五禽戏锻炼联合耳穴压豆在肩周炎患者中的应用观察

目的:观察五禽戏锻炼联合耳穴压豆在肩周炎患者中的应用疗效。方法:选取我院肩周炎患者60例(2017年6月-2018年12月),治疗方案不同分组。耳穴压豆组(30例)接受耳穴压豆治疗,联合组(30例)接受五禽戏锻炼联合耳穴压豆治疗。对比两组疗效、治疗前后肩关节功能[日常生活活动能力量表(Activity of Daily Living Scale,ADL)、关节活动度(Range of Motion,ROM)、徒手肌力量表(Manual Muscle Test,MMT)、疼痛]改善、中医症状积分、视觉模拟评分法(Visual Analog Scale,VAS)。结果:联合组总有效率高于耳穴压豆组(P<0.05);联合组治疗1个疗程后疼痛、ADL、ROM及MMT评分较耳穴压豆组高(P<0.05);联合组治疗1个疗程后肩部刺痛、抬举受限、局部肿胀评分较耳穴压豆组低(P<0.05);联合组治疗1个疗程后VAS评分较耳穴压豆组低(P<0.05)。结论:五禽戏锻炼联合耳穴压豆治疗肩周炎,能显著提高治疗效果,减轻肩部疼痛,改善肩关节功能。     

Efficacy of Topical Vibratory Stimulation for Reducing Pain During Trigger Point Injection to the Gastrocnemius: A Randomized Controlled Trial

ObjectiveTo evaluate the efficacy of topical vibratory stimulation for reducing pain during trigger point injection (TPI).DesignDouble-blind randomized placebo-controlled clinical trial.SettingTertiary care university hospital.ParticipantsA total of 136 participants were randomly recruited from among patients with myofascial pain syndrome who were scheduled for TPI. Of these, 65 were excluded because they met the exclusion criteria, and 11 because they refused to participate. Finally, 60 participants were enrolled. No participants dropped out of the study.InterventionParticipants were randomly assigned to the vibration group or control group. TPI was performed with 0.5% lidocaine using a 25-gauge needle. A vibrator was applied to the popliteal fossa for 3 to 5 seconds prior to and during TPI to the gastrocnemius; 100-Hz vibration was turned on for the vibration group and turned off for the control group.Main Outcome MeasuresPain intensity during TPI was assessed using a 100-mm visual analog scale (VAS) as a primary outcome, and participant satisfaction and preference for repeated use were measured using 5-point Likert scales as a secondary outcome. These parameters were evaluated immediately after TPI. The primary outcome was evaluated using analysis of covariance and secondary outcome using the Mann-Whitney U test.ResultsVAS scores for pain during TPI were significantly lower in the vibration group (30.30; 95% confidence interval [CI], 22.65-39.26) compared with the control group (47.58; 95% CI, 38.80-56.52; F=7.74; P< .01). The mean difference in VAS scores between the 2 groups was 17.27 (95% CI, 5.24-29.30). Participant satisfaction and preference for repeated use were significantly higher in the vibration group than in the control group (P<.05). No participant showed any side effects.ConclusionTopical vibratory stimulation significantly decreased pain during TPI of the gastrocnemius.     

中医药核心指标集研究利益相关群体选择实施要点＊

核心指标集是通过一系列规范的研制过程，形成某种疾病所有相关临床研究必须报告的、统一的、标准化的最小指标集合。确定哪些指标为核心结局指标，需要经过不同利益相关群体层层筛选并最终达成共识决定。相关利益群体的代表性，决定了核心指标集的系统性和合理性。因此，在核心指标集研制过程中利益相关群体的选择至关重要。本文对中医药核心指标集研制中利益相关群体的种类选择、样本量、参与环节、权重分配以及患者代表群的特殊性等相关要点进行归纳总结，以期为中医药核心指标集研究的开展提供方法学借鉴。     

孙远征教授运用循经远取动法治疗痛症举隅

痛症是临床上较为常见的症状之一,往往影响患者的工作与生活,近年来得到了人们的广泛重视。孙远征教授在明辨痛症病因、针灸镇痛机理的基础上,根据传统经络循行及疼痛部位的特点,结合"标本根结"理论,遵循"经脉所过,主治所及"和"上病下治,下病上治"的选穴原则,同时配合运动疗法,提出了循经远取动法治疗痛症。尤其在治疗软组织痛症方面,疗效显著,值得临床上加以总结应用。     

附着龈重建应用于口腔种植修复中的临床效果观察

目的探讨附着龈重建应用于口腔种植修复中的临床效果。方法将本院于2016年10月-2018年10月期间收治的行口腔种植修复治疗的附着龈缺失患者82例作为研究资料,依据治疗方案分组,对照组为传统修复治疗方案,观察组采用附着龈重建治疗修复方案,各41例,评价两组术后不同阶段附着龈宽度、龈缘外形及附着点重建改善效果,并评价患者评价治疗满意度。结果术后3个月观察组患者附着龈宽度改善Ⅲ级率56.10%明显高于对照组0.00%,龈缘外形与附着点重建Ⅲ级率60.98%明显高于对照组0.00%(P <0.05);术后6个月观察组患者附着龈宽度改善Ⅲ级率75.61%明显高于对照组0.00%,龈缘外形与附着点重建Ⅲ级率73.17%明显高于对照组0.00%(P <0.05);观察组治疗满意度97.56%与对照组70.73%比较明显更高(P <0.05)。结论针对行口腔种植修复治疗的附着龈缺失患者采用附着龈重建治疗修复方案利于快速恢复附着龈增加宽度,改善龈缘外形及附着点重建效果,获得患者的高度满意度,治疗价值较高。     

中药补气活血方离子导入配合穴位按摩治疗糖尿病周围神经病变效果观察

目的:探讨中药离子导入联合穴位按摩应用在糖尿病周围神经病变的临床疗效及应用价值。方法:选取2016年1月至2018年10月西宁市城北区中医院收治的糖尿病周围神经病变210例作为研究对象,按照治疗方案不同分为对照组和观察组,每组105例,对照组给予西医基础治疗,观察组在对照组基础上联合中药离子导入与穴位按摩治疗,比较2组治疗效果。结果:观察组患者治疗总有效率为97.14%显著高于对照组的86.67%,组间比较差异有统计学意义(P<0.05)。观察组治疗后肢体麻木评分(1.53±0.11)分,肢体疼痛评分(1.34±0.12)分,倦怠乏力评分(1.23±0.14)分,手足畏寒评分(1.33±0.14)分;对照组疗后肢体麻木评分(2.06±0.38)分,肢体疼痛评分(1.96±0.34)分,倦怠乏力评分(1.84±0.37)分,手足畏寒评分(1.85±0.32)分,组间比较差异有统计学意义(P<0.05)。观察组治疗后尺神经传导速度(51.68±3.75)m/s,胫神经传导速度(39.96±2.98)m/s,腓总神经传导速度(38.43±2.88)m/s;对照组治疗后尺神经传导速度(45.32±2.86)m/s,胫神经传导速度(37.04±2.41)m/s,腓总神经传导速度(35.06±2.19)m/s,组间比较差异有统计学意义(P<0.05)。结论:中药离子导入联合穴位按摩应用在糖尿病周围神经病变可以提升临床疗效,改善神经传导素,减轻临床症状评分,值得在临床推广应用。     

至阳八阵穴隔附子饼灸治疗糖尿病胃轻瘫临床研究

目的观察至阳八阵穴隔附子饼灸治疗脾胃气虚型糖尿病胃轻瘫的疗效及对胃泌素(GAS)、胃动素(MTL)和血管活性肠肽(VIP)水平的影响。方法86例脾胃气虚型糖尿病胃轻瘫患者随机分为对照组和治疗组,每组43例。治疗组给予至阳八阵穴隔附子饼灸;对照组口服枸橼酸莫沙必利片。治疗12周后观察胃轻瘫主要症状指数量表症状积分改善情况、胃排空率及血清GAS、MTL、VIP水平。结果治疗组治疗后在胃轻瘫主要症状指数量表症状积分及胃排空率方面明显高于对照组,差异均有统计学意义(P<0.05)。治疗组治疗后血清GAS、MTL水平明显高于对照组,血清VIP水平明显低于对照组,差异均有统计学意义(P<0.05)。治疗组总有效率为90.7%,明显高于对照组的72.1%(P<0.05)。结论采用至阳八阵穴隔附子饼灸能快速促进糖尿病胃轻瘫患者胃功能的恢复,改善症状和体征,其作用机制可能与升高患者血清GAS和MTL水平,降低VIP水平有关。