安睡药浴用于脾胃虚寒型胃脘痛并睡眠障碍效果观察

目的改善脾胃虚寒型胃脘痛患者睡眠障碍。方法将62例脾胃虚寒型胃脘痛合并睡眠障碍患者按入院顺序分为观察组和对照组各31例。对照组给予脾胃虚寒型胃脘痛常规护理,观察组在此基础上使用安睡药浴护理。连续12d后评价效果。结果观察组睡眠障碍改善程度显著优于对照组(P<0.05)。结论安睡药浴护理干预能有效改善脾胃虚寒型胃脘痛患者的睡眠障碍。     

自制J型固定枕辅助摆放无痛胃肠镜检查体位

目的探讨自制J型固定枕辅助无痛胃肠镜检查患者体位摆放的效果。方法将160例行无痛胃肠镜检查患者随机分为观察组和对照组各80例。对照组在检查过程中按传统方法取屈髋屈膝左侧卧位,观察组使用自制J型固定枕辅助摆放检查体位。观察两组患者检查前和检查中心率、血氧饱和度、术后苏醒时间、舒适度及护士满意度。结果观察组检查中心率及血氧饱和度波动幅度显著小于对照组,苏醒时间显著短于对照组,舒适度及护士满意度显著高于对照组(P0.05,P0.01)。结论使用自制J型固定枕辅助摆放无痛胃肠镜检查体位有利于稳定患者检查中的心率及血氧饱和度,缩短苏醒时间,提高舒适度及护士满意度。     

火龙罐综合灸改善宫颈癌化疗患者心脾两虚型睡眠障碍的效果

目的 观察火龙罐综合灸疗法对宫颈癌化疗患者心脾两虚型睡眠障碍的影响。方法 选择宫颈癌化疗心脾两虚型睡眠障碍患者共73例,回顾性按照住院时间分为对照组42例和观察组31例。对照组给予宫颈癌化疗常规护理,观察组在常规护理基础上在第2～4个化疗周期前1 d及后1 d各加用火龙罐综合灸1次,干预3个化疗周期共6次。结果 干预后,观察组睡眠障碍改善率显著高于对照组,且中医证候积分、匹兹堡睡眠质量指数评分和癌症患者生命质量测定量表评分显著优于对照组（均P＜0.05）。结论 火龙罐综合灸疗法能有效改善宫颈癌化疗心脾两虚型睡眠障碍患者的睡眠状况及中医症状,提高其生存质量。     

Roux-en-Y胃旁路术改善非肥胖性2型糖尿病患者的糖脂代谢

目的 观察Roux-en-Y胃旁路术对非肥胖性2型糖尿病患者血糖和血脂代谢的影响.方法 共37例非肥胖2型糖尿病患者接受Roux-en-Y胃旁路术,观察其手术前、手术后3个月和6个月的体质量指数、糖化血红蛋白、空腹血糖、胰岛素、C肽、胰岛素抵抗指数、甘油三酯、总胆固醇、高密度脂蛋白和低密度脂蛋白含量的变化,并比较口服葡萄糖后2 h血糖、胰岛素和C肽的变化.结果 本组37例患者无严重围手术期并发症.手术前、手术后3个月和6个月体质量指数变化之间相比差异均无统计学意义(P>0.05);手术前、手术后3个月和6个月空腹血糖[(8.8±0.9)mmol/L、(7.0±2.0)mmol/L、(6.3±0.6)mmol/L,P<0.01]、糖化血红蛋白[(8.2%±1.2%、7.0%±0.8%、6.2%±0.7%,P<0.01]、空腹胰岛素[(10.6±1.2)mU/L、(9.0±0.9)mU/L、(9.0±0.8)mU/L,P<0.05]、空腹C肽[(1.9±0.5)nmol/L、(1.2±0.6)nmol/L、(1.2±0.4)nmol/L,P<0.01]、空腹甘油三酯[(3.3±0.8)mmol/L、(2.7 ±0.9)mmol/L、(2.6±0.7)mmol/L,P<0.05]、空腹总胆固醇[(6.5±1.8)mmol/L、(4.6±0.9)mmol/L、(4.2±1.0)mmol/L,P<0.05]、空腹低密度脂蛋白[(3.6±1.2)mmol/L、(2.8±0.8)mmol/L、(2.7±0.2)mmol/L,P<0.01]、餐后2 h血糖[(18.6±3.0)mmol/L、(12.7±2.3)mmol/L、(11.4±2.0)mmol/L,P<0.01]、胰岛素抵抗指数[(3.2±1.7)、(2.6±1.6)、(2.5±1.3),P<0.05]之间相比差异均有统计学意义.空腹高密度脂蛋白[(1.2±0.1)mmol/L、(1.4±0.4)mmol/L、(1.4±0.2)mmol/L,P<0.01]、餐后2 h胰岛素[(17.2±3,4)mU/L、(26.3±4.7)mU/L、(28.6±4.1)mU/L,P<0.01]、2 h C肽[(4.2±1.0)nmol/L、(6.3±1.5)nmol/L、(6.2±1.4)nmol/L,P<0.01]在手术后均明显升高.结论 Roux-en-Y胃旁路术可改善非肥胖性2型糖尿病患者血糖和血脂代谢,且与体质量指数变化无关.

Abstract：

Objective To evaluate Roux-en-Y gastric bypass operation on carbohydrate and lipid metabolism in type 2 diabetes mellitus patients with BMI range of 24 -29. Methods Thirty seven cases of type 2 diabetes mellitus patients undergoing Roux-en-Y gastric bypass operation were studied. Body mass index (BMI), glycosylated hemoglobin ( GHbAlc), fasting glucose ( FPG), fasting insulin (FIns) and C-peptide( FC-p), HOMA-IR, oral glucose tolerance (OGTT) including 2 hour insulin (2hIns) and C-peptide (2hC-p) , plasma levels of total cholesterol (TC), triglycerides(TG), high density lipoprotein( HDL-c)and low density lipoprotein ( LDL-c) were measured preoperatively and on 3 months, 6 months, later postoperatively. Result There was no statistically significant difference between BMI values measured preoperatively and postoperatively (P>0. 05 ). Serum levels measured in pre-operative and third and sixth post-operative months were: FPG (8. 8 ± 0. 9, 7. 0 ± 2. 0, 6. 3 ± 0. 6, P<0. 01) ( mmol/L) , GHbAlc (8.2±1.2, 7.0±0.8, 6.2±0.7, P<0.01)(%), FIns(10. 6 ±1. 2, 9.0±0.9, 9.0±0.8, P<0.05)(mU/L), FC-p(1.9±0.5, 1.2 ±0.6, 1.2 ±0.4, P<0. 01) (nmol/L), TG(3.3 ±0.8, 2.7 ±0.9,2.6±0.7, P<0.05)(mmol/L), TC(6.5±1.8, 4.6±0.9, 4.2 + 1.0, P<0. 05) (mmol/L)and LDL-c (3. 6 ±1.2, 2. 8 ±0.8, 2. 7 ±0.2, P<0.01) (mmol/L), 2 hour glucose after OGTT(2hPG) (18. 6 ±3.0, 12.7 ±2.3, 11.4±2.0, P<0. 01) (mmol/L), HOMA-IR(3. 2 ± 1. 7, 2.6±1.6, 2. 5 ±1.3, P<0. 05). Postoperative levels of HDL-c (1. 2 ± 0. 1, 1. 4 ± 0. 4, 1. 4 ± 0. 2, P<0. 01) ( mmol/L) , 2hIns (17. 2 ±3.4, 26. 3 ±4.7, 28. 6 ±4.1, P<0. 01) (mU/L)and 2hC-p(4. 2 ± 1. 0, 6. 3 ± 1. 5, 6. 2 ± 1.4,P<0. 01 ) ( nmol/L) were significantly higher than that of the pre-operative values ( P<0. 01 ).Conclusions Roux-en-Y gastric bypass significantly improves the metabolism of carbohydrate and lipid in type 2 diabetes patients with BMI 24-29, and the effects are not associated with weight loss.     

火龙罐疗法对心肾不交型围绝经期患者睡眠障碍的影响

目的 探讨火龙罐疗法改善心肾不交型围绝经期患者睡眠障碍的效果.方法 将69例心肾不交型围绝经期睡眠障碍患者随机分为对照组(34例)和观察组(35例).对照组给予常规针刺治疗,观察组给予火龙罐疗法,均每3天1次,连续10次.于干预后评价两组患者睡眠障碍改善程度,于干预前后及随访期(干预后1个月)采用匹兹堡睡眠质量指数(P...     

园艺疗法联合皮内针在肝郁化火型广泛性焦虑障碍患者中的应用

目的 观察园艺疗法联合皮内针用于改善肝郁化火型广泛性焦虑障碍的临床效果。方法 将159例肝郁化火型广泛性焦虑障碍患者随机分为园艺疗法组、皮内针组和联合组各53例。三组均给予中医情志护理,在此基础上,园艺疗法组予以传统中草药园艺治疗,皮内针组予以皮内针治疗,联合组实施园艺疗法联合皮内针治疗。三组治疗均每周1次,共8周。比较三组治疗前后汉密尔顿焦虑量表评分、中医证候积分、匹兹堡睡眠质量指数量表评分及下丘脑-垂体-肾上腺轴血清指标水平。结果 园艺疗法组53例、皮内针组52例、联合组51例完成研究。治疗第8周,联合组汉密尔顿焦虑量表评分、中医证候积分、匹兹堡睡眠质量指数量表评分、下丘脑-垂体-肾上腺轴血清指标水平均优于园艺疗法组和皮内针组（均P＜0.05）。结论 园艺疗法联合皮内针应用于肝郁化火型广泛性焦虑障碍患者可有效改善患者的焦虑状态和中医症状,提高睡眠质量,缓解下丘脑-垂体-肾上腺轴功能过度亢进。     

Prevalence of sleep disturbance in patients with low back pain

Low back pain (LBP) is a common health condition that is often associated with disability, psychological distress and work loss. Worldwide, billions of dollars are expended each year trying to manage LBP, often with limited success. Recently, some researchers have reported that LBP patients also report sleep disturbance as a result of their LBP. However, as most of this evidence was obtained from highly selected groups of patients or from studies with small samples, high quality data on prevalence of sleep disturbance for patients with LBP are lacking. It is also unclear whether sleep disturbance is more likely to be reported by patients with recent-onset LBP than by patients with persistent LBP. Finally, it is not known whether high pain intensity, the most relevant condition-specific variable, is associated with higher rates of reported sleep disturbance. The present study aimed to determine the prevalence of reported sleep disturbance in patients with LBP. In addition, we aimed to determine whether sleep disturbance was associated with the duration of back pain symptoms and whether pain intensity was associated with reported sleep disturbance. Data from 1,941 patients obtained from 13 studies conducted by the authors or their colleagues between 2001 and 2009 were used to determine the prevalence of sleep disturbance. Logistic regression analyses explored associations between sleep disturbance, the duration of low back symptoms and pain intensity. The estimated prevalence of sleep disturbance was 58.7% (95% CI 56.4–60.7%). Sleep disturbance was found to be dependent on pain intensity, where each increase by one point on a ten-point visual analogue scale (VAS) was associated with a 10% increase in the likelihood of reporting sleep disturbance. Our findings indicate that sleep disturbance is common in patients with LBP. In addition, we found that the intensity of back pain was only weakly associated with sleep disturbance, suggesting that other factors contribute to sleep problems for LBP patients.     

Anesthesia and distant results of surgical treatment in patients with stomach cancer

Based on the study of the late results of surgical treatment in 373 patients with gastric cancer, subjected to radical subtotal gastrectomy, it was found that a group of patients operated under fluothane anesthesia shows the highest survival rate. As evidenced by the authors' findings the use of ether narcosis results in 16--27% reduction of yearly survival during the first five years. The most poor results were noted in a group of patients operated under neuroleptanalgesia.     

Quality of sleep in patients with chronic low back pain: a case-control study

Animal experiments and studies in humans clearly show that the relation between pain (acute and chronic) and sleep quality is two-way: sleep disorders can increase pain, which in turn may cause sleep disorders. Sleep disorders and chronic low back pain are frequent health problems and it is unsurprising that the two can co-exist. This study was conducted to evaluate if sleep disorders and chronic pain associated are more frequently than one would expect. The objective of the study was to compare sleep quality in a population of patients with chronic low back pain and a control population. Sleep quality was assessed in 101 patients with chronic low back pain (CLBP) and in 97 sex- and age-matched healthy control subjects using the Pittsburgh Sleep Quality Index [PSQI; score from 0 (no disorder) to 21]. The French version of the Dallas Pain Questionnaire (DPQ) was used to assess the impact of low back pain on patients’ quality of life. This impact was taken as nil in the healthy controls. The patients with CLBP and the controls were comparable in age, sex, and height, but mean bodyweight was higher in the CLBP group (70.3 ± 14.5 vs. 61.8 ± 11.4 kg; P < 0.05). The patients with CLBP were also more frequently on sick leave than the controls (32.3%; n = 31 vs. 0.0% n = 0; P < 0.001). Coffee, tea, and cola intakes were comparable in the two groups. Patients with CLBP had statistically higher scores in all items of the PSQI than the healthy controls. The mean PSQI was 4.7 ± 3.2 for the healthy controls and 10.9 ± 7.9 for the patients with CLBP (P < 0.0001). Sleep disorders were greater when the impact of CLBP on daily life (the four aspects of the DPQ) was greater [P < 0.0001]). The sleep of the patients with CLBP was significantly altered compared with that of the healthy controls, in proportion to the impact of low back pain on daily life. Our findings do not indicate whether sleep disorders are a cause or a consequence of CLBP. The exoirements comply with the current laws of the country in which it was performed.     

Evaluation of pain perception in patients with temporomandibular disorders.

PURPOSE: The aim of this study was to assess the pain perception of patients with temporomandibular disorders and to investigate a possible association between pain sensitivity and temporomandibular disorders. PATIENTS AND METHODS: Fifty patients with temporomandibular disorders who were diagnosed according to research diagnostic criteria for temporomandibular disorders and 45 healthy volunteers were conducted. Visual analog scale, designed as 0 being no pain and 100 being worst pain ever experienced, was used to determine subjective pain expression during maximum mouth opening in patients and control subjects. All subjects' pressure pain thresholds were measured 3 times on the hypothenar region of the left hand with a mechanical algometer. Mean value of measured scores was assumed to be the general pressure pain threshold of the individual. RESULTS: Patients with temporomandibular disorder had significantly lower general pressure pain threshold values than pain-free subjects. Women had lower general pressure pain threshold values than men within groups as well. In the patient group, those with limited mouth opening (50 mm). However this result was statistically insignificant. CONCLUSIONS: According to the results of this study temporomandibular disorder patients were significantly different in terms of general pain perception. Systemic pain regulation mechanisms might be involved in temporomandibular disorder development. Some symptoms of temporomandibular disorder patients such as movement limitation and subjective pain expression might be originated from pain perception discrepancies besides severity of disease.     

Patient-reported pain and impaired sleep quality in adult patients with cystic fibrosis

BackgroundSleep impairment has been described in patients with cystic fibrosis (CF). Pain is a known cause of sleep disturbance and as pain is commonly reported in patients with CF, we sought to find an association between impaired sleep quality and pain.MethodsFifty adult CF patients completed surveys of pain and sleep quality. The results were analyzed with additional clinical data including age, sex, nutritional status, and lung function.ResultsThirty-two patients (64%) reported recent pain and 33 patients (66%) reported abnormal sleep quality. The patients with pain report worse sleep quality than those without pain (p = 0.006). There was a strong correlation between impaired sleep quality and pain (p < 0.0001).ConclusionsWe found that pain and poor sleep quality are reported in a majority of adult CF patients and there is a strong correlation between the two. This will have important clinical implications in the evaluation and treatment of adult patients.