王艳君教授治疗顽固性面瘫经验撷要

王艳君教授用针灸治疗顽固性面瘫临证取穴善取大椎调整督脉,倡用中脘和胃治本;善用巨刺缪刺,经络并调,补虚泻实;重视针刺顺序,调顺气机,治疗中察舌辨证,巧用灸罐,从而提高临床疗效,有其独特的治疗特色。     

101例高血压患者中医证型与血压昼夜节律的相关性分析

目的:探讨血压昼夜节律与性别、年龄、病程、中医证型等的相关性。方法:本次研究收集河北省中医院住院高血压患者101例,根据24 h动态结果,分为杓型组24例、非杓型组77例,比较两组性别、年龄、病程、中医证型的分布情况。结果:两组之间性别、年龄、病程差异无显著性(P0.05),两组比较,痰湿壅盛证差异具有显著性(P0.05)。结论:"非杓型"高血压患者更易出现痰湿壅盛证。     

调督针法治疗脑梗死后足下垂的疗效观察

目的观察调督针法治疗脑梗死后足下垂的临床疗效。方法将62例脑梗死后足下垂患者随机分为2组,2组均进行常规康复训练并强化足背屈训练,对照组31例予普通针刺治疗,治疗组31例予调督针法治疗。2组均治疗4周,观察2组治疗前后Fugl-Meyer运动功能评分(FMA)、功能性步行量表分级(FAC)、修订的Ashworth痉挛评定量表评分情况。结果 2组治疗后下肢FMA评分均升高,与本组治疗前比较差异均有统计学意义(P0.05),且治疗组治疗后下肢FMA评分高于对照组治疗后(P0.05);治疗组治疗后小腿三头肌修订的Ashworth评分分级与本组治疗前比较差异无统计学意义(P0.05),对照组治疗后小腿三头肌修订的Ashworth评分分级与本组治疗前比较差异有统计学意义(P0.05),2组治疗后小腿三头肌张力Ashworth评分分级组间比较差异均有统计学意义(P0.05)。2组治疗后FAC分级均明显优于本组治疗前(P0.05),治疗组治疗后FAC分级情况显著优于对照组(P0.05)。结论与普通针刺法相比,调督针法能显著改善脑梗死足下垂患者下肢的运动功能及步行能力,脑梗死后足下垂是调督针法的优势病种。     

新冠肺炎疫情期间本科生临网实习教学探索

新冠肺炎疫情期间为响应教育部“停课不停教,停课不停学”号召,将学生实习由医院临床转为居家临网。线上实习具有多平台、多资源、不受时空限制等优势,但同时也面临由于缺乏真实的临床感受和体验而造成认知与临床综合能力不足的问题,如学习质量下降、临床技能不足、人文素养缺乏和临床思维受限。疫情后时代,线上教学必将从应急模式转为线下教学的常规辅助。本文通过远程PBL实习教学、病例库建设、角色扮演和引进模拟实验室等方法尽量缩小临床实习与临网实习的差距,为未来临床实习线上线下混合教学模式发展提供参考。     

基于中医时间医学指导的原发性高血压的治疗及研究进展

中医时间医学是中医理论指导下研究人体生命活动的周期性和变化规律,以指导临床诊治、养生及预防的一门科学。以中医时间医学为理论指导采用针刺、穴位贴敷、足浴、穴位按摩、服用中药等方法治疗原发性高血压具有确切疗效。     

辰时针刺对原发性高血压患者的降压效应

ObjectiveTo observe the anti-hypertensive effect of time acupuncture on primary hypertension so as to provide the therapeutic regimen for the treatment of primary hypertension.MethodsA total of 120 patients with primary hypertension were randomized into a western medication group and an acupuncture-medication group, 60 cases in each one. In the western medication group, levoamlodipine maleate tablets were prescribed for oral administration. In the acupuncture-medication group, on the base of the treatment as the western medication group, time acupuncture was combined in the period of a day from 7:00 a.m. to 9:00 a.m. The duration of treatment was 4 weeks in the two groups. Before and after treatment, blood pressure, serum endothelin (ET) and nitrious oxide (NO) were measured successively and the clinical therapeutic effect was evaluated.Results(1) Blood pressure: the systolic and diastolic pressure after treatment were all lower than that before treatment in the two groups, indicating statistical differences (all P < 0.05). After treatment, the systolic and diastolic pressure in the acupuncture-medication group were lower than that of the western medication group, indicating significant differences (both P < 0.05). (2) ET and NO: after treatment, ET in the acupuncture-medication group was lower than the western medication group and NO was higher than the western medication group, indicating statistical differences (both P < 0.05). (3) Clinical therapeutic effect: the total effective effect of anti-hypertension was 89% in the acupuncture-medication group, higher than 63% in the western medication group, indicating statistical difference (P < 0.05).ConclusionThe combined treatment of western medication and time acupuncture (7:00 am to 9:00 am) achieves better effect on primary hypertension as compared with simple western medication and its anti-hypertensive effect is probably related to the decrease of ET and the increase of NO.     

燕赵高氏调督通络针法治疗紧张性头痛疗效研究

目的:研究"燕赵高氏调督通络针法"对紧张性头痛的治疗效果。方法:将72名符合入组标准的紧张性头痛患者按照就诊先后顺序分为2组,每组36名患者。治疗组以"燕赵高氏调督通络针法"治疗,对照组以常规针法进行治疗。以视觉模拟法(VAS)评价2组患者治疗前、治疗5次后及治疗结束1个月后的头痛程度,比较2组患者的治疗效果。结果:2种疗法在治疗5次后及治疗结束1个月后的头痛程度VAS评分与治疗前相比均有明显下降(P0.05);治疗组在治疗结束后1个月头痛评分与治疗前头痛评分的差值明显大于对照组(P0.05));2种疗法在治疗的有效率方面并无明显差别(P0.05)。结论:2种针灸方法对紧张性头痛均有明显的缓解疼痛作用,但"燕赵高氏调督通络针法"治疗紧张性头痛的作用效应持续时间明显优于对照组。     

中医专业大学生师承教育相关因素的调研与分析

近年来关于院校教育与师承教育利弊得失的讨论很多,有人提出"吸取传统教育和院校教育长处"的新型模式。为此,我们开展了本科阶段引入师承教育的改革探索,采用自行设计的调查问卷方式调查中医系五年级在校大学生,以期了解中医专业大学生师承教育与不同因素之间的关系,结果显示个人兴趣组选择喜欢师承教育、了解师承教育的比例高于父母选择组,因此如何提高中医的广泛认知,尤其是让青年一代学习中医,热爱中医,值得思考。因此,加强宣传,推广师承教育模式或许是实现这一目的的有效途径之一。