黄芪桂枝五物汤治疗神经根型颈椎病麻木症之探析

麻木是临床诸多疾病的常见症状,遵循历代医家对于麻木的认识,结合临床的观察和实践,黄芪桂枝五物汤作为经典名方治疗神经根型颈椎病,以病证结合,方证相应的思路进行论治,是临床使用的关键点。     

Peripheral neuropathy,polymyalgia and arthralgia: A paraneoplastic syndrome associated with myeloma

Summary We describe a patient with peripheral neuropathy, polymyalgia, arthralgia and cervical vertebral osteosclerosis who was subsequently diagnosed to have fatal multiple myeloma with IgG gammopathy and lambda urinary chains. The initial presentation and clinical features are discussed.     

不同强弱刺激对痛痹患者肢体血流图的影响

目的:探讨不同强度针刺刺激量对痛痹患者肢体血流图的影响。方法:选择以寒邪为主的下肢痛痹病人41例,在患肢悬钟针刺得气后行捻转手法,通过同一病人强、弱刺激后观察患侧肢体血流图,计算波幅值以做比较。结果:强刺激针后使波幅下降,弱刺激针后使波幅上升。结论:不同刺激量可以引起患肢血管舒缩机能截然不同的规律性反应。     

筋会穴用于痺证的临床与实验研究

目的　观察筋会穴阳陵泉治疗痺证的疗效及实验依据。方法　用单取筋会穴阳陵泉或针或灸或针灸兼施的方法治疗痺证,并与传统多穴组及药物治疗组比较,另作相关实验观察。结果　其有效率达90.5%,与传统多穴治疗组比较,虽然P>0.05,无显著差异,但临床总体疗效较其为高;与药物治疗组比较,P<0.01,有显著意义。实验观察显示针刺筋会穴阳陵泉能提高机体痛阈及耐痛阈。结论　表明筋会穴用于痺证的治疗,其疗效是肯定的。     

Osteoclastogenesis induced by CHIKV-infected fibroblast-like synoviocytes: A possible interplay between synoviocytes and monocytes/macrophages in CHIKV-induced arthralgia/arthritis

Fibroblast-like synoviocytes are known to migrate from joint to joint and are proposed to be one of the key players in the inflammatory cascade amplification in rheumatoid arthritis patients. In the recent CHIKV epidemic, patients developed arthritis-like syndrome and the synoviocyte is one of the suspected players in CHIKV-induced polyarthritis. Thus, to learn more on this syndrome, the responses of fibroblast-like synoviocytes to chikungunya virus (CHIKV) infection, and the interaction between CHIKV-infected synoviocytes and phagocytes, were investigated. Primary human fibroblast-like synoviocyte (HFLS) cultures were infected with clinical isolates of CHIKV at an MOI of 0.001 pfu/cell. Data indicated that HFLS are permissive to CHIKV replication, generating peak titers of 10⁵–10⁶ pfu/ml. Interestingly, CHIKV-infected HFLS cultures secreted mainly the mediators that are responsible for phagocytes recruitment and differentiation (RANKL, IL-6, IL-8 and MCP-1) but not arthritogenic mediators (TNF-α, IL-1β, MMP-1, MMP-2 or MMP-13). The interaction between CHIKV-infected synoviocytes and phagocytes was studied using UV-irradiated, CHIKV-infected HFLS supernatant. Data revealed that supernatants from CHIKV-infected HFLS cultures not only induced migration of primary human monocytes, but also drove monocytes/macrophages into osteoclast-like cells. These differentiated osteoclast-like cells produced high levels of TNF-α and IL-6, principal mediators of arthritis. This data suggests a potential interplay between infected HFLS and recruiting phagocytes which may responsible for the arthralgia/arthritis in CHIKV-infected patients.     

Alternate sessions of transcranial direct current stimulation (tDCS) reduce chronic pain in women affected by chikungunya. A randomized clinical trial

ContextThousands of people worldwide have been infected by the chikungunya virus (CHIKV), and the persistence of joint pain symptoms has been considered the main problem. Neuromodulation techniques such as transcranial direct current stimulation (tDCS) act on brain areas involved in the processing of chronic pain. It was previously demonstrated that tDCS for five consecutive days significantly reduced pain in the chronic phase of chikungunya (CHIK).ObjectiveTo analyze the effect of alternate tDCS sessions on pain and functional capacity in individuals affected by CHIK.MethodsIn a randomized clinical trial, 58 women in the chronic phase of CHIK were divided into two groups: active-tDCS (M1-S0, 2 mA, 20 min) and sham-tDCS. The Visual Analogue Scale (VAS) and the Brief Pain Inventory (BPI) were used to assess pain, while the Health Assessment Questionnaire (HAQ) assessed functional capacity. These scales were used before and after six sessions of tDCS in nonconsecutive days on the primary motor cortex, and at follow-up consultation 7 and 15 days after the last session. A repeated measures mixed-model ANOVA was used for comparison between groups (significant p-values < 0.05).ResultsA significant pain reduction (Z [3, 171] = 14.303; p < 0.0001) was observed in the tDCS group compared to the sham group; no significant difference in functional capacity was observed (Z [1.57] = 2.797; p = 0.1).ConclusionOur results suggest that six nonconsecutive sessions of active tDCS on M1 reduce pain in chronic CHIKV arthralgia.     

慢性关节疼痛患者伴发抑郁症的多因素Logistic回归分析

目的探讨慢性关节疼痛患者伴发抑郁症的原因及其相关因素,并提出预防与处理对策。方法分析630例慢性关节疼痛患者,选择性别、年龄、疼痛程度、病程、婚姻状况、疾病认知、文化程度、个性特征、医疗费用及并发抑郁症指标进行统计,采用Logistic多因素回归分析。结果 630例患者中患有抑郁症52例。疼痛程度、病程、疾病认知、文化程度、个性特征、医疗费用因素与抑郁症有相关性(P<0.05)。结论疼痛程度、病程、疾病认知、文化程度、个性特征、医疗费用是慢性关节疼痛患者产生抑郁症的危险因素。认真做好关节疼痛患者的健康教育,提高疾病认知性可以避免抑郁症的发生。     

腰痛舒合剂治疗腰椎间盘突出症临床研究

目的观察腰痛舒合剂治疗腰椎间盘突出症临床疗效。方法将320例腰椎间盘突出症患者随机分为2组,在配合卧床休息的基础上,治疗组200例予腰痛舒合剂,每次1袋,每日2次口服 对照组120例予腰痛宁胶囊,每次6粒,每日1次,睡前30min口服。2组均8周为1个疗程,判定疗效。结果治疗组治愈率82.0%,对照组治愈率48.3%,2组比较差异有统计学意义（P〈0.05）,治疗组优于对照组。治疗组有效率97.5%,对照组95.8%,2组有效率比较差异无统计学意义（P〉0.05）。治疗组随访184例,6个月内无复发,1年内复发7例,复发率为3.80%,对照组随访96例,6个月内复发7例,1年内复发11例,复发率为18.75%,2组复发率比较差异有统计学意义（P〈0.05）,对照组高于治疗组。结论腰痛舒合剂治疗腰椎间盘突出症疗效确切,复发率低,值得推广。     

关节镜治疗髋关节周围钙化性肌腱炎

目的:探讨关节镜治疗髋关节周围钙化性肌腱炎的可行性以及临床疗效.方法:回顾分析2013年5月至2018年7月采用关节镜手术治疗髋关节周围钙化性肌腱炎16例患者的病例资料,男10例,女6例,年龄35～63(44.50±6.67)岁,左髋9例,右髋7例,病程1～8(3.18±1.97)d.术前、术后1 d及末次随访采用疼痛...