十二指肠球部溃疡合并幽门螺杆菌感染时胃局部胃泌酸,生长抑素和前…

该研究通过测定十二指肠球部溃疡合并幽门螺杆菌感染患者胃液，胃窦粘膜胃泌素，生长抑素，前列腺素Ｅ２的含量，观察幽门螺杆菌根除后上述指标变化，并与浅表性胃炎患者对照，探讨幽门螺杆菌感染在十二指肠球部溃疡发病中的作用。     

十二指肠溃疡病胃泌素分泌特点的研究

时４组胃十二指肠疾病者及正常对照组作了试餐后血清胃泌素浓度测定。证实十二指肠溃疡病伴有高胃泌素血症；清除其伴随的幽门螺杆菌感染后，其血清胃泌素浓度下降。提示伴随十二指肠溃疡病的高胃泌素血症乃在此特定条件下所获得，清除此诱发因素，可能有利于十二指肠溃疡的愈合。     

穴位按摩及耳穴贴压应用于高血压患者的效果评价

目的 观察穴位按摩及耳穴贴压王不留行籽对高血压患者的疗效.方法 将100例高血压患者随机分为观察组和对照组各50例,观察组在常规应用降压药的同时加用穴位按摩及王不留行籽耳穴贴压治疗.对照组常规应用降压药治疗.比较2组治疗前后血压的变化情况.结果 2组治疗后收缩压及舒张压均显著低于治疗前.降压总有效率观察组为98％,对照组为88％,2组血压控制有效率差异无统计学意义;2组症状疗效比较观察组的总有效率显著高于对照组.结论 穴位按摩及耳穴贴压可作为高血压患者的一种辅助降压手段,能有效地降低血压,尤其对改善头痛、眩晕、急躁易怒等症状效果良好.     

血清试餐胃泌素监测十二指肠溃疡患者幽门螺杆菌根除效果的研究

为探讨十二指肠溃疡（ＤＵ）患者血清试餐胃泌素（ＭＳＧ）对幽门螺杆菌（ＨＰ）感染的反应，评估抗ＨＰ治疗后ＭＳＧ的降低水平及其用于判定ＨＰ根除效果的可靠性，对５２例ＨＰ阳性ＤＵ患者治疗前后分别进行胃镜检查，取胃粘膜ＨＰ培养、病检及快速尿素酶试验，并测定其血清ＭＳＧ浓度。结果发现，ＤＵ患者血清ＭＳＧ浓度（１５４８±６３８ｐｇ／ｍｌ）较对照组（６０９±２５８ｐｇ／ｍｌ）明显升高（Ｐ＜０００１），但经治疗后，ＨＰ被根除者ＭＳＧ明显下降（５６５±１７７ｐｇ／ｍｌ），与治疗前比较差异有非常显著性（Ｐ＜０００１）。ＨＰ未根除者ＭＳＧ下降不明显（１２８２±２３５ｐｇ／ｍｌ），与治疗前比较差异无显著性（Ｐ＞００５）。如果以ＭＳＧ下降率≥３０％视为ＨＰ根除，与ＨＰ培养、病检及尿素酶方法比较，其敏感性为８７０％，特异性为８３３％，阳性预测值９７５％，阴性预测值４５５％，准确性８６５％。提示ＨＰ感染可引起ＤＵ患者血清ＭＳＧ升高，ＨＰ根除后则迅速下降，其一定范围的降低幅度可能对判定ＨＰ根除是一可靠的，无创伤性的较好指标     

幽门螺杆菌感染阴性十二指肠球部溃疡临床研究

十二指肠球部溃疡（DU）是消化系统常见疾病，近年来认为幽门螺杆菌（Hp）感染在溃疡发病机制中有重要作用，其感染率DU71.1％～85.1％。海安李堡中心医院从2000年8月～2006年11月共做胃镜检查7225例，其中检出十二指肠溃疡842例，经Hp检测其中发现幽门螺杆菌感染阴性62例，笔者进行了临床研究，现分析探讨如下。     

耳穴贴压对改善维持性血液透析患者便秘的效果观察

目的探讨耳穴贴压对改善维持性血液透析患者便秘的效果,为临床护理干预提供借鉴。方法选择我院治疗维持性血液透析患者90例,随机分为观察组和对照组各45例。对照组给予基础治疗和护理,观察组在对照组的基础上增加耳穴(大肠、小肠、直肠、脾、肾、内分泌)贴压护理干预。观察两组患者治疗30 d时的效果。结果两组维持性血液透析患者治疗30 d时的疗效比较差异有统计学意义(P<0.01),观察组效果明显好于对照组。结论耳穴贴压可明显改善维持性血液透析患者的便秘症状,操作简便安全。     

耳穴贴压对高血压阴虚体质患者生活质量的影响

目的探讨耳穴贴压对高血压阴虚体质患者生活质量的影响。方法目的性抽样选择杭州市某社区高血压阴虚体质患者76例,按随机数字表法分为干预组和对照组各38例,干预组采用耳穴贴压和常规治疗,对照组为常规治疗,干预时间为12周。于干预前、干预后12周采用健康调查简表(the MOS item short from health survey,SF-36)评定患者的生活质量。结果干预前,两组患者SF-36各维度得分差异均无统计学意义(均P>0.05);干预12周后,干预组患者SF-36中8个维度得分除机体疼痛和活力维度外均较对照组明显提高(P<0.05或P<0.01)。结论耳穴贴压有助于提高高血压阴虚体质患者的生活质量,方法简便可行,具有一定的推广性。     

耳穴贴压缓解骨科患者术后疼痛的效果研究

目的探讨耳穴贴压定点取穴在缓解骨科患者术后疼痛中的应用效果。方法选取2016年1月—12月入院并符合纳入标准的86例骨伤患者为研究对象,将其随机分为试验组与对照组,每组各43例,试验组术后在常规护理的基础上执行定点取穴耳穴贴压,对照组术后予以常规护理,记录两组患者术后疼痛评分、镇痛药物的使用量及两组患者对护理的满意度。结果两组患者术后疼痛数字评分均随着住院时间的推移而降低,且各时间段试验组疼痛评分低于对照组(P<0.05);试验组术后1周布洛芬的平均使用量少于对照组,试验组患者对疼痛护理的满意率较高。结论耳穴贴压定点取穴对缓解骨科患者术后疼痛应用效果良好,患者对护理的满意度高,临床上值得推广应用。     

耳穴贴压治疗乳腺癌患者失眠效果观察

目的观察耳穴贴压治疗乳腺癌患者失眠的临床效果。方法选择2011年6月—2014年5月在普外科住院的符合入组标准的90例患者,按自愿原则分为观察组和对照组各45例,对照组按常规方法治疗和护理,观察组在对照组基础上采取耳穴贴压治疗方法。观察比较1个疗程结束时两组患者临床疗效。结果观察组治疗后失眠症状较治疗前及对照组治疗后明显改善(P0.01)。结论耳穴贴压治疗可以有效改善乳腺癌患者失眠症状,提高其睡眠质量。     

耳穴贴压在大肠癌造口病人症状群中的效果评价

[目的]探讨耳穴贴压在大肠癌造口病人症状群管理中的应用效果。[方法]选择2015年8月—2016年10月大肠癌造口病人80例作为研究对象,按就诊顺序采用随机数字表法分为对照组和观察组各40例。对照组给予大肠癌造口术后常规护理,观察组在术后常规护理基础上实施耳穴贴压。于干预前和干预2周后使用中文版安德森症状评估量表(Chinese version of the M.D.Anderson Symptom Inventory,MDASI-C)比较两组病人多种症状的改善情况。[结果]两组病人干预后大多数癌症相关症状有不同程度的改善,且观察组在疼痛、乏力、睡眠不安、困倦的改善上优于对照组(均P0.05)。[结论]在常规护理基础上给予耳穴贴压能够改善大肠癌造口病人部分癌症相关症状,有助于大肠癌病人症状群的管理。     

Effect of vagotomy on gastrin secretion in patients with duodenal ulcer

The basal and food-stimulated gastrin secretion after selective proximal vagotomy, selective gastric vagotomy and truncular vagotomy was found to be elevated. Hypergastrinemia increased as gastric secretion was inhibited, thus attesting to the role of acid formation inhibition in the origin of the postvagotomy increase in the hormonal secretion. However the values of the intragastral pH being equal, the blood gastrin level was higher after vagotomy as compared to that seen in unoperated peptic ulcer patients. After vagotomy coupled with antrumectomy gastrin secretion remained at the level seen in the unoperated patients, indirect evidence for increased function of extraantral G cells. Inhibition of gastric secretion is no single cause of the postvagotomy hypergastrinemia, since the latter was essentially increased in the early postoperative times and in the presence of the vagotomy-induced disorders. It is concluded that increased secretion of gastrin after vagotomy secures trophic and compensatory-adaptation processes.     

耳穴贴压对ICU患者紧急抢救时邻床清醒患者应激反应的影响

目的探讨耳穴贴压对重症监护病房（intensiveeareunit,ICU）患者紧急抢救时邻床清醒患者应激反应的影响。方法采用随机数字表法,将50例入住ICU的清醒患者分为试验组和对照组,每组各25例。抢救时两组患者均常规给予干预措施（所有邻床清醒患者用围帘隔开、专职护士进行心理护理）,试验组在此基础上采用耳穴贴压。观察两组患者在抢救时即刻（0min）、30min、1h心率、收缩压、血糖、血浆儿茶酚胺（肾上腺素、去甲肾上腺素）、皮质醇指标情况的差异。结果抢救时30min、1h试验组患者各项应激指标均低于对照组,两组比较,差异具有统计学意义（均P〈0．05）。结论耳穴贴压对降低ICU患者紧急抢救时邻床清醒患者应激反应具有较好的效果。     

耳穴贴压对胃癌病人术后胃肠功能恢复影响的Meta分析

目的:系统评价耳穴贴压对胃癌病人术后胃肠功能恢复的干预效果。方法:计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台(WanFang Data)、中文科技期刊数据库(VIP)、PubMed、EMbase、Web of Science、CINAHL(EBSCO Host)和Cochrane临床对照实验中心注册数据库(Cochrane Central Register of Controlled Trials,CENTRAL)中关于耳穴贴压对胃癌病人术后胃肠功能恢复的随机对照试验及半随机对照试验。检索时间为建库至2020年5月31日。依据文献纳入及排除标准进行筛查、提取资料,利用Cochrane手册5.1.0推荐的随机对照试验偏倚风险评估工具评价文献质量,采用RevMan 5.2软件进行Meta分析。结果:最终纳入12项研究,包括1370例研究对象。Meta分析结果显示,术前对干预组病人采用耳穴贴压,肛门首次排气时间短于对照组接受常规护理的病人[MD=-34.52,95%CI(-48.24,-20.81),P<0.00001],术后干预组肛门首次排气时间短于对照组病人[MD=-11.92,95%CI(-14.39,-9.44),P<0.00001],术前干预组首次排便时间短于对照组病人[MD=-34.98,95%CI(-47.69,-22.26),P<0.00001],术后干预组首次排便时间短于对照组病人[MD=-10.62,95%CI(-15.86,-5.37),P<0.0001],术后干预组肠鸣音恢复时间短于对照组病人[MD=-7.58,95%CI(-10.25,-4.92),P<0.00001],术后干预组腹胀消失时间短于对照组病人[MD=-3.46,95%CI(-4.76,-2.16),P<0.00001]。结论:现有证据表明,耳穴贴压能够有效改善胃癌病人术后的胃肠功能情况。由于本研究评价指标间存在异质性,因此,需要更多临床多中心、大样本、高质量的研究进一步评价耳穴贴压对胃癌术后病人胃肠功能恢复的综合效果。     

耳穴磁疗联合止吐药多模式治疗甲状腺切除术患者术后恶心呕吐的疗效分析

目的:探讨耳穴磁疗对甲状腺切除术患者术后恶心、呕吐(postoperative nausea and vomiting,PONV)及伤口疼痛的治疗效果。方法:46例接受甲状腺手术的患者随机分为多模式组(M组)和单一模式组(S组),各23例。M组给予耳穴磁疗联合格拉司琼和地塞米松以预防PONV,S组仅给予格拉司琼和地塞米松。比较两组术后0~2h、2~6h、6~24h、0~24h的PONV发生率和术后视觉模拟疼痛评分(visual analogue scale,VAS)。结果:M组完成随访23例,S组完成随访20例,纳入研究。两组患者的一般资料、手术时间和麻醉时间差异均无统计学意义。两组患者既往PONV史、晕动病史及吸烟史差异无统计学意义。两组患者术中舒芬太尼使用量差异无统计学意义。M组术后0~2h、2~6h、6~24h、0~24h恶心发生率均低于S组(P0.05);M组术后0~2h和0~24h呕吐发生率低于S组(P0.05)。M组术后PONV管理满意度高于S组(P=0.004)。两组患者术后止吐药物使用率差异无统计学意义。M组术后2h和6hVAS评分均低于S组(P0.05);两组患者术后24hVAS评分差异无统计学意义。两组术后拔管时间、对指令有反应时间和24h恢复质量评分差异均无统计学意义。结论:与单一用药模式相比,耳穴磁疗联合止吐药的多模式治疗能显著降低甲状腺切除术患者PONV发生率,同时可减轻患者术后早期伤口疼痛。     

Characteristics of disordered duodenal acidification in patients with duodenal peptic ulcer

Duodenal acidification was studied in 53 peptic ulcer patients. Gastric and duodenal pH was studied using an electric probe with silver chloride and antimony electrodes. For a study of the mechanisms of changes of duodenal acidification gastrin was investigated using various exercise tests. Two types of disorders of duodenal acidification were established in the patients: related and unrelated to the vagus nerve. Characterization of the mechanism of disorders of duodenal acidification was provided. A study of duodenal acidification in peptic ulcer gave an opportunity for the development of effective pathogenetically substantiated therapeutic measures.     

Quality of life in patients with duodenal ulcer

AIM: To examine influence of duodenal ulcer (DU) on quality of life (QL) and changes in QL after different DU treatments. MATERIAL AND METHODS: QL in DU was assessed with Russian version of SF-36 questionnaire in 66 DUpatients with Helicobacter pylori (HP) aged 16-80 years (mean age 44.6 +/- 17.3 years). RESULTS: DU healing was achieved after 2 weeks of therapy with ranitidine (300 mg/day), amoxicilline (2000 mg/day), metronidasole (1000 mg/day), and famotidin (40 mg/day), amoxicilline (2000 mg/day, clarithromycin (1000 mg/day) in 69.2 and 94.9% cases (p = 0.04), after 4 weeks--88.2 and 96.8%, rrespectively (p = 0.52). Hospital stay was 16.1 +/- 2.1 and 22.2 +/- 3.4 (p < 0.05), respectively. Exacerbation of DU leads to deterioration of QL according to all the SF-36 scales. Four weeks of therapy produced a statistically significant (p < 0.05) improvement of QL by all the scales. In failure of HP eradication QL worsened. CONCLUSION: QL is low in exacerbation of DU associated with HP. Antihelicobacter therapy improves QL of DUpatients. QL investigations help to select most effective therapy.     

Efficacy of galavit in patients with duodenal ulcer

The aim of the study was to investigate clinical efficacy of the medical complex Galavit in patients with acute phase of duodenal ulcer (DU) in. The subjects were 60 DU patients aged 32 +/- 2 years with ulcerous defects of 0.4 to 1.3 cm in diameter. In patients receiving Galavit, pain was coped with by Mann-Whitney method in 2.5 +/- 0.2 days, p < 0.001; in the control group--in 5.7 +/- 0.1 days. In the Galavit group the ulcers healed in 11.3 +/- 0.2 days, p < 0.001; in the control group--17.8 +/- 0.3 days; in 4 cases (13.3%) the ulcerous defects healed with forming of rough scars. Galavit elevated T-lymphocyte rate from 53.1 +/- 0.6% to 65.1 +/- 0.2%, p < 0.001; T-helper inductor level--from 27.8 +/- 0.2% to 38.5 +/- 0.3%, p < 0.001; cytotoxic T-lymphocyte level--from 18.5 +/- 0.5% to 27.3 +/- 0.3%, p < 0.001; B-lymphocyte level--from 12.3 +/- 0.2% to 19.1 +/- 0.1%, p < 0.001. The therapy significantly lowered malonic aldehyde level by 23.5%, trienoic conjugate level--by 61.6%; superoxide dismutase level rose 1.6 times, catalase level--1.4 times, glutathion reductase level--from 19.03 +/- 1.17 to 27.01 +/- 1.24 optical density units/mg, p < 0.001. The study did not find any significant changes in the immune status and lipid peroxidative/antioxidative system of patients receiving basic therapy. The results show that Galavit has anti-inflammatory effect, improves immune status and anti-oxidative protection. It is appropriate to administer Galavit as a component of DU basic therapy. The results show that Galavit has anti-inflammatory effect, improves immune status and anti-oxidative protection. It is appropriate to administer Galavit as a component of DU basic therapy.     

Effect of auricular pellet acupressure on antioxidative systems in high-risk diabetes mellitus

OBJECTIVES: Free radicals and lipid peroxides, both of which are easily formed in the diabetic state, play an important role in the development of diabetic complications. Antioxidative therapy may help prevent diabetic complications caused by lipoperoxidation and free-radical formation in diabetes mellitus (DM). A number of findings suggest that oxidative stress exists in persons with high-risk DM. Auricular pellet acupressure has reportedly been an effective treatment method for a variety of medical conditions, including anxiety, juvenile myopia, essential hypertension, and senile vascular dementia. However, its effects on antioxidative enzymes have not been elucidated. We therefore evaluated the impact of auricular pellet acupressure on antioxidative status in persons with high-risk DM. SUBJECTS: Our study involved 69 persons with high-risk DM, who were allocated either to undergo acupressure as active treatment for the experimental group or to a control group. INTERVENTIONS: The experimental group in the study received auricular pellet acupressure three times daily for 5 consecutive days. After a 2-day rest period, the procedure was performed on the contralateral ear. Acupressure was performed twice on each ear, with each application followed by its application to the contralateral ear, over a total treatment period of 20 days. The control groups did not undergo auricular pellet acupressure. DESIGN AND OUTCOME MEASURES: At the end of the 20-day period of treatment of the experimental group, blood was collected from all of the study participants for assay of serum superoxide dismutase (SOD) and catalase concentrations, as was also done for the control group. RESULTS: Serum concentrations of SOD (p < 0.05) and catalase (p < 0.0001) were significantly higher in the experimental group than in the control group. CONCLUSIONS: Our findings suggest that auricular pellet acupressure can increase the concentration of antioxidative enzymes in persons with high-risk DM.