针刺与电刺激治疗脑卒中后吞咽障碍随机对照研究

目的:比较针刺配合康复训练与电刺激配合康复训练治疗脑卒中后吞咽障碍的疗效。方法:选取97例脑卒中后发生吞咽障碍的患者,随机分为针刺组(32例)、电刺激组(35例)和康复组(30例)。康复组给予常规治疗(神经内科常规治疗方法及康复训练),针刺组给予常规治疗配合针刺治疗,穴取风池、扶突、额三针等;电刺激组给予常规治疗配合电刺激治疗。采用洼田饮水试验、咯痰功能计分及吞咽功能透视检查进行吞咽功能疗效评估。结果:治疗后针刺组总有效率为96.9%(31/32),电刺激组为94.3%(33/35),均优于康复组的66.7%(20/30)(P0.01)。治疗后各组吞咽功能较治疗前均有显著改善(均P0.05),治疗后针刺组与电刺激组均优于康复组(均P0.05)。结论:针刺和电刺激配合康复训练比单纯的康复训练疗效更好,针刺与电刺激治疗吞咽障碍的疗效相当。     

电针治疗轻度认知功能障碍:多中心随机对照研究

目的:验证“通督调髓”电针法干预轻度认知功能障碍(MCI)患者的临床疗效,拟为针灸临床治疗该病提供循证医学A级证据.方法:采用多中心随机对照试验(RCT)的方法,将192例MCI患者随机分为电针组和尼莫地平组,每组96例.电针组采用电针神庭、百会、四神聪、风池隔日1次;尼莫地平组采用口服尼莫地平每日3次,4周为一疗程,共治疗8周.治疗前、治疗1个疗程和治疗2个疗程后分别进行简易精神状态检查表(minimum mental state examination,MMSE)和图形再认测验,结束治疗后的1个月、3个月和6个月分别采用MMSE量表进行随访评价.结果:电针组的总有效率为50.0％(47/94),优于尼莫地平组的34.4％(32/93,P＜0.05).治疗第1疗程后两组MMSE总评分,认知、记忆和言语维度评分组间比较差异均无统计学意义(均P＞0.05);治疗第2疗程后MMSE量表总评分,认知、记忆和视空间技能维度评分两组均有显著提高(均P＜0.01),且电针组优于尼莫地平组(均P＜0.05),但言语维度评分两组间比较差异无统计学意义(P＞0.05).电针组图形再认得分治疗2个疗程后较治疗前显著改善(P＜0.01),并优于尼莫地平组(P＜0.05).治疗后1个月、3个月和6个月的MMSE量表总评分组间比较差异均有统计学意义(均P＜0.01),电针组远期疗效优于尼莫地平组.结论:“通督调髓”电针法和尼莫地平均能显著改善MCI患者的认知功能,电针较尼莫地平更能显著提高MCI患者的综合认知能力和短时记忆能力,且在改善MCI患者认知、记忆和视空间技能维度方面尤佳;在结束治疗后的半年时间内,电针的远期疗效优于尼莫地平.     

贴麻后火针剥除术治疗寻常疣:多中心随机对照研究

目的:比较贴麻后火针剥除术、单纯火针与液氮冷冻治疗寻常疣的临床疗效。方法:将900例寻常疣患者随机分为火针剥除术组(300例,脱落2例)、火针组(300例,脱落4例)和液氮冷冻组(300例,脱落5例)。火针剥除术组采用复方利多卡因乳膏贴麻处理后行火针治疗,并剥除疣体坏死组织;火针组仅行火针治疗,不行贴麻及剥除术;液氮冷冻组采用液氮冷冻法治疗,3组均每周治疗1次,共治疗3周。观察3组患者治疗前后皮损(数目、大小、厚度、颜色、瘙痒、同形反应)评分及外周血T淋巴细胞(+3CD、+4CD、+8CD、+4CD/+8CD)水平,记录3组试验过程中的不良反应,并于治疗后5周随访时评定临床疗效。结果:与治疗前比较,3组患者治疗后各项皮损评分均降低(P<0.05),外周血T淋巴细胞水平均上升(P<0.05)。治疗后火针剥除术组各项皮损评分均低于火针组及液氮冷冻组(P<0.05),T淋巴细胞水平均高于火针组及液氮冷冻组(P<0.05);液氮冷冻组各项皮损评分均低于火针组(P<0.05)。随访时火针剥除术组总有效率为88.6%(264/298),高于火针组的81.4%(241/296)及液氮冷冻组的81.4%(240/295,P<0.05)。液氮冷冻组感染、灼痛及瘢痕不良反应发生例数高于火针剥除术组及火针组(P<0.05)。结论:贴麻后火针剥除术可有效治疗寻常疣,改善患者皮损情况及免疫功能,其疗效优于单纯火针及液氮冷冻。     

电针治疗中风后尿失禁:多中心随机对照研究

目的:评价电针治疗中风后尿失禁的临床疗效.方法:将中风后尿失禁患者204例随机分为电针组(136例)、留置导尿组(68例).电针组穴取曲骨、中极、水道、气海、百会等,行电针疗法,每周治疗5次;留置导尿组给予留置导尿,每2～4 h放尿1次,定期给予膀胱冲洗,配合膀胱康复训练,4周后评定疗效.观察两组患者治疗前后排尿日记(每次排尿间隔时间、夜尿次数、排尿不畅、尿失禁程度)、膀胱容量、病人满意度等,并评定两组疗效.结果:电针组总有效率为96.2％(125/130),优于留置导尿组的87.5％(56/64,P＜0.05);治疗后除留置导尿组夜尿次数无改变外,两组排尿日记各项评分与总分均显著改善(均P＜0.001),且电针组均优于留置导尿组(P＜0.001,P＜0.05);治疗后两组病人满意度、膀胱容量均显著改善(均P＜0.001),电针组亦优于留置导尿组(均P＜0.001).结论:电针治疗中风后尿失禁疗效显著,可明显改善尿失禁症状,增加膀胱容量,疗效优于常规留置导尿.     

不同针刀进针点治疗腰椎间盘突出症：随机对照研究

目的:比较压痛点、椎间孔点、关节突关节点3种不同针刀进针点治疗腰椎间盘突出症(LDH)的临床疗效及安全性。方法:将105例LDH患者随机分为压痛点组(35例,脱落1例)、椎间孔点组(35例)、关节突关节点组(35例,脱落1例)。3组分别取腰骶部及臀部阳性反应点、椎间孔外口点、椎体关节突关节点进行针刀治疗,每周1次,共治疗4次。观察各组治疗前,治疗2、4周后及治疗后3个月随访时日本骨科协会评估治疗分数(JOA)、腰椎Oswestry功能障碍指数(ODI)评分及视觉模拟量表(VAS)评分,并观察疗效及安全性。结果:治疗2、4周后及随访时,各组患者JOA评分均较治疗前升高(P<0.05);治疗4周后及随访时,压痛点组、关节突关节点组患者JOA评分高于椎间孔点组(P<0.05)。治疗2、4周后及随访时,除椎间孔点组治疗2周后ODI评分外,各组患者ODI、VAS评分均较治疗前降低(P<0.05),压痛点组、关节突关节点组患者ODI评分低于椎间孔点组(P<0.05);治疗2周后,压痛点组、关节突关节点组患者VAS评分低于椎间孔点组(P<0.05);治疗4周后及随访时,...     

Abdominal acupuncture for insomnia in women: a randomized controlled clinical trial

A randomized single-blind trial was conducted to evaluate the efficacy of short-term abdominal acupuncture as a novel treatment for insomnia in Chinese women. Forty-four patients between the ages of 22 and 56 were randomly assigned to an acupuncture (n = 23) and a medication group (n = 21). The acupuncture group received abdominal acupuncture once a day for the first three days and once every three days for the remaining 11 days. In addition, every subject in acupuncture group also received a placebo pill once daily. Abdominal acupuncture was administered according to a standardized protocol involving four master and four adjunctive acupoints: Zhongwan (CV 12), Xiawan (CV 10), Guanyuan (CV 4), and Qihai (CV 6); bilateral Shangqu (KI 17), Huaroumen (ST 24), Xiafengshidian, and Qipang. Subjects in the medication group were treated with sham acupuncture at the same time as the acupuncture group and received estazolam once a day. The outcome measure was the Leeds Sleep Evaluation Questionnaire (LSEQ), administered before and after the trial. Subjects who received abdominal acupuncture lowered their LSEQ scores by an average of 26.32 points (95% CI: 37.34, 15.30). After controlling for potential confounding factors, the effect of abdominal acupuncture in relieving insomnia was still statistically significant. Results indicate that short-term abdominal acupuncture is more effective than pharmacological treatment for relieving insomnia in adult women and has few adverse effects.     

Acupuncture-movement therapy for acute lumbar sprain: a randomized controlled clinical trial

OBJECTIVE: Several studies have reported that acupuncture is effective for treatment of acute lumbar sprain, but they neglected to consider that acupuncture cannot remarkably improve lumbar activity. We performed a randomized controlled trial to evaluate the effect of acupuncture-movement therapy versus conventional acupuncture in the treatment of acute lumbar sprain.METHODS: Sixty patients were randomized into four groups: the acupuncture-movement(AM)group, sham acupuncture-movement(SAM) group,conventional acupuncture(CA) group, and physical therapy(PT) group. Patients in the AM group were treated with acupuncture at Yintang(EX-HN 3) and exercise of the lumbar region during acupuncture.Patients in the SAM group were treated with sham acupuncture at Yintang(EX-HN 3) and exercise of the lumbar region during sham acupuncture. Conventional acupuncture was performed in the CA group, and physical therapy was applied in the PT group. Each treatment lasted for 20 min. Patients were assessed before and after treatment using a visual analogue scale(VAS) and the Roland Morris Questionnaire(RMQ).RESULTS: The VAS and RMQ scores in the AM group were significantly lower after than before treatment(P 0.01). The AM group reported lower RMQ scores in after-treatment and 24 h after treatment and lower VAS score in 24 h after treatment in comparison with those of the CA, SAM, and PT groups(P 0.05).CONCULSION: Acupuncture-movement therapy is effective for treating acute lumbar sprain with a persistent pain-relief and remarkable improvement of lumbar activity. Movement, that is, lumbar exercise during acupuncture, enhances the effect of acupuncture.     

针刺治疗抑郁性神经症：多中心随机对照研究

目的：观察针刺对于抑郁性神经症的临床疗效。方法：采用多中心随机对照研究，将440例患者分为针刺组、百忧解组、非穴位针刺组。针刺组采用四关穴（合谷、太冲）为主的穴位，百忧解组服用药物百忧解20mg／d，非穴位针刺组患者接受针刺治疗，但取穴偏离真正的穴位。在治疗前、后进行汉密尔顿抑郁量表（HAMD）计分，按HAMD减分率进行疗效评价，以Asberg氏抗抑郁药副反应量表（SERS）结合严重不良反应记录进行安全性评估，对数据进行意向性分析（ITT分析）。结果：针刺组的总有效率为86．4％，优于非穴位针刺组的59．1％及百忧解组的72．7％；针刺组的HAMD计分与百忧解组相当，而且2组均优于非穴位针刺组；针刺组及非穴位针刺组的SERS计分均明显低于百忧解组，未见晕针等严重针刺不良反应记录。结论：针刺对于抑郁性神经症是一种有效、安全的疗法；针刺治疗抑郁性神经症的疗效可能优于百忧解或与百忧解相当，但副作用远低于百忧解。     

针刺肝胆经穴治疗偏头痛:多中心随机对照研究

目的:评价针刺肝胆经腧穴治疗偏头痛的临床疗效.方法:采用多中心、随机、对照的方法,将253例偏头痛患者随机分为针刺组和西药组;针刺组以针刺肝胆经腧穴治疗,穴取太冲、阳陵泉、风池、曲泉为主;西药组采用盐酸氟桂利嗪(西比灵)片剂口服治疗,共4个疗程.观察两组治疗后3月和6月总体疗效和治疗前后头痛积分,1年后随访观察两组疗效稳定性.结果:两组治疗后头痛平均发作次数和平均持续时间均较治疗前明显改善(均P<0.01),治疗后两组比较,针刺组改善程度优于西药组(均P<0.05).针刺组治疗后和治疗后3个月、6个月止痛总有效率分别为93.0%、93.0%、87.7%,优于西药组的85.6%、86.5%、69.2 9/6(均P<0.01);1年后疗效稳定性针刺组明显优于西药组(P<0.05).结论:针刺肝胆经穴治疗偏头痛是安全、有效的,且远期疗效稳定.     

穴位注射联合Vitalstim电刺激治疗脑卒中后吞咽障碍：随机对照研究

目的:观察穴位注射联合Vitalstim电刺激治疗脑卒中后吞咽障碍的疗效。方法:将98例首次脑卒中后吞咽障碍患者随机分为穴位注射组(35例,脱落2例)、电刺激组(31例,脱落3例)和联合组(32例,脱落3例)。分别予"吞咽"穴注射甲钴胺注射液治疗、Vitalstim电刺激治疗及二者联合治疗,每天1次,10次为一疗程,共治疗2个疗程。观察各组患者治疗前后舌肌厚度及电视透视吞咽功能检查(VFSS)评分。结果:治疗后,各组患者舌肌厚度均较治疗前降低(P<0.05),VFSS评分均较治疗前增加(P<0.05);治疗后,联合组患者舌肌厚度及VFSS评分变化幅度均大于穴位注射组和电刺激组(P<0.05)。结论:甲钴胺注射液穴位注射和Vitalstim电刺激均对脑卒中后吞咽障碍有治疗作用,且二者有协同作用。     

针刺治疗脑卒中后抑郁：随机对照研究

【摘要】目的：探讨针刺治疗脑卒中后抑郁的疗效和安全性。方法：采用随机双盲对照设计,将符合DSM-IV目前重性抑郁发作诊断标准的43例脑卒中患者简单随机分入实验组（针刺+安慰剂）组和对照组（安慰针刺+氟西汀）;依次于治疗前、第1、2、4、6周末双盲法用Hamilton抑郁量表、Asberg抗抑郁药副作用量表和自编针刺不良反应清单进行疗效和安全性评价。结果：治疗第6周末,实验组和对照组有效率分别为73.9%（17/23）和80.0%（16/20）,疗效差异无统计学意义（?2=0.222,P=0.637）;重复测量方差分析显示实验组的Asberg抗抑郁药副作用评分显著低于对照组（F=5.19,P=0.01）;两组针刺不良反应发生率分别为13.0%（3/23）和15.0%（3/20）,差异无统计学意义（?2=0.034,P=0.853）。结论：针刺疗法治疗脑卒中后抑郁的疗效与氟西汀相当,没有明显药物治疗引起的副作用。 【关键词】 针刺;氟西汀;脑卒中后抑郁;随机对照研究     

经络三联法治疗寻常型银屑病：多中心随机对照研究

目的:评价经络三联法治疗寻常型银屑病的有效性和安全性.方法:采用随机、阳性药物对照、多中心临床研究,将233例分为三联法组(116例)和药物组(117例).三联法组采用用穴位埋线、耳背刺络、耳压三联法进行治疗,埋线根据皮损部位选局部3～4个穴位,2周治疗1次;耳穴取肺、肝、皮质下、神门、头部及四肢部及皮肤严重部分对称点,耳穴贴压每次取3～5穴.药物组口服迪银片,每次5片,每日2次.两组均治疗6周后比较临床疗效、皮损面积评分、皮损严重程度评分情况及安全性.结果:三联法组愈显率为57.8%,药物组为51.3%,两组疗效差异无统计学意义(P＞0.05);两组治疗后皮损面积评分及皮损严重程度评分均较治疗前明显降低(均P＜0.01),组间比较差异无统计学意义(P＞0.05);三联法组不良反应的发生率明显低于药物组.结论:经络三联法治疗寻常型银屑病是有效和安全的.     

Efficacy of HuaDan Anshen Mistura for treating insomnia: a randomized,double-blind,placebo-controlled,multi-center clinical trial

Objective

To evaluate the effect of HuaDan Anshen Mistura (mistura) in clinical treatment of Chinese patients with insomnia.

Methods

In this randomized, double-blind, placebo-controlled, multi-center study, 244 patients with insomnia were randomly assigned to a placebo group, a low-dose (10 mL/day), or a high-dose (20 mL/day) mistura group. Efficacy was assessed by using the sleep dysfunction rating scale (SDRS) and Clinical Global Impression-Improvement (CGI-I) scores. Safety and tolerability assessments included emergent adverse events, laboratory tests, and electrocardiograms.

Results

Total SDRS scores decreased in all three groups, and there were significant differences between the placebo group and the low- and high-dose mistura groups (P=0.000). CGI-I ratings in the low- and high-dose mistura groups were significantly better than that of the placebo group (P=0.000). Incidences of rebound insomnia were similar in all three groups (placebo group: 6.94%, low-dose mistura group: 12.99%, and high-dose mistura group: 10.96%; P=0.475). The efficacy of HuaDan Anshen Mistura in the low- or high-dose group was significantly better than that of the placebo group (P=0.000), but with no significant difference found between the low- and high-dose mistura groups (P=0.887). The rates of adverse events were similar in the three groups (placebo 2.44%, low-dose mistura 0%, and high-dose mistura 5%; P=0.088).

Conclusion

HuaDan Anshen Mistura is an effective and generally well-tolerated hypnotic medicine for the treatment of Chinese patients with insomnia.     

穴位贴敷治疗支气管哮喘：多中心随机对照研究

目的:观察穴位敷贴对支气管哮喘患者临床症状、生活质量的影响.方法:采用多中心、随机、双盲试验方法,将188例患者分为药物贴敷组(125例)及安慰组(63例).两组均取大椎、肺俞、天突等穴,药物贴敷组贴敷胡椒、白芥子、细辛等中药研磨混合姜油及姜汁制成的药饼;安慰组贴敷红米、黑米、玉米混合少量姜汁制成的圆饼.观察两组患者在生活质量评分(AQLQ),日间、夜间症状评分及自我疗效评分、肺功能值方面的变化.结果:药物贴敷组在AQLQ量表中日常行为、环境因素、AQLQ总计分值及日间症状、自我疗效评分方面较安慰组明显改善(均P<0.05).两组患者肺功能1秒钟用力呼气容积(FEV_1)及1秒钟用力呼气容积占预计值百分比(FEV_1/FVC)无明显差异(均P>0.05).结论:穴位敷贴对支气管哮喘患者临床症状改善显著,并能提高患者的生活质量.     

腕踝针治疗中老年患者睡眠障碍临床随机对照研究

目的评价腕踝针治疗中老年患者睡眠障碍的临床疗效。方法采用随机对照的临床研究方法,将89例睡眠障碍的中老年患者随机分成运动组、腕踝针组、联合治疗组,每组29例。运动治疗由专门康复治疗师进行教授。腕踝针治疗取双侧上1区,并由注册的同一名针灸治疗师进行治疗。结果组间比较:在治疗4周后,3组的PSQI总分与治疗前比较,差异有统计学意义(P<0.05),其中日间功能障碍表现的尤为明显,联合治疗组的效果优于运动组和腕踝针组;在12周随访时,3组日间功能障碍、PSQI总分与治疗前比较,运动组的效果优于腕踝针组和联合治疗组;治疗4周与12周随访时比较,3组日间功能障碍、PSQI总分运动组优于腕踝针组和联合治疗组。结论腕踝针治疗中老年患者睡眠障碍与运动疗法具有相近的临床疗效,可以有效地改善中老年患者睡眠质量,并且对患者抑郁情况与中医体质况状亦有所改善。     

The effect of acupuncture on allergic rhinitis: a randomized controlled clinical trial

Allergic rhinitis is a common health problem usually treated with drug therapy. Some patients experience side effects of drug therapy while others fear the use of drugs. Acupuncture is an interesting alternative to traditional treatment. The few studies evaluating acupuncture indicate a possible clinical effect on allergic rhinitis. This study compared active versus sham acupuncture in 40 consecutive patients with a history of allergic rhinitis and a positive skin test. Patients were randomized and assessed prior to treatment and then reassessed after 12 months. Improvements in symptoms using visual analogue scales, reduction in skin test reactions and levels of specific immunoglobin E (IgE) were used to compare the effect of treatment. For one allergen, mugwort, a greater reduction in levels of specific IgE (p = 0.019, 0.039) and skin test reaction (p = 0.004) was seen in the group receiving active acupuncture compared to the group receiving sham acupuncture. However, this finding might be an artifact. No differences in clinical symptoms were seen between active versus sham acupuncture, thus the conclusion being that the effect of acupuncture on allergic rhinitis should be further evaluated in larger randomized studies.     

针刺联合西药治疗盆腔炎性疾病后遗症慢性盆腔痛:多中心随机对照研究

目的:比较针刺联合布洛芬缓释胶囊与单纯口服布洛芬缓释胶囊治疗盆腔炎性疾病(PID)后遗症慢性盆腔痛(CPP)的疗效。方法:将144例患者随机分为观察组(72例,脱落10例)和对照组(72例,脱落9例)。对照组予口服布洛芬缓释胶囊治疗,每次1粒;观察组在对照组基础上行针刺治疗,穴取关元、水道、归来、肾俞、次髎,其中水道、归来、肾俞、次髎行电针疗法。两组均于月经来潮前10 d开始治疗,每日1次,每个月经周期治疗10 d,共治疗3个月经周期,随访3个月经周期。记录两组患者治疗前后及随访时下腹部、腰骶部视觉模拟量表(VAS)评分和治疗前后局部体征评分、生活质量量表(WHOQOL-BREF)评分。结果:与治疗前比较,两组患者治疗后及随访时下腹部、腰骶部VAS评分均降低(P<0.05),且观察组患者治疗后及随访时VAS评分均低于对照组(P<0.05)。与治疗前比较,除对照组宫骶韧带触痛评分外,两组治疗后局部体征评分均降低(P<0.05),且观察组附件区压痛评分及局部体征总评分均低于对照组(P<0.05)。与治疗前比较,两组WHOQOL-BREF生理领域评分均升高(P<0.05),观察组心理、社会关系、环境领域评分升高(P<0.05),且观察组生理领域评分高于对照组(P<0.05)。结论:针刺联合布洛芬缓释胶囊可有效改善盆腔炎性疾病所致慢性盆腔痛患者疼痛症状、体征,提高其生活质量,其疗效优于单纯口服布洛芬缓释胶囊。