电子温灸仪治疗膝骨关节炎的随机对照、非劣效性临床研究

目的以传统艾灸疗法为对照,采用电子温灸仪(DZWJY-1型)治疗膝骨关节炎,评价该仪器的临床疗效及安全性。方法将124例膝骨关节炎患者随机分为电子温灸仪组与传统艾灸组,每组62例。电子温灸仪组采用DZWJY-1型电子温灸仪治疗,传统艾灸组采用传统艾灸疗法。两组疗程均为4周,观察临床疗效及安全性,比较膝痛VAS评分、WOMAC评分(总分及分项评分)的变化情况。结果 (1)试验期间,电子温灸仪组完成试验60例,脱落2例;传统艾灸组完成试验58例,脱落3例,剔除1例。(2)FAS分析结果显示,电子温灸仪组的显效率为75.81%、有效率为91.94%,传统艾灸组的显效率为68.85%、有效率为90.16%;组间临床疗效比较,差异无显著统计学意义(P0.05)。电子温灸仪组与传统艾灸组有效率差值的95%可信区间为-9.05～12.77,按照预设15%非劣标准,非劣效检验合格。(3)治疗前及治疗2周、治疗4周组内分别比较,两组膝痛VAS评分差异均有统计学意义,均明显下降(P0.01)。组间治疗2周、治疗4周比较,膝痛VAS评分差异均无统计学意义(P0.05)。(4)治疗前及治疗2周、治疗4周组内分别比较,两组WOMAC总分及疼痛评分、僵直评分、活动难度评分差异均有统计学意义,均明显下降(P0.01)。组间治疗2周、治疗4周比较,WOMAC总分及疼痛评分、僵直评分、活动难度评分差异均无统计学意义(P0.05)。(5)两组不良反应发生率均为0%。结论电子温灸仪(DZWJY-1型)治疗膝骨关节炎的临床疗效不劣于传统艾灸疗法,可明显缓解疼痛,改善关节功能。     

针刺联合耳穴压籽治疗后循环缺血性眩晕疗效观察

目的 使用经颅多普勒超声（transcranial doppler,TCD）、眩晕障碍量表（dizziness handicap inventory,DHI）、眩晕评估评分量表（dizziness assessment rating scale,DARS）及中医证候量表评价针刺联合耳穴压籽治疗后循环缺血性眩晕的疗效。方法 招募上海中医药大学附属龙华医院后循环缺血性眩晕（气血亏虚型）患者67例,随机分为治疗组（针刺+耳穴压籽治疗）34例和对照组（针刺治疗）33例。针刺选穴为百会、风池、肾俞、肝俞、脾俞、足三里。针刺治疗每次20 min,1周3次,12次（4周）为1个疗程。耳穴压籽选穴：枕、皮质下、神门、脾,于每日早晨7:00至晚间7:00嘱患者对穴位进行4次按压,每3 h 1次,每个穴位匀速按压30次。治疗次数：两耳交替压籽,1周3次,12次（4周）为1个疗程。在治疗前、治疗2周、治疗4周时分别对患者进行TCD检测以及DHI、DARS、中医证候积分评分。结果 治疗组在治疗2周和4周后对后循环缺血性眩晕（posterior circulation ischemic vertigo,PCIV...     

温和灸治疗原发性痛经疗效观察

目的观察温和灸治疗原发性痛经的临床疗效。方法将58例原发性痛经患者,采用自身前后对照的方法,在月经来潮前10 d开始用百笑灸对三阴交、关元、命门穴交替进行治疗,以1个月经周期为1个疗程,治疗2个疗程后观察患者治疗前后VAS评分和痛经评分量表积分的变化情况,并判定疗效。结果患者治疗前后VAS评分及疼痛症状积分比较,差异均具有统计学意义(P0.01)。58例患者经治疗后,痊愈15例,显效33例,有效8例,无效2例。总有效率为96.6%。结论温和灸是一种治疗原发性痛经的有效方法,能显著降低患者VAS评分及痛经症状积分。     

Observation on lower-reinforcing and upperreducing acupuncture method for hyperplasia of mammary gland and its influence on estradiol and progesterone

Objective

To observe the clinical effect of lower-reinforcing and upper-reducing acupuncture method for hyperplasia of mammary gland (HMG) and its influence on estradiol (E₂) and progesterone (P).

Methods

A randomized, single-blinded and controlled trial was conducted. A total of 124 cases conforming to the inclusion criteria were randomized by random number table into a treatment group and a control group, with 62 cases in each group. Patients in both groups received acupuncture therapy at the same acupoints, while patients in the treatment group received lower-reinforcing and upper-reducing method, and patients in the control group received even reinforcing-reducing manipulation. The treatment started around 10 d before menstruation and was conducted every other day. Patients received 5 treatments in each menstruation cycle for consecutive 3 cycles. The levels of E₂, P and E₂/P and clinical efficacy were measured before and after treatment.

Results

After treatment, the breast lump size, pain intensity and concomitant symptoms score in both groups were substantially lower than those before treatment, showing statistical significances (all P<0.01), and the improvement in the treatment group was higher than that in the control group, and the between-group comparisons showed statistical significances (all P<0.01). After treatment, the overall effective rate was 91.9% in the treatment group, higher than 72.6% in the control group, and the between-group comparison showed a statistical significance (P<0.01). After treatment, levels of E₂, P and E₂/P value showed no statistical significance when compared with those before treatment in the two groups (all P>0.05).

Conclusion

Lower-reinforcing and upper-reducing acupuncture method can effectively alleviate clinical symptoms and signs in HMG patients, and produce a better effect than even reinforcing-reducing manipulation. The majority of HMG patients’ E₂, P level and E₂/P value were not beyond the normal ranges; therefore, acupuncture showed no substantial influence on E₂ and P levels and E₂/P value.

     

针灸治疗膝关节骨性关节炎的临床疗效观察

目的：观察针灸治疗膝关节骨性关节炎的临床疗效。方法：将93例患者随机分为艾灸组36例、电针组36例和西乐葆组21例。艾灸组给予艾灸治疗（取穴：神阙、内膝眼、外膝眼、血海、梁丘穴）,电针组给予电针治疗（取穴：内膝眼、外膝眼、血海、梁丘穴）,西乐葆组给予西乐葆药物治疗,疗程均为28 d。观察患者的膝关节疼痛VAS评分及膝关节功能积分。结果：治疗后7 d、14 d、28 d,三组患者的膝关节疼痛VAS评分较治疗前均显著降低（P〈0.05,P〈0.01）,且治疗后28 d,西乐葆组患者的VAS评分较艾灸组和电针组亦显著降低（P〈0.05）。治疗后7 d、14 d、28 d,三组患者的膝关节功能积分较治疗前均显著升高（P〈0.05,P〈0.01）,且治疗后28 d,艾灸组和电针组患者的膝关节功能积分较西乐葆组亦显著升高（P〈0.05）。结论：艾灸、电针、西乐葆治疗均能有效改善膝关节骨性关节炎患者的临床症状,改善膝关节功能。     

"头八针"治疗紧张性头痛的临床研究

目的:通过观察治疗前后患者TCD水平的变化,并应用VAS评分、中医证候量表等指标,评价比较"头八针"穴组、西药组对紧张性头痛的疗效.方法:63例患者随机分为试验组(n=33)、西药组(n=30),分别予"头八针",西药妙纳进行治疗,并分别记录治疗前后患者VAS评分、头痛持续时间、头痛发作频率、椎基底动脉血流速度及中医头痛证候积分.结果:经治疗,两组患者VAS评分、头痛频率、头痛发作次数、椎基底动脉血流速度及中医证候积分皆较治疗前有所改善.试验组在VAS评分、头痛频率、中医证候积分上均优于西药组,头痛发作次数、椎基底动脉血路速度改善方面血流速度差异无统计学意义(P>0.05).结论:采用"头八针"治疗紧张性头痛的临床疗效较西药明显改善,值得推广.