耳针配合刺络拔罐治疗带状疱疹36例

[目的]探讨耳针配合刺络拔罐治疗带状疱疹的效果。[方法]将72例患者按照数字表法随机分为两组,观察组与对照组各36例患者。观察组给予耳针配合刺络拔罐治疗,对照组给予常规西药治疗。记录两组患者的治疗效果、有无后遗神经痛、疼痛评分(VAS)及症状体征量化积分。[结果]观察组患者治疗的总有效率达100%,明显高于对照组的77.78%(P0.05)。观察组患者的后遗神经痛的发生率为0.00%,明显低于对照组的25.00%(P0.01)。治疗1个疗程后,两组患者的症状体征量化积分及VAS评分均显著性降低(P0.05),且观察组下降幅度更大(P0.05);治疗2个疗程,两组患者的症状体征量化积分及VAS评分大幅改善(P0.05),但是两组患者间症状体征量化积分、VAS评分均无统计学差异(P0.05)。[结论]耳针配合刺络拔罐治疗带状疱疹,见效快且无后遗神经痛,治疗效果显著。     

华蟾素局部注射加针灸围刺治疗眼睑带状疱疹

目的 观察华蟾素注射液局部注射加针灸围刺治疗带状疱疹的疗效.方法 将确诊为眼睑带状疱疹的患者(50例),用75％乙醇消毒病灶,用1寸的针灸针,针尖向病灶中心围刺,针尖距病灶皮肤边缘约3mm,体针取合谷穴,留针15 min,取针后,在眼睑、颜面、发际,取3个病变严重部位,注射华蟾素各1ml,每日1次,5次为1个疗程 结果 50例患者的皮肤疱疹均在用药后2～7 d消失,10d皮肤恢复正常.结论 华蟾素注射液局部注射加针灸围刺治疗眼睑带状疱疹疗效确切,值得在临床上推广应用.     

新癀片治疗带状疱疹有效性和安全性的系统评价

[目的] 系统评价新癀片治疗带状疱疹的有效性和安全性。[方法] 双人计算机检索中文数据库包括中国知网、万方数据库、维普数据库、中国生物医学文献数据库,外文数据库包括PubMed、Embase、Cochrane library,共7个中英文数据库。检索新癀片治疗带状疱疹有效性与安全性的随机对照试验（RCT）相关文献,各数据库检索时限为建库至2023年2月7日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.4软件进行Meta分析。[结果] 共纳入10个RCTs,包括820例患者。Meta分析结果显示,新癀片联合西医常规与单用西医常规治疗相比可降低带状疱疹患者视觉模拟评分法（VAS）评分[MD=-0.93,95% CI（-1.57,-0.28）,P=0.005],显著提升总有效率[RR=1.24,95% CI（1.12,1.37）,P<0.000 1]和治愈率[RR=1.68,95% CI（1.43,1.96）,P<0.000 01],缩短止痛时间[MD=-2.13,95% CI（-3.02,-1.23）,P<0.000 01],止疱时间[MD=-1.50,95% CI（-2.70,-0.29）,P=0.02],结痂时间[MD=-2.03,95% CI（-2.94,-1.11）,P<0.000 1]和痊愈时间[MD=-2.27,95% CI（-3.27,-1.27）,P<0.000 01]。新癀片联合组对比常规组不良反应发生率无明显差异。[结论] 现有证据表明,新癀片联合西医常规治疗使用可降低VAS评分,提高治疗的有效率和治愈率,缩短带状疱疹止痛、止疱、结痂和痊愈时间,安全性方面较好。由于受到纳入研究数量和质量的限制,上述结论仍有待于高质量研究进一步验证。     

Observation on efficacy of acupuncture combined with rehabilitation training for post-stroke balance disorders

ObjectiveTo comparatively analyze clinical efficacy of treating post-stroke balance disorders with trunk muscles acupuncture combined with rehabilitation training and rehabilitation training alone.MethodsIn a randomized control study, 59 patients were randomly divided into two groups in sequence of admission. Both groups were given conventional medical treatment; the acupuncture combined with rehabilitation training group (group A, 30 cases) was treated with trunk muscles acupuncture combined with rehabilitation training, and the rehabilitation training group (group B, 29 cases) was treated with rehabilitation training alone. Both groups were treated six times per week with four weeks as a course of treatment, and a total of four courses were given. Before and after treatment, efficacy of balance function and integral of activities of daily living (ADL) of patients were evaluated.ResultsThe score of balance function of patients in group A and in group B after treatment (38.47 ± 11.34, 32.55 ± 10.02) was higher than that in the two groups before treatment (14.56 ± 6.00, 13.51 ± 6.28), and the differences were statistically significant (both P<0.05). After treatment, the score of balance function of patients in group A was higher than that in group B (P<0.05). The score of ADL of patients in group A and in group B after treatment (61.33 ± 18.47, 51.72 ± 17.28) was higher than that in the two groups before treatment (22.50 ± 6.79, 24.48 ± 7.23), and the differences were statistically significant (both P<0.05). After treatment, the score of ADL of patients in group A was higher than that in group B (P<0.05).ConclusionThe balance function and ADL of patients with post-stroke balance disorders could be improved with trunk muscles acupuncture combined with rehabilitation training, and its efficacy was superior to rehabilitation training alone.     

丹参制剂治疗带状疱疹随机对照试验的系统评价

目的评价丹参制剂治疗带状疱疹的疗效。方法计算机检索Cochrane图书馆随机对照试验库(CCTR)、MEDLINE、中国生物医学数据库(CBM)、清华期刊全文数据库(CNK I)、万方数据库;手工检索和2009年1—10月的10余种中文医学期刊。对所纳入的研究进行方法学质量评价和M eta分析。结果共检索到13个符合纳入标准的临床试验,共计1 285例患者。M eta分析显示丹参制剂治疗带状疱疹与同期随机对照的西药基础治疗组相比临床疗效更好,且能减少带状疱疹后遗神经痛。结论本研究提示丹参制剂治疗带状疱疹与西药基础治疗相比,可提高临床疗效。但由于纳入的临床试验方法学质量相对偏低,样本量偏小,尚需更多高质量的研究来加以验证。     

Observation on clinical efficacy of tension-balance acupuncture therapy in treating knee osteoarthritis

ObjectiveBy comparison of the clinical efficacy of treating knee osteoarthritis with tension-balance acupuncture therapy and conventional acupuncture therapy, the effectiveness of treatment of knee osteoarthritis with tension-balance acupuncture therapy was evaluated.MethodsSixty-three patients with knee osteoarthritis in conformity with the diagnostic criteria were randomly divided into the tension-balance-acupuncture group (32 cases, balance group for short) and the conventional acupuncture group (31 cases, conventional group for short) according to random number table. In the balance group, patients with the pain in the anterior flexor group were needled at Bìguān (

ST 31), Fēngshì (

GB 31), Hèd

ng (

EX-LE 2), Dúbí (

ST 35), Yánglíngquán (

GB 34), Xuèh?i (

SP 10) and Liángqiū (

ST 34). Afterwards the patients were repositioned in prone position. They were given the treatment by needling at Huántiáo (

GB 30), Chéngfú (

BL 36), W

izhōng (

BL 40), W

iyang (

BL 39), Yīnlíngquán (

SP 9), Qūquán (

LV 8) and Chéngshān (

BL 57). Patients with the pain in the posterior extensor group were needled at ST 31, GB 31, EX-LE2, ST 35, GB 34, SP 10 and ST 34. Then the patients were repositioned in prone position. They were given the treatment by needling at GB 30, BL 36, BL 40, BL 39, SP 9, LV 8 and BL 57. They were treated once a day with five days as a course of treatment and two days as an interval. After three courses, Lequesne indiceses before and after the treatment and clinical efficacy of the treatment were observed. In the conventional group, patients were treated in a sitting position by needling at ST 35, Xīy?n (

EX-LE 5), Zúsānl

(

ST 36), GB 34, Xuánzhōng (

GB 39), SP 9, EX-LE2, ST 34, Shènshù (

BL 23) and Píshù (

BL 20). They were treated once a day with five days as a course of treatment and two days as an interval. After three courses, the clinical efficacy of the treatment was observed.ResultsAfter three courses, improved Lequesne indices score was (5.55 ± 1.08) in the balance group while improved Lequesne indices score was (2.14 ± 0.57) in the conventional group, indicating that improved Lequesne indices score in the balance group was superior to that of the conventional group with the significant difference (P<0.05); efficacy rate in the balance group was 84.37% while that of the conventional group was 58.06%, and efficacy rate in the balance group was superior to that of the conventional group (P<0.01).ConclusionClinical efficacy of treatment of knee osteoarthritis in the balance group was superior to that of the conventional group, worthy of clinical promotion.     

灸法治疗带状疱疹

目的总结归纳灸法治疗带状疱疹的临床治疗方法及经验,为临床选用有效治疗方案提供参考及为相关研究进行探索。方法利用各种文献数据库搜集有关灸法治疗带状疱疹的相关文献及不同灸法治疗带状疱疹的临床报道,并进行总结归纳。结果中医治疗带状疱疹方法多种多样,包括针刺法、灸法、刺络拔罐法、中药内服外敷法等。灸治本病又包括艾灸、铺棉灸、灯草灸、神灯照灸法、直接火灸法等,艾灸包括艾条灸、麦粒灸、隔姜灸、隔蒜灸、雷火灸。结论中医认为本病多由情志内伤,肝气郁结,久而化火或脾失健运,蕴湿化热,湿热搏结复感邪毒,侵淫肌肤脉络而发为疱疹。灸法治疗带状疱疹具有引邪外出,引热外出,化瘀解毒,消肿止痛之功。     

挑刺泻毒并点灼配合针药治疗30例带状疱疹临床观察

目的：观察挑刺疱疹泻毒并点灼配合针药治疗带状疱疹的临床效果。方法：经征得患者同意获得治疗组30例病例,以同期仅采用针药结合电针治疗的33例病例作为对照组。观察经治疗1周及2周后的综合效果,包括完全痊愈率、完全脱痂病例比率以及是否遗留后遗神经痛。结果：两组总有效率和治愈率差异显著。局部挑刺火灼组完全痊愈率（90.00%）明显高于对照组（81.82%）,两者差异显著（P〈0.05）。治疗组病例经7天治疗后,完全脱痂病例比率为83.33%,对照组为60.61%。治疗组仅1例有轻微后遗神经痛,而对照组为3例。两组比较,差异有高度统计学意义（P〈0.01）。结论：局部挑刺点灼配合针药治疗带状疱疹见效快,脱痂快,疗程短,后遗神经痛少。     

庄礼兴教授分期治疗带状疱疹临床经验探析

文章介绍庄礼兴教授治疗带状疱疹的思路和经验。通过跟师学习,收集庄礼兴教授近10年来治疗带状疱疹的病例资料,探析其运用针灸疗法分期治疗带状疱疹的诊疗思路及中药的组方规律,总结庄礼兴教授针药结合治疗带状疱疹的经验,并举验案1则加以佐证。庄礼兴教授认为治疗带状疱疹应分期施治,疹前期注重疏风止痛,出疹期注重清热活血通络,疹后期强调透邪解郁,注重柴胡剂的运用,并配合调神针法调畅情志。所举验案为一带状疱疹的老年患者在针药结合的治疗下痊愈且未再发,充分印证了庄礼兴教授的经验和方法。庄礼兴教授针药结合、分期辨证,辅以调神针法治疗带状疱疹疗效显著,值得学习与推广。     

Economic evaluation of treating herpes zoster with various methods of acupuncture and moxibustion

Objective

To analyze the cost effect of surrounding acupuncture plus electric acupuncture, cotton-sheet moxibustion, puncturing with red-hot needles, tapping plus cupping on herpes zoster.

Methods

Five hundred patients with herpes zoster were randomly divided into group A (surrounding acupuncture plus electric acupuncture), group B (cotton-sheet moxibustion), group C (puncturing with red-hot needles), group D (tapping plus cupping), and group E (Western medicine). The treatment was carried out twice a day in group E and once a day in the other four groups. The curative effect was observed on the 10th day of treatment; the cost was calculated for the five therapies, and the cost-effect ratio (C/E) and increment ratio (ΔC/ΔE) were analyzed.

Results

After the 10-day treatment, there was no statistical difference (P>0.05) in the curative effect among the five groups. Pain being alleviated one day faster than in group E amounted to a saving of RMB 21.90 yuan in group A, a saving of RMB 21.87 yuan in group B, a saving of RMB 26.00 yuan in group C, and a saving of RMB 20.23 yuan in group D. Compared with group C, the values of ΔC/ΔE were RMB 1.55, 2.81, and 0.21 yuan in groups A, B, and D, respectively.

Conclusions

The curative effect in groups A, B, C, and D was similar to that in group E, but the C/E was better than in group E.     

刺络放血加神经阻滞治疗急性期带状疱疹29例

目的：观察刺络放血加神经阻滞治疗急性带状疱疹神经痛的临床疗效。方法：将58例急性带状疱疹神经痛患者随机分为治疗组和对照组各29例。治疗组采用刺络放血加神经阻滞治疗;对照组采用西药治疗。结果：治疗组总有效率为100.0%,明显优于对照组的总有效率72.4%,两组间差异具有统计学意义（P〈0.05）。结论：刺络放血加神经阻滞治疗能使疱疹尽早结痂并脱落,并能降低后遗神经痛的发生。与传统的药物治疗方法比较,治疗效果显著,适宜临床应用和推广。     

针刺结合麦粒灸治疗肾虚肝郁型围绝经期抑郁症临床疗效观察

目的:比较针刺结合麦粒灸与口服盐酸氟西汀胶囊治疗肾虚肝郁型围绝经期抑郁症的临床疗效。方法:将60例肾虚肝郁型围绝经期抑郁症患者随机分为观察组和对照组,每组30例。观察组采用针刺结合麦粒灸治疗,针刺穴取百会、印堂、风池等,留针30 min;麦粒灸穴取肝俞、肾俞、命门、涌泉,每穴灸3壮,均隔日1次,每周3次。对照组予口服盐酸氟西汀胶囊,每次20 mg,每天1次。两组均治疗8周。分别于治疗前后及治疗后1、3、6个月随访时观察两组患者汉密尔顿抑郁量表(HAMD)评分、改良Kupperman评分,并于治疗后评定两组临床疗效。结果:两组患者治疗后及随访时各时点HAMD评分、改良Kupperman评分均较治疗前降低(P<0.01),且观察组HAMD评分均低于对照组(P<0.01)。观察组总有效率为93.3%(28/30),优于对照组的80.0%(24/30,P<0.01)。结论:针刺结合麦粒灸可有效治疗肾虚肝郁型围绝经期抑郁症,较口服盐酸氟西汀胶囊,具有更加稳定、持续的疗效。     

药艾灸配合中药内服治疗肱骨外上髁炎1则

肱骨外上髁炎又称网球肘,是骨伤科临床常见病和多发病。笔者将1例采用药艾灸配合中药内服治疗肱骨外上髁炎的典型病例进行了总结。结果表明,药艾灸配合中药内服治疗肱骨外上髁炎疗效好,值得临床推广使用。     

2019—2020针灸随机对照临床试验年度证据分析

[目的] 通过对2019年发表于中英文医学期刊的针灸随机对照临床试验（RCT）进行收集和分析评价,对针灸临床证据的生产和转化应用进行阶段性总结,为后续研究的开展和证据使用提供参考。[方法] 通过天津中医药大学循证医学中心创建的针灸临床证据库（ACU-CED）系统,获取2019—2020年度发表的针灸RCT文献并进行统计分析。[结果] 检索共获得7 452篇文献,其中,中文7 310篇,英文142篇,总样本量66万余例。纳入研究覆盖全球22个国家和地区,涉及3 000余个机构,共发表于559个中英文医学期刊。研究共涉及23个疾病系统,其中神经系统疾病和肌肉骨骼/结缔组织病相关研究占比逾40%。干预措施的选择涉及各类针灸疗法,超半数研究采用针灸联合中医或西医类其他疗法的组合方式,对照形式以药物疗法及常规治疗占比较高。大部分研究存在较显著的方法学问题,随机、分配隐藏、盲法等均存在描述不清或者应用错误等情况。此外,研究方案注册和伦理审查批准等方面执行不到位。[结论] 2019—2020年度针灸RCT发文量大,研究疾病谱分布较为集中,研究普遍存在方法学问题。建议按照临床研究注册和发表规范,加强研究设计和实施过程的质量控制;学术期刊应落实出口把关的职责,以进一步提高针灸临床研究质量,服务临床科学决策。     

针刺联合运动想象对脑卒中软瘫上肢精细动作的影响

目的:探讨针刺联合运动想象对脑卒中软瘫上肢精细动作的影响.方法:将62例上肢处于软瘫期的脑卒中偏瘫患者随机分为观察组(30例)、对照组(32例).对照组采用常规西药治疗及肢体被动运动基础上予头穴透刺(百会透太阳为主)加患肢局部透刺(肩髃透臂臑、曲池透少海、外关透内关等)治疗,留针30 min;观察组在对照组治疗基础上针刺留针期间予运动想象疗法.两组均每天治疗1次,每周治疗5天,共治疗4周.分别于入组时、治疗2周、4周后,及第6周、8周、90天后随访记录上肢动作研究量表(ARAT)和改良Fugl-Meyer (FMA)评分.结果:①上肢ARAT评分:从第2周起,各时间点两组比较,观察组ARAT评分均较对照组有显著提高(均P＜0.05).观察组组内各时间点两两比较,评分均有显著性提高(均P＜0.05);对照组组内各时间点两两比较,第2周与治疗前比较P＞0.05,其余时间点评分均有显著提高(均P＜0.05).②上肢FMA评分:第2周、第90天时,观察组FMA评分显著高于对照组(均P＜0.05).观察组组内各时间点两两比较,评分均显著提高(均P＜0.05);对照组组内各时间点两两比较,除第90天与第8周比较P＞0.05外,其余时间点均P＜0.05.结论:采用针刺联合运动想象疗法对脑卒中软瘫期早期干预能有效促进上肢协调功能和精细动作的恢复,尤其在改善精细动作方面,疗效优于单纯针刺治疗.     

盐酸伐昔洛韦片和阿昔洛韦注射液治疗带状疱疹的临床疗效比较

目的比较盐酸伐昔洛韦片和阿昔洛韦注射液治疗带状疱疹的临床疗效和安全性。方法选取上海市皮肤病医院2012年2月—2014年1月收治的带状疱疹患者100例,随机分为治疗组和对照组,每组各50例。治疗组口服盐酸伐昔洛韦片,2片/次,2次/d;对照组静脉滴注阿昔洛韦注射液加入250 m L 0.9%生理盐水中,5 mg/kg,2次/d。两组均连续治疗8 d。观察并记录两组患者的临床疗效和不良反应。结果治疗后,治疗组和对照组的总有效率分别为98%、96%,两组比较差异无统计学意义。两组患者皮损停止进展时间、开始结痂时间、一半皮疹结痂时间、所有皮疹脱痂时间和开始出现无疼痛时间相比差异无统计学意义。治疗组疼痛完全消失时间显著短于对照组,两组比较差异有统计学意义（P〈0.05）。治疗组后遗神经痛的发生率低于对照组,两组比较差异有统计学意义（P〈0.05）。结论盐酸伐昔洛韦片治疗带状疱疹具有较好的临床疗效,可以有效缩短疼痛时间,减少后遗神经痛的发生,值得临床推广使用。     

硬膜外阻滞在带状疱疹治疗中的应用

目的　观察硬膜外阻滞与无环鸟苷治疗带状疱疹的疗效。方法　将 96例带状疱疹患者随机分为硬膜外组 (n =66 ,Ⅰ组 )和无环鸟苷组 (n =30 ,Ⅱ组 ) ,比较两组在治疗 1周前后的疼痛VAS评分 ,止痛、止疱、结痂时间及有无后遗神经痛和不良反应。结果　在治疗 1周后患者疼痛VAS评分 ,Ⅰ组较治疗前明显降低 (P <0 .0 5) ,Ⅰ组明显低于Ⅱ组 (P <0 .0 5) ;Ⅰ组的止痛、止疱、结痂时间明显优于Ⅱ组 (P <0 .0 1 ,P <0 .0 5 ,P <0 .0 5)。随访 1周时的痊愈率、总有效率Ⅰ组显著高于Ⅱ组 (P <0 .0 1 )。Ⅰ组无后遗神经痛 ,Ⅱ组后遗神经痛者达 1 3 .3 %(P <0 .0 1 )。结论　硬膜外阻滞治疗带状疱疹的疗效明显优于无环鸟苷     

针灸结合拔罐治疗带状疱疹43例

针灸治疗带状疱疹43例加拔罐,收到良好的效果。     

罗哌卡因复合抗病毒药物硬膜外封闭对带状疱疹的疗效观察

目的：探讨急性带状疱疹治疗的新方法。方法：将120例急性带状疱疹患者随机分为2组,对照组共60例,常规内科方法治疗;治疗组60例,使用穿琥宁、罗哌卡因、维生素类神经营养药物硬膜外注射。观察两组治疗效果。结果：对照组总有效率约为88．33％,与治疗组相比有显著差异（P〈0．05）,治疗组疗程明显短于对照组（P〈0．05）.结论：该种方法显著优于传统的带状疱疹治疗,并有效地预防带状疱疹后遗疼痛,极大的缩短病程,既减轻了病人的痛苦,又节约了医疗费用,值得推广。     

针灸配合补充维生素A治疗干眼症的疗效观察

[目的]观察针灸配合补充维生素A治疗干眼症的临床疗效。[方法]115例维生素A缺乏所致的干眼症患者,来源于2013年7月—2016年6月苏州大学附属第一医院康复科和苏州市相城区元和医院针灸科门诊及所在医院眼科转诊患者,按就诊先后顺序采用随机数字表法将患者随机分为观察组40例、对照A组38例、对照B组37例。对照A组采用针灸治疗,对照B组采用补充维生素A治疗,观察组采用针灸配合补充维生素A治疗。通过3个疗程的治疗进行效果评价。[结果]观察组患者的泪液分泌量、泪膜破裂时间等改善明显;观察组总有效率为97.50%;对照A组总有效率为73.68%;对照B组总有效率为75.68%。观察组总有效率明显高于对照A组和对照B组,差异有统计学意义(P0.05),对照A组和对照B组之间比较差异无统计学意义(P0.05)。[结论]针灸配合补充维生素A治疗维生素A缺乏所致的干眼症,具有疗效显著,无副作用,操作简便等优势,值得推广使用。