体外冲击波疗法治疗胫骨结节骨软骨炎的疗效观察

目的 观察体外冲击波疗法对胫骨结节骨软骨炎患者的临床疗效.方法 将60例胫骨结节骨软骨炎患者采用随机数字表法分为试验组和对照组,每组各30例.试验组采用体外冲击波疗法;对照组采用微波治疗、减少运动量和充分休息局部制动.结果 试验组和对照组治疗后胫骨结节部疼痛目测类比评分较治疗前均明显降低(P<0.05),分别为(2.2±1.3)分比(7.9±2.4)分、(4.8±2.6)分比(8.2±2.5)分,且试验组明显优于对照组(P<0.05).试验组治愈率[83.33%(25/30)]明显高于对照组[63.33%(19/30)],差异有统计学意义(P<0.05).结论 体外冲击波疗法是胫骨结节骨软骨炎的一种有效治疗方法.     

中西医结合治疗复发性口腔溃疡的临床疗效分析

目的：分析中西医结合治疗复发性口腔溃疡的临床疗效。方法：收集我院2010年3月-2013年3月期间诊治的复发性口腔溃疡患者200例作为研究对象，以抛硬币的方式分为试验组与对照组，每组患者各100例。对照组患者单纯采用西药治疗，试验组采用中西医结合治疗，对两组患者的治疗效果进行分析对比。结果：研究结果显示，试验组中有79例（79．0％）显效，19例（19．0％）有效，2例（2．0％）无效，总有效率为98．0％；对照组中有66例（66．0％）显效，20例（20．0％）有效，14例（14．0％）无效，总有效率为86．0％，试验组患者的治疗效果明显优于对照组（P〈0．05）。结论：中西医结合治疗复发性口腔溃疡具有良好的临床疗效，能有效提高治疗效果，值得在临床应用上推广。     

中医中药辨证施治治疗脑血管痉挛性头痛临床分析

目的：分析中医中药辨证施治治疗脑血管痉挛性头痛的临床疗效。方法：收集我院2011年11月--2013年11月期间诊治的脑血管痉挛性头痛患者100例作为研究对象,采用随机分组的方式将患者分为试验组与对照组,每组患者各50例。对照组患者采用西医对症治疗,试验组采用中医中药辨证施治治疗,对两组患者的治疗效果进行分析对比。结果：研究结果显示,试验组中有33例（66．0％）显效,14例（28．0％）有效,3例（6．0％）无效,总有效率为94．0％;对照组中有16例（32．0％）显效,18例（36．0％）有效,16例（32．0％）无效,总有效率为68．0％,试验组患者的显效率和总有效率明显高于对照组（P〈0．05）。结论：中医中药辨证施治治疗脑血管痉挛性头痛具有良好的临床疗效,值得在临床应用上推广。     

推拿牵引加中药治疗腰椎间盘突出症60例临床分析

目的评价推拿牵引加中药治疗腰间盘突出症的临床效果，与单纯的牵引加中药治疗相比较。方法对120例腰椎间盘突出症患者随机分为推拿牵引加中药治疗组60例（治疗组），单纯牵引中药治疗组60例（对照组），观察比较两组疗效。结果治疗组治愈42例，占70％；显效15例，占25％；有效3例，占5％；无效0例，总有效率为100％；对照组治愈21例，占35％；显效16例，占26．67％；有效10例，占16．67％；无效13例，占21．67％，总有效率为78．3％。结论推拿牵引加中药治疗腰椎间盘突出症优于单纯牵引加中药治疗。     

改良细导管引流治疗肝硬化腹腔积液的疗效观察

目的观察和评价改良细导管引流治疗肝硬化大量腹腔积液的疗效和安全性。方法将80例肝硬化大量腹腔积液患者按住院顺序随机分为治疗组和对照组，每组40例。治疗组予改良细导管引流术治疗，对照组予传统的腹腔穿刺抽液术治疗，观察两组疗效。结果治疗组显效11例，有效22例，无效7例，总有效率为82．5％（33／40）；对照组显效9例，有效10例，无效21例，总有效率为47．5％（19／40），治疗组总有效率显著优于对照组，差异有统计学意义（P〈0．01），且未见明显不良反应。结论改良细导管引流治疗肝硬化大量腹腔积液安全、有效、经济，且并发症少，值得基层医院推广。     

妇科抗炎Ⅱ号胶囊治疗慢性盆腔炎的疗效观察

目的：研究妇科抗炎Ⅱ号胶囊治疗慢性盆腔炎的临床疗效。方法：将符合纳入标准的700例慢性盆腔炎患者，按就诊序号及按随机数字表法分为3组：即治疗组240例，西药对照组230例，中成药对照组230例。结果：3组均对照观察治疗3个疗程（30天）后，治疗组240例中临床治愈率为65．83％，显效率占22．51％，有效率占8．33％，无效率占为3．33％，总有效率占96．67％；西药对照组230例中，痊愈占36．96％，显效率占19．50％，有效占13．90％，无效占29．57％，总有效率70．43％；中成药对照组230例，痊愈占39．13％，显效占20．80％，有效占14．78％，无效占25．22％，总有效率74．78％。治疗组总有效率与中成药对照组比较经卡方检验P〈0．05；与西药对照组比较P〈0．01。说明治疗组疗效明显优于中、西药对照组。结论：妇科抗炎Ⅱ号胶囊治疗慢性盆腔炎取得显著的临床疗效。     

低分子肝素与冠心宁注射液合用治疗不稳定性心绞痛疗效观察

目的观察低分子肝素合用冠心宁注射液治疗不稳定性心绞痛的疗效。方法120例患者随机分成对照组和治疗组,每组60例;疗程14d。对照组采用包括卧床休息、吸氧及药物阿司匹林、B受体阻滞剂、钙拮抗剂及硝酸酯类常规治疗。治疗组在对照组的基础上加用低分子肝素（速避凝）0．3ml,腹壁皮下注射,冠心宁注射液20ml静脉滴入,以上两药物均1次／d,持续14d。结果心绞痛疗效：对照组和治疗组显效率分别为26．67％和58．33％,总有效率分别为56．67％和88．33％（P〈0．05）。心电图疗效：对照组和治疗组显效率分别为26．67％和60．0％,总有效率分别为53．33％和91．67％（P〈0．05）。治疗组血粘度明显降低。结论两组患者治疗结果差别显著,两药台用治疗不稳定性心绞痛安全、有效,可降低心绞痛的发生。     

金乌骨通胶囊治疗膝关节骨性关节炎59例临床观察

目的观察金乌骨通胶囊治疗膝关节骨性关节炎的临床疗效。方法将116例膝骨性关节炎患者随机分为乌骨通胶囊组（59例）和天麻杜仲胶囊组（57例），治疗30d。结果乌骨通胶囊组痊愈3例，显效16例，有效38例，无效2例，有效率96．61％；天麻杜仲胶囊组痊愈0例，显效12例，有效34例，无效11例，有效率80．70％。两组比较差异有显著性（P〈0．01）。结论金乌骨通胶囊治疗膝骨性关节炎有较好的疗效，且疗效明显优于天麻杜仲胶囊。     

米索前列醇与催产素对足月妊娠患者促宫颈成熟的临床效果分析

目的探讨米索前列醇与催产素用于产科临床引产的疗效。方法选择68例住院分娩有引产指衙的单胎、头位、胎膜完整、宫颈评分≤4分的足月妊娠初产妇，随机分为观察组与对照组各34例。结果观察组显效15例（44．1％）、有效18例（52．9％）、无效1例（2．9％），总有效率为97．1％；对照组显效8例（23．5％）、有效15例（44．1％）、无效11例（32．4％），总有效率为67．6％。结论观察组有效率明显高于对照组。两组总有效率比较，差异有统计学意义（x^2=10．04，P〈0．01）。     

尿毒清颗粒配合爱希特灌肠治疗慢性肾功能衰竭疗效观察

目的：探讨尿毒清颗粒配合爱希特治疗轻-中度慢性肾功能衰竭的临床疗效。方法：选择慢性慢功能衰竭60例，随机分为对照组及治疗组两组，每组各30例，两组进行显效、有效、无效比较。结果：治疗组，显效率30％、有效率47％、无效23％，对照组、显效率10％、有效33％、无效率37％，治疗组总有效率明显高于对照组（P〈0．01）结论：尿毒清颗粒口服配合爱希特灌肠联合应用方法，治疗慢性肾衰疗效明显。     

The Functional Pain Scale: reliability,validity, and responsiveness in an elderly population

OBJECTIVES: Because of difficulty experienced in assessing pain in frail older patients and the lack of pain assessment tools with standardization in the elderly, the Functional Pain Scale (FPS), an instrument incorporating both subjective and objective components to assess pain, was developed and evaluated. DESIGN, SETTING, PARTICIPANTS, AND MEASURES: One hundred subjects more than 65 years old participated in the validity, reliability, and responsiveness (the clinical sensitivity of the instrument to change) testing of the Functional Pain Scale. Subjects were recruited from a geriatrics inpatient setting, a geriatrics outpatient setting, and a local hospice (residing in their homes). Ninety-four of the subjects completed all phases of testing. Reliability was tested using a test-retest format and a correlation matrix. Criterion-related validity was established as compared with the Visual Analog Scale (VAS), the Present Pain Intensity (PPI), the McGill Short Form Questionnaire (MPQ-SF), and the Numeric Pain Scale (NPS) instruments. Responsiveness for the FPS, the VAS, the PPI, the MPQ-SF, and the NPS instruments was determined using five previously described techniques: effect size, standardized response means, relative efficiency, direct comparison of t test scores, and direct comparison of P values. A cumulative index was developed to rank each scale. Cumulative responsiveness index scores were based on individual scale performance for each separate responsiveness test. The lowest score in the cumulative responsiveness index indicated the most responsive scale. RESULTS: Interrater reliability for instruments tested exceeded 0.95 for all instruments tested. Validity testing showed high correlations as well (r = 0.62, r = 0.85, r = 0.80, r = 0.90 for the VAS, the PPI, the MPQ-SF, and the NPS respectively). Responsiveness evaluated overall by the responsiveness index was best for the Functional Pain Scale (7) followed by the Visual Analog Scale (12), the Present Pain Intensity (13), the McGill Pain Questionnaire-Short Form (19), and the Numerical Pain Questionnaire (24). CONCLUSIONS: The Functional Pain Scale was determined to be reliable, valid, and responsive. The responsiveness of the Functional Pain Scale was superior to the other instruments tested. The Functional Pain Scale is an acceptable instrument for assessing pain in older adults and may reflect changes in pain better than other instruments tested. Further testing in other populations is warranted.     

A questionnaire found disease-specific WORC index is not more responsive than SPADI and OSS in rotator cuff disease

ObjectivesTo compare responsiveness and minimal clinically important change (MCIC) for the disease-specific Western Ontario Rotator Cuff index (WORC) and the two region-specific questionnaires Shoulder Pain and Disability Index (SPADI) and Oxford Shoulder Scale (OSS) in patients with rotator cuff disease receiving corticosteroid injection therapy.Study Design and SettingOne hundred twenty-one patients with rotator cuff disease. Western Ontario Rotator Cuff index, SPADI, and OSS were administered before treatment and at 2 and 6 weeks after corticosteroid injection. Responsiveness was compared between questionnaires using the standardized response mean (SRM), area under the receiver operating characteristic curve, and reliable change proportion (RCP) statistics. Minimal clinically important change estimates were reported.ResultsThe differences between questionnaires were small and not consistent across the different responsiveness indices. Shoulder Pain and Disability Index was significantly more responsive than OSS measured by SRM and RCP at 2 and 6 weeks. Western Ontario Rotator Cuff index was significantly more responsive than OSS in RCP and area under receiver operating characteristic curve at 6 weeks. Shoulder Pain and Disability Index was significantly more responsive than WORC measured by RCP at 2 weeks. Minimal clinically important change was estimated to 5, 275, and 20 points for OSS, WORC, and SPADI, respectively.ConclusionsAll questionnaires are suitable for measuring change in patients with rotator cuff disease. Disease-specific WORC index is not more responsive than the region-specific SPADI and OSS in rotator cuff disease.     

Conducting a needs assessment to justify the provision of occupational therapy services in a rheumatology outpatient clinic

Investigating the best method of service delivery, or the 'need' for a particular service is gaining increasing support as demands intensify across the health-care system, often with reduced financial resources. Following a restructuring within the Occupational Therapy department at the Austin and Repatriation Medical Centre, a limited amount of time (0.2 EFT Grade II) became available to provide additional services within the hospital. Occupational therapy services to patients of the rheumatology outpatient clinics had ceased since funding cuts approximately 7 years before, yet there had been numerous requests for service. As part of quality assurance activities, a needs assessment was conducted, interviewing clients attending these outpatient clinics. The Health Assessment Questionnaire, a Visual Analogue Scale for Pain, and a non-standardised questionnaire were used to assess the need for occupational therapy by this patient group. Thirty-five people were interviewed over a period of 2 weeks. The results supported increased occupational therapy involvement with this client population within the rheumatology outpatient clinic specifically in the areas of improving functional performance, pain management and hand therapy. The study also highlighted a need for promotion of the occupational therapy role both with clients and the medical staff.     

音乐、心理疗法用于糖尿病治疗的评价

目的观察音乐、心理疗法治疗糖尿病的作用。方法应用抑郁自评量表、糖尿病生活质量测评量表对120例糖尿病患者评定，其中治疗组60例，给予音乐治疗、心理干预及糖尿病综合治疗，对照组60例，常规治疗。结果治疗1个月、3个月后空腹血糖、餐后2h血糖、糖化血红蛋白、血压，治疗组比对照组明显下降，且血糖波动小。结论音乐、心理干预治疗可改善糖尿病患者糖代谢及抑郁症状。     

醛糖还原酶抑制剂对糖尿病周围神经病变的疗效观察

目的观察醛糖还原酶抑制剂依帕司他治疗糖尿病周围神经病变的有效性及安全性，方法临床确诊糖尿病周围神经病变（DNP）的80名患者随机分为试验组和对照组,分别给予依帕司他（50mg,3次/d）和甲钴胺（50mg,3次/d）治疗16周,治疗期间评价患者症状、体征及左侧正中神经、尺神经、腓神经和胫神经感觉神经传导速度（SNCV），结果两组治疗有同等改善,治疗后较治疗前主观症状（分别由治疗前20，35和18，57降至治疗后9，16和11，18）和客观评估（分别由治疗前5，50和5，00降至治疗后3，63和3，95）均有显著性改善,试验组胫后神经（治疗前41，02 m/s升至治疗后47，44m/s）、腓神经（治疗前33，34 m/s升至治疗后41，27m/s）及对照组正中神经（治疗前40，07 m/s升至治疗后46，75 m/s）、胫后神经（治疗前32，34 m/s升至治疗后45，30 m/s）SNCV均有改善（P＜0，05），结论依帕司他治疗糖尿病周围神经病变安全有效。     

The quality of life outcome following treatment for lower urinary tract symptoms

This study aims to assess the impact of medical and surgical treatment on treating lower urinary tract symptoms (LUTS) on pain, prostatic symptoms, disease-specific quality of life and health-related quality of life. Patients scheduled for medical (alpha-blockers) and surgical treatment (transurethral resection of the prostate, TURP) were recruited in the study. The patients were assessed using the Visual Analogue Scale (VAS), Present Pain Intensity (PPI), International Prostate Symptom Score (I-PSS) and Health-Related Quality of Life (HRQOL) at 3-month, 6-month and 12-month (baseline). Before treatment, most of the patients with LUTS had severe pain, LUTS and deterioration of health-related quality of life. Following treatment, both medical and surgical treatment improved their pain, LUTS and health-related quality of life. Both treatments are effective in relieving the symptoms of pain, LUTS and health-related quality of life.     

Are improvements in shame and self‐compassion early in eating disorders treatment associated with better patient outcomes?

Compassion‐focused therapy (CFT; Gilbert, 2005, 2009) is a transdiagnostic treatment approach focused on building self‐compassion and reducing shame. It is based on the theory that feelings of shame contribute to the maintenance of psychopathology, whereas self‐compassion contributes to the alleviation of shame and psychopathology. We sought to test this theory in a transdiagnostic sample of eating disorder patients by examining whether larger improvements in shame and self‐compassion early in treatment would facilitate faster eating disorder symptom remission over 12 weeks. Participants were 97 patients with an eating disorder admitted to specialized day hospital or inpatient treatment. They completed the Eating Disorder Examination‐Questionnaire, Experiences of Shame Scale, and Self‐Compassion Scale at intake, and again after weeks 3, 6, 9, and 12. Multilevel modeling revealed that patients who experienced greater decreases in their level of shame in the first 4 weeks of treatment had faster decreases in their eating disorder symptoms over 12 weeks of treatment. In addition, patients who had greater increases in their level of self‐compassion early in treatment had faster decreases in their feelings of shame over 12 weeks, even when controlling for their early change in eating disorder symptoms. These results suggest that CFT theory may help to explain the maintenance of eating disorders. Clinically, findings suggest that intervening with shame early in treatment, perhaps by building patients' self‐compassion, may promote better eating disorders treatment response. (Int J Eat Disord 2014; 47:54–64)     

Pain characteristics and pain catastrophizing in incarcerated women with chronic pain

Chronic pain in incarcerated women is understudied and poorly described. Study objectives were to describe pain characteristics, correlates, and predictors in a convenience sample of incarcerated women with chronic pain. A survey packet that included the Brief Pain Inventory Short Form (BPI-SF) and the Pain Catastrophizing Scale (PCS) was distributed to all inmates at a state prison for women. Those who self-identified as having chronic pain ≥4 on a 0-10 numeric rating scale were invited to complete the survey. Demographics and medical and psychiatric diagnoses were abstracted by chart review. Participants (N=159) rated their current and average pain intensity as severe. Pain catastrophizing was found to predict average pain intensity and level of pain-related interference in functioning. Pain catastrophizing is treatable with behavioral intervention in the general population. Findings suggest that pain catastrophizing may be an important target for research and treatment in incarcerated women with chronic pain.     

“治未病”理论在类风湿性关节炎中医护理中的应用

目的探讨"治未病"理论在类风湿性关节炎患者临床护理中的应用。方法将来我院就诊的符合类风湿性关节炎诊断标准的60例患者随机分为治未病组30例和对照组30例。将"治未病"理论应用于类风湿性关节炎患者的健康教育中,从中医辨证施护、心理、饮食、用药、功能锻炼等方面进行护理。患者入院时及入院2 w后应用11点疼痛程度数字等级量表(Pain Intensity Numerical Rating Scale,PI-NRS)来测定观察护理前后疼痛强度(PI)、疼痛缓解度(PAR)的变化,对镇痛有效率进行评价。结果入院时及入院2 w后两组患者疼痛强度(PI)、疼痛缓解度(PAR)、镇痛显效率及总有效率比较,差异均有统计学意义(p<0.05)。结论 "治未病"理论应用于类风湿性关节炎患者的临床护理中,在减轻患者疼痛、提高患者生存质量方面具有良好的效果。     

The effects of powdered fertilized eggs on depression

This 12-week, double-blind, placebo-controlled study investigated the effects of fertilized egg powder (Young Tissue Extract; YT?) intake on outcome measures for depression. Fifty-five patients with depression were randomly assigned to receive YTE, YTE plus Melissa officinalis, or placebo for 12 weeks. At baseline, there were no significant differences in scores on the Hamilton Depression Rating Scale (HAM-D) or Beck Depression Inventory II (BDI-II) among the 3 groups. At 12 weeks, the HAM-D scores in groups treated with YTE or YTE with M. officinalis were both significantly lower than those in the placebo group. In addition, both treatment groups showed a significant improvement in depression as measured by the change in HAM-D scores from baseline to 12 weeks, whereas the placebo group showed no significant change. There were no significant differences between the 2 treatment groups. The study indicates that the fertilized egg powder has an antidepressive effect and may be an alternative or adjunct to antidepressive medication for some patients, but further research is necessary.