头穴透刺法治疗失眠症的随机对照研究

背景：失眠已成为威胁公众身体健康的突出问题,针灸在治疗失眠方面具有疗效高和副作用小的优势。 目的：观察头穴透刺法治疗失眠症的临床疗效。 设计、场所、对象和干预措施：将符合纳入标准、源于解放军总医院针灸科门诊的70例失眠患者随机分为头穴透刺组和常规针刺组,其中脱落4例,最终头穴透刺组纳入32例,常规针刺组纳入34例。头穴透刺组给予头穴透刺法,而常规针刺组则给予一般针刺疗法。两组患者均治疗4周。 主要结局指标：比较两组临床疗效、治疗前后匹兹堡睡眠质量指数量表积分和睡眠结构各成分的变化。 结果：头穴透刺组总有效率为90.6%,优于常规针刺组的73.5%（P＜0.05）。头穴透刺法对睡眠质量、睡眠时间及睡眠效率的改善均优于常规针刺法（P＜0.05,P＜0.01）。头穴透刺法能明显增加睡眠总时间和深睡期时间,与常规针刺组相比,差异有统计学意义（P＜0.01）。 结论：头穴透刺法治疗失眠症的临床疗效优于常规针刺法,主要体现在改善睡眠质量、睡眠时间及睡眠效率等方面。     

首发型未服药非器质性睡眠障碍患者前瞻性记忆与工作记忆相关分析

目的 探讨首发型未服药非器质性睡眠障碍（NI）患者前瞻性记忆与工作记忆之间的相关性。方法 将2015年1月至2016年1月在安徽省精神卫生中心首次就诊未服药的80例NI患者设为观察组（NI组）,同时期选择与其人口学资料相匹配的80例合肥社区志愿者作为健康对照组（HC组）,采用基于事件前瞻性记忆（EBPM）范式和基于时间前瞻性记忆（TBPM）范式评估两组患者EBPM、TBPM得分,通过客体、语音及空间工作记忆测试评估两组患者的反应时间及错误数,比较两组研究对象EBPM、TBPM得分及客体、语音及空间工作记忆反应时长及错误数。采用Pearson相关分析NI组前瞻性记忆与工作记忆相关性。结果 NI组在EBPM和TBPM得分低于HC组,差异有统计学意义[(1 448.95±294.54)ms比(1 310.20±180.30)ms;(1 485.26±271.59)ms比(1 397.68±268.08)ms,P均<0.05],NI组在工作记忆中客体和空间工作记忆的反应时长均长于HC组,差异均有统计学意义; Pearson相关分析显示,NI组EMPI得分与客体工作记忆反应呈负相关（r=-0.310,P=0.005）。结论 NI患者存前瞻性记忆与工作记忆损伤,前瞻性记忆损伤与工作记忆损伤有一定相关性。     

星状神经节阻滞结合头针治疗原发性顽固失眠症的效果

目的观察星状神经节阻滞结合头针治疗原发性顽固失眠症的效果。方法原发性顽固失眠症患者115例,采用星状神经节阻滞结合头针治疗,同时原催眠药物继续服用。于治疗前和治疗后隔2d采用匹兹堡睡眠质量指数及多导睡眠图评估主观与客观睡眠质量。结果治疗结束后6个月时评估治疗效果,痊愈、显效、差效、无效率依次为68．7％（79／115例）、27．8％（32／115例）、3．5％（4／115例）、0％（0／115例）;治疗前后匹兹堡睡眠质量指数及多导睡眠图评估比较差异有统计学意义（P〈0．05）,且可达到催眠药物减量的效果。结论星状神经节阻滞结合头针对原发性顽固失眠症具有较好的疗效。     

针灸治疗失眠症的随机对照试验评价

目的：对用针灸治疗失眠症的临床效果进行评价.方法：通过文献检索分析研究的方法,检索到2009年1月至2012年12月有关针灸治疗失眠症的临床对照试验相关文献共128篇,删除没有明确说明随机分配方法的RCT研究论文69篇,仅对剩余的59篇文献进行归类分析.结果：符合条件的7篇RCT共425例患者满足纳入标准,将针灸组和药物组进行对比,比值（OR）为3.25,95%的置信区间[2.50,5.05],P〈0.0001,差异显著,具有统计学意义.结论：针灸治疗失眠症可能有效,目前还不能明确针灸治疗失眠症的临床效果.     

Western medication plus Traditional Chinese Medicine preparations in patients with chronic heart failure: a prospective,single-blind,randomized, controlled,and multicenter clinical trial

Objective

To assess the efficacy and safety in patients with chronic heart failure (CHF) of Western medication plus Traditional Chinese Medicine (TCM) preparations.

原发性失眠症患者家庭功能和应对方式与睡眠质量的关系

目的了解家庭生活事件、家庭功能等对原发性失眠症的影响。方法向在社区卫生服务站就诊，持续3个月以上的原发性失眠者和无失眠者各56例发放家庭功能量表、匹茨堡睡眠质量指数量表和特质应对反应方式问卷。失眠者问卷回收48份，作为病例组；无失眠者问卷回收52份，作为对照组。对问卷进行分析。结果病例组与对照组的睡眠质量差异有统计学意义（Х^2=10．75，P〈0．05）；两组的特质应对反应方式差异有统计学意义（Х^2=4．03，P〈0．05）；消极应对反应方式与睡眠质量的关联性，经卡方检验Х^2=4．05，P〈0．05。两组的家庭功能差异无统计学意义（Х^2=3．39，P〉0．05）。结论生活事件、家庭功能障碍是通过患者的特质应对反应方式影响患者睡眠后_旨的。     

头颈灸疗法及应用

从头颈灸疗法的定义、理论依据、灸具、应用等方面对“头颈灸”进行探讨认为,阴升阳降理论、传统的脏腑经络理论和名老中医周楣声教授、蔡圣朝主任医师灸法的治疗经验是头颈灸的理论和治疗应用基础.根据定位施灸、定性施灸、定量施灸以及头颈灸配合施灸法、头颈灸运动疗法的运用,佐证了头颈灸疗法在临床推广应用的可行性.     

Efficacy of acupuncture and moxibustion in treating Bell’s palsy: a multicenter randomized controlled trial in China

Background Bell‘s palsy involves acute facial paralysis due to inflammation of the facial nerve. Acupuncture and moxibustion (acu-moxi) is beneficial in treating facial palsy. In order to verify the efficacy of acu-moxi on Bell‘s palsy, a randomized single-blind, multicenter clinical trial was performed.Methods A total of 480 patients from four clinical centers were involved in this trial, of whom 439 completed the trial and 41 did not. All patients were randomly assigned to either the control group or to one of two treatment groups. The control group was treated with prednisone, vitamin B1, vitamin B12,and dibazole; the treatment groups were treated either with acu-moxi alone or in combination with prednisone, Vitamin B1, vitamin B12, and dibazole. Symptoms and signs, the House-Brackmann scale, and facial disability index (FDI) scores were assessed and determined both pre- and post-treatment to evaluate the effectiveness of the treatment methods. Results The characteristics of the control and two treatment groups were comparable without statistically significant differences before treatment. There were significant differences between the control and treatment groups after treatment (X^2=15.265, P=0.018). According to evaluations based on the House-Brackmann scale and FDI scores, the effectiveness of treatment in the two treatment groups was better than in the control group and was most effective in patients receiving acumoxi treatment alone (Z=-2.827, P=0. 005).Conclusion The efficacy of acu-moxi treatment for Bell‘s palsy is verified scientifically.     

Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma: a Meta-analysis of randomized control trials

ObjectiveTo systematically evaluate the effectiveness and safety of heat-sensitive moxibustion (HSM) on asthma.MethodsLarge databases in China and overseas were searched by electronic and manual means to collect information on randomized controlled trials (RCTs). Two evaluators independently extracted data and evaluated the quality of RCTs according to Cochrane Review Handbook v5.0. RevMan v5.0.20 was used for statistical analyses.ResultsFourteen RCTs involving 637 patients were collected. Thirteen RCTs compared the effects of HSM and Western Medicine. After 3-month treatment and after 6-month follow-up, there was no significant difference in effective rate [relative risk (RR) =1.01, 95% CI (0.92, 1.12), and 1.12, (0.93, 1.36), respectively], in the asthma control test score of asthma symptoms [weighted mean difference (WMD) = − 1.54, 95% CI (− 3.54, 0.47), and 1.41, (− 0.48, 3.29), respectively] and in the forced expiratory volume in 1 second (FEV₁) and peak expiratory flow (PEF). One RCT compared the effect of HSM with warm-suspended moxibustion. After 6-month follow-up, there was a significant difference in FEV₁ and PEF [WMD=0.51, 95% CI (0.10, 0.92), and 1.78, (1.06, 2.50), respectively]. After 3-month treatment, there was no significant difference between the two groups. One RCT compared the effect of HSM with acupoint application. After 3-month treatment, there was no significant difference in the effective rate [RR=0.68, 95% CI (0.42, 1.12)].ConclusionsHSM did not show superiority to conventional Western Medicine and acupoint application in terms of curative effects, and may be superior to warm-suspended moxibustion with regard to long-term curative effects. Because of low quality of the included RCTs, this conclusion must be bolstered with higher-quality RCTs.     

蔗糖铁注射液治疗血液透析患者肾性贫血的多中心临床研究

目的 比较蔗糖铁与口服琥珀酸亚铁治疗血液透析患者肾性贫血的疗效与安全性.方法 采用同期随机对照的多中心研究.结果 选择维持性血液透析患者中肾性贫血者77例,静脉给药组40例,口服铁剂组37例,除口服组血红蛋白(Hb)均值(90.34 g/L)高于静脉组(84.31 g/L,P＜0.05)外,两组年龄、性别、身高、干体重等基础情况均无显著性差异.治疗后Hb、红细胞压积(HCT)、网织红细胞计数(Ret)两组均有升高,静脉组Hb、HCT比口服组升高更显著(P＜0.001),且Hb上升速度快于口服组;该组血清铁、铁蛋白、转铁蛋白饱和度治疗后均升高(P＜0.001),且升高幅度大于口服组(P＜0.001);静脉组不良反应少于口服组(P＜0.05).结论 静脉用蔗糖铁治疗肾性贫血安全有效.     

艾灸头部穴位为主对血管性痴呆患者脑脊液中生长抑素和精氨酸血管加压素水平影响的随机对照试验

背景：血管性痴呆（vascular dementia,VaD）患者血浆和脑脊液中多种神经肽类物质发生明显变化;有效地干预神经肽水平,对VaD的预防和治疗十分重要。目的：以艾灸头部穴位为主治疗VaD,观察其改善临床症状和调控脑脊液中与学习记忆相关的神经肽物质生长抑素（somatostatin,SS）和精氨酸血管加压素（arginine vasopressin,AVP）水平的作用。设计、场所、对象和干预措施：65例VaD患者均为安徽中医学院针灸医院门诊或住院病例。按随机数字表法分为艾灸组（33例）和西药组（32例）。艾灸组患者给予隔附子饼压灸,反复灸20min;西药组口服吡拉西坦素片0.8g,3次/d。两组均治疗4个疗程,4周为1个疗程。主要结局指标：比较两组治疗前后长谷川痴呆智能检查量表（Hasegawas Dementia Scale,HDS）、简易智能精神状态检查量表（Mini-Mental State Examination,MMSE）和日常生活能力量表（Activity of Daily Living Scale,ADL）积分变化,以及脑脊液中SS和AVP水平。结果：艾灸组总有效率与西药组比较,差异有统计学意义（P〈0.01）。两组治疗前后HDS、MMSE和ADL积分比较,差异均有统计学意义（P〈0.05,P〈0.01）,艾灸组HDS、MMSE和ADL量表积分治疗前后差值较西药组有所改善（P〈0.05,P〈0.01）。两组治疗后脑脊液SS和AVP水平较治疗前明显升高（P〈0.01）,艾灸组治疗后SS和AVP升高水平较西药组明显（P〈0.01）。结论：艾灸能改善临床相关症状积分,调控与学习记忆相关的神经肽物质,是治疗VaD的有效方法。     

社会技能训练对有行为问题儿童影响的随机对照研究

目的:验证以社会技能训练为主的综合矫正模式对儿童行为问题的干预效果.方法:选取7～14岁符合Rutter行为问题标准的101名儿童,用隐藏式随机数字信封法将其随机分为干预组50人和对照组51人.对干预组采用以社会技能训练为主的干预方案,进行为期12周的干预;对照组等待12周,在干预组干预结束后才开始进行干预.采用Rutter儿童行为父母问卷、教师问卷和Achenbach儿童行为量表作为儿童行为问题评定工具.结果:干预后,比较两组Rutter儿童行为父母问卷的减分值,干预组总分减分(4.10±3.21)、A(反社会行为/违纪行为)分减分(1.10±1.37)和N(神经症行为)分减分(1.32±0.91)与对照组总分减分(1.29±3.15)、A分减分(0.53±1.17)和N分减分(0.71±1.10)相比差异有统计学意义(均为P＜0.05),干预组有34%的儿童恢复正常.比较两组的Rutter儿童行为教师问卷的减分值,干预组总分减分(2.50±1.96)、A分减分(0.74±1.10)和N分减分(0.96±0.95)与对照组总分减分(0.82±1.60)、A分减分(0.12±0.48)和N分减分(0.43±0.81)比较差异有统计学意义(均为P＜0.01),干预组有58%的儿童恢复正常.比较两组的Achenbach儿童行为量表,干预组总分减分(5.44±3.98)、体诉减分(1.10±1.27)和违纪减分(1.36±1.35)与对照组总分减分(1.49±3.34)、体诉减分(0.33±1.52)和违纪减分(0.65±1.26)相比差异有统计学意义(均为P＜0.01),干预组干预后的总有效率为54%.结论:以社会技能训练为主的综合矫正模式可以有效改善儿童的行为问题,并且切实可行.     

隧道式拖线术治疗低位蹄铁型肛周脓肿的随机对照临床试验

背景：隧道式拖线术在复杂性肛瘘的治疗上有一定疗效,欲借鉴此手术经验,将其用于低位蹄铁型肛周脓肿。目的：分析隧道式拖线术治疗低位蹄铁型肛周脓肿的临床疗效。设计、场所、对象和干预措施：将68例上海市天山中医医院肛肠科的低位蹄铁型肛周脓肿患者随机分为治疗组和对照组各34例。治疗组采用隧道式拖线术,对照组采用多切口切开引流术。主要结局指标：观察两组术后疼痛、创面愈合时间、平均创面瘢痕面积、肛门功能状况以及术后复发情况,术后随访0．5～3年。结果：治疗组术后疼痛持续时间以及创面愈合时间均比对照组短（P〈0．01）;但两组术后复发率比较,差异无统计学意义（P〉0．05）。结论：隧道式拖线引流术治疗低位蹄铁型肛周脓肿疗效显著。     

Effectiveness and safety of auricular acupoint bloodletting in treatment of insomnia: an assessor-blinded pilot randomized controlled trial

OBJECTIVE

To evaluate the effectiveness and safety of auricular acupoint bloodletting in treatment of insomnia

Xiyanping injection therapy for children with mild hand foot and mouth disease: a randomized controlled trial

Objective

To evaluate the clinical effects of Xiyanping injection intervention in pediatric patients with mild hand foot and mouth disease (HFMD).

Heat-sensitive moxibustion for lumbar disc herniation:a meta-analysis of randomized controlled trials

OBJECTIVE:To assess the efficacy and safety of heat-sensitive moxibustion in the treatment of lumbar disc herniation(LDH).METHODS:Randomized controlled trials(RCTs) involving heat-sensitive moxibustion in the treatment of LDH were retrieved from the Chinese Biological Medical Literature database(1978-20011),Weipu database(1989-2011),Wanfang digital journal(1998-2011),China National Knowledge Internet(1979-2011),PubMed(1966-2011),EMBASE(1980-2011),and Cochrane Library(Issue 1,2011).Hand-search of the relevant journals from the Library of Jiangxi University of Traditional Chinese Medicine was also adopted for the collection of data.Data were extracted and evaluated by two reviewers independently with a specially designed extraction form.The Cochrane Collaboration’s RevMan 5.0.20 software was used for data analyses.RESULTS:A total of 6 trials involving 580 patients were included.Meta-analysis showed that the total effectiveness rate in the heat-sensitive moxibustion group was significantly different when compared with conventional moxibustion [RR=1.19,95% CI [1.06,1.33)] and diclofenac sodium [RR=1.47,95% CI [1.17,1.85)],but similar to that of acupuncture.The cure rate in the heat-sensitive moxibustion group was significantly different when compared with conventional moxibustion [RR=1.58,95% CI(1.04,2.40)] and diclofenac sodium [RR=1.91,95% CI(1.01,3.60)],but similar with that of acupuncture.In terms of the Japanese Orthopaedic Association scores,significant differences were noted in subjective indices,objective indices,and daily life subscales.Two trials reported that there were no adverse events over the duration of treatment.CONCLUSION:Compared with conventional moxibustion,acupuncture,and diclofenac sodium,heat-sensitive moxibustion in the treatment of LDH is superior in efficacy.Further large-scale trials are required to define the role of heat-sensitive moxibustion in the treatment of this disease.     

Calcium-containing versus calcium-free replacement solution in regional citrate anticoagulation for continuous renal replacement therapy: a randomized controlled trial

Background:A simplified protocol for regional citrate anticoagulation (RCA) using a commercial calcium-containing replacement solution, without continuous calcium infusion, is more efficient for use in continuous renal replacement therapy (CRRT). We aim to design a randomized clinical trial to compare the safety and efficacy between calcium-free and calcium-containing replacement solutions in CRRT with RCA.Methods:Of the 64 patients receiving RCA-based postdilution continuous venovenous hemodiafiltration (CVVHDF) enrolled from 2017 to 2019 in West China Hospital of Sichuan University, 35 patients were randomized to the calcium-containing group and 29 to the calcium-free replacement solution group. The primary endpoint was circuit lifespan and Kaplan–Meier survival analysis was performed. Secondary endpoints included hospital mortality, kidney function recovery rate, and complications. The amount of 4% trisodium citrate solution infusion was recorded. Serum and effluent total (tCa) and ionized (iCa) calcium concentrations were measured during CVVHDF.Results:A total of 149 circuits (82 in the calcium-containing group and 67 in the calcium-free group) and 7609 circuit hours (4335 h vs. 3274 h) were included. The mean circuit lifespan was 58.1 h (95% CI 53.8–62.4 h) in the calcium-containing group vs. 55.3 h (95% CI 49.7–60.9 h, log rank P = 0.89) in the calcium-free group. The serum tCa and iCa concentrations were slightly lower in the calcium-containing group during CRRT, whereas the postfilter iCa concentration was lower in the calcium-free group. Moreover, the mean amounts of 4% trisodium citrate solution infusion were not significantly different between the groups (171.1 ± 15.9 mL/h vs. 169.0 ± 15.1 mL/h, P = 0.49). The mortality (14/35 [40%] vs. 13/29 [45%], P = 0.70) and kidney function recovery rates of AKI patients (19/26, 73% vs. 14/24, 58%, P = 0.27) were comparable between the calcium-containing and calcium-free group during hospitalization, respectively. Six (three in each group) patients showed signs of citrate accumulation in this study.Conclusions:When compared with calcium-free replacement solution, RCA-based CVVHDF with calcium-containing replacement solution had a similar circuit lifespan, hospital mortality and kidney outcome. Since the calcium-containing solution obviates the need for a separate venous catheter and a large dose of intravenous calcium solution preparation for continuous calcium supplementation, it is more convenient to be applied in RCA-CRRT practice.Registration:Chinese Clinical Trial Registry (www.chictr.org.cn, ChiCTR-IPR-17012629)     

重症肌无力患者抑郁、焦虑、失眠发生率及其相关因素分析

目的 探讨重症肌无力(MG)患者抑郁、焦虑、失眠的发生率及其相关因素.方法 采用汉密顿焦虑量表、汉密顿抑郁量表、匹兹堡睡眠质量指数量表、MG日常生活量表及自制一般情况调查表对2009年11月至2010年7月在中山大学附属第一医院神经科门诊就诊的161例MG患者进行调查,并用逐步Logistic回归统计方法对各相关因素进行分析.结果 本组患者中抑郁发生率58.3%,焦虑发生率45.3%,失眠发生率39.1%.对MG影响较大的相关因素有:并发抑郁是年龄、肢体乏力、日常生活量表评分;并发失眠是年龄、呼吸困难、患胸腺瘤、术后1个月情况、糖皮质激素用量;并发焦虑的相关因素是分享经验.结论 MG患者半数左右存在不同程度的情感障碍,其相关因素可为防治MG并发情感障碍提供参考依据.     

Effect of Sini San Freeze-dried powder on sleep-waking cycle in insomnia rats

ObjectiveTo investigate the effects of the Sini San at different doses on each sleeping state [slow-wave sleep 1 (SWS1), slow-wave sleep 2 (SWS2), rapid-eye-movement (REM), wakefulness (W)] in insomnia rats and to identify its mode of acaction for improving sleep.MethodsThe insomnia rats were randomly divided into a high-, medium- or low-dose group of Sini San (equal to crude drug 8.8, 4.4, or 2.2 g/kg, respectively) for seven consecutive days.ResultsCompared with pre-administration, SWS2 was significantly increased after administration of the low dose. Compared with pre-administration, W was significantly decreased and SWS1, SWS2, and the total sleeping time (TST) were markedly increased after administration of the medium dose. Compared with pre-administration, W was significantly decreased and SWS1, SWS2, rapid-eye-movement sleep, and TST were significantly longer after administration of the high dose. The effects of Sini San on sleep-wake cycle are dose-dependent.ConclusionThe results suggest that Sini San extends SWS1 and SWS2, which increases the total sleeping time.     

Effect of electroacupuncture on chemotherapy-induced peripheral neuropathy in patients with malignant tumor: a single-blinded,randomized controlled trial

Objective

To evaluate the effect of electroacupuncture on chemotherapy-induced peripheral neuropathy (CIPN), quality of life and immune status of patients with malignant tumors.