手法结合高频电治疗急性腰扭伤100例分析

目的 根据急性腰扭伤的分型及发病机理，探讨治疗急性腰扭伤便捷、有效的治疗方法。方法 急性腰扭伤分为腰后关节紊乱型、腰后关节嵌顿型、肌肉绞缩型、肌肉劳伤型、骶髂关节错位型、混合型。根据年龄大小及体质强弱分别采用推顶复位法、顺拨法、推髂搬腿法和高频电治疗相结合。结果 经l一3次治疗，症状和体征明显减轻，甚至消失，最多不超过5次。l00例中治愈52例，显效39例，好转9例，显效率达91％。其中50例配合高频电治疗。结论 手法加高频是治疗急性腰扭伤便捷、安全、有效的方法。     

Psychological response in spinal manipulation (PRISM): a systematic review of psychological outcomes in randomised controlled trials

BACKGROUND: The most important risk factors for back and neck pain are psychosocial. Nevertheless, systematic reviews of spinal manipulation have concentrated on pain and spine related disability, and ignored psychological outcomes. OBJECTIVE: To assess whether spinal manipulation was effective in improving psychological outcome. DESIGN: Systematic review of randomised controlled trials (RCTs). METHODS: RCTs were identified by searching Medline, CINAHL, Embase, CENTRAL, AMED, PsycINFO until November 2005. Trials reporting psychological outcomes including the mental health components of generic outcomes were extracted, and combined where appropriate in meta-analyses. RESULTS: One hundred and twenty nine RCTs of spinal manipulation were identified; 12 had adequately reported psychological outcomes. Six trials with a verbal intervention comparator were combined in a meta-analysis, and found a mean benefit from spinal manipulation equivalent to 0.34 of the population standard deviation (S.D.) [95% confidence interval (CI) 0.23-0.45] at 1-5 months; 0.27 of the S.D. [95% CI 0.14-0.40] at 6-12 months. Eight trials with a physical treatment comparator were combined in a meta-analysis and found a mean benefit of 0.13 of the S.D. [95% CI 0.01-0.24] in favour of manipulation at 1-5 months; 0.11 of the S.D. [95% CI -0.02 to 0.25] at 6-12 months. CONCLUSIONS: There was some evidence that spinal manipulation improved psychological outcomes compared with verbal interventions.     

悬吊运动技术对运动引起的腰痛的疗效分析

目的：观察悬吊运动技术（SET）对运动引起的腰痛的疗效，并与传统推拿治疗比较，为推广新的物理疗法提供依据。方法：将29例因运动引起腰痛的受试者随机分为两组，SET组15例，推拿组14例，分别进行SET治疗和推拿治疗，疗程共8周，实验开始和结束时进行VAS评分和血清CK、LDH测试。结果：①VAS评分在治疗后分别为SET治疗组1.76±1.58，推拿治疗组3.08±2.35，与治疗前相比均明显下降(P<0.01),且SET组低于推拿组(P<0.01)；②血清测试中，CK治疗后分别为SET治疗组41.32±6.88，推拿组48.75±7.12，LDH治疗后分别为SET组866±100.02，推拿组955±102.6，CK与LDH治疗后均明显下降(P<0.01)，LDH变化SET组更加明显(P<0.05)，但CK变化与推拿组相比不明显。结论：悬吊运动技术对运动性腰痛有着较好的治疗效果，由于SET技术具有明显缓解疼痛症状和治疗作用和降低血清LDH指标的效果，作为较新的无创理疗技术值得推广使用。     

“个体化计时”子午流注针法治疗脑卒中后肩痛临床研究

目的 :观察"个体化计时"子午流注针法治疗脑卒中后肩痛的临床疗效。方法 :90例脑卒中后肩痛患者随机分为治疗组和对照组各45例,治疗组采用"个体化计时"子午流注针法,对照组采用"地方平太阳时"子午流注针法,10 d为一疗程,治疗3个疗程后观察比较临床疗效。结果:治疗组与对照组总有效率分别为88.89%、82.22%,两组比较差异无统计学意义(P0.05);两组治愈率分别为44.44%和26.67%,治疗组优于对照组(P0.05)。结论:"个体化计时"子午流注针法治疗脑卒中后肩痛疗效显著。     

不同频率一指禅推法对脾虚家兔胃肠黏膜形态学的影响

目的:观察不同频率一指禅推法对胃肠黏膜形态学的影响,探索手法频率与效应之间的关系。方法:48只家兔于实验室适应性喂养7 d后随机抽取8只作为空白对照组(K组),其余家兔随机分为A、B、C、D和P组(模型对照组),每组8只,造脾虚模型,A、B、C、D组分别在中脘、天枢(双)给予50~100次、101~150次、151~200次和201~250次/min频率段的一指禅推法,手法干预结束后剖腹观察胃肠道外观变化、光镜下观察黏膜病理变化、电镜观察胃底组织、投射电镜观察十二指肠组织。结果:B组与K组形态最为接近,A、C和D组都存在不同程度的病理改变,P组胃肠黏膜病变最严重,形态改变明显异于其他组。结论:不同频率的一指禅推法干预脾虚家兔存在频率-效应差异,即手法频率可以影响手法治疗效应;一指禅推法干预脾虚家兔适宜频率段为101~150次/min。     

经筋手法结合改良小角度矢状位扳法治疗寰枢关节半脱位40例的临床疗效观察

目的：探讨对寰枢关节半脱位采用经筋手法结合改良小角度矢状位扳法与常规推拿疗法治疗的临床疗效观察,为临床治疗该病症提供参考。方法：对80例寰枢关节半脱位患者随机分组,观察两组的治愈率、好转率和治疗前后影像学寰齿间隙差值等指标,并统计结果。结果：治疗组治愈率为70.00%,对照组为42.50%,治疗组总有效率为97.472%,对照组为82.50%,两组经χ2 检验差异有显著性;治疗前后影像学寰齿前间隙及齿状突侧间隙差值比较（P＜0.05）,差异有统计学意义。结论：经筋手法结合改良小角度矢状位扳法治疗寰枢关节半脱位疗效优于常规推拿疗法,本法值得临床进一步推广。     

Three-trocar laparoscopic duodenal switch after sleeve gastrectomy

Laparoscopic duodenal switch is a recognized bariatric procedure, which can be performed in one step or as a second step after laparoscopic sleeve gastrectomy (LSG). Mainly, indications as primary surgery are super-obese or super super-obese patients, and after LSG indications are the presence of insufficient weight loss or weight regain, associated with morbid obesity co-morbidities, without gastroesophageal reflux. In this video, the authors report the technique of reduced port laparoscopic duodenal switch after LSG. The procedure is performed using a 12-mm trocar in the umbilicus, a 5-mm trocar in the right flank, and a 5-mm trocar in the left flank. One or more temporary percutaneous sutures are passed into the hepatic ligaments to increase the exposure of the first duodenum. The optical system is switched from 10 mm to 5 mm and introduced in the left 5-mm flank trocar at the step of the linear stapler insertion through the umbilical trocar. Classic construction with 150-cm alimentary limb and 100-cm common limb is performed. The duodeno-jejunostomy is fashioned in an end-to-side handsewn technique and the jejuno-ileostomy in the side-to-side semimechanical linear stapler technique. Both Petersen and mesenteric defects are closed. The umbilical access is finally meticulously closed, avoiding incisional hernia. Reduced port laparoscopic duodenal switch after LSG is a safe and feasible technique. Besides the enhanced cosmetic outcomes, this surgery is associated with a reduced use of painkillers, fewer trocar complications, and quick patient convalescence.     

手法整复颈椎配合铍针松解治疗颞颌关节功能紊乱60例

目的:评价手法整复颈椎配合铍针松解治疗颞颌关节功能紊乱的临床疗效。方法:自2012年3月至2017年5月,应用手法整复颈椎配合铍针松解治疗颞颌关节功能紊乱60例,男26例,女34例;年龄18~60岁,平均32.5岁;病程1周~5年,平均3个月。对患者颞颌关节最大主动张口度、弹响程度、VAS疼痛评分,进行治疗前和治疗后随访评估。结果:60例均获随访,时间6~24个月,平均12个月。末次随访时,颞颌关节最大主动张口度从治疗前的(1.99±0.47)cm提高至治疗后的(3.17±0.19)cm,关节弹响度从治疗前100%降至治疗后的(27.33±13.51)%,VAS评分从治疗前的4.73±0.67降至治疗后的1.80±0.53。结论:采用手法整复颈椎配合铍针松解治疗颞颌关节功能紊乱,具有操作简便、疗效确切、疗程短等优点,是治疗颞颌关节功能紊乱的有效方法。     

一种具有传统中医针刺补泻手法的新型智能电针仪设计

针对目前电针产品无仿传统针刺补泻法的电针针法和人体刺激耐受性的问题,本文提出了一种基于PIC单片机实现的新型智能电针仪.该电针仪由单片机、信号发生电路、功率驱动、液晶显示、按键输入、安全保护和声音提示等部分组成.着重介绍了利用单片机实现仿传统中医针刺补泻手法,并采用模糊划分与混沌处理结合的方法,解决人体刺激的适应性.仪器具有多种针法选择、输出定时、自动报警等优点且设计符合医疗器械安全规范,可用于临床穴位针法刺激和经皮穴位神经电刺激.     

《药品分剂量操作规范》团体标准解读

浙江省健康服务业促进会于2023年发布了《药品分剂量操作规范》团体标准。标准规定了药品分剂量操作的基本要求、操作规程、质量检测、储存与效期管理等内容,特别是在各种分剂量模式上提供了详实可操作的流程,为其提供了工作依据。本文对团体标准的研制背景和主要技术内容进行了详实解读,旨在为标准的宣贯和落地实施提供指导和参考。