中医治疗椎动脉型颈椎病研究进展

中医治疗椎动脉型颈椎病(cervical spondylosis of vertebral artery type,CSA)的主要方法有针灸治疗、中药治疗、手法治疗、综合疗法治疗等,其中针灸治疗包括电针治疗、其他针具治疗、灸法治疗;中药治疗包括中药内服治疗与中药外用治疗;手法治疗是采用不同推拿手法改善颈部肌肉紧张状态;综合疗法为电针、推拿、艾灸、中药熏蒸等相结合,为目前临床应用较多的治疗方法。目前,中医治疗CSA仍存在一些问题,比如研究样本量较小、无高质量、多中心随机对照研究,对照组设计欠科学、观察指标简单、无远期疗效观察等;大部分研究手法及中药治疗缺乏安全性、规范性探讨。因此未来临床研究本病应扩大样本量,采取多中心、随机对照模式,细化研究指标,并将安全性、规范性纳入研究范围,制定手法量学标准,为CAS的实际推广治疗本病方法提供依据。     

Effectiveness of Anma massage therapy in alleviating physical symptoms in outpatients with Parkinson's disease: A before-after study

We aimed to confirm the physical effects of a single Anma massage session and continuous Anma massage therapy for outpatients with Parkinson's disease (PD). Twenty-one PD outpatients (mean age, 64.43 ± 8.39 [SD] years; Hoehn and Yahr stage I–IV) received a single 40-min Anma massage session involving upper and lower limb exercises and some subsequently received seven weekly Anma massage sessions. After a single session, visual analogue scale scores were significantly lower for muscle stiffness, movement difficulties, pain, and fatigue; gait speed and pegboard test time were significantly shortened; stride length was significantly lengthened; and shoulder flexion and abduction were significantly improved. No significant changes occurred in controls. After continuous sessions, we found general improvements in the same outcomes. In conclusion, Anma massage might effectively alleviate various physical PD symptoms; furthermore, because it is given through clothing, Anma massage is accessible for PD patients with movement difficulties.     

Occupational Therapy Intervention for Residents in a Skilled Nursing Facility: A Focus on Atypical Patients

The 1990 implementation of the Omnibus Budget Reconciliation Act (OBRA) has expanded opportunities for occupational therapists to treat individuals with non-traditional illnesses. Therapists working in skilled nursing and long term care can benefit from gaining an understanding of the OBRA guidelines and patient's rights, especially regarding restraint reduction. Occupational therapists possess the necessary skills to assess and treat these individuals to help maximize their functioning as well as improve their quality of life (Moon-Sperling & Pinson, 1991). The premise of this article is to inform therapists about various types of ethical and legal intervention with atypical patients in skilled nursing facilities and to introduce therapists to the laws supporting provision of these services. [Article copies available for a fee from The Haworth Document Delivery Service: 1–800–342–9678. E-mail address: getinfo@haworth.com]     

中药联合穴位按摩在产后缺乳治疗中的应用体会

母乳喂养的优越性众所周知,但各种因素可引起产后缺乳。笔者导师在治疗产后缺乳上采用中药联合穴位按摩进行治疗,疗效显著,值得临床推广应用。     

针刺结合腹部按摩治疗脑出血患者便秘30例临床观察

目的:观察探讨针刺结合腹部按摩治疗脑出血便秘的作用。方法:将60例脑出血患者随机分为观察组和对照组,观察组给予针刺和腹部按摩,对照组给予针刺治疗,在脑出血患者入院后确诊为脑出血便秘即开始治疗,1次/d,连续10天。结果:观察组治疗脑出血后便秘的总有效率为93.3%,对照组的总有效率为80.0%,两组差异具有统计学意义。结论:针刺结合腹部按摩治疗脑出血后便秘疗效显著,优于针刺组,在保证疗效更显著的基础上,相对更经济。     

穴位按摩对长期卧床患者发热恢复的效果观察

目的：探讨穴位按摩方法对长期卧床患者发热恢复的作用。方法：将84例长期卧床发热患者随机分为常规组和穴位按摩组，每组各42例。常规组给予发热后常规护理，穴位按摩组在常规护理基础上，实施双侧风池、太阳、合谷和大椎穴交替按摩。结果：两组患者体温恢复正常时间和三天内体温反弹例数比较，差异均存在统计学意义（P〈0．05）。其中按摩组体温恢复时间和三天内体温反弹例数均小于常规组。结论：穴位按摩可有效促进长期卧床发热患者体温的恢复。     

小针刀结合推拿手法治疗CSA的临床疗效观察

目的探求小针刀结合推拿手法治疗CSA的临床疗效。方法 400例CSA患者随机分成A（药物治疗组）、B（小针刀治疗组）、C（推拿手法治疗组）、D（小针刀结合推拿手法治疗组）4个组,对400例患者在小针刀治疗前、后分别进行临床疗效及疗程对比观察。结果 A组治疗总有效率65.9%;B组总有效率74.6%;C组总有效率80.3%;D组总有效率95.9%。A、B、C、D 4组平均时间分别为2.80周、2.08周、1.95周、1.74周。结论小针刀结合推拿手法治疗对椎动脉型颈椎病有明确的治疗作用,且与单纯药物治疗组、小针刀治疗组、推拿治疗组相比,其疗效更强,疗程最短。     

基于文献研究的推拿外治法不良事件分析与对策

[目的] 了解国内推拿不良事件现状,促进推拿手法的标准化,从而提高推拿治疗的安全性。[方法] 采用回顾性期刊文献研究,检索中国知网中国期刊全文数据库、维普中文科技期刊全文数据库、万方数据库、中国生物医学文献数据库的推拿不良事件病例报道类文献,对使用的手法、意外情况类型、原发疾病、事故原因、病例数等进行统计分析。[结果] 检出有效文献202篇,共 709个病例。分析结果显示推拿不良事件主要包括骨折与脱位、神经损伤、晕厥、截瘫、椎间盘突出症等。扳法、按法、牵引、被动肢体屈伸等手法标准化程度低,在推拿治疗中易导致不良事件发生。[结论] 部分推拿手法的安全性尚待提高,推拿手法标准化是提高其安全性的重要途径,相关工作亟待开展。