中药熏洗联合丹参冻干粉针剂穴位注射治疗膝关节骨性关节炎随机平行对照研究

[目的]观察中药熏洗联合丹参冻干粉针剂穴位注射治疗膝关节骨性关节炎疗效。[方法]使用随机平行对照方法,将42例住院及门诊患者按就诊顺序编号方法随机分为两组。对照组21例双氯芬酸钠缓释片,75mg／次,2次／d。治疗组21例①中药熏洗（羌活、独活、麻黄各30g,红花15g,川芎30g,蜂房20g,蜈蚣2条,全蝎10g,艾叶30g,伸筋草30g,透骨草15g,枳壳20g,等）,1剂／d,水煎4000mL,30min/次,熏洗。②穴位注射（足三里、内外膝眼、委中）,丹参冻干粉针剂400mL＋0．9％氯化钠注射液2mL,0．2mL／穴,隔日注射1次。连续治疗15d为1疗程。观测临床症状、膝关节功能、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈3例,显效11例,有效5例,无效2例,总有效率90．48％。对照组痊愈1例,显效6例,有效8例,无效6例,总有效率71．43％。治疗组疗效优于对照组（P〈0．05）。[结论]中药熏洗联合丹参冻干粉针剂穴位注射治疗膝关节骨性关节炎,疗效满意,无副作用,值得推广。     

中国首次基孔肯雅热流行患者的临床特点

目的 分析基孔肯雅热患者的临床特点,为防控该病提供借鉴.方法 分析46例确诊为基孔肯雅热的住院患者的临床症状、体征.血常规,生物化学指标以及治疗方案.组间比较采用t检验.结果 46例基孔肯雅热患者中,发热、皮疹及关节痛分别为46、42和41例,分别占100.0%、91.3%和89.1%;15例患者外周血WBC下降,占32.6%,乳酸脱氢酶及血清磷酸肌酸激酶升高比例分别为45.5%(20/44)和28.9%(13/45),3例ALT升高.利巴韦林治疗与单纯对症治疗效果相比,发热时间延长(t=2.588,P=0.013).结论 基孔肯雅热主要表现为发热、皮疹、关节痛,对症治疗预后好,抗病毒治疗对缩短病程可能无益.

Abstract：

Objective To analyze clinical features of patients with chikungunya fever and provide future reference for prevention and control of the disease. Methods Forty-six confirmed chikungunya fever inpatients were included. Their clinical symptoms, signs, blood count, key biochemical indicators and treatments were analyzed. The comparison between groups were done by ttest. Results The percentages of total cases presenting with fever, rash and joint pain were 100. 0% (46/46), 91. 3% (42/46) and 89. 1% (41/46), respectively. Fifteen (32.6%) cases displayed leucopenia. Increases in lactose dehydrogenase (LDH) and creatine kinase (CK) were observed in 45. 5%(20/44) and 28. 9%(13/45) of the cases, respectively. Three cases displayed an increase of alanine aminotransferase (ALT). Administration of ribavarin extend febrile time compared to symptom-relieving treatments (t=2. 588, P = 0. 013). Conclusions Clinical features of chikungunya fever include fever, rash and joint pain. Good prognosis can be resulted from symptom-relieving treatment. Antiviral treatment may not be beneficial to reducing course of disease.     

活血通络汤配合舒血宁治疗糖尿病性周围神经病变40例

[目的]观察活血通络汤配合舒血宁治疗糖尿病性周围神经病变疗效。[方法]将80例随机分为两组,均给予饮食控制、合理运动,口服降糖药物或注射胰岛素。对照组40例弥可保片500μg日3次口服。治疗组40例活血通络汤配合舒血宁静滴。两组均治疗60天进行疗效判定。[结果]治疗组显效18例,有效18例,无效4例。对照组显效10例,有效19例,无效1例。总有效率治疗组(90.00%)优于对照组(72.50%)(P<0.05)。[结论]活血通络汤配合舒血宁治疗糖尿病性周围神经病变疗效满意,患者依从性好,值得推广。     

当归四逆汤治疗痹证浅析

当归四逆汤治疗痹证的特点:一是血虚寒凝,肢体经脉气血闭阻,不通则痛的肢体关节疼痛,局部发凉,四肢厥冷的痛痹证;二是血虚寒凝进而引起血脉瘀阻的脉痹证,四肢厥冷,手足青紫,脉细欲绝或无脉症。     

痹证经筋论治探析

痹证是肌肉、筋骨、关节发生酸痛、麻木、重着、屈伸不利、甚或关节肿大灼热为主要临床表现的疾病,经筋是十二经脉经气濡养筋肉骨节的体系,经筋理论认为经筋结构或功能异常是引起痹痛或加重痹痛的关键,应用"解结法"解除"横络"卡压是经筋理论治疗痹证的重要治则。     

清热利湿法治疗湿热痹阻型强直性脊柱炎疗效评价

目的:观察清热利湿法治疗湿热痹阻型强直性脊柱炎的临床疗效。方法:将68例患者随机分为治疗组和对照组,治疗组采用清热利湿的中药协定方,对照组采用缓解病情的西药。疗程为2个月。治疗前后评价强脊疾病活动指数(BASDAI)、疾病功能指数(BASFI)、晨僵时间、血沉(ESR)、C-反应蛋白(CRP)、血尿常规、肝肾功能、大便隐血。结果:治疗后两组各项指标和疗前相比均有显著性差异(P0.05或P0.01);组间对比,两组患者综合疗效比较无显著性差异(P0.05),而不良反应发生情况明显优于对照组(P0.05)。结论:清热利湿法对强直性脊柱炎有较好的疗效,且安全可靠。     

浅谈痹证从痰论治

背景:痹证的成因较为复杂,其中因痰致痹是临床常见原因。目的:揭示痰邪致痹的临床证治规律。方法:总结文献并结合个人经验探讨痹证诊治。结论:活血化痰、针药齐施是治疗痹证的有效方法。     

股四头肌等长收缩练习治疗膝骨性关节炎的病例对照研究

目的:探讨股四头肌等长收缩练习治疗膝骨性关节炎的临床疗效,并建立膝骨性关节炎运动处方。方法:2008年1月至2010年9月采用股四头肌等长收缩练习治疗膝骨性关节炎120例,其中男39例,女81例;年龄40～85岁,平均62.50岁;病程1个月～30年。按就诊先后顺序分为2组,治疗组60例,男21例,女39例;年龄40～85岁,平均(62.27±8.99)岁;病程2个月～30年,给予玻璃酸钠关节腔注射加股四头肌等长收缩练习治疗。对照组60例,男18例,女42例;年龄41～80岁,平均(62.72±8.34)岁;病程个1个月～30年,给予常规玻璃酸钠关节腔注射治疗。分别观察2组膝关节疼痛、功能及积液等指标,比较其临床疗效。结果:120例均获随访,时间1～3年,平均18个月。参照JOA判定标准:治疗组治愈12例,显效33例,有效14例,无效1例;对照组治愈7例,显效14例,有效31例,无效8例,治疗组疗效优于对照组。治疗组累计复发7膝(1年内复发3膝,1年后复发4膝),对照组累计复发31膝(1年内复发13膝,1年后复发18膝),治疗组复发病例少于对照组。结论:股四头肌等长收缩练习在治疗膝骨性关节炎中具有明显的缓解症状、改善关节功能、增强关节稳定性及减缓关节退变进程的作用,远期临床疗效较好。     

Frequency of temporomandibular arthralgia among myofascial pain patients with pain on palpation of ipsilateral masseter

Aims:

The masseter muscle is a common source of referred pain to the temporomandibular joint (TMJ), with a possibility of false positive diagnoses for arthralgia when diagnosed by research diagnostic criteria for temporomandibular disorders (RDC/TMD) clinical examination. The current study investigated the distribution of arthralgia diagnoses among individuals with myofascial pain, with or without pain on masseter palpation.

Methodology:

The study was conducted with 255 outpatients. Clinical data and questionnaires were directly entered into software that deploys algorithms based on the diagnostic criteria of the RDC/TMD, and automatically classifies and stores the diagnosis of each patient evaluated. An association between diagnostic subgroups was verified by calculating the odds ratio (OR), and the statistical significance was tested using the Chi-square test.

Results:

A higher frequency of concordance (about three times greater) between myofascial pain and arthralgia occurred when there was pain on palpation in the region of the ipsilateral masseter muscle, and the association was statistically significant.

Conclusions:

The results of this study revealed a threefold increase in the risk for the presence of temporomandibular arthralgia in cases of myofascial pain combined with pain on palpation in the region of the ipsilateral masseter muscle.