中西医结合治疗糖尿病足90例临床护理

目的：探讨采用中西医结合治疗糖尿病足的护理方法。方法：将糖尿病足患者90例随机分为治疗组60例和对照组30例，两组均予以常规内科综合治疗，加强全身及局部护理，观察组在此基础上采用中药足浴；对照组则采用温水足浴。观察两组综合临床疗效、局部溃疡愈合情况及不良反应发生情况。结果：治疗组痊愈26例，显效34例，总有效率100％；对照组痊愈6例，显效13例，总有效率63．3％，两组比较有显著性差异（P〈0．05）。结论：常规护理结合中药足浴治疗糖尿病足安全、有效，值得临床推广应用。     

中西医结合治疗糖尿病足90例临床护理

目的 探讨采用中西医结合治疗糖尿病足的护理方法 .方法 将糖尿病足患者90例随机分为治疗组60例和对照组30例,两组均予以常规内科综合治疗,加强全身及局部护理,观察组在此基础上采用中药足浴;对照组则采用温水足浴.观察两组综合临床疗效、局部溃疡愈合情况及不良反应发生情况.结果 治疗组痊愈26例,显效34例,总有效率100%;对照组痊愈6例,显效13例,总有效率63.3%,两组比较有显著性差异(P<0.05).结论 常规护理结合中药足浴治疗糖尿病足安全、有效,值得临床推广应用.     

中西医结合治疗糖尿病足46例护理干预

目的:探讨中西医结合治疗糖尿病足的护理方法.方法:将糖尿病足患者89例随机分为中西组46例和对照组43例,两组均予以常规内科综合治疗.中西组同时配合健康教育及心理疏导、中医辨证、饮食及患处局部护理、中药足浴;对照组则采用温水足浴;比较两组疗效.结果:中西组治愈率(93.5%)明显高于对照组(79.1%)(P<0.05),住院时间、换药次数和换药费用均明显低于对照组(P<0.05).结论:糖尿病足结合辨证论治的护理干预可明显缩短住院时间,提高临床治愈率,值得推广.     

尼莫地平联合龙血竭治疗糖尿病足的临床观察及护理

目的观察尼莫地平联合龙血竭粉以及护理干预措施治疗糖尿病足的临床效果。方法将58例糖尿病足患者随机分为治疗组28例和对照组30例,两组均予常规内科综合治疗、全身及足局部护理、足部溃疡面均给予清创;治疗组除以上治疗外另口服尼莫地平片和龙血竭胶囊,足溃疡面龙血竭粉湿敷,比较两组疗效。结果治疗组总有效率96.4%,对照组总有效率70%。治疗组疗效明显优于对照组(P0.01)。结论中西医结合治疗及加强护理对糖尿病足疗效显著,值得推广。     

艾灸治疗糖尿病足的疗效观察及护理

[目的]探讨艾灸治疗糖尿病足的疗效.[方法]将入选的糖尿病足病人64例按入院先后顺序分为治疗组34例,对照组30例,两组均予常规内科综合治疗,加强全身及局部护理.治疗组在常规治疗及护理基础上创面加用艾条依次使用温和灸、回旋灸、雀啄灸三步法施灸,每日1次或2次,4周后观察两组病人临床疗效、局部溃疡愈合时间及不良反应发生情况.[结果]治疗组糖尿病足具有较好的临床疗效,局部溃疡愈合时间短,与对照组比较差异有统计学意义(P<0.05).[结论]常规治疗护理结合中医艾灸疗法治疗糖尿病足具有较好的临床疗效,局部溃疡愈合时间短.     

碘伏换药治疗糖尿病足溃疡的疗效观察

目的观察0.5%碘伏换药治疗糖尿病足溃疡的效果。方法将糖尿病足溃疡患者105例,随机分成两组,实验组55例,对照组50例。实验组:糖尿病足溃疡创面采用0.5%碘伏清洗,碘伏浸泡无菌纱布湿敷。对照组:采用常规方法,生理盐水100ml 0.5%甲硝唑100ml 庆大霉素16万U 山莨菪碱20mg 胰岛素24U浸泡无菌纱布湿敷。结果糖尿病足Ⅱ度溃疡的治愈率显著高于对照组(P<0.01),溃疡平均愈合时间明显短于对照组(P<0.01);Ⅰ度、Ⅲ度溃疡的治愈率,两组比较无明显差异(P>0.05),但Ⅰ度溃疡平均愈合时间明显短于对照组(P<0.01)。两组Ⅰ度、Ⅱ度、Ⅲ度治疗有效率比较无明显差异。结论0.5%碘伏换药治疗糖尿病足溃疡与常规方法相比Ⅰ、Ⅱ度溃疡愈合时间明显缩短,Ⅱ度溃疡治愈率明显提高,但两种方法对Ⅰ、Ⅲ度治愈率及各度溃疡治疗有效率无明显差异。     

中西医治疗糖尿病足坏疽临床研究及分析

目的 比较中西医结合方法与传统方法治疗糖尿病足坏疽的疗效。方法 将60例糖尿病足坏疽患者分为治疗组、对照组。治疗组在控制血糖的基础上采用自制中药分4个阶段进行局部换药。对照组在控制血糖的基础上采用山莨菪碱加胰岛素治疗糖尿病足坏疽。结果 治疗组有效率100％，治愈率87．5％；对照组有效率77．6％，治愈率61．2％，两组疗效比较差异有显著性（P〈0．05）。结论 中西医结合治疗糖尿病足坏疽疗效优于用山莨菪碱加胰岛素换药治疗，中西医结合的方法使创面肉芽生长迅速、愈合快、疗程短等，建议推广使用中西医结合方法治疗糖尿病足坏疽。     

中西医结合治疗糖尿病足溃疡60例临床护理

目的：探讨中西医结合治疗糖尿病足溃疡的护理方法。方法：将100例糖尿病足溃疡患者随机分为治疗组60例和对照组40例,两组均予以常规内科综合治疗、全身及足局部护理,足溃疡面均给予西药湿敷;治疗组除以上治疗外口服中药汤剂,足溃疡面中药制剂湿敷,比较两组疗效。结果：治疗组总有效率93．3％,治愈时间（17．7&#177;6．5）d;对照组总有效率80．0％,治愈时间（23．4&#177;7．5）d。治疗组疗效明显优于对照组（P〈0．01）。结论：中西医结合治疗及加强护理治疗糖尿病足溃疡疗效显著,值得推广。     

中西医结合治疗糖尿病足溃疡60例临床护理

目的:探讨中西医结合治疗糖尿病足溃疡的护理方法.方法:将100例糖尿病足溃疡患者随机分为治疗组60例和对照组40例,两组均予以常规内科综合治疗、全身及足局部护理,足溃疡面均给予西药湿敷;治疗组除以上治疗外口服中药汤剂,足溃疡面中药制剂湿敷,比较两组疗效.结果:治疗组总有效率93.3%,治愈时间(17.7±6.5) d;对照组总有效率80.0%,治愈时间(23.4±7.5) d.治疗组疗效明显优于对照组(P<0.01).结论:中西医结合治疗及加强护理治疗糖尿病足溃疡疗效显著,值得推广.     

桃红四物汤治疗糖尿病足的临床疗效观察

目的观察桃红四物汤治疗糖尿病足的临床疗效。方法 66例糖尿病足患者随机分为对照组和治疗组,对照组30例采用常规治疗,治疗组36例在常规治疗的基础上加用口服桃红四物汤治疗,治疗3个疗程,比较两组患者经治疗后的临床疗效,局部溃疡愈合情况。结果治疗组的总有效率88.8%。对照组总有效率66.6%。治疗组疗效明显高于对照组,差异有统计学意义(P<0.05)。结论桃红四物汤对糖尿病足有确切疗效。     

Integrative Medicine in Family Medicine Residency

Background

As specialists who care for families and communities, family physicians have a responsibility to respond to evolving views of healthcare among their patients. Americans are using complementary and alternative medicine (CAM) with increasing frequency and family physicians are well suited to becoming the guides for ensuring the safe and effective integration of conventional and complementary approaches to healthcare.

Methods

US National Institutes of Health National Centers for Complementary and Alternative Medicine funding was used to design, implement and evaluate an educational intervention for residents and faculty members in our family medicine residency programme at the Maine Medical Center (Portland, ME, USA). Key components of the project were a series of half-day workshops, faculty development and a resident curriculum. The resident curriculum includes experiences designed to address physician Wellness, communication with patients and coordination of care with community CAM providers. The project engaged community CAM practitioners as teachers and in patient care.

Results

Faculty members and residents reported an increase in knowledge and confidence in discussing and utilising CAM modalities. They reported improvement in their ability to find reliable information on CAM and a dramatic increase in level of comfort discussing CAM with patients.

Conclusions

Our experience suggests that family physicians are well suited to becoming patient guides for the safe and effective integration of conventional and complementary approaches to healthcare.     

牛人

有了网络,便有了无穷尽的鲜活语言。 最早让我一头雾水的是女儿告诉我的“好郁闷”这个词儿。而如今,当我有了解不开或做不好的某件事时,也情不自禁的发出感叹,“好郁闷呐!”     

牛人

有了网络,便有了无穷尽的鲜活语言。 最早让我一头雾水的是女儿告诉我的“好郁闷”这个词儿。而如今,当我有了解不开或做不好的某件事时,也情不自禁的发出感叹,“好郁闷呐!”     

关于循证医学的问题与思考

本文阐述了对循证医学的"三原则"和实践循证医学的"五程式"的理解;循证医学是人类数千年形成的道德准则和公理在医学上的体现,是先进的临床医学模式和临床实践的方法论,其产生的基础是临床科研方法学的发展和完善、最佳证据数据库的产生以及信息技术的发展,归根结底是一切为了人类健康的需要.本文还就中医现代化与循证医学的关系进行了探讨,认为中医现代化的定义就是科学化和国际化,科学化的前提是标准化,中医临床实践的科学化首先就要探索诊断技术的标准化;中医理论主要是临床医学的实践理论而不是基础医学理论,循证医学是临床医学模式,循证医学模式应成为中医临床实践的标准化模式,由此推动中医诊断治疗的标准化;沟通中医与西医之桥不在于使中医的传统理论"现代化",而在于共同的疗效评价标准,由此,中医的疗效就能得到国际认可,而实现中医的国际化.     

Men of Medicine

The five-year survival rate for resection of carcinoma of the colon is now 50 per cent. The rate is higher for carcinoma of the right colon than for that of the left colon due to more radical excision of the right colon and mesocolon, heft hemicolectomy with ligation of the inferior mesenteric artery and anastomosis of the transverse colon to the rectal ampulla is the preferred procedure. Carcinoma at or below the peritoneal reflection is treated by abdominoperineal resection plus left hemicolectomy.     

Observation Medicine in Emergency Medicine Residency Programs

OBJECTIVE: To evaluate observation unit (OU) prevalence, emergency medicine (EM) resident exposure in observation medicine (OM), EM faculty/residency director (RD) OM training, and RD attitudes toward OM. METHODS: Information was obtained from residency programs by telephone during a four-month period. RESULTS: Survey respondents indicated that 36.1% have OUs and 44.9% plan to have an OU. Observation medicine resources include textbooks 32.0%, articles 45.9%, lectures 36.9%, fellowships 2.5%, and research 26.2%. Observation medicine patient care occurs: 1) during residency: 25.4% of RDs, 11.3% of entire faculty; 2) as an attending: 45.1% of RDs. CONCLUSIONS: Nearly two-thirds of EM programs have or are planning an OU. Resources are lagging behind. This survey describes current OM education strategies to teach OM.     

Men of Medicine

Although this department of POSTGRADUATE MEDICINE is regularly headed “Men of Medicine,” this month's biographic sketch is devoted to a “woman in medicine,” whose contributions to medical practice and education have been truly outstanding. For these contributions and for her devotion to the highest ideals of her profession, the Editors are pleased to include Dr. Elise L'Esperance in the list of leading contemporary physicians honored in this series.