预在该病治疗中具有显著优势。本文结合近年来相关文献,分别从CINV的病理机制、中医及西医防治方法进行综述,以期为临床防治CINV提供参考。     

常克教授辨治小儿外感发热经验

分析总结常克教授辨治小儿外感发热的经验。常克教授在诊法方面重视舌诊、咽诊,细辨邪气属性。同时针对邪气具有体质从化的特点,结合小儿"阳常有余""形气未充"的生理特点,重视截断疗法的应用,阻隔传变,安"未受邪之地"。用药方面,以证为先,细审药性,灵活使用药对,提高了处方的疗效性。附典型医案1则,以资验证。     

Association between sports participation and overall health in children and adolescents

Emerging evidence revealed that participating in sports may have benefits for health, but the association between sports participation and self-rated overall health has not been clearly established in children and adolescents. The present study aimed to examine the cross-sectional relationships between sports participation and self-rated overall health. A national sample of 42,777 (mean age = 9.4 ± 5.2, 48.3% girls) United States children and adolescents completed self-administered questionnaires and were included in the final analysis. The crude and adjusted odds ratio (ORs) and 95% CI were used to analyze the association between sports participation and self-rated overall health. Results indicated that children and adolescents participated in sports were more likely to report better overall health (OR = 1.92, 95%CI: 1.83, 2.02) compared to those not participating in sports. This study found that sport participation was positively associated with self-rated overall health in children and adolescents. This study offers evidence concerning adolescents’ health literacy promotion.     

Successful treatment of ankylosing spondylitis with alternative and complementary medicine withdrawal of adalimumab treatment

Background and purposeCurrent treatment strategies for ankylosing spondylitis (AS) include adalimumab and other biological drugs. However, treatment failures and side effects are commonly observed. This report documents the successful use of supplements and dietary changes to treat a patient with AS after cessation of adalimumab therapy.Patient presentationA 38-year-old human leukocyte antigen B27 positive female patient with AS showed no improvement when treated with a non-steroidal anti-inflammatory drug. The patient then began adalimumab therapy with some success; however, after nine months, she developed a disseminated and refractory Molluscum contagiosum infection. Adalimumab was withdrawn, and the patient started taking supplements, while adopting an anti-inflammatory diet (dairy-free, gluten-free, and sugar-free). Normalization of inflammatory markers was achieved after two months, and magnetic resonance imaging of the sacroiliac revealed a notable physical improvement.     

中药治疗儿童紫癜性肾炎血尿型辨证及用药规律分析

目的探讨中药治疗儿童紫癜性肾炎血尿型的辨证及用药规律,以期为本病的临床诊治提供参考。方法利用国内三大中文数据库《中国知网中国学术期刊网络出版总库》《维普中文科技期刊数据库》和《万方数据中国学术期刊数据库》,以"血尿""紫癜性肾炎"为检索词,检索2000—2019年国内公开发表的使用中医药治疗儿童紫癜性肾炎血尿型的临床文献,对文献报道中所辨证型及所用药物的分类、功效、药性、药味、归经进行统计分析。结果在符合纳入条件的中医药治疗儿童紫癜性肾炎血尿型的52篇临床文献中,共涉及101味中药,12类药物,累积频次1299次,其中居前5位的药物类别分别是清热药、补虚药、止血药、活血化瘀药和利湿药,居前20位的单味药分别是生地黄、当归、旱莲草、三七、茜草、甘草、白茅根、山萸肉、黄柏、黄芪、党参、白术、栀子、大蓟、小蓟、丹参、知母、地龙、虎杖、枸杞子。辨证分型主要有血热妄行证、阴虚内热证、脾肾两虚证、脾不统血证、瘀血阻络证、湿瘀互结证、气阴两虚证。结论儿童紫癜性肾炎血尿型辨证以血热妄行证为主,多从"瘀""热""虚""湿"论治,常运用活血化瘀、清热解毒、凉血止血、益气养阴类中药治疗。     

Muscle energy technique for chronic obstructive pulmonary disease: A feasibility study

ObjectiveThis study aimed to investigate the feasibility of implementing a manual therapy technique (muscle energy technique, MET) protocol in a hospital pulmonary rehabilitation (PR) program for patients with moderate to severe chronic obstructive pulmonary disease (COPD).Please cite this article as: Baxter DA, Coyle ME, Hill CJ, Worsnop C, Shergis JL. Muscle energy technique for chronic obstructive pulmonary disease: A feasibility study. J Integr Med. 2023; 21(3): 245–253.MethodsParticipants aged 40 years and over, with moderate to severe COPD, were recruited into this 12-week study. The primary outcome measures were feasibility (acceptability of the intervention and attendance/adherence to the trial) and safety (adverse events, AEs). All participants received the MET and PR therapies. Participants and assessors were unblinded. Semi-standardized MET was delivered on 6 occasions (a maximum of once per week) at the hospital directly before a PR session. Participants undertook PR sessions as per the hospital program at a frequency of two days per week for 8 weeks. Participants were contacted 4 weeks after their final MET treatment via a telephone call to assess acceptability of the intervention.ResultsThirty-three participants were enrolled, with a median age of 74 years (range 45–89 years). The median number of MET sessions that participants attended was 5 (range 0–6) out of a possible 6 sessions (83% attendance). At follow-up, participants overwhelmingly enjoyed the MET treatment with some subjectively reporting improved breathing. There were no major AEs related to the intervention, with the majority of AEs classified as expected events related to COPD exacerbations.ConclusionIt is feasible to implement a manual therapy protocol using MET as an adjunct to PR in a hospital setting. Recruitment rates were satisfactory and there were no AEs related to the MET component of the intervention.