肌骨超声引导下针刀治疗伸直型膝关节僵硬35例临床观察

目的:探讨肌骨超声引导下针刀治疗伸直型膝关节僵硬的临床疗效.方法:将70例伸直型膝关节僵硬患者随机分为治疗组与对照组,每组各35例.对照组予常规针刀松解治疗,治疗组在肌骨超声引导下行针刀松解治疗.观察比较2组膝关节功能分级情况、膝关节肿胀度、滑膜厚度、膝关节屈曲最大被动活动度及Lysholm膝关节功能评分.结果:治疗组优良率为97.1％(34/35),高于对照组的20.0％(7/35),组间比较,差异有统计学意义(P＜0.01).2组膝关节肿胀程度、滑膜厚度、膝关节被动屈曲最大活动度、膝关节功能评分治疗后组间比较及治疗前后组内比较,差异均有统计学意义(P＜0.05或P＜0.01).结论:肌骨超声引导下针刀治疗伸直型膝关节僵硬能提高治疗效果,改善膝关节功能.     

针灸治疗黄褐斑的取穴规律

目的:运用数据挖掘技术分析针灸治疗黄褐斑的取穴特点和规律。方法:收集中国知网、万方数据知识服务平台和维普数据库中针灸治疗黄褐斑的临床文献,建立黄褐斑的针灸临床处方数据库,采用SPSS19.0和Clementine 12软件对数据进行描述性分析、关联规则分析和聚类分析。结果:针灸治疗黄褐斑,所选经脉以膀胱经选用频次最高,其次为脾经、大肠经和胃经,所选腧穴频次最多主要为三阴交,其次为足三里、血海、曲池、合谷、肝俞。关联规则分析显示穴位之间相关性最高的是足三里-血海-三阴交。聚类分析结果显示,存在6个核心用穴群。结论:针灸治疗黄褐斑,以肝脾肾三脏同治,主以益肾助阳,辅以补脾养血,疏肝通络,重视交会穴。     

早期肠内营养在重症急性胰腺炎中的疗效观察

目的:观察早期肠内营养对重症急性胰腺炎患者的影响。方法:选择重症胰腺炎患者共50例,分为观察组和对照组各25例。观察组给予肠内营养支持治疗,对照组采用肠外营养支持治疗。观察两组并发症、住院时间、腹痛缓解时间、死亡情况等。结果:观察组感染发生率、消化道出血发生率显著低于对照组,差异有统计学意义(P<0.05);观察组腹痛缓解时间、住院时间和死亡率显著低于对照组,差异有统计学意义(P<0.05)。结论:早期肠内营养能够显著降低重症急性胰腺炎患者相关并发症,缩短住院时间,促进患者康复,降低死亡率,值得临床借鉴。     

Observation on clinical effects of Zhu Lian’s type I excitation needling technique for postpartum urinary retention

Objective

To observe the clinical effects of Zhu Lian’s type I excitation needling technique for postpartum urinary retention.

Methods

A total of 60 cases with postpartum urinary retention were recruited and divided randomly into an observation group and a control group, 30 cases in each group. The control group was treated with routine acupuncture, and stimulated with sparse and dense wave of electric acupuncture for 15 min after arrival of needling sensation, and then the needles were taken out. The observation group was treated with Zhu Lian’s type I excitation needling technique, by inserting the needles with the quick inserting method, swift and temporary lifting and thrusting technique for shallow insertion for 5 times, by an in-and-out technique, without retaining the needles.

Results

The total effective rate was 96.7% in the observation group and 83.3% in the control group. The difference in the total effective rate between the two groups was statistically significant (P<0.05). After the treatment, the first urination time was shorter in the observation group than that in the control group, with a statistical significance (P<0.01). After the treatment, the volume of residual urine after the first urination was less in the observation group than that in the control group (P<0.01).

Conclusion

Zhu Lian’s type I excitation needling technique can effectively promote the voluntary urination and bladder emptying in patients with postpartum urinary retention, and it takes effect faster.

     

血清和肽素对脓毒症早期诊断及预后评估的临床意义

目的 探讨血清和肽素对脓毒症早期诊断和预后评估的价值.方法 感染患者149例,其中普通感染患者(普通感染组)50例,脓毒症患者(脓毒症组)49例,严重脓毒症及脓毒性休克患者(严重脓毒症及脓毒性休克组)50例,另取同期健康体检者65例为正常对照组,测定各组血清和肽素浓度,并与降钙素原(PCT)、APACHEⅡ评分相互比较,观察其与脓毒症诊断及预后的关系.结果 严重脓毒症及脓毒性休克组、脓毒症组、普通感染组血清和肽素、PCT浓度较对照组明显升高(均P<0.05),脓毒症组与普通感染组比较差异有统计学意义(P<0.05).脓毒症组与严重脓毒症及脓毒性休克组血清和肽素、PCT浓度比较差异有统计学意义(P<0.05),随病情加重有不断升高趋势.脓毒症生存组血清和肽素、PCT浓度明显低于死亡组(P＜0.05).血清和肽素浓度及PCT浓度与APACHEⅡ评分呈正相关.结论 和肽素有助于脓毒症的早期诊断,和肽素、PCT和APACHEⅡ评分的联合应用有助于评估脓毒症患者的病情严重程度和预后.     

小针刀松解术治疗上交叉综合征30例临床研究

目的:观察小针刀松解术治疗上交叉综合征的临床疗效。方法 :将60例上交叉综合征患者随机分为治疗组和对照组。2组均予红外线照射治疗,治疗组联合小针刀松解"小T"(即枕后项平面上5个点+颈椎棘突上4个点)及喙突部治疗,对照组联合针刺"小T"及喙突部治疗。每周1次,3次为1个疗程。治疗1个疗程后,比较2组患者视觉模拟评分法(VAS)评分、头前倾角(FHA)及圆肩角(FSA)变化情况。结果 :2组患者治疗后VAS评分及FHA、FSA均较治疗前明显降低(P0.05,P0.01),且治疗组治疗后VAS评分及FHA、FSA均明显低于对照组(P0.05)。结论 :小针刀松解"小T"及喙突部联合红外线照射治疗上交叉综合征能改善局部疼痛,有效纠正患者圆肩、驼背、头前倾等错误姿势。