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991.
目的：探讨不同医学营养治疗方法对老年2型糖尿病患者血糖波动性的影响。方法将85例2型糖尿病患者按完全随机分组法分为3组,对照组29例、低血糖生成指数（GI）膳食组27例、水溶性膳食纤维组29例,3组均参照中国糖尿病医学营养治疗指南给予糖尿病膳食指导,并给予口服降糖药,低 GI 膳食组早晚餐完全用低 GI 膳食替代,水溶性膳食纤维组在早、晚餐时各添加水溶性膳食纤维10 g 。干预期为1个月,干预前后观察各组患者血糖、血脂、肾功能及血糖波动情况。结果与干预前比较,各组干预后血糖均有不同程度下降（P ＜0．05）,低 GI 膳食组及水溶性膳食纤维组干预后血糖波动性指标明显下降（P＜0．05）。与对照组比较,干预后低 GI 膳食组空腹血糖平均值、餐后血糖平均值、血糖平均值明显下降（P＜0．05）,干预后低 GI 膳食组和水溶性膳食纤维组血糖标准差、平均血糖波动幅度明显低于对照组（P＜0．05）。结论老年2型糖尿病患者在糖尿病膳食指导及口服药物治疗基础上,给予低 GI 膳食替代治疗或添加水溶性膳食纤维,能有效控制血糖水平,明显降低血糖的波动性。 相似文献
992.
目的：观察2型糖尿病患者在胰岛素强化治疗前、后的同型半胱氨酸（Hcy ）水平,探究新诊断糖尿病的患者血糖控制对于Hcy的影响程度。方法抽取该院128例符合标准的新诊断2型糖尿病患者,分为对照组和强化组各64例。给予对照组口服磺脲类药物,给予观察组使用胰岛素进行强化治疗。在治疗3个月后比较两组患者治疗前、后的FBG、HbA1c等相关指标的变化情况。结果所有患者经过治疗后,Hcy、FBG、PBG和HbA1c都较治疗前有所下降,且强化组Hcy下降更明显,差异有统计学意义（P＜0．05）。结论胰岛素强化治疗能够有效治疗新诊断2型糖尿病。 相似文献
993.
目的：研究银丹心脑通软胶囊对2型糖尿病氧化应激及血管内皮功能的影响。方法86例2型糖尿病患者按照随机数字表法分成常规降糖治疗组（常规组,n＝40）和银丹心脑通软胶囊治疗组（银丹心脑通组,n＝46）。常规组患者在控制饮食、运动等基础上给予降糖治疗使血糖连续达标12周,银丹心脑通组在常规治疗血糖达标基础上加用银丹心脑通软胶囊（每次1．2 g ,每日3次）连续治疗12周。检测两组患者治疗前后血脂、丙二醛（MDA）、超氧化物歧化酶（SOD）、一氧化氮（NO）、内皮素（ET）等相关因素变化,应用超声检测肱动脉血流介导的内皮依赖性舒张功能（FMD）和非内皮依赖性血管舒张功能（NMD）。结果治疗12周后两组患者血浆总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL‐C）、MDA、ET 较治疗前均有明显下降,高密度脂蛋白胆固醇（HDL‐C）、SOD、NO、FMD则较治疗前升高（P＜0．05）;而且银丹心脑通组治疗后上述各项指标与常规组治疗后比较也有显著变化（P＜0．05）。结论银丹心脑通软胶囊可下调2型糖尿病氧化应激,调节糖尿病脂代谢异常,明显改善损伤的血管内皮功能。 相似文献
994.
目的：研究老年2型糖尿病患者体质量指数（BMI）和腰臀比（WHR）与血小板参数的相关性。方法选取2012年10月到2014年2月该院收治的82例2型糖尿病患者作为研究对象,选取同期进行健康体检的80例健康老年人作为对照组。将患者按照BM I分为3组,Ⅰ组（正常组）23例,Ⅱ组（超质量组）38例,Ⅲ组（肥胖组）21例。比较各组患者和对照组的血糖、糖化血红蛋白（HbA1c）水平、血脂异常和腹型肥胖的发生率;比较不同BMI和WHR的老年人血脂水平和血小板参数,比较不同血脂水平老年人的血小板参数。结果3组患者的血糖、HbA1c水平、BMI、WHR、血脂异常和腹型肥胖的发生率高于对照组,差异有统计学意义（P＜0．05）。不同BMI和WHR老年人的血脂水平和血小板参数差异有统计学意义（P＜0．05）。不同血脂水平老年人的血小板参数差异有统计学意义（P＜0．05）。结论老年2型糖尿病患者BMI和WHR与血小板参数具有一定的相关性,可能与肥胖和血脂代谢紊乱对血管内皮的损伤有关。 相似文献
995.
Meng-Ting Lin Ming-Yen Hsiao Yu-Kang Tu Tyng-Guey Wang 《Archives of physical medicine and rehabilitation》2018,99(7):1383-1394.e6
Objective
To compare the efficacy of intra-articular (IA) steroid injection and distension in patients with frozen shoulder.Data Sources
Databases, including MEDLINE (via PubMed), Embase, Scopus, and Cochrane Library, were searched for studies published up to November 2016.Study Selection
We included all published randomized controlled trials (RCTs), quasi-experimental studies, and observational studies investigating the effectiveness of IA steroid injection, distension, and physiotherapy in patients with frozen shoulder. Sixteen RCTs and 1 observational study were enrolled in meta-analysis.Data Extraction
Full texts were independently reviewed, and quality of RCTs was assessed with The Cochrane Collaboration's tool. The primary outcome was functional improvement; the secondary outcomes included pain reduction and external rotation (ER) improvement.Data Synthesis
In pairwise meta-analysis, pooled standardized mean difference (SMD) of functional improvement and pain reduction revealed equal efficacy at 3 follow-up time points. With respect to ER improvement, distension has a superior effect compared with IA steroid injection in the short term [(2–4wk; SMD, ?.36; 95% confidence interval [CI], ?.68 to ?.04) and medium term (6–16wk; SMD, ?0.80; 95% CI, ?1.32 to ?0.29). The network meta-analysis indicated a better efficacy for distension than for IA steroid injection in ER improvement only in the medium term (6–16wk; SMD, ?0.70; 95% CI, ?1.19 to ?0.21).Conclusions
IA steroid injection was as effective as distension in shoulder function improvement, pain reduction, and increasing ER of the shoulder. Distension yielded better ER improvement in the medium term but to a minor extent in the long term. For patients with predominant ER limitation, early distension could be considered the primary choice of treatment. 相似文献996.
Arash Babaei-Ghazani Peyman Roomizadeh Bijan Forogh Seyed-Mohammad Moeini-Taba Amin Abedini Mona Kadkhodaie Fateme Jahanjoo Bina Eftekharsadat 《Archives of physical medicine and rehabilitation》2018,99(4):766-775
Objective
To review the literature and assess the comparative effectiveness of ultrasound-guided versus landmark-guided local corticosteroid injections in patients with carpal tunnel syndrome (CTS).Data Sources
Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), Embase (Ovid), and Web of Science (from inception to February 1, 2017).Study Selection
Randomized controlled trials (RCTs) comparing ultrasound-guided injection with landmark-guided injection in patients with CTS were included.Data Extraction
Two authors independently screened abstracts and full texts. The outcomes of interest were Symptom Severity Scale (SSS) and Functional Status Scale (FSS) scores of the Boston Carpal Tunnel Questionnaire and 4 electrodiagnostic parameters, including compound muscle action potential (CMAP), sensory nerve action potential (SNAP), distal motor latency (DML), and distal sensory latency (DSL).Data Synthesis
Overall, 569 abstracts were retrieved and checked for eligibility; finally, 3 RCTs were included (181 injected hands). Pooled analysis showed that ultrasound-guided injection was more effective in SSS improvement (mean difference [MD], ?.46; 95% confidence interval [CI], ?.59 to ?.32; P<.00001), whereas no significant difference was observed between the 2 methods in terms of the FSS (MD, ?.25; 95% CI, ?.56 to .05; P=.10). There were also no statistically significant differences in improvements of CMAP (MD, 1.54; 95% CI, 0.01 to 3.07; P=.05), SNAP (MD, ?0.02; 95% CI, ?6.27 to 6.23; P>.99), DML (MD, .05; 95% CI, ?.30 to .39; P=.80), or DSL (MD, .00; 95% CI, ?.65 to .65; P>.99).Conclusions
This review suggested that ultrasound-guided injection was more effective than landmark-guided injection in symptom severity improvement in patients with CTS; however, no significant differences were observed in functional status or electrodiagnostic improvements between the 2 methods. 相似文献997.
Is Going Beyond Rasch Analysis Necessary to Assess the Construct Validity of a Motor Function Scale?
Tiffanie Guillot Sylvain Roche Pascal Rippert Dalil Hamroun Jean Iwaz René Ecochard Carole Vuillerot 《Archives of physical medicine and rehabilitation》2018,99(9):1776-1782.e9
Objective
To examine whether a Rasch analysis is sufficient to establish the construct validity of the Motor Function Measure (MFM) and discuss whether weighting the MFM item scores would improve the MFM construct validity.Design
Observational cross-sectional multicenter study.Setting
Twenty-three physical medicine departments, neurology departments, or reference centers for neuromuscular diseases.Participants
Patients (N=911) aged 6 to 60 years with Charcot-Marie-Tooth disease (CMT), facioscapulohumeral dystrophy (FSHD), or myotonic dystrophy type 1 (DM1).Interventions
None.Main Outcome Measure(s)
Comparison of the goodness-of-fit of the confirmatory factor analysis (CFA) model vs that of a modified multidimensional Rasch model on MFM item scores in each considered disease.Results
The CFA model showed good fit to the data and significantly better goodness of fit than the modified multidimensional Rasch model regardless of the disease (P<.001). Statistically significant differences in item standardized factor loadings were found between DM1, CMT, and FSHD in only 6 of 32 items (items 6, 27, 2, 7, 9 and 17).Conclusions
For multidimensional scales designed to measure patient abilities in various diseases, a Rasch analysis might not be the most convenient, whereas a CFA is able to establish the scale construct validity and provide weights to adapt the item scores to a specific disease. 相似文献998.
Yael Goverover Nancy D. Chiaravalloti Amanda R. O&#x;Brien John DeLuca 《Archives of physical medicine and rehabilitation》2018,99(2):390-407
Objective
To update the clinical recommendations for cognitive rehabilitation of people with multiple sclerosis (MS), based on a systematic review of the literature from 2007 through 2016.Data Sources
Searches of MEDLINE, PsycINFO, and CINAHL were conducted with a combination of the following terms: attention, awareness, cognition, cognitive, communication, executive, executive function, language, learning, memory, perception, problem solving, reasoning, rehabilitation, remediation, training, processing speed, and working memory. One hundred twenty-nine articles were identified and underwent initial screening.Study Selection
Fifty-nine articles were selected for inclusion after initial screening. Nineteen studies were excluded after further detailed review. Forty studies were fully reviewed and evaluated.Data Extraction
Articles were assigned to 1 of 6 categories: attention, learning and memory, processing speed and working memory, executive functioning, metacognition, or nonspecified/combined cognitive domains. Articles were abstracted and levels of evidence were decided using specific criteria.Data Synthesis
The current review yielded 6 class I studies, 10 class II studies, and 24 class III studies. One intervention in the area of verbal learning and memory received support for a practice standard, 2 computer programs received support as practice guidelines (in the area of attention and multicognitive domains), and several studies provided support for 5 practice options in the domains of attention and learning and memory.Conclusions
Substantial progress has been made since our previous review regarding the identification of effective treatments for cognitive impairments in persons with MS. However, much work remains to be done to optimize rehabilitation potential by applying the most methodologically rigorous research designs to provide class I evidence in support of a given treatment strategy. 相似文献999.
Lin Liu Qiang-Min Huang Qing-Guang Liu Nguyen Thitham Li-Hui Li Yan-Tao Ma Jia-Min Zhao 《Archives of physical medicine and rehabilitation》2018,99(1):144-152.e2
Objective
To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP).Data Sources
PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases were searched until January 2017.Study Selection
Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included.Data Extraction
Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at postintervention and follow-up.Data Synthesis
A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (standardized mean difference [SMD], ?1.06; 95% confidence interval [CI], ?1.77 to ?0.36; P=.003) and functional disability (SMD, ?0.76; 95% CI, ?1.46 to ?0.06; P=.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at postintervention (SMD, 0.83; 95% CI, 0.55–1.11; P<.00001).Conclusions
Moderate evidence showed that dry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear. 相似文献1000.
Virginie Pécourneau Yannick Degboé Thomas Barnetche Alain Cantagrel Arnaud Constantin Adeline Ruyssen-Witrand 《Archives of physical medicine and rehabilitation》2018,99(2):383-389.e1