腰痛散循经火疗治疗寒湿腰痛临床研究

目的:观察腰痛散循经火疗治疗寒湿腰痛的临床疗效。方法:选取寒湿腰痛患者60例,按随机数字表法分为治疗组和对照组各30例。对照组采用腰痛散湿热敷,治疗组在对照组湿热敷的基础上运用腰痛散循经火疗。采用疼痛数字评分法(NRS)和日本骨科协会评估治疗分数(JOA)分别对2组患者进行客观评价,比较2组临床疗效。结果:治疗组总有效率为96.66%,显著高于对照组73.33%(P<0.05)。治疗前,2组NRS评分、JOA评分比较,差异均无统计学意义(P>0.05)。治疗后,2组NRS评分较治疗前降低,JOA评分较治疗前升高(P<0.05);且治疗组NRS评分低于对照组,JOA评分高于对照组(P<0.05)。结论:腰痛散循经火疗治疗寒湿腰痛效果显著,症状改善明显,安全有效,进一步提高了患者的生活质量。     

Hypersensitivity and hyperalgesia in somatoform pain disorders

Objective

In psychiatry, pain disorders not explained by structural lesions have been classified for decades as somatoform pain disorders, the underlying concept being somatization. In a parallel move, somatic medicine has defined an expanding group of similar pain disorders, known as functional pain syndromes. Functional pain syndromes are characterized by enhanced pain sensitivity. The aim of our study was to investigate the proportion of patients with somatoform pain disorders who also meet the criteria of functional pain syndromes and the extent to which patients with somatoform pain disorders also show enhanced pain sensitivity.

Methods

Data on pain sensitivity in 120 hospitalized patients were obtained by means of two algometric methods. The group of patients with somatoform pain disorders was further divided into two subsets: patients with and those without a co-diagnosis of a functional pain syndrome. Patients with nociceptive pain served as control group.

Results

Of the 120 in-patients selected, 67 fulfilled the criteria of a somatoform pain disorder of which 41 (61%) also met the co-diagnosis of a functional pain syndrome. Patients with somatoform pain disorder differed from controls in that they showed enhanced pain sensitivity, irrespective of whether a functional pain syndrome was concomitantly present (P< .001).

Conclusions

Somatoform pain disorders show considerable overlap with functional pain syndromes, including enhanced pain sensitivity. This suggests the relevance of integrating somatosensory aspects of pain into a modified understanding of somatoform pain disorders.     

消化内科住院患者NRS-2002营养风险筛查及营养支持应用的调查与分析

目的：使用营养风险筛查工具NRS-2002(nutritional screening 2002)对我院消化内科住院患者的营养不良、营养风险进行筛查并了解营养干预应用情况。方法：选取2020年3月-2020年6月我院消化内科住院患者288例,通过人体测量及NRS-2002进行营养风险筛查,并调查患者住院期间的营养支持情况。结果：消化内科住院患者营养不良发生率13.31%,营养风险发生率33.45%,无营养风险患者的营养支持率为70.81%,有营养风险的患者营养支持率为30.11%。结论：NRS-2002营养筛查工具适合消化内科住院患者的营养筛查。住院患者存在较高营养风险发生率,但营养支持应用欠规范。     

RFH-NPT与NRS-2002在肝硬化住院患者营养风险评估中的应用比较

目的:比较皇家自由医院-营养优先次序工具(RFH-NPT)与营养风险筛查2002(NRS-2002)对肝硬化患者营养风险评估的应用效果。方法:收集肝硬化住院患者213例,进行一般信息登记与访谈、人体测量、生化学检查,并对每位患者采用RFH-NPT与NRS-2002工具进行营养风险评分。结果:RFH-NPT、NRS-2002分别筛选出62.91%(134/213)、53.05%(113/213)的肝硬化患者存在营养风险;RFH-NPT对肝硬化住院患者营养风险筛出率显著高于NRS-2002(χ~2=4.249,P=0.039)。营养风险随着疾病严重程度加重而随之升高,在Child C级患者中,RFHNPT对营养风险的筛出率(88.46%,69/78)高于NRS-2002(67.95%,53/78)(χ~2=9.628,P=0.002)。结论:RFH-NPT在肝硬化住院患者的营养风险筛选中优于NRS-2002。     

Nutritional Risk Screening 2002 was associated with acute kidney injury and mortality in patients with acute coronary syndrome: Insight from the REACP study

Background and aimsAcute kidney injury (AKI) is a common complication of acute coronary syndrome (ACS), and is associated with increased risk of morbidity and mortality. We aimed to evaluate the impact of malnutrition risk at admission assessed using Nutritional Risk Screening 2002 (NRS-2002) on AKI and mortality in patients with ACS.Methods and resultsWe enrolled 3185 ACS patients from the retrospective multi-centre study. AKI was defined as criteria of the 2012 Kidney Disease Improving Global Outcomes. Risk of malnutrition was defined as NRS-2002 score ≥3. The end points were AKI and all-cause mortality. There were 926 (29.1%) patients with risk of malnutrition and 481 (15.1%) patients complicated with AKI during hospitalisation, and 378 (12.0%) patients died during the 13.1 (8.5–20.4) months of follow-up. Patients with NRS-2002 score ≥3 had a higher incidence of AKI and all-cause mortality (P < 0.001). Multivariate logistic and Cox regression analysis showed that the adjusted odd ratios and hazard ratios of categorised NRS-2002 (<3 vs. ≥3) for AKI and mortality were 1.643 (95% confidence interval: 1.242–2.172, P < 0.001) and 2.026 (95% confidence interval: 1.491–2.753, P < 0.001), respectively. In structural equation modelling, the indirect effects of NRS-2002 on mortality via AKI were 54.1% (P < 0.001).ConclusionThe risk of malnutrition assessed using NRS-2002 was useful in identifying high-risk patients with AKI and mortality, and patients with ACS may benefit from further nutritional intervention and prevention of AKI.Registration numberChiCTR1900024657.