平衡火罐联合雷火灸治疗肩凝症的疗效评价

目的评价和分析平衡火罐联合雷火灸治疗肩凝症的疗效,为合理制订治疗方案提供研究依据。方法选取72例肩凝症患者作为研究对象,应用随机数字表法分为观察组和对照组,每组各36例。对照组患者给予常规针灸治疗,观察组患者给予平衡火罐联合雷火灸治疗。对两组患者的治疗前、后的视觉模拟评分法(VAS)评分、Constant-Murley肩功能评定表评分进行评价和比较,对两组患者的疗效和临床有效率进行观察和比较。结果两组患者治疗后的VAS评分均较治疗前显著下降,各维度Constant-Murley评分均较治疗前显著上升,差异有统计学意义(P 0.05),观察组患者治疗后的VAS评分显著低于对照组,各维度Constant-Murley评分显著高于对照组,差异有统计学意义(P 0.05)。观察组患者的临床疗效分布优于对照组,临床有效率高于对照组,差异均有统计学意义(P 0.05)。结论相对于常规的针灸疗法,应用平衡火罐联合雷火灸治疗肩凝症,能够显著缓解疼痛症状,改善关节功能,提高治疗效果。     

臭氧配合小针刀痛点治疗肩周炎30例临床观察

目的观察臭氧配合小针刀痛点治疗肩周炎的临床疗效。方法将2011年9月至2013年12月在该院骨科确诊为肩周炎的60例患者随机分为治疗组和对照组,各30例。治疗组给予配制液(2%利多卡因1.25 m L、曲安奈德10 mg加生理盐水至10 m L)注射、臭氧配合小针刀痛点治疗;对照组给予配制液(同治疗组)封闭注射治疗。比较治疗前后两组患者视觉模拟评分法(VAS)、Constant-Murley肩关节功能及疼痛评分,镇痛及肩关节功能恢复总有效率。结果经1~3次治疗后,两组患者的VAS及Constant-Murley肩关节功能评分均明显优于治疗前,且治疗组显著优于对照组,差异均有统计学意义(P<0.05);治疗组患者的镇痛总有效率[93.33%(28/30)]和肩关节功能总有效率[90.00%(27/30)]均高于对照组[83.33%(25/30),60.00%(18/30)],差异均有统计学意义(P<0.05)。结论臭氧配合小针刀痛点治疗肩周炎具有良好疗效。     

针灸联合刺络放血拔罐法治疗肩周炎的临床疗效

目的探讨针灸联合刺络放血拔罐治疗肩周炎的临床疗效。方法选择2015年1~11月在我院治疗的肩周炎患者60例为研究对象,随机分为研究组和对照组各30例。研究组采用针灸联合刺络放血拔罐治疗,对照组采用阿西美辛缓释胶囊治疗治疗。比较两组患者的临床疗效及治疗前后肩关节活动功能评分。结果研究组临床疗效优于对照组,差异有统计学意义(P0.01);研究组总有效率显著高于对照组,差异有统计学意义(P0.05)。两组治疗后肩关节活动功能评分较治疗前显著升高,差异均有统计学意义(P0.01);治疗后,研究组患者肩关节活动功能评分显著高于对照组,差异有统计学意义(P0.01)。随访6个月,研究组复发率显著低于对照组(P0.05)。结论针灸联合刺络放血拔罐法治疗肩周炎具有较好的效果,值得临床推广。     

关节松动手法结合针灸蜡疗在治疗肩周炎中的疗效观察

目的探讨关节松动手法结合针灸蜡疗治疗肩周炎的疗效。方法选取我院接收的肩周炎患者101例,随机分组,对照组50例,观察组51例,对照组给予针灸蜡疗法,观察组行关节松动手法结合针灸蜡疗,比较两组临床疗效、肩关节评分及关节活动度(ROM)、视觉模拟评分(VAS)。结果治疗后观察组肩关节评分高于对照组,差异具有统计学意义(P<0.05);治疗后观察组ROM评分高于对照组,VAS评分低于对照组,差异具有统计学意义(P<0.05);观察组总有效率(94.12%)高于对照组76.00%,差异具有统计学意义(P<0.05)。结论关节松动手法结合针灸蜡疗应用于肩周炎,疗效显著,可有效改善患者关节活动度,缓解患者疼痛症状。     

苍龟探穴针刺疗法联合当归注射液穴位注射对肩周炎患者VAS评分及肩关节活动度的影响

目的:探讨苍龟探穴针刺疗法联合当归注射液穴位注射对肩周炎患者VAS评分及肩关节活动度的影响。方法:选取某院收治的肩周炎患者90例,随机数字表法分组,各45例,对照组给予当归注射液穴位注射治疗,观察组在对照组基础上采用苍龟探穴针刺疗法,均治疗5周。采用视觉模拟疼痛量表(VAS)对治疗前后两组疼痛程度进行评分,并采用肩关节评分法(ConstantMurley,C-M)评估两组肩关节活动度,并统计对比两组治疗效果。结果:观察组治疗有效率为93.33%,较对照组的75.56%高,差异有统计学意义(P0.05);治疗5周后,观察组VAS评分低于对照组,C-M评分高于对照组,差异有统计学意义(P0.05)。结论:苍龟探穴针刺疗法联合当归注射液穴位注射治疗肩周炎患者,能有效降低VAS评分,快速降低疼痛程度,提高肩关节活动度,提高临床治疗效果。     

关节松动术配合针刺治疗肩周炎的疗效及对肩关节功能的影响

目的探讨关节松动术配合针刺治疗对肩周炎的疗效及对肩关节功能的影响。方法选择2010年1月~2013年1月我院就诊的肩周炎患者80例为研究对象。所有患者根据入院顺序采用随机数字表法分为观察组和对照组,每组各40例,两组患者均行关节松动术,观察组同时联合针刺治疗,针刺选取穴位:主穴肩髑、肩髎、肩贞、阿是穴、条口,配穴合谷、外关、曲池。每次选取3~4穴,施以提插捻转平补平泻综合针刺手法,得气为度,留针30min,1次/d;比较两组患者治疗后的疗效及VAS评分、肩关节活动度情况。结果治疗后比较两组的疗效,观察组的优良率为92.5%,与对照组的优良率75.0%比较,差异具有显著性(P0.05)。观察组与对照组患者治疗前VAS评分比较,差异无统计学意义(P0.05)。观察组治疗1个疗程后、治疗2个疗程后VAS评分分别较治疗前显著降低,且观察组治疗1个疗程后、治疗2个疗程后VAS评分分别显著低于对照组,差异有统计学意义(P0.05)。对照组患者治疗1个疗程后VAS评分较治疗前未见明显变化,但对照组患者治疗2个疗程后VAS评分较治疗前显著降低。观察组与对照组患者治疗前前屈、外展、后伸、内旋、外旋活动度比较,差异无统计学意义(P0.05)。观察组患者前屈、外展、后伸、内旋、外旋活动度治疗后分别较治疗前明显增加,且观察组的肩关节活动度分别显著高于对照组,差异有统计学意义(P0.05)。结论关节松动术配合针刺治疗肩周炎疗效确切,可以显著减轻患者的疼痛,改善患者的肩关节功能,值得推广和应用。     

肌筋膜触发点毫针刺法联合艾灸治疗肩周炎的临床疗效观察

目的 探究肌筋膜触发点毫针刺法联合艾灸治疗肩周炎的临床疗效。方法 选择肩周炎患者64例，随机分为观察组和对照组，各32例。对照组采用常规西药治疗，观察组在对照组基础上给予肌筋膜触发点毫针刺法联合艾灸治疗。比较两组临床疗效、视觉模拟评分法(VAS)评分、牛津大学肩关节评分(OSS)评分、肩关节活动度、日常生活活动能力量表(ADL)评分。结果 治疗后，观察组治疗总有效率高于对照组高(P<0.05);两组VAS评分、OSS评分均降低(P<0.05),且观察组更低(P<0.05);两组肩关节内转、外展、前屈、后伸活动度均提高(P<0.05),且观察组更高(P<0.05);治疗后1、2、3个月，两组ADL评分呈下降趋势(P<0.05),治疗后1个月，观察组ADL评分低于对照组(P<0.05);治疗后2、3个月，两组ADL评分比较无明显差异(P>0.05)。结论 肌筋膜触发点毫针刺法联合艾灸治疗肩周炎临床疗效较好，有利于减轻疼痛程度、改善肩关节活动范围和肩关节功能，并可改善患者的短期生活质量。     

毫针焠刺疗法联合抗阻力拉伸治疗寒湿痹阻型肩周炎效果观察

目的 观察毫针焠刺疗法联合抗阻力拉伸治疗寒湿痹阻型肩周炎的效果。方法 选取该院2020年10月至2022年10月收治的肩周炎患者122例,随机分为观察组与对照组各61例。对照组予以抗阻力拉伸治疗,观察组予以毫针焠刺联合抗阻力拉伸治疗,比较两组治疗前后简化McGill疼痛问卷量表（SF-MPQ）评分、Constant-Murley肩关节功能评估量表（CMS）评分、肩关节活动度（外旋、内旋、前屈、外展角度）及疗效。结果 观察组总有效率（93.4%,57/61）明显高于对照组（80.3%,49/61）,治疗后观察组SF-MPQ评分低于对照组,CMS评分高于对照组,肩关节外旋、内旋、前屈、外展角度大于对照组,差异均有统计学意义（P <0.05）。结论 毫针焠刺疗法联合抗阻力拉伸治疗寒湿痹阻型肩周炎效果满意,能有效促进症状恢复,增加患者肩关节活动范围。     

郑氏手法联合肩袖肌群锻炼治疗中国女子水球运动员肩痛疗效分析

目的 观察郑氏手法联合肩袖肌群锻炼治疗中国女子水球运动员肩痛的疗效;方法 将35名参加集训与比赛的运动员随机分为治疗组与对照组,治疗组18例,对照组17例,治疗组采用郑氏推拿配合肩袖肌群锻炼,对照组单纯采用郑氏推拿治疗,评价指标为视觉模拟评分(VAS)、Constant-Murley肩关节功能评分,治疗前后数据由SPSS19.0软件统计;结果 两组患者基线资料(病程、专项训练年限及年龄)经统计学分析,差异均无统计学意义(P>0.05)。治疗前两组运动员间VAS评分比较,差异无统计学意义(P>0.05);治疗后两组运动员VAS评分均较治疗前降低,且治疗组的降低程度大于对照组,P<0.05。治疗前两组运动员间Constant-Murley评分比较,差异无统计学意义(P>0.05);治疗后两组运动员VAS评分均较治疗前增加,且治疗组的增加程度大于对照组,P<0.05;结论 郑氏推拿配合肩袖肌群功能锻炼能有效缓解中国女子水球运动员的肩痛症状、改善肩部功能、增强肩关节稳定性,其疗效优于单纯推拿治疗。     

熥药外敷治疗肩关节周围炎的临床疗效

目的探讨熥药外敷治疗肩关节周围炎(肩周炎)的临床疗效。方法选取2014年6月—2015年10月黑龙江中医药大学附属第二医院骨伤科收治的肩周炎患者70例,采用随机数字表法分为治疗组与对照组,各35例。治疗组患者予以熥药外敷治疗,对照组患者予以洛芬待因片联合麝香壮骨膏治疗。观察两组患者治疗前后视觉模拟评分法(VAS)评分、临床疗效及不良反应发生情况。结果治疗前两组患者VAS评分比较,差异无统计学意义(P>0.05),治疗后治疗组患者VAS评分低于对照组,差异有统计学意义(P<0.05);治疗组患者总有效率高于对照组,差异有统计学意义(P<0.05);两组患者均未发生严重不良反应。结论熥药外敷治疗肩关节周围炎的临床疗效显著,可提高患者的生活质量,且不良反应少。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.