脑卒中偏瘫虚秘患者的辨证饮食调护

目的 探讨脑卒中虚秘患者的辨证分型与饮食调护的方法 及效果.方法 将96例脑卒中偏瘫虚秘患者随机分成观察组(50例)和对照组(46例).观察组按辨证分型进行饮食调护,对照组按便秘常规进行治疗及护理.结果 观察组总有效率96.0%,平均起效时间(2.89士0.61)d;对照组总有效率67.4%,平均起效时间(4.76士0.81)d.两组治疗总有效率和起效时间比较,差异有显著性意义(均P＜0.01).结论 辨证饮食调护可有效治疗脑卒中偏瘫患者虚秘,且无不良反应,有利于患者居家治疗.     

中药酒浴促进脑卒中偏瘫患者康复的效果观察

目的观察中药酒浴疗法对康复期脑卒中偏瘫患者的应用效果。方法将200例偏瘫患者分为两组。治疗组（140例）采用中药酒浴液进行坐浴，每周3次，4周为1个疗程；对照组（60例）除浴液中不加入白酒外，余均同治疗组。结果治疗组总有效率91．43％，对照组53．33％，治疗组显著高于对照组（χ^2=38．10，P〈0．01）。结论中药酒浴治疗脑卒中偏瘫，可使药物在药力和酒力的推动下直接而全面地起到通达和疏导作用，从而提高疗效。     

辨证分型应用中药结肠透析治疗慢性肾衰竭早中期32例疗效观察

目的：探讨辨证分型应用中药结肠透析对慢性肾衰竭（CRF）早中期患者疗效的影响.方法：选择慢性肾衰竭早中期患者（血肌酐707 μmol/L以下）63例,治疗组32例,对照组31例.治疗组采用电子结肠透析机进行辨证分型中药结肠透析,对照组采用辨证分型传统中药灌肠方法.观察患者治疗前后症状以及肾功能改善情况.结果：症状积分比较显示治疗组效果优于对照组;肾功能比较显示治疗组尿素氮、肌酐、尿酸均较治疗前明显下降,而对照组尿素氮、尿酸下降不明显;临床疗效比较显示治疗组总有效率90.6％,对照组总有效率70.9％,差异有统计学意义.结论：辨证分型应用中药结肠透析治疗慢性肾衰竭早、中期疗效明显.     

中西医结合治疗扁平疣的疗效观察

目的：探讨扁平疣的中西医结合治疗。方法：将138例扁平疣患者，分别进行中医辨证分型，肝胆湿热型62例，瘀血阻滞型46例，阴虚火旺型30例。采用随机方法将3型患者分别平均分成治疗组和对照组。每组中肝胆湿热型31例，瘀血阻滞型23例，阴虚火旺型15例。治疗组给予中医辨证分型，中药内服及外搽联合重组干扰素α-2b肌注，对照组用聚肌胞外搽联合重组干扰素α－2b肌注。观察两组的疗效。结果：治疗组总有效率为94．20％，对照组总有效率为72．46％，治疗组疗效明显高于对照组（P＜0．05）。结论：中西医结合治疗扁平疣疗效确切。     

地奥司明片口服治疗痔急性发作的临床观察

为观察地奥司明片口服对痔急性发作症状的临床疗效,将120例痔急性发作患者随机分为两组,治疗组60例给予口服地奥司明片治疗,对照组60例给予口服痔宁片治疗,对照观察两组肛门疼痛、肛门水肿、便血、痔黏膜改变的时效和疗效。结果显示,治疗组肛门疼痛、便血的平均起效时间、平均消除时间均优于对照组（P〈0．05）。7d后两组均能显著改变临床症状及降低症状积分,但治疗组临床症状的改善及积分变化优于对照组（P〈0．05）,治疗组总有效率优于对照组（P〈0．05）。结果表明,地奥司明片口服治疗痔急性发作起效快,疗效显著。     

多功能艾灸刮痧按摩器在老年髋部骨折虚秘患者中的应用

目的 探讨多功能艾灸刮痧按摩器在老年髋部骨折虚秘患者中的应用效果。 方法 将80例老年髋部骨折虚秘患者采用随机数字表法分为观察组和对照组各40例;在常规护理基础上,对照组采用九宫经络推拿法推拿腹部,观察组采用自行研制的多功能艾灸刮痧按摩器推拿腹部。比较两组治疗效果、首次排便时间、间隔排便时间、72 h排便次数及推拿时间。 结果 观察组疗效优于对照组,首次排便时间、间隔排便时间短于对照组,72 h排便次数多于对照组,但两组比较差异无统计学意义（均P＞0.05）;观察组推拿时间显著短于对照组（P＜0.01）。 结论 对老年髋部骨折虚秘患者采用多功能艾灸刮痧按摩器推拿腹部,与手法推拿治疗虚秘的疗效相当,但其平均推拿耗时短,护士操作更节力,可提高护理工作效率。     

地奥司明片治疗急性发作痔92例临床分析

为观察地奥司明片对痔急性发作症状的I临床疗效,将146例痔患者分为两组,治疗组92例给予地奥司明片治疗,对照组54例给予痔速宁片治疗,对照观察两组药物对疼痛、便血、水肿、黏膜改变的时效和疗效。结果显示,治疗组对疼痛、便血的平均起效时间分别为（15．0±1．21）h和（25．0±2．33）h,症状消除时间分别为（3．7±1．2）d和（4．4±1．5）d,对照组疼痛、便血的平均起效时间分别为（22．0±0．84）h和（36．0±1.57）h,症状消除时间分别为（5．1±1．2）d和（5．6±1．2）d,治疗组优于对照组（P〈0．05）。7d后便血、黏膜改变的分值下降,治疗组优于对照组（P〈0．05）,治疗组和对照组显效率分别为69．6％和48．1％（P〈0．05）。结果表明,地奥司明片治疗痔急性发作起效快,疗效显著。     

热毒宁治疗轮状病毒肠炎疗效观察

为探讨热毒宁治疗轮状病毒肠炎的疗效,将200例轮状病毒肠炎患儿随机分为治疗组和对照组各100例,对照组采用补液、微生态治疗、保护胃肠黏膜及合理饮食等综合治疗,治疗组在对照组治疗的基础上加用热毒宁治疗。治疗期间观察体温、大便次数及大便性状改变,观察两组的总有效率、止泻时间及住院时间。结果显示,止泻时间及住院时间治疗组分别为（2．68±1．61）d和（3．15±1．40）d,对照组分别为（3．79±1．66）d和（4．75±1．78）d,两组差异有统计学意义（P〈0．01）。显效率及总有效率治疗组分别为88％和96％,对照组分别为62％和82％,两组差异有统计学意义（P〈0．01）。结果表明,热毒宁治疗轮状病毒肠炎疗效确切,能迅速改善临床症状,缩短住院时间,减少患儿痛苦,避免或减轻腹泻所致的生长停滞。     

大肠水疗结合辨证保留灌肠治疗慢性功能性便秘临床疗效观察

为探讨大肠水疗结合辨证保留灌肠治疗慢性功能性便秘的治疗效果,回顾162例慢性功能性便秘患者资料,其中86例采用大肠水疗结合辨证保留灌肠治疗（治疗组）,76例采用常规中药汤剂口服治疗（对照组）,对比分析两组患者临床疗效。结果显示,治疗组显效46例,有效28例,无效12例,总有效率86．0％;对照组显效36例,有效24例,无效16例,总有效率78．9％;治疗组总有效率高于对照组,P〈o．05。观察显效及有效者6个月,治疗组74例患者中复发12例（16．2％）,对照组60例患者中复发18例（30．0％）,治疗组复发率明显低于对照组,P〈0．05。结果表明,大肠水疗结合辨证保留灌肠治疗慢性功能性便秘效果好,治愈后复发率低。     

系统性红斑狼疮患者的辨证施护

目的 探讨中医辨证施护对系统性红斑狼疮（SLE）的临床效果。方法 将98例SLE患者按住院单双号分为观察组（50例）和对照组（48例）。两组均予口服中药和激素治疗，对照组采用内科常规护理，观察组在此基础上根据不同临床分型予以辨证施护和情志护理。结果 观察组疗效显著优于对照组（P〈0．01）。结论 采用中医辨证施护及情志护理，可缓解SLE患者临床症状，提高患者生活质量。     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.