电极、激光刺激穴位配合音乐治疗原发性1级高血压病临床研究

目的:探讨原发性1级高血压病安全、有效、简单、易行的非药物治疗方法。方法:将126例原发性1级高血压病患者分为肝火亢盛、阴虚阳亢、痰湿壅盛、阴阳两虚4型,随机分为光电音治疗组、针刺组和安慰剂组,每组42例。光电音治疗组和针刺组均进行辨证取穴,肝火亢盛型取太冲、曲池,阴虚阳亢型取太溪、三阴交,痰湿壅盛型取足三里、丰隆,阴阳两虚型取太溪、关元,分别采用多模式音频脉冲光电治疗仪和针刺治疗,每天1次。安慰剂组口服淀粉片剂25mg,每次1片,每天3次。3组均10天为一疗程,共治疗3个疗程。比较3组治疗前后血压及中医证候积分变化情况。结果:光电音治疗组和针刺组均可降低血压(均P0.01),且光电音治疗组降低收缩压的效果更佳(P0.05)。光电音治疗组降压总有效率为90.5%(38/42),优于针刺组的71.4%(30/42,P0.05)与安慰剂组的19.1%(18/34,P0.01)。光电音治疗组和针刺组均可改善中医证候积分,且组间差异无统计学意义(P0.05)。结论:多模式音频脉冲光电治疗仪治疗原发性1级高血压病临床疗效肯定,具有无创、操作简便的优点。     

冲击波治疗肩周炎临床对照研究

目的：观察冲击波治疗肩周炎的疗效及安全性。方法：将60例患者随机分为冲击波组（30例）和常规理疗组（30例）,冲击波组采用痛点冲击波治疗,常规理疗组则采用超短波和中频脉冲电治疗,所有患者均在上述治疗后进行肩周炎医疗体操训练,每日2次,每次30min,共治疗15天;采用简化McGill疼痛问卷（SF＋MPQ）、Constant Murley肩关节评分（CMS）于治疗前、治疗结束时、治疗后2周进行评估。结果：治疗后2周,冲击波组PRI、VAS、PPI均低于对照组（P＜0．05）,CMS评分高于对照组（P＜0．05）。结论：冲击波治疗对肩周炎疗效显著,作用持续时间长。     

2种胸腰椎骨折分型在不同专业医师中应用的可信度和可重复性研究

目的探讨胸腰椎骨折的Denis分型和胸腰椎损伤分类及严重程度评分（TLICS）分型系统在不同专业医师中应用的可信度和可重复性。方法分别由不同专科医师采用2种分型方法对85例胸腰椎骨折进行分类,间隔2个月后再次分型。分析2种分型的观察者间可信度和观察者内可重复性。结果按观察者间可信度,Denis分型的Kappa值在0．632～0．735,平均为0．661（基本可信）。TUCS分型具体分值的Kappa值在0．217～0．316,平均为0．273（轻中度可信）。TUCS的推荐治疗分类Kappa值在0．641～0．764,平均为0．704（基本可信）。按观察者内可重复性,Denis分型Kappa值在0．375—0．580,平均为0．459（中度可信）。TLICS分型具体分值的Kappa值在0．319～0．478,平均为0．380（轻中度可信）。TLICS的推荐治疗分类Kappa值在0．617～0．785,平均为0．724（基本可信）。结论胸腰椎骨折的Denis分型在各个专业医师中应用的可信度较好,仍有一定的临床价值。TLICS评分的推荐治疗分型在各个专业医师中的可信度与可重复性均更高,更有利于相互交流及指导治疗。     

Non-Invasive Treatment to Grade 1 Essential Hypertension by Percutaneous Laser and Electric Pulse to Acupoint with Music: A Randomized Controlled Trial

Objective

To study a non-drug therapy for hypertension disease by combining percutaneous laser and electric pulse stimulation to acupoint with music, and to test the efficiency of the combining treatment to grade 1 essential hypertension.

Methods

A total of 174 patients with grade 1 essential hypertension were randomly assigned to 3 groups with a random number table after Chinese medicine (CM) syndrome differentiation: the photoelectric and musical treatment group (Group 1, with a self-developed multi-mode audio frequency pulse photoelectric therapeutic apparatus), acupuncture group (Group 2), and oral placebo group (Group 3), 58 cases per group. The curative effect of each group was evaluated by the changes of blood pressure and CM syndrome integral before and after treatment.

Results

Compared with Group 3, there were significant decrease of blood pressure and CM syndrome integral in Group 1 and Group 2 (P<0.01). Compared with Group 2, Group 1 showed the highest decrease in systolic pressure (P<0.017). The total effective rate of anti-hypertension in Group 1 (91.38%, 53/58) was significantly higher than that in Group 2 (74.13%, 43/58) and Group 3 (18.97%, 11/58, P<0.05 or P<0.01); and that in Group 2 was also significantly higher than that in Group 3 (P<0.01). There were significant difference in the total effective rate of CM syndrome integral in both Group 1 (93.10%, 54/58) and Group 2 (84.48%, 49/58) as compared with Group 3 (17.24%, 10/58, P<0.01), while there was no significant difference between Group 1 and Group 2 (P>0.05).

Conclusions

The multi-mode audio frequency pulse photoelectric therapeutic apparatus, combining music, laser and electric pulse stimulation, is clinically useful for grade 1 essential hypertension. This "three in one" therapy method is non-invasive, easy and simple to handle. It is expected to be popularized as a new alternative treatment.