中药熏蒸联合针灸推拿治疗中风的临床效果

目的：观察中药熏蒸联合推拿和针灸治疗中风的临床疗效。方法：选取2018年11月至2020年7月南通大学第二附属医院收治的中风患者100例作为研究对象，按照入院顺序进行编号，按编号单双数不同分为对照组和观察组，每组50例。对照组给予推拿+针灸治疗，观察组则在对照组基础上给予中药熏蒸治疗。比较2组患者临床疗效、红细胞压积（HCT）、纤维蛋白原（FBG）、血浆黏度（CP）、免疫学（lgA，lgG，lgM）、神经缺损（NDF）、运动功能（FMA）、临床痉挛指数（CSI）及不良反应。结果：治疗后，观察组临床有效率为96.00%，对照组为84.00%，差异有统计学意义（P<0.05）；2组FBG、CP、HCT、IgA、IgM、IgG水平均显著降低，且观察组显著低于对照组（P<0.05）；2组NDF、CSI评分均明显降低，且观察组明显低于对照组（P<0.05）；2组FMA评分上升，且观察组显著高于对照组（P<0.05）；对照组与观察组的不良反应发生率分别为10.00%和12.00%，差异无统计学意义（P>0.05）。结论：改良中药熏蒸法联合推拿、针灸可改善中风患者血循环状态和免疫调节，促进神经及运动功能恢复，疗效确切。     

Massage therapy as a non-pharmacological analgesia for procedural pain in neonates: A scoping review

IntroductionNeonates who undergo painful medical procedures should be given analgesics to reduce future adverse risks. The evidence for massage therapy (MT) as an analgesic method still varies, both in its terminology and implementation. Only a few studies on this topic have been conducted using a standardised trial approach. This review can thus become the basis for better future research.ObjectiveThis review aims to identify literature on MT practices as a method to manage or control pain in neonates undergoing painful procedures.MethodsThe methodology for this review followed the JBI scoping review methodology guidelines. Searches were performed in several databases: MEDLINE (PubMed), CINAHL (EBSCO), Scopus (Elsevier) and EMBASE. Data collected were then extracted by two independent reviewers, synthesised and presented in the form of tables and narratives.ResultsFifteen studies involving a total of 1,058 neonates in nine countries were identified in the search as meeting the criteria set for this review. One study was a comparative study, five were quasi-experiment studies and nine were randomised control trials (RCT).ConclusionThe implementation of massage as a non-pharmacological analgesic method for neonates undergoing painful procedures varied among the reviewed studies. Differences were identified in terms of the body part massaged, the duration and intensity of the massage, the level of pressure and the combination of massage with other methods. All studies presented positive results for reducing pain intensity in neonates undergoing procedural pain. Therefore, it is crucial that the method used for giving massage should be practical, accurate and safe.     

髌骨内推治疗膝骨关节炎疗效观察

目的观察髌骨内推治疗膝骨关节炎(KOA)的临床疗效。方法将90例KOA患者随机分为2组,对照组45例予盐酸氨基葡萄糖胶囊治疗,治疗组45例在对照组治疗基础上应用髌骨内推治疗。2组均治疗1个月。比较2组治疗后1、3个月疗效;观察2组治疗前后双下肢肌肉围度、膝关节髌骨压痛评分及国际膝关节文献委员会膝关节评估表(IKDC)评分变化。结果治疗组治疗后1个月治愈率37.78%,总有效率84.44%;对照组治疗后1个月治愈率17.78%,总有效率68.89%。治疗组治疗后3个月治愈率62.22%,总有效率95.56%;对照组治疗后3个月治愈率28.89%,总有效率77.78%。2组治疗后3个月治愈率、总有效率均高于本组治疗后1个月(P0.05);治疗组治疗后1、3个月治愈率、总有效率均高于对照组治疗同期(P0.05)。2组治疗前、治疗后1个月患侧下肢肌肉围度均较本组健侧肌肉围度减少(P0.05)。2组治疗后1、3个月患侧肌肉围度均较本组治疗前增加(P0.05)。治疗组治疗后1、3个月患侧下肢肌肉围度均高于对照组治疗同期(P0.05)。2组治疗后3个月患侧下肢肌肉围度均较本组治疗后1个月增加(P0.05)。2组治疗后膝关节髌骨压痛评分低于本组治疗前(P0.05),治疗后3个月膝关节髌骨压痛评分低于治疗后1个月(P0.05);治疗组治疗后膝关节髌骨压痛评分低于对照组治疗同期(P0.05)。2组治疗后IKDC评分均高于本组治疗前(P0.05),治疗后3个月IKDC评分高于治疗后1个月(P0.05);治疗组治疗后IKDC评分高于对照组治疗同期(P0.05)。结论髌骨内推治疗KOA疗效确切,可以改善患者关节疼痛及延缓退化变形,无不良反应,宜长期坚持。     

A comparison of two scar massage protocols in pediatric burn survivors

The current evidence to support the use of massage for scar management is conflicting in the literature. The purpose of this study was to compare two scar massage protocols administered with pediatric burn survivors to determine if a more structured and standardized approach to scar massage could improve outcome. A retrospective review of the medical records of 100 children who received massage during the time period when two different protocols were implemented was conducted and data that was collected as part of the clinical exam regarding scar height, vascularity, pliability, itch and pain were extracted. Comparisons were made within subject for scar changes from baseline to follow up and between subjects receiving Protocol A and those receiving Protocol B for the same scar characteristics. Versions of the Vancouver Scar Scale were used to assess scars, while visual analogue scale, Itch Man Scale and Wong-Baker Faces Pain Scale were used to assess itch and pain. Results demonstrated improvements in itch and vascularity over time with both scar massage protocols. However, when comparing patients who received Protocol A to those who received Protocol B, there was no difference found in scar height, vascularity, pliability, itch or pain. Using commonly applied subjective scar assessment tools, we did not find clinically meaningful changes in scar characteristics with the implementation of a structured scar massage program compared to a general approach to massage. Further research is needed to better define the impact of massage on the recovery experience for burn survivors.     

硬膜外阻滞辅助按摩治疗腰椎间盘突出症的疗效观察

本文采用硬膜外阻滞辅助按摩治疗椎间盘突出症患者２５例，经临床观察证实，本文方法疗程短，治愈率高、痛苦小、患者易接受。每日治疗一次，７次为一疗程。第一疗程治愈率达７６％，第一、第二疗程会计治愈率达９６％。全部患者均随访３个月以上，且无一例复发。     

新生儿游泳＋抚触疗法对新生儿胆红素的影响

目的：探讨新生儿游泳＋抚触疗法对新生儿胆红素的影响。方法：对200例生理产出生的足月正常新生儿随机分为两组，对照组100例给予单纯沐浴护理，研究组100例给予游泳＋抚触疗法。观察两组新生儿胆红素的动态变化及24h后母乳喂养次数、新生儿体重、睡眠时问。结果：研究组新生儿胆红素指数明显低于对照组，研究组有2例出现高胆红素血症，对照组13例出现高胆红素血症；研究组新生儿母乳喂养次数、新生儿体重、睡眠时问明显优于对照组。结论：新生儿游泳＋抚触疗法可减少“肠一肝”循环，降低高胆红素血症的发生率，促进新生儿生长发育。     

应用SPECT研究中医按摩对脑卒中患者局部脑血流功能的影响

目的　研究中医按摩对脑卒中患者局部脑血流功能的影响。方法　应用单光子发射计算机断层显像半定量分析技术测定 6例脑卒中患者按摩前后的局部脑血流量。结果　 6例脑卒中患者按摩前皆有不同程度局部脑血流减低 ,按摩患肢后 ,对侧大脑半球原脑血流减低区皆有不同改善 ,其中对侧额顶叶及同侧大脑白质区按摩前后差异显著。从图像表现来看 ,脑血流功能改善以病灶周边较明显 ,病变范围小、程度轻者更明显。按摩前后脑血流功能评分差异显著 ,分别为 - 2 7± 1 6和 - 1 2± 1 7,t=- 3 .8,P <0 .0 5。结论　中医按摩疗法对脑卒中患者的脑血流功能改善有肯定的作用 ,这种作用同躯体感觉、运动传入冲动刺激有关 ,可反射性引起神经系统各级水平的反应     

Effectiveness of traditional Thai massage versus Swedish massage among patients with back pain associated with myofascial trigger points

The aim of this study was to verify the effectiveness of traditional Thai massage (TTM) among patients with back pain associated with myofascial trigger points (MTrPs). Swedish massage (SM) was selected as the treatment for the comparison group. One hundred and eighty patients were randomly allocated to receive either TTM or SM for 6 sessions during a 3–4 week period, with follow-up 1 month later. Results indicated that pain intensity, assessed using the visual analog scale (VAS), among patients in both groups was reduced by more than half after 3 weeks of treatment and for up to one month afterwards (P<0.05) with no significant difference in VAS between the groups. Similar improvements were found for most other outcome measures. We conclude that TTM and SM are effective in reducing back pain among patients with MTrPs. We therefore suggest that massage therapy, and in particular Thai massage, be considered as an alternative primary health care treatment for this disorder.     

侧卧交叉按压微调法治疗颈性眩晕的临床研究

目的:对侧卧交叉按压微调法与传统推拿方法治疗椎动脉型颈椎病(Cervical Spandylosis of Vertebral Arterytype,CSA)的临床疗效进行观察、比较及评价。方法:选取156名CSA患者,并将其随机分为传统推拿组和按压微调组。将2组治疗前后的临床疗效分别使用通用的临床评定方法和改良《颈性眩晕症状与功能评估量表》法进行评估比较、分析。结果:传统推拿组及按压微调组总有效率(包括痊愈、显效、有效)分别为83.12%和93.67%,痊愈率分别为:15.58%和30.38%,2组总有效率及痊愈率差异均有统计学意义(P<0.05);量表评估方法显示:2组治疗方法均可显著改善CSA患者眩晕、颈肩痛、头痛、日常生活及工作、心理及社会适应等症状(P<0.01),而按压微调组较传统推拿组对于改善眩晕、日常生活及工作、心理及社会适应等症状更为显著(P<0.01,P<0.05),对于颈肩痛及头痛症状改善无显著作用(P>0.05)。结论:传统推拿方法及侧卧交叉按压微调法对于改善CSA的各种症状均有显著疗效,且侧卧交叉按压微调法疗效尤为显著。     

针灸推拿治疗腰椎间盘突出对照研究

目的：探讨针灸推拿治疗腰椎间盘突出临床效果。方法整群选取该院2013年1月—2015年1月对收治的164例腰椎间盘突出症患者治疗方法进行回顾性分析,随机分为2组各82例,观察组采用针灸推拿治疗,对照组采用单纯推拿治疗,比较两组疗效。结果观察组总有效率为95.3%,症状平均消失时间为（12.6±2.1）d,对照组总有效率为76.8%,症状平均消失时间为（23.4±3.5）d,两组比较差异有统计学意义（P＜0.05）。结论针灸推拿是治疗腰椎间盘突出症的有效方法,值得临床应用。