芒针透刺背俞穴联合黄芪桂枝五物汤对卒中后平衡功能障碍的改善作用

[目的]探讨芒针透刺背俞穴联合黄芪桂枝五物汤对卒中后平衡功能障碍的影响.[方法]选择2019年1月—2020年3月于重庆市北碚区中医院康复科和脑病科住院治疗的84例卒中后平衡功能障碍患者进行前瞻性研究,根据随机数字表法将纳入研究的病例分为观察组和对照组.两组患者均采取常规对症治疗,对照组采用黄芪桂枝五物汤,观察组采用芒...     

利用1mL针头连续褥式缝合虹膜根部离断的疗效分析

目的:观察以1mL注射器针头连续褥式缝合虹膜根部离断的临床效果。方法:在1mL注射器针头的辅助下,对37例外伤性虹膜根部离断的患者行连续褥式缝合,术后观察虹膜复位情况、瞳孔形状、视力、炎症反应等,探讨此方法的疗效和并发症。结果:虹膜根部离断全部复位,瞳孔复圆或近圆,复视消除,视力提高。无缝线脱落,迁延不愈的炎症等并发症,复位效果好。结论:利用1mL注射器针头连续褥式缝合虹膜根部离断是一种有效的术式,复位效果满意,并发症少,安全系数高,值得推广。     

甘露醇加温泵推对小儿静脉留置针留置时间的影响

目的探讨20％甘露醇加温至35～37℃后微量泵推注对小儿静脉留置针留置时间的影响。方法将微量泵推注20％甘露醇的患儿随机分为加温组79例和常温组77例。加温组采用微量泵推注加热至35-37℃的甘露醇,常温组采用微量泵推注常温15～20℃的甘露醇,每日2～4次,3-5m1·k^-1·次^-1,15-30min内推注完毕。观察两组对小儿静脉留置针留置时间的影响。结果两组小儿静脉留置针留置时间的比较有显著性差异（P〈0．01）。结论甘露醇加温微量泵推注可延长小儿静脉留置针留置时间。     

不同年龄小儿静脉留置针临床应用的效果观察

摘要目的探讨不同年龄小儿静脉留置针临床应用的效果。方法将520例患儿按照年龄分为新生儿组、1个月～2岁组、3～6岁组和7～12岁组,各130例。并在各组内随机再分为两组,分别使用静脉留置针和传统头皮针实施静脉输液治疗,观察比较穿刺后并发症发生率。结果新生儿组与7～12岁组比较,两种静脉穿刺方法并发症发生率无显著性差异（P〉0．05）,但分别与1个月～2岁组和3～6岁组比较有显著性差异（P〈0．05）,3～6岁组与1个月～2岁组比较有显著性差异（P〈0．05）;新生儿组和7～12岁组中,采用两种穿刺方法并发症发生率比较有显著性差异（P〈0．05）,1个月～2岁组和3～6岁组中,采用两种穿刺方法并发症发生率比较无显著性差异（P〉0．05）。结论不同年龄组患儿静脉穿刺并发症发生率存在差异,通过采用静脉留置针可以降低并发症发生率,但1个月～2岁组和3～6岁组中效果不好。     

头部电针透穴、体针联合氟西汀治疗脑卒中后抑郁临床研究

目的:观察头部电针透穴、体针联合氟西汀治疗对脑卒中后抑郁患者脑电图及抑郁情况的影响。方法:选取122例脑卒中后抑郁患者为研究对象,按随机数字表法分为对照组和研究组各61例。对照组给予盐酸氟西汀胶囊治疗,研究组在此基础上联合头部电针透穴、体针治疗,2组均治疗4周。对比2组临床疗效,评估患者治疗前后的脑电图及抑郁情况。结果:研究组总有效率86.89%,高于对照组的68.85%,差异有统计学意义(P<0.05)。与治疗前比较,治疗后2组脑电图正常患者比率均升高,研究组脑电图正常患者比率高于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,治疗后2组汉密尔顿抑郁量表(HAMD)评分均降低,且研究组HAMD评分低于对照组,差异均有统计学意义(P<0.05);2组血浆5-羟吲哚乙酸(5-HIAA)水平均升高,且研究组血浆5-HIAA水平高于对照组,差异均有统计学意义(P<0.05)。结论:头部电针透穴、体针联合氟西汀可有效改善脑卒中后抑郁患者的临床症状,调节5-HIAA水平,疗效优于单纯使用氟西汀治疗。     

风三针治疗中风后吞咽障碍临床研究

目的:观察“风三针”针刺疗法在治疗中风后吞咽障碍的临床疗效。方法:随机收集中风后吞咽障碍患者60例,按照不同的治疗方法分为对照组和治疗组各30例。两组均先进行吞咽康复训练,后治疗组予风三针针刺治疗,观察两组治疗后洼田饮水试验评分,VFSS吞咽难度评分,并进行对比分析其临床疗效。结果:对照组及治疗组在治疗4个疗程后,治疗组总有效率93.33%高于对照组70.00%(P<0.05); 两组洼田饮水试验评分治疗后均低于治疗前(P<0.05),治疗组的评分低于对照组(P<0.05); 两组的VFSS吞咽难度评分治疗后均高于治疗前(P<0.05); 治疗组的VFSS难度评分高于对照组(P<0.05)。结论:“风三针”针刺疗法在治疗中风吞咽障碍中临床疗效确切。     

引气归元针法的研究进展

引气归元针法是腹针常用的针刺取穴手法,通过腹部腧穴的针刺刺激以调理先天、后天,从而达到神气条达、气血荣和、驱邪治病的目的。本文通过检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)和万方数字化期刊全文数据库等相关文献,从相关学者对引气归元针法的理论探讨、临床运用两个方面进行分析总结,以期为临床研究提供参考。     

Sensitivity for detecting fibrillation potentials: a comparison between concentric and monopolar needle electrodes

The sensitivity of monopolar and concentric electrodes for detecting fibrillation potentials (FP) has never been formally compared. We studied 35 muscles with FP, sampling 20 sites each with concentric and monopolar needles. The concentric needle identified 0.88 +/- 3.44 (mean +/- standard deviation) more sites with spontaneous activity. Although statistically significant (Wilcoxon signed rank test P less than .03), this difference in sensitivity did not appreciably affect diagnostic interpretation. Subjects described the concentric needles as more painful. Needle insertions in 25 other muscles demonstrated that needle movement generated the majority of FP. We suggest that the increased tissue injury caused by concentric needles may account for both their increased sensitivity and discomfort.     

肩三针配合康复训练治疗肩手综合征随机对照研究

目的:随机对照观察肩三针配合康复训练治疗肩手综合征临床疗效,探讨临床价值,以期丰富肩手综合征的治疗方案。方法:选取2016年1月至2017年12月黄石市第四医院收治的肩手综合征急性期患者82例作为研究对象,按照就诊顺序编号,采用数字随机表法分为对照组和观察组,每组41例。2组患者均予以神经营养、个性化控糖降脂降压治疗,及运动疗法和作业疗法等康复训练,观察组在此基础上再以肩三方案可有效提高急性期肩手综合征患者病情康复质量,提升临床症状改善效率,提升临床疗效,针为主穴配合对症穴位进行针刺治疗,1次/d,每周连续治疗6 d停1 d。2组患者均连续治疗8周为1个疗程。观察2组患者治疗前、后肩痛视觉模拟评分(VAS)、上肢动作研究量表(ARAT)、上肢关节活动度Fugl-Meyer评分(FMA)、中国临床神经功能缺损程度评分标准(CSS)评分及血清炎性反应因子变化,并行治疗前后比较、组间比较;每周对患者肩痛、活动受限、手腕红肿热痛症状、手指屈曲受限状况进行测评,统计2组患者上述临床症状改善时间。完成治疗后综合评价2组患者临床疗效并比较。结果:1)治疗8周后,2组患者肩痛VAS评分、CSS评分均较治疗前明显降低,且观察组低于对照组,差异有统计学意义(P0.05);2)治疗后2组患者血清炎性反应因子IL-2、IL-6、TNF-α均较治疗前明显降低,且观察组低于对照组,差异有统计学意义(P0.05);3)完成治疗后,2组患者ARAT评分、FMA评分均较治疗前提高,且观察组高于对照组,差异有统计学意义(P0.05);4)观察组患者肩痛、活动受限、手腕红肿热痛症状、手指屈曲受限临床症状改善时间明显较对照组短,差异有统计学意义(P0.05);5)完成治疗后,观察组患者临床总有效率明显高于对照组,差异有统计学意义(P0.05)。结论:肩三针配合康复训练可后效改善患者机体炎性反应状态,促进患者临床症状改善效率,提高资料效果,具有较高临床价值。     

Strength of commonly used spinal needles: the ability to deform and resist deformation

We investigated the strength of commonly used spinal needles in relation to the amount of deformation, and registered forces during standardised testing. We investigated differences between manufacturers for the same length and gauge of Luer and non‐Luer needles, and examined the effect of the internal stylet in terms of needle strength. A specialised rig was designed to perform the testing in both the horizontal and axial plane, reflecting common industrial tests and clinical use. Needles from four commonly used manufacturers were used (Vygon, Becton Dickinson, B Braun, and Pajunk). Needles of 25 G and 27 G were tested in 90‐mm and 120‐mm lengths. We found significant differences in terms of the size of final deformation and ‘toughness’/resistance to deformation between needles of different brands. There were also significant differences between horizontal tests conducted as an industry standard and our own axial test. This may have bearing on clinical use in terms of the incidence of bending and breakage. The presence of the internal stylet resulted in significantly greater toughness in many needles, but had little effect on the degree of deformation. Comparison of Luer and non‐Luer needles of the same brand and size showed few significant differences in strength. This result is reassuring, given the imminent change from Luer to non‐Luer needles that is to occur in the UK.