项丛刺结合颈夹脊穴针刺、TDP神灯照射治疗颈源性眩晕50例临床观察

目的观察项丛刺结合颈夹脊穴针刺、TDP神灯照射治疗颈源性眩晕的临床疗效。方法将97例颈源性眩晕患者随机分为治疗组和对照组。对照组47例采用颈夹脊穴针刺联合TDP神灯照射治疗,治疗组50例在对照组治疗方法的基础上结合项丛刺治疗。连续治疗10次为1个疗程,2个疗程后统计疗效。结果治疗组总有效率为94.00%,显著高于对照组的80.85%,2组比较差异有统计学意义(P0.05);与同组治疗前比较,2组治疗后颈性眩晕症状与功能评估(ESCV)评分显著升高,差异均有统计学意义(P0.05),且治疗组治疗后ESCV评分显著高于对照组,差异有统计学意义(P0.01)。结论项丛刺结合颈夹脊穴针刺、TDP神灯照射治疗颈源性眩晕疗效满意,并能迅速缓解眩晕、头痛、颈肩痛等症状,值得临床推广运用。     

项丛刺配合颈夹脊穴针刺治疗颈性眩晕30例疗效观察

目的观察项丛刺配合颈夹嵴穴针刺治疗颈性眩晕临床疗效。方法 60例颈性眩晕患者分治疗组和对照组,各30例。对照组服甲磺酸倍他司汀片,治疗组行项丛刺配合颈夹嵴穴针刺。疗程为4周。比较两组治疗前后眩晕症状改善情况。结果治疗组总有效率为96.7%(29/30),显著高于对照组83.3%(25/30),差异有统计学意义(P0.05)。结论项丛刺配合颈夹嵴穴针刺治疗颈性眩晕疗效较好。     

电针颈夹脊穴治疗颈源性眩晕67例、

目的观察电针颈夹脊穴配合牵引治疗颈源性眩晕的临床疗效。方法将符合纳入标准的颈源性眩晕患者130例,随机分为两组。治疗组67例采用电针颈夹脊穴结合牵引治疗,对照组63例单纯采取牵引法治疗,观察两组临床疗效。结果治疗组显效率75％,对照组显效率57％,两组显效率比较P〈0．05。结论电针颈夹脊穴可明显改善颈源性眩晕患者临床症状。     

针刺董氏奇穴常规穴配合TDP神灯照射治疗原发性痛经临床研究

目的：观察针刺董氏奇穴常规穴配合TDP神灯对痛经快速治疗的临床疗效研究。方法：将216例原发性痛经患者随机分为两组,治疗组108例采用针刺董氏奇穴常规穴配合TDP神灯照射治疗;对照组108例采用针刺常规穴配合TDP神灯照射治疗。结果：治疗组疗效明显优于对照组。结论：针刺董氏奇穴常规穴配合TDP神灯照射治疗原发性痛经效果好,治愈率高。     

健脾调神法治疗颈源性眩晕痰湿中阻型的疗效观察

目的观察健脾调神法治疗颈源性眩晕的临床疗效。方法将60例痰湿中阻型颈源性眩晕患者随机分为两组,每组30例。治疗组取颈3~5夹脊穴、本神、神庭透百会、内关、三阴交、丰隆、足三里等穴位,针刺得气后,施相应的补泻手法,留针30 min。对照组采用常规药物治疗(注射用七叶皂苷钠15 mg、丹参川芎嗪10 ml),均每日治疗1次,7 d为1个疗程。疗程结束后对比两组治疗后疗效。结果治疗组治疗前后症状评分比较,差异有统计学意义(P0.01),两组病例治疗前后症状评分差值比较差异有统计学意义(P0.05);两组病例治疗后总有效率比较差异有统计学意义。结论颈性眩晕采用健脾调神针刺法临床疗效确切,安全可靠,具有广阔的应用前景,值得临床推广应用。     

针刺治疗老年性颈性眩晕

目的:观察针刺相应颈夹脊、风池、外风池(经验穴)、肩井、大椎、陶道、太冲治疗老年性颈性眩晕的临床疗效。方法:随机将108例老年性颈性眩晕患者分为治疗组60例,对照组(单纯用葛根素氯化钠注射液)48例。观察两组的临床疗效。结果:一个疗程后,治疗组和对照组治疗均能减轻眩晕,治疗组与对照组的总有效率分别为98.3%和88.3%,治疗组疗效明显优于对照组,差异有非常显著性意义(P<0.01)。结论:针刺相应颈夹脊、风池、外风池等穴是治疗老年性颈性眩晕的有效治疗方法。     

葛根汤加减联合针刺疗法治疗颈源性眩晕的疗效观察

目的:探讨葛根汤加减联合针刺疗法治疗颈源性眩晕的疗效.方法:选取2019年2月至2020年2月收治的98例颈源性眩晕患者分为观察组和对照组.对照组给予常规西药治疗,观察组给予葛根汤加减联合针刺治疗,比较两组患者临床疗效,治疗前后ESCV评分、DHI评分、脑血流速度及血液流变学指标.结果:观察组患者临床疗效总有效率较对照组显著提高(P<0.05);治疗前两组患者ESCV评分、DHI评分、脑血流速度及血液流变学指标无显著性差异(P>0.05),治疗后观察组患者ESCV评分、DHI评分、脑血流速度及血液流变学指标优于对照组患者(P<0.05).结论:葛根汤加减联合针刺疗法治疗颈源性眩晕可显著缓解患者临床症状,恢复脑血流速度,改善血液流变学指标,优于常规西药治疗,值得推广.     

整脊疗法联合颈夹脊穴针刺治疗颈源性高血压30例

目的观察整脊疗法联合颈夹脊穴针刺治疗颈源性高血压的疗效。方法采用随机数字表法将60例颈源性高血压患者分为对照组和观察组各30例,分别采用常规穴位针刺法和整脊疗法联合颈夹脊穴针刺法进行治疗,疗程为4周。观察2组治疗前后舒张压和收缩压的变化,并比较2组临床疗效。结果与治疗前比较,2组治疗后舒张压和收缩压均明显降低(P<0.05);与对照组比较,观察组舒张压和收缩压治疗前后的差值均明显提高(P<0.05)。观察组疗效优于对照组(P<0.05)。结论整脊疗法联合颈夹脊穴针刺治疗颈源性高血压疗效显著,操作简便,值得临床推广。     

头针配合穴位透刺法治疗颈性眩晕38例临床报道

目的观察运用头针配合穴位透刺法治疗颈性眩晕的临床疗效.方法采用头针配合穴位透刺法治疗颈性眩晕患者38例,并与常规颈部夹脊穴针刺法进行比较.结果治疗组疗效优于对照组(P<0.05).结论头针配合穴位透刺法可以更有效地改善眩晕患者的症状.     

针刺加激光照射治疗椎动脉型颈椎病临床观察

目的 观察针刺加激光治疗椎动脉型颈椎病的临床疗效.方法 椎动脉型颈椎病患者采用针刺颈夹脊加激光照射治疗,并与推拿对照组进行疗效比较.结果 治疗组总有效率为87.5%,与对照组总有效率(65.5%)比较有显著性差异(P<0.05),且针刺夹脊穴加激光照射的疗效具有持续性和积累性,治疗组治疗2个疗程后治愈率和有效率均较治疗1个疗程为高.结论 针刺加激光照射治疗椎动脉型颈椎病是安全有效的方法 .     

Correlation of cervical cytology with cervical histology

OBJECTIVE: To correlate cervical cytology with Cervical histology. METHODOLOGY: A hospital based prospective study was carried out in consecutive total forty-three patient attending oncology clinic of Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal from 1st Bhadra 2061 to end of Falgun 2061 (18th August 2004-12th February 2005) during authors posting in this clinic. All patients who underwent cervical biopsy on either indication of clinically suspected lesions or abnormal cytology were correlated with Pap smear report. Pap smear was carried out in conventional technique using Ayre's spatula. Cervical biopsy was carried out with help of punch biopsy forceps in operation Theatre without the guidance of colposcopy. All pertinent information regarding patient profile in terms of their age, parity, age at marriage, age at 1st child birth, smoking habit, contraceptive use, and symptom of vaginal discharge was taken. Reports of Pap smear and cervical biopsy of these patients were collected from oncology clinic during their follow up visit and all these information and finding were entered in structured questionnaire. The reporting of Pap smear was done in Bethesda system. The average duration between performing Pap smear and biopsy was of one month. Statistical analysis was carried out by EPI-INFOS6 system. RESULT: Of forty three patients who underwent cervical cytology 22 cases were of Benign lesion, 8 cases of LSIL, 9 cases of HSIL, 3 cases of invasive carcinoma and 1 of ASCUS. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and p-value in benign grade was 76%, 83.3%, 86.4%, 71.4%, 79.1%, 0.0004 respectively. Similarly sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and p-value in LSIL was 60%, 93.9%, 75%, 88.6%, 86%,0 .0008 respectively. For HSIL it was 100%, 89.5%, 55.6%, 100%, 90.7 0.0001 respectively. Respectively for carcinoma it was 100% for sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy p-value was 0.00008. CONCLUSION: Pap smear significantly correlated with cervical histology.     

前路椎体次全切与椎间盘切除减压植骨融合内固定术治疗双节段颈椎病的临床疗效比较

目的 比较椎体次全切除减压融合术(anterior cervical corpectomy and fusion,ACCF)与椎间盘切除减压植骨融合内固定术(anterior cervical discectomy and fusion,ACDF)对邻近双节段脊髓型颈椎病的治疗效果.方法 回顾性分析2013年1月至2015年3月北京朝阳医院收治的63例因相邻双节段脊髓型颈椎病行前路手术治疗的患者临床及影像学资料,其中ACCF组31例,ACDF组32例.统计所有患者基线资料、手术时间、出血量、住院天数、手术相关并发症.比较两组术前及末次随访时颈椎曲度、T1椎体倾斜角(T1 Slope)、融合节段Cobb角、融合节段高度、植入物下沉、融合率、头尾端邻近节段骨化分级、日本骨科协会(Japanese Orthpaedic Association,JOA)评分及颈痛、上肢痛视觉模拟评分(visual analogue score,VAS).结果 随访时间为12～40个月.ACCF组出血量显著高于ACDF组(P＜0.05);术前、末次随访时颈椎曲度、T1椎体倾斜角、融合节段Cobb角、融合节段高度比较差异均无统计学意义(P＞0.05);末次随访时,2组均获得100％融合率,植入物下沉比较,差异无统计学意义(P＞0.05).与术前相比,末次随访时ACCF组影像学参数差异无统计学意义(P＞0.05),ACDF组颈椎曲度、融合节段Cobb角、融合节段高度显著增加(P＜0.05).术前两组JOA评分、VAS评分差异均无统计学意义,末次随访时差异亦无统计学意义,末次随访时两组JOA评分、VAS评分均较术前明显改善(P＜0.05).末次随访时,2组各影像学参数与JOA评分和VAS评分均无显著相关性(P＞0.05).结论 两种颈椎前路手术均可获得满意的临床效果,ACDF在出血量及改善颈椎曲度、融合节段Cobb角、融合节段高度等方面优于ACCF.两种颈椎前路术后影像学指标与临床评分均无显著相关性.     

宫颈糜烂程度与宫颈病变的关系初探

目的探讨宫颈糜烂程度与宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）及宫颈癌的关系。方法随机抽取就诊于我院妇产科门诊的600名患者为研究对象,设宫颈光滑组、轻度糜烂组、中度糜烂组和重度糜烂组4组,比较各组CIN和宫颈癌的疾病构成比。结果各组无病变、CINⅠ、CINⅡ、CINⅢ及宫颈癌的疾病构成比分别为：宫颈光滑组92.57%、3.38%、2.02%、2.15%和0.67%;轻度糜烂组92.10%、3.29%、1.97%、2.63%和0.66%;中度糜烂组90.85%、3.92%、1.96%、2.61%、0.65%;重度糜烂组91.84%、3.40%、2.04%、2.72%和0.68%。各组之间的疾病构成比比较,差异无统计学意义。结论宫颈糜烂程度与宫颈病变之间无直接相关性,不应该将宫颈糜烂作为宫颈病变的高危因素。对光滑的宫颈更应警惕宫颈病变的发生。     

动态颈椎MR检查在脊髓型颈椎病诊断中的价值

颈椎MR检查是目前脊髓型颈椎病诊断的主要检查方法,但忽略了颈椎的动态变化,不能全面反映脊髓受压及椎管狭窄的情况,而且对于脊髓型颈椎病的早期诊断也存在一定的缺陷。动态颈椎MR检查可以弥补这一缺陷,并且做到早期诊断、早期治疗。但目前研究病例数相对较少,不能全面客观地反映动态颈椎MR的诊断价值。     

紧急宫颈环扎术在宫颈机能不全中的应用

目的研究紧急宫颈环扎术在宫颈机能不全中的应用。方法将2015年12月～2018年12月所收治的80例宫颈机能不全孕妇作为研究对象,分成实验组与对照组,每组各40例。对照组进行常规药物治疗,实验组进行宫颈环扎术治疗,对比两组临床效果。结果实验组孕妇足月生产率、胎儿阿氏评分、延长孕周及临床治疗满意程度均明显高于对照组孕妇,组间比较差异有统计学意义(P0.05)。结论紧急宫颈环扎术在宫颈机能不全患者治疗中的应用效果显著,能够提高孕妇足月生产率,降低流产率,有效延长孕妇孕周,同时提高患者对于临床治疗的满意程度,值得临床推广与使用。     

宫颈环扎术治疗宫颈机能不全的疗效

目的:探讨宫颈环扎术治疗妊娠期宫颈机能不全的疗效.方法:54例确诊妊娠合并宫颈机能不全者,32例施行宫颈环扎术治疗(环扎组),22例拒绝手术(非环扎组),观察其妊娠结局等各项指标.结果:环扎组与非环扎组除早产率外,足月妊娠率、流产率及新生儿成活率比较差异均有统计学意义(P均＜0.05).结论:宫颈机能不全行宫颈环扎术可...     

光电探测系统与细胞学检测在宫颈癌筛查中的对照研究

目的 探讨光电探测系统(TS)与细胞学检测在宫颈癌筛查中的临床意义.方法 对392例患者依次进行TS、巴氏涂片(Pap)、液基薄层细胞学检测(TCT)及人类乳头状瘤病毒(HPV)检测,以阴道镜和病理学检查为金标准,比较4种方法及联合方法的灵敏度、特异度、Kappa值和应用受试者工作特征曲线(ROC)的曲线下面积.结果 (1)Pap、TCT、TS及HPV检测的灵敏度分别为32.2%、42.2%、74.4%和47.8%,特异度分别为96.7%、93.7%、78.8%和84.8%.TCT并联HPV、TCT并联TS、Pap并联TS、HPV并联TS的灵敏度分别为65.6%、87.8%、82.2%和86.7%,特异度分别为81.1%、74.5%、75.8%和67.2%.(2)比较ROC曲线下面积,TS与Pap、TIS与HPV检测有统计学差异(P＜0.05),而TCT与Pap、TCT与TS没有统计学差异;使用并联筛查方法时,TS并联其他方法与相应非TS方法比较,有统计学差异(P＜0.05),但与单独使用TS相比,无统计学差异,四种并联方法之间无统计学差异.结论 (1)TS作为一种宫颈癌早期筛查技术,具有即时检测即时诊断的效果.(2)本研究中TS的诊断效果评价优于Pap及HPV,等同于TCT,TS联合细胞学检测可以提高细胞学检测的筛查效果.     

Diagnostic cervical zygapophyseal joint blocks for chronic cervical pain

OBJECTIVES: (1) To determine the prevalence of cervical zygapophyseal joint pain in a specialist clinical setting; (2) to review the number of diagnostic blocks needed to identify the segmental level of the symptomatic joints; and (3) to determine the distribution of segmental levels of cervical zygapophyseal joint pain in a clinical setting. DESIGN AND SETTING: Retrospective audit of patients of three independent rehabilitation medicine specialists who had undergone cervical zygapophyseal joint blocks in hospital outpatient clinics and private rooms. PATIENTS: 97 patients aged 18-82 years with chronic neck pain (with or without headache) of more than six months' duration refractory to conservative therapies. INTERVENTION: Diagnostic fluoroscopic cervical third occipital and medial branch blocks of zygapophyseal joints. Diagnosis required confirmation by a repeat procedure. RESULTS: 35 of 97 patients (36%) had a confirmed symptomatic cervical zygapophyseal joint (95% CI, 27%-45%). The symptomatic segmental level was found at the first attempt by reference to a standard pain diagram in 83% of cases (29 of 35). The most common symptomatic levels were C3-4 (11/35; 31%) and C5-6 (10/35; 29%). CONCLUSION: The prevalence of cervical zygapophyseal joint pain estimated in this clinical study is lower than that found in previous research setting studies, but our requirement for confirmation by a repeat block (which many patients declined) makes our estimate conservative; it is likely that the true prevalence is higher. Zygapophyseal joints are clearly a common source of pain in patients presenting with chronic neck pain, with or without headache. Cervical zygapophyseal joint pain is readily diagnosable, enabling patients to seek further, targeted treatment.