Early filiform needle acupuncture for poststroke depression: a meta-analysis of 17 randomized controlled clinical trials

OBJECTIVE: To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL: We retrieved data from the Chinese National Knowledge Infrastructure(1979–2012), Wanfang(1980–2012), VIP(1989–2012), Chinese Biomedical Literature(1975–2012), PubMed(1966–2012), Ovid Lww(–2012), and Cochrane Library(–2012) Database using the internet. SELECTION CRITERIA: Randomized controlled trials on filiform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the included articles scored at least 4 points on the Jadad scale. Exclusion criteria: other acupuncture therapies as treatment group, not stroke-induced depression patients, score 4 points, non-randomized controlled trials, or animal trials. MAIN OUTCOME MEASURES: These were the Hamilton Depression Scale scores, clinical effective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events. RESULTS: A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with filiform needle acupuncture than those treated with simple antidepressant drugs [relative risk = 1.11, 95% confidence interval(CI): 1.03–1.21, P = 0.01]. At 6 weeks, clinical effective rate was similar between filiform needle acupuncture and antidepressant drug groups. At 2 weeks after filiform needle acupuncture, Hamilton Depression Scale(17 items) scores were lower than in the antidepressant drug group(mean difference =-2.34, 95%CI:-3.46 to-1.22, P 0.000,1). At 4 weeks, Hamilton Depression Scale(24 items) scores were similar between filiform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 articles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the filiform needle acupuncture group. CONCLUSION: Early filiform needle acupuncture for poststroke depression can perfectly control depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of filiform needle acupuncture were better than those of antidepressant drugs.     

Intrahepatic Glissonian approach and outflow vascular occlusion during partial hepatectomy

Under ultrasound guidance, a blunt suture needle was inserted around the Glissonian pedicle and then sutured. This technique significantly reduced the blood loss and facilitated the procedure of partial hepatectomy. We applied this technique in 182 patients who needed partial hepatectomy. We concluded that this method is simple and easy to occlude the vascular inflow and outflow, and allows an accurate delineation of the anatomic zone and therefore, simplifies the procedure of partial hepatectomy.     

微针联合Q开关1064nm激光治疗黄褐斑疗效观察

目的:观察微针联合Q开关1 064nm激光治疗黄褐斑的临床疗效。方法:将122例患者随机分为联合组、激光组、微针组、对照组。联合组31例,采用微针联合激光的方式治疗;激光组39例,采用单一激光治疗;微针组23例,采用单一微针治疗;对照组29例,口服维生素C治疗,观察患者面部皮损的消退情况。有效率以基本治愈和显效两项统计。结果:联合组:31例患者经过治疗后,临床治愈5例,显效10例,好转14例,无效2例,总有效率48.39%;激光组:39例,临床治愈2例,显效12例,好转17例,无效8例,总有效率35.9%;微针组:23例,临床治愈2例,显效7例,好转11例,无效3例,总有效率39.13%;对照组:29例,临床治愈0例,显效1例,好转17例,无效11例,总有效率3.45%;与激光组、微针组、对照组比较,联合组总有效率显著增高(P0.01)。结论:微针联合Q开关1 064nm激光治疗黄褐斑,较传统单一方法治疗有效率高,值得临床推广。     

微创小针刀内括约肌切断术治疗肛裂358例

为观察采用微创小针刀内括约肌切断术治疗陈旧性肛裂的效果,对358例陈旧性肛裂患者采用眼科虹膜小针刀内括约肌切断术治疗。结果显示,358例患者均一次性治愈,疗程5～8d,无术后并发症及后遗症;随访1年,均无复发。结果表明,小针刀微创术与其他内括约肌切断术相比,具有操作简便、治疗彻底、创伤小、疗程短,无术后并发症及后遗症等优点。     

滞针术临床研究进展

滞针术是指毫针刺入腧穴后,将针柄向同一个方向进行捻转,使针身与肌纤维相缠绕的一种使针感保持持续且强烈的行针手法。滞针术临床多用于痛症、急症、顽症的治疗,相比于常规针刺治疗,其具有操作简便、取穴少、针感强烈等优势。对滞针术的起源、机制及临床应用进行综述,分析现存问题并提出展望,以期可以更好地指导临床应用。     

刃针搜法治疗脑梗死后感觉障碍的临床研究

目的:探究刃针搜法治疗脑梗死后感觉障碍的临床作用机制。方法:将90例脑梗死后感觉障碍患者随机分为刃针治疗组、针刺对照组、药物对照组,每组30例。3组患者分别治疗14 d,评价治疗效果,并进行治疗前后的血液流变学、神经元功能、血流动力学、体感诱发电位等相关指标检测。结果:治疗后刃针治疗组疗效明显高于其他两组,差异有统计学意义(P<0.05)。与治疗前比较,3组患者治疗后Fugl-Meyer评分显著提高(P<0.05);患侧体感诱发电位(SEP)N20潜伏期明显缩短(P<0.05)、波幅明显增高(P<0.05);血浆粘度、血小板聚集率、纤维蛋白原等血液流变学指标明显改善(P<0.05);血清S100B、基质金属蛋白酶-9(MMP-9)显著下降(P<0.05),金属蛋白酶组织抑制剂-1(TIMP-1)显著升高(P<0.05);病侧大脑中动脉舒张末期血流速度(Vd)、收缩期最大血流速度(Vs)、平均血流速度(Vm)显著升高;刃针治疗组上述指标变化较药物对照组和针刺对照组显著(P<0.05)。结论:刃针搜法通过改善脑梗死后感觉障碍患者脑部组织血液循环和供血情况、改善神经元功能、促进感觉神经传导通路修复等作用机制达到治疗效果。     

子午流注火针刺法对急性痛风性关节炎的临床疗效观察

目的选择急性痛风性关节炎患者为研究对象,基于子午流注理论采用火针治疗方式,观察临床疗效及对血清尿酸水平的影响。方法将符合急性痛风纳入标准的60例随机分组,治疗组采用基于子午流注火针疗法,对照组采用口服依托考昔及少量秋水仙碱。疗程1周,观察对比患者治疗前后临床证候(关节疼痛、压痛、红肿及活动度)积分、疗效指数及血清尿酸水平。结果治疗组总有效率达100.00%,明显优于对照组总有效率83.33%(P<0.01);治疗组血清尿酸降低水平优于对照组。结论子午流注火针疗法可明显改善急性痛风患者的临床症状,降低血清尿酸水平。     

揿针疗法联合常规医护措施治疗癌性疼痛临床研究

目的:观察在常规止痛和护理措施基础上加予揿针刺激耳穴治疗癌性疼痛的临床疗效。方法:将120例轻、中度癌性疼痛患者随机分为对照组和观察组各60例。2组轻度、中度疼痛患者分别口服布洛芬缓释胶囊、盐酸曲马多缓释片口服,并给予综合护理措施,观察组加予揿针刺激耳穴治疗,2组均连续治疗10 d。比较治疗前、治疗10 d后的疼痛视觉模拟评分法(VAS)评分、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分,以全面疼痛评估量表评价治疗前后疼痛对日常活动、情绪、睡眠、步行能力、正常工作、与他人之间的关系、生活享受7个方面的影响。比较2组的疼痛缓解率。结果:治疗后,观察组疼痛缓解率为83.33%,高于对照组的65.00%,差异有统计学意义(P<0.05)。2组VAS、SDS及SAS评分均较治疗前下降(P<0.01),观察组3项评分均低于对照组(P<0.01)。2组日常活动、情绪、睡眠、步行能力、正常工作、与他人之间的关系及生活享受评分均较治疗前下降(P<0.01),观察组7项评分均低于对照组(P<0.01)。结论:在现代医学常规止痛和护理措施的基础上加用揿针刺激耳穴干预癌性疼痛患者,可进一步减轻癌痛,缓解患者的抑郁和焦虑,减轻癌痛对日常生活的影响,提高临床疗效。     

芒针联合脊髓电刺激疗法治疗下肢缺血性疼痛及对患者疼痛与睡眠质量评分的影响

目的:探究芒针联合脊髓电刺激(SCS)疗法对下肢缺血性疼痛患者匹兹堡睡眠质量(PSQI)、视觉模拟评分(VAS)的影响。方法:选取下肢缺血性患者106例,按随机数字表法将患者分为SCS治疗组与联合治疗组各53例。其中SCS治疗组使用SCS疗法治疗,联合治疗组患者使用芒针联合SCS疗法治疗。红外热成像仪检测皮肤温差,多普勒血流控制仪检测踝肱指数(ABI),记录两组患者患肢冷感评分及麻木评分,记录患者间歇性跛行距离,经皮氧分压监测仪检测经皮氧分压(TcPO₂),VAS、PSQI评估患者疼痛状况与睡眠状况。结果:治疗后,与SCS治疗组相比,联合治疗组皮肤温差、踝肱指数均较高(P<0.05)。治疗后,与SCS治疗组相比,联合治疗组冷感评分、麻木评分均明显降低(P<0.05)。治疗后,与SCS治疗组相比,联合治疗组经皮氧分压、间歇性跛行距离均明显升高(P<0.05)。治疗后,与SCS治疗组相比,联合治疗组SAS评分、PSQI评分均较低(P<0.05)。治疗后,联合治疗组治疗有效率高于SCS治疗组(P<0.05)。结论:应用芒针联合SCS疗法对下肢缺血性疼痛患者进行治疗,能够有效改善患者病情,减轻冷感及麻木情况,改善皮肤组织的氧供量及下肢微循环,减轻患者疼痛,提高患者睡眠质量,效果明显。     

内镜超声引导下胰腺实性占位细针穿刺活检术的护理配合

正内镜超声(endoscopic ultrasound,EUS)是结合了普通内镜检查与腔内超声波探查功能的一种特殊内镜诊治技术。利用安装在内镜前端的微型高频超声探头,在常规内镜检查的基础上,可将消化道黏膜下及其邻近脏器或组织的解剖结构清晰地呈现出来。在诊断胰腺占位时,EUS被认为是最敏感的技术,可探查出直径小于5 mm的占位,是发现早期胰腺癌极为有效的工具。内镜超声引导下细针穿刺活检术(endoscopic