慢性荨麻疹食物不耐受IgG检测及饮食护理

采用ELISA法检测96例慢性荨麻疹患者食物不耐受的血清特异性IgG,并随机分为实验组和对照组各48例,两组患者均同时使用药物治疗,病情完全控制后停用药物,对实验组中查出食物不耐受的患者进行饮食调节治疗,将检测结果为阳性的食物全部忌食;对照组则不进行饮食调整。结果96例慢性荨麻疹患者食物不耐受的血清特异性IgG的检测阳性率为89.6%,实验组治疗有效率88.9%,对照组为26.2%,两组比较差异有统计学意义（P〈0.01）。提示对慢性荨麻疹患者进行食物特异性IgG检测,可作为慢性荨麻疹患者寻找过敏原的一个有效途径,并对慢性荨麻疹患者提供饮食指导。     

慢性荨麻疹食物不耐受IgG检测及饮食护理

采用ELISA法检测96例慢性荨麻疹患者食物不耐受的血清特异性IgG,并随机分为实验组和对照组各48例,两组患者均同时使用药物治疗,病情完全控制后停用药物,对实验组中查出食物不耐受的患者进行饮食调节治疗,将检测结果为阳性的食物全部忌食;对照组则不进行饮食调整.结果96例慢性荨麻疹患者食物不耐受的血清特异性IgG的检测阳性率为89.6%,实验组治疗有效率88.9%,对照组为26.2%,两组比较差异有统计学意义(P＜0.01).提示对慢性荨麻疹患者进行食物特异性IgG检测,可作为慢性荨麻疹患者寻找过敏原的一个有效途径,并对慢性荨麻疹患者提供饮食指导.     

肠易激综合征患者食物不耐受检测及饮食指导

目的 通过对肠易激综合征(IBS)患者进行食物不耐受检测,了解患者食物不耐受情况.方法 选取本科住院的肠易激综合征患者72例,采集外周静脉血,应用酶联免疫吸附法按试剂盒说明书检测患者血清14种食物抗原的特异性IgC抗体.结果 72例进行食物不耐受检测中有55例阳性结果,阳性率达76.4%.55例阳性结果中1种食物特异性IgG升高者21例(38.2%),2种食物特异性IgG升高者17例(30.9%),3种食物特异性IgG升高者12例(21.8%),4种及以上食物特异性IgG升高者5例(9.1%).14种常见食物的过敏情况中鸡蛋致敏性最高,其次依次为虾、牛奶、蟹、大豆、鳕鱼、牛肉,而大米、鸡肉、小麦、西红柿致敏性较低,猪肉测得数值为0.结论 测定食物特异性IgG抗体水平,寻找肠易激综合征(IBS)患者可能存在的不耐受食物并对其进行相应的饮食指导可有效地预防IBS的反复发作或病情加重.     

食物不耐受检测临床意义的探讨

目的通过食物不耐受检测，为慢性肠炎、慢性湿疹、慢性疲劳综合征等慢性疾病致病因素的寻找提供实验室依据。方法用ELISA法检测血清14种食物特异性IgG。结果通过对66例标本14项食物特异性IgG检测结果分析，全部阴性的病例为4例，仅有1项食物不耐受的8例，2项以上食物不耐受的54例。结论食物不耐受可能是某些慢性疾病的致病因素之一。     

音乐疗法结合药熨法对慢性疲劳综合征干预的临床观察

目的 初步探讨音乐疗法对慢性疲劳综合征的干预作用,以寻求一种更简单、更有效的防治慢性疲劳综合征的方法.方法 按照随机对照原则,将合格的慢性疲劳综合征患者随机分为观察组和对照组,观察组给予音乐疗法结合药熨法治疗,而对照组仅采用药熨法治疗,比较治疗前后两组患者的疲劳评定量表(FAI)及精神症状自评量表(SCL-90)评分变化,以及治疗后两组间的评分差异.结果 治疗后总有效率观察组92.18%,对照组78.57%.结论 音乐疗法结合药熨法对慢性疲劳综合征患者的干预,可以改善患者的症状,从而提高患者的生活质量.     

过敏性紫癜患儿食物不耐受检测及其意义

目的探讨过敏性紫癜患儿食物不耐受血清特异性IgG水平对其病因诊断及饮食治疗的意义。方法用食物不耐受IgG体外检测试剂盒检测30例过敏性紫癜患儿和20例健康对照儿童的血清特异性IgG水平。结果实验组30例过敏性紫癜患者的血清总IgG阳性率为76.67%,其中对1种食物不耐受为3例,对2种以上食物不耐受者为20例。健康对照组20例血清总IgG阳性率为25%,对1种食物不耐受为2例,对2种以上食物不耐受者为3例,常见的引起不耐受的食物依次为牛奶、虾、鸡蛋清和鸡蛋黄、蟹、大豆、鳕鱼、大米、小麦、猪肉、牛肉等,实验组饮食上经避免不耐受食物及抗过敏治疗疗程缩短,疗效优于对照组。结论血清特异性IgG水平检测对过敏性紫癜的病因诊断有参考意义,对患儿饮食治疗及营养状态的改善具有重要的指导意义。     

饮食干预对慢性荨麻疹患者影响的研究

目的:探讨饮食干预对由食物过敏原引起的慢性荨麻疹患者的影响.方法:选取慢性荨麻疹14种食物过敏原特异性IgG抗体阳性病例96例,随机分为干预组50例和对照组46例,两组均口服咪唑斯丁(皿治林),每日1片,连服28 d,干预组同时进行饮食干预.两组患者于第1日、28日、35日由专人评价皮损面积、发作频率、风团数量、瘙痒程度等指标.干预组中12例患者在饮食干预3个月行14种食物过敏原特异性IgG检测.结果:干预组第28日、35日有效率分别为84.0%、86.0%,对照组有效率为56.5%、45.7%,干预组治疗效果明显优于对照组(P<0.05).12例患者在饮食干预后IgG检测结果与干预前相比阳性率降低,差异有统计学意义(P<0.05).结论:饮食干预可有效减轻由食物过敏原特异性IgG引起慢性荨麻疹患者的症状,并降低不耐受食物的阳性率、阳性级别.     

针刺治疗慢性疲劳综合征临床研究

目的探讨针灸治疗慢性疲劳综合征的临床疗效。方法选择自2014年1月至2016年12月辽宁中医药大学附属医院收治的63例慢性疲劳综合症患者为研究对象。将63例患者随机分为针刺组(n=33)和西药组(n=30)。针刺组运用中医辨证取穴方法进行毫针针刺治疗,西药组采用口服常规营养支持药物、增强免疫力药物、镇静催眠药物等进行对症处理。30 d为1个疗程,治疗4个疗程后,观察并比较两组患者的疲劳量表-14(FS-14)评分及临床疗效。结果治疗4个疗程后,两组患者的FS-14评分均较治疗前有所下降(P<0.05),且治疗后针刺组评分低于西药组,两组比较,差异有统计学意义(P<0.05);针刺组治疗有效率为81.8%(27/33),显著高于西药组的43.3%(13/30),两组比较,差异有统计学意义(P<0.05)。结论针刺法治疗慢性疲劳综合征临床疗效满意,安全可靠。     

食物IgG4抗体检测在婴幼儿腹泻病中的临床意义研究

选取100例腹泻患儿,采用酶联免疫吸附法检测100例腹泻患儿血清中7种食物过敏原特异性Ig G4,并根据Ig G4浓度结果采取不同的健康饮食指导,观察患儿症状改善及食物耐受的情况。急性、迁延性、慢性腹泻病患儿中,均以牛奶过敏原特异性Ig G4阳性率最高;不给于食物回避治疗,急性腹泻病组有效率78.33%,迁延性、慢性腹泻组有效率27.50%;迁延性、慢性腹泻组中无效患儿,食物不回避组治疗有效率35.00%,明显低于食物回避组的86.36%(P0.05)。食物Ig G4抗体检测结果对指导腹泻患儿进行正确喂养有着一定的意义,但是食物过敏是一个复杂的变态反应,需要全面分析才能指导患儿正确饮食。     

河南地区442例儿童食物不耐受临床分析

目的分析河南地区442例儿童的食物不耐受情况,为临床饮食指导提供依据。方法选择442例行食物不耐受检测的儿童为研究对象,分析其食物不耐受情况。结果442例儿童中≥1种食物不耐受者395例(89.4%),其中1、2、3种食物不耐受者居多。儿童食物不耐受阳性及高度敏感集中在鸡蛋、牛奶两种食物。0~<3岁与3~6岁儿童的鸡蛋不耐受阳性率差异显著(P<0.05)。结论儿童食物不耐受发病率高,其中以牛奶、鸡蛋为主,根据检测结果可及时发现饮食中不适宜食物,并及时调整饮食有利儿童生长发育。     

调制中频电疗法配合刺五加胶囊治疗慢性疲劳综合征

目的：观察调制中频电疗法穴位刺激及口服刺五加胶囊对慢性疲劳综合征（CFS）的临床疗效。方法：CFS患者63例,随机分为A、B2组。A组32例采用调制中频电疗法穴位刺激及口服刺五加胶囊治疗;对照组31例按常规剂量应用谷维素、维生素B1、维生素B6口服或氨基酸静脉滴注治疗。治疗前后用疲劳量表（FS-14）、抑郁及焦虑自评量表（SDS、SAS）对患者进行评定。结果：治疗6周后,FS-14、SDS、SAS评分2组与治疗前比较均明显下降（P〈0．05,0．01）,A组减分率明显低于B组。临床疗效比较,A组治愈率及总有效率均明显高于B组（90．6％、67．7％与65．6％、29．0％,P〈0．05）。结论：调制中频电疗法及刺五加胶囊治疗能显著改善CFS患者躯体和精神症状,提高临床疗效。     

Chronic Fatigue Syndrome: A description of graded exercise treatment

Patients with chronic fatigue syndrome complain of exercise intolerance and weakness, which may be partially related to lack of physical conditioning. Recent studies suggest that graded exercise therapy is a helpful treatment for the majority of patients. This article describes how to apply the treatment, adapted for clinical use. This incorporates recommendations and protocols for assessment of patients at baseline and throughout treatment, and details on monitoring of progression, through a low intensity graded exercise programme.     

中医五音疗法在慢性疲劳综合征患者中的应用

目的观察中医五音疗法对慢性疲劳综合征（chronicfatiguesyndrome,CFS）患者的影响。方法将CFS患者分为治疗组30例和对照组29例。治疗组治疗采用中医五音疗法,对照组采用普通音乐疗法,连续治疗3个月。采用疲劳量表（fatiguescale-14,FS-14）、抑郁状态问卷（depressionstatusinventory,DSI）及疼痛视觉模拟量表（visualanaloguescale,VAS）对患者进行测评。结果治疗后,治疗组患者FS-14、DSI及VAS得分均低于对照组（均P〈0．05）。结论中医五音疗法可降低CFS患者疲劳程度和抑郁情绪及缓解患者疼痛的程度。     

How relevant are exercise capacity measures for evaluating treatment effects in chronic fatigue syndrome? Results from a prospective, multidisciplinary outcome study

OBJECTIVE: To evaluate the outcome of a multidisciplinary treatment programme for patients with chronic fatigue syndrome, including health-related quality of life (HRQoL) and psychosocial variables, and exercise capacity measures. DESIGN: A six-month prospective outcome study. SETTING: University outpatient rehabilitation clinic; group setting. SUBJECTS: One hundred and sixteen women fulfilling chronic fatigue syndrome criteria. INTERVENTIONS: Cognitive behaviourally and graded exercise-based strategies; emphasis on adaptive lifestyle changes. MEASURES: Short Form General Health Survey (SF-36); Symptom Checklist (SCL-90); Causal Attribution List (CAL); Self-Efficacy Scale (SE); maximum progressive bicycle ergometer test with respiratory gas analysis; and isokinetic leg strength test, before and after treatment. RESULTS: The total group significantly improved on nearly all reported HRQoL/psychosocial variables. Changes in exercise capacity measures were rather modest and did not correlate or only weakly correlated with HRQoL/psychosocial variables. Subgroup analyses indicated that less fit patients improved significantly more on exercise capacity measures than their more fit counterparts. Patients who were fitter at baseline scored better on pretreatment HRQoL/psychosocial variables, but both subgroups improved similarly on these variables. CONCLUSIONS: Health-related quality of life and psychosocial functioning in patients with chronic fatigue syndrome improves after a six-month cognitive behaviourally and graded exercise-based multidisciplinary treatment programme. Increase in exercise capacity measures is not a necessary condition for reported improvements, except for less fit patients.     

度洛西汀与帕罗西汀治疗慢性疲劳综合征对照研究

目的探讨度洛西汀与帕罗西汀治疗慢性疲劳综合征的临床疗效和安全性。方法将58例慢性疲劳综合征患者随机分为两组,每组29例,分别口服度洛西汀和帕罗西汀治疗,观察8周。采用疲劳量表-14、抑郁自评量表、焦虑自评量表和副反应量表评定临床疗效和不良反应。结果治疗后两组疲劳量表-14、抑郁自评量表、焦虑自评量表评分均较治疗前显著下降（P〈0．01）,度洛西汀组较帕罗西汀组下降更显著（P〈0．05或0．01）;治疗8周末度洛西汀组显效率（82．8％）显著高于帕罗西汀组（58．6％）（Х^2=4．08,P〈0．05）;两组不良反应均轻微,发生率比较差异无显著性（P〉0．05）。结论度洛西汀与帕罗西汀治疗慢性疲劳综合征疗效均显著,安全性高,但度洛西汀起效更快,疗效更好,优于帕罗西汀治疗。     

小儿慢性迁延性腹泻与食物不耐受的相关性分析

目的通过检测并对比慢性迁延性腹泻病患儿与健康体检儿童血清中食物特异性IgG抗体的水平,分析小儿慢性迁延性腹泻病的发生与食物不耐受是否具有相关性。方法随机抽取深圳市儿童医院2015年1-12月临床诊断为慢性迁延性腹泻病的患儿105例,并选取健康体检儿童94例作为对照组,采用酶联免疫法检测受检者血清中14种食物过敏原特异性IgG抗体的浓度水平。结果慢性迁延性腹泻病多见于0~1岁的小婴儿,105例慢性迁延性腹泻病患儿的14种食物特异性IgG抗体阳性率水平从高到低依次排列为:牛奶、鸡蛋、西红柿、大米、小麦、鳕鱼、玉米、牛肉、大豆、鸡肉、猪肉、蘑菇、虾和蟹;94例健康体检儿童的14种食物特异性IgG抗体阳性率水平从高到低依次排列为:牛奶、鸡蛋、西红柿、大米、小麦、大豆、鳕鱼、玉米、牛肉、蟹、鸡肉、蘑菇、虾和猪肉;其中牛奶、牛肉和大豆的食物特异性IgG在两组间的比较中具有统计学意义(P0.05)。结论食物不耐受有可能是婴幼儿发生慢性迁延性腹泻病的重要病因之一,可以通过合理调整小儿饮食治疗小儿慢性迁延性腹泻病。     

健康管理缓解飞行员慢性疲劳综合征的效果研究

目的 评估疗养护理过程中,实施健康管理对飞行员慢性疲劳综合征的疗效.方法 根据慢性疲劳综合征的诊断标准选定97名飞行员作为研究对象,随机分为实验组47人和对照组50人,分别接受健康管理+疗养护理和常规疗养护理.在疗养始末分别用简易疲劳量表(BFI)、疲劳问卷(FS)和疲劳程度评定量表(FAI)对2组飞行员进行慢性疲劳程度的评估.结果 2组飞行员经疗养护理,各项慢性疲劳症状均较实施疗养护理前有所改善,但实验组的改善程度更加显著.结论 在疗养护理过程中,实施健康管理可显著减轻飞行员的慢性疲劳,增进疗养效果.     

Interstate Postgraduate Medical Assembly

Abstract

Fatigue is commonly reported in the primary care setting; however, its cause is often unclear. This article presents 3 cases involving patients with chronic fatigue syndrome who responded poorly to treatment. After clinical evaluation, all patients were found to meet criteria for attention–deficit/hyperactivity disorder (ADHD) and underwent a standard regimen of a psychostimulant medication. After treatment with psychostimulants, the 3 patients reported improved symptoms of fatigue and pain, and cognitive and core ADHD symptoms. These cases suggest that ADHD and chronic fatigue syndrome (and possibly fibromyalgia) share a common underlying mechanism. This article presents a model suggesting that over time, ADHD (predominantly inattentive type) develops into a syndrome of chronic fatigue and pain. These cases indicate that fatigue may be an important presenting symptom of adult ADHD. These cases also suggest the need for additional research to determine the prevalence of ADHD in patients who present with fatigue, and, in those meeting criteria for ADHD, the responsiveness of fatigue to psychostimulant treatment.     

Quality of life and symptom severity for individuals with chronic fatigue syndrome: findings from a randomized clinical trial.

OBJECTIVE: Chronic fatigue syndrome is a profoundly disabling condition characterized by severe, unrelenting fatigue and a number of other physical and cognitive symptoms. Currently, there is no cure or widely accepted treatment for chronic fatigue syndrome, and few rehabilitation programs exist to address quality of life issues in chronic fatigue syndrome. In the present randomized clinical trial, the effects of an integrative, consumer-driven rehabilitation program on quality of life and symptom severity for individuals with chronic fatigue syndrome were examined. METHOD: Forty-seven participants were randomly assigned to either an immediate program group (n = 23) or a delayed program control group (n = 24) and assessed with the Chronic Fatigue Syndrome Symptom Rating Scale and the Quality of Life Index before the program, after program participants completed the group phase, and after program participants completed the one-on-one phase. It was hypothesized that the program would lead to improvements in quality of life and an overall reduction in symptom severity. RESULTS: Linear growth models were estimated comparing program and control conditions over time using random-effects regression analyses. Significant condition by time interactions were observed for the main outcomes of symptom severity and overall quality of life. Effect sizes for these interactions involving symptom severity (Cohen's d = 0.71) and overall quality of life (Cohen's d = .66) were moderate. CONCLUSIONS: Findings indicate that consumer driven programs such as this one can have a positive impact on symptom severity and quality of life over time for individuals with chronic fatigue syndrome.     

Chronic fatigue syndrome: an approach combining self-management with graded exercise to avoid exacerbations.

Controversy regarding the aetiology and treatment of patients with chronic fatigue syndrome continues among the medical professions. The Cochrane Collaboration advises practitioners to implement graded exercise therapy for patients with chronic fatigue syndrome using cognitive behavioural principles. Conversely, there is evidence that exercise can exacerbate symptoms in chronic fatigue syndrome, if too-vigorous exercise/activity promotes immune dysfunction, which in turn increases symptoms. When designing and implementing an exercise programme for chronic fatigue syndrome it is important to be aware of both of these seemingly opposing viewpoints in order to deliver a programme with no detrimental effects on the pathophysiology of the condition. Using evidence from both the biological and clinical sciences, this paper explains that graded exercise therapy for people with chronic fatigue syndrome can be undertaken safely with no detrimental effects on the immune system. Exercise programmes should be designed to cater for individual physical capabilities and should take into account the fluctuating nature of symptoms. In line with cognitive behaviourally and graded exercise-based strategies, self-management for people with chronic fatigue syndrome involves encouraging patients to pace their activities and respect their physical and mental limitations, with the ultimate aim of improving their everyday functioning.