穴位贴敷配合电针治疗膝骨性关节炎

研究穴位贴敷配合电针治疗膝骨性关节炎的效果。选取膝骨性关节炎患者70例,随机分为研究组和对照组,每组35例,对照组应用电针进行治疗,研究组在对照组的基础上加用穴位贴敷进行治疗,比较两组的临床疗效。研究组总有效率94.3%明显高于对照组的82.9%,两组比较,差异具有统计学意义(P0.05)。穴位贴敷配合电针治疗膝骨性关节炎具有较好的临床疗效,能明显改善患者的临床症状,减轻患者的病痛。     

穴位按摩联合穴位贴敷对腰椎手术后疼痛的影响

目的探讨穴位按摩联合穴位贴敷对腰椎手术后疼痛的影响。方法选取2017年6月—2017年12月在本院脊柱骨病一科进行腰椎手术的210例患者为研究对象,按随机数字表法分为穴位按摩组、穴位贴敷组、穴位按摩联合穴位贴敷组,各70例。方法穴位按摩组按摩足三里、气海、环跳、委中,穴位贴敷组,穴位同穴位按摩组。穴位按摩联合穴位贴敷组,先行穴位按摩,再给予穴位贴敷。观察3组患者腰椎手术后不同时间点疼痛评分、疼痛改善总有效率及功能锻炼依从性情况。结果穴位按摩联合穴位贴敷组患者不同时间点疼痛评分低于穴位按摩组和穴位贴敷组,疼痛改善总有效率和功能锻炼依从性均高于穴位按摩组和穴位贴敷组,差异具有统计学意义(P0.05),穴位按摩组和穴位贴敷组组间比较,差异无统计学意义(P0.05)。结论穴位按摩联合穴位贴敷能显著减轻腰椎手术后疼痛症状,能提高患者功能锻炼的依从性,有利于康复。     

贴敷疗法联合臭氧治疗膝骨性关节炎的疗效观察

目的观察贴敷疗法联合臭氧治疗膝骨性关节炎的临床疗效。方法回顾本院收治的48例膝骨性关节炎患者,随机均分为单用消肿膏贴敷治疗组（A组）、单用关节腔臭氧注射治疗组（B组）以及消肿膏贴敷联合关节腔臭氧注射治疗组（C组）三组,每组16例,记录治疗前及治疗后1、3、6个月时患者VAS疼痛评分及6个月后膝关节功能评分。结果三组病例治疗后1个月疼痛程度均有明显减轻,其中C组效果最好,其次为B组及A组,治疗后3个月及6个月疼痛程度较1个月时有所增加,但与治疗前相比差异有显著性（P〈0.05）;治疗后6个月的膝关节功能改善情况C组明显优于B组及A组,差异均有显著性（P〈0.05）。结论采用贴敷疗法联合臭氧治疗膝骨性关节炎,其疗效明显优于单用消肿膏贴敷及单用关节腔注射臭氧治疗。     

远红外陶瓷粉与永磁铁结合贴敷治疗膝关节炎临床研究

目的：探讨远红外淘瓷粉与永磁铁结合贴敷治疗骨性膝关节炎的临床疗效。方法：采用随机分组方法，将194例骨性膝关节炎分为观察细和治疗组，观察组采用传统的推拿结合中医药敷贴治疗，治疗组采用远红外陶瓷粉与永磁铁结合贴教治疗。结果：远红外陶瓷粉与永磁铁结合贴敷（治疗组）治疗的总有效率为88．54%，观察组的总有效率为78．20％。结论：远红外陶瓷与永磁铁结合贴敷治疗骨性膝关节炎总体疗效显著（P〈0．05）．方法简单，是骨性膝关节炎实用、有效的治疗方法之一。     

中药封包联合穴位贴敷对不同证型膝骨性关节炎的临床治疗效果分析

目的 探讨在各证型膝骨性关节炎(KOA)患者中行中药封包联合穴位贴敷治疗的效果,评价各证型KOA患者用药后关节症状改善程度,为其治疗方案提供参考依据.方法 将KOA患者按证型分为肝肾亏虚证、风寒湿痹证、痰瘀互结证及气血两虚证4组,先后给予中药封包外敷及穴位贴敷联合治疗,观察患者症状改善及缓解程度,治疗前后采用视觉模拟评...     

穴位按摩联合中药贴敷治疗糖尿病胃轻瘫的疗效观察

目的观察穴位按摩联合中药贴敷治疗糖尿病胃轻瘫的疗效。方法将84例脾虚气滞型糖尿病胃轻瘫患者按随机数字表分为观察组和对照组各42例,两组均给予糖尿病常规治疗,对照组予枸橼酸莫沙比利片口服,观察组采用穴位按摩及中药贴敷治疗,1d为1疗程,2个疗程后观察两组患者临床症状改善情况。结果观察组、对照组临床症状改善总有效率分别为92.86%、76.19%,空腹血糖及餐后2h血糖值明显下降,两组比较差异有统计学意义。结论穴位按摩联合中药贴敷治疗糖尿病胃轻瘫有较好疗效。     

中药穴位贴敷联合腹部按摩改善美施康定所致便秘的临床观察

目的观察中药穴位贴敷联合腹部按摩改善美施康定所致便秘的临床效果。方法将80例服用美施康定的肿瘤便秘患者随机分为试验组和对照组各40例,两组均采用便秘常规护理措施,试验组在对照组基础上加用中药穴位贴敷联合腹部按摩,治疗7d时比较两组患者便秘缓解的临床疗效和首次排便时间。结果试验组患者总有效率为95.0%,高于对照组的77.5%,对照组患者首次排便时间为(4.40±0.70)h,试验组患者为(3.66±0.78)h,两组比较差异有统计学意义(P0.05)。结论中药穴位贴敷联合腹部按摩治疗口服美施康定引起的便秘效果良好。     

穴位贴敷联合中药泥灸在寒湿痹阻型类风湿关节炎患者中的应用

目的 探讨穴位贴敷联合中药泥灸对寒湿痹阻型类风湿关节炎患者疾病活动度和疼痛的影响效果,为临床有效护理寒湿痹阻型类风湿关节炎患者提供借鉴方法。方法 选择2022年6月—2023年4月在医院内分泌科住院的寒湿痹阻型类风湿关节炎活动期患者90例为研究对象,按照组间基本特征具有可比性原则分为对照组、穴位贴敷组和穴位贴敷联合中药泥灸组,对照组行常规护理,穴位贴敷组在常规护理的基础上给予穴位贴敷,穴位贴敷联合中药泥灸组在穴位贴敷组的基础上给予中药泥灸。比较3组患者干预前后的疾病活动度（DAS28）评分、疼痛视觉模拟量表（VAS）评分、晨僵时间和中医疗效评分。结果 护理干预前,3组患者DAS28评分、VAS评分、晨僵时间以及中医疗效评分比较,差异均无统计学意义（P>0.05）;护理干预后,穴位贴敷联合中药泥灸组DAS28评分、VAS评分、晨僵时间的改善情况优于对照组和穴位贴敷组,差异具有统计学意义（P<0.05）;3组患者中医疗效比较,差异有统计学意义（P<0.05）。结论 穴位贴敷联合中药泥灸可有效缓解寒湿痹阻型类风湿关节炎患者的疾病活动度,缩短晨僵时间,提高中医疗效,延缓关节畸...     

穴位按摩联合穴位贴敷治疗小儿痰热壅肺型咳嗽效果观察

目的观察穴位按摩联合穴位贴敷治疗小儿痰热壅肺型咳嗽的临床疗效。方法痰热壅肺型咳嗽患儿150例随机分为A、B、C三组,各50例。西医常规对症治疗基础上采取不同的中医辅助疗法,A组实施穴位按摩,B组实施穴位贴敷,C组实施穴位按摩联合穴位贴敷组。对比3组患儿咳嗽消失时间、治疗效果、住院时间及治疗后日间、夜间咳嗽症状计分及总积分。结果 C组有效率90.0%(45/50),高于A组的66.0%(33/50)和B组的68%(34/50),差异有统计学意义(P0.01);治疗后C组日间、夜间咳嗽症状计分及咳嗽症状总积分低于A组和B组,差异有统计学意义(P0.01);C组患儿咳嗽消失时间、住院时间较A组和B组缩短,差异有统计学意义(P0.01)。结论穴位按摩联合穴位贴敷治疗小儿痰热壅肺型咳嗽疗效确切,能促进患儿康复。     

中药贴敷联合穴位按摩对卵巢癌化疗患者食欲减退的影响

目的:探讨中药贴敷联合穴位按摩对卵巢癌化疗患者食欲减退的影响。方法:将66例卵巢癌患者随机分为对照组32例和观察组34例,对照组给予一般护理常规,观察组在对照组基础上给予中药贴敷联合穴位按摩,通过观察患者食欲及BMI变化情况评价干预效果。结果:观察组食欲评分高于对照组(P0.05)。结论:中药贴敷和穴位按摩作为传统中医外治法中的特色技术,二者联合使用可改善患者食欲减退症状,提高临床治疗效果。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Wie zuverlässig sind Angaben zu nichtentzündlichen ausgedehnten Schmerzen?

ZusammenfassungFragestellung Es wurde geprüft, wie sich der Differenziertheitsgrad zweier Schmerzmessmethoden auf Angaben zur Ausgedehntheit klinischer Schmerzen auswirkt. Zugleich wurde der Referenzzeitraum variiert, über den die Patienten berichten sollten.Methode Erfasst wurde der Einfluss zu Lasten der Befragungsdifferenziertheit durch den Vergleich zweier Körperschema-Bildvorlagen. Drei Referenzzeiträume (Schmerz aktuell, letzte Woche, letztes halbes Jahr) wurden vorgegeben.Ergebnisse Patienten mit ausgedehnten Schmerzen gaben bei differenzierter Befragung um so mehr Schmerzen an, je weiter die Schmerzen zurück lagen und je größer der Berichtszeitraum war. Patienten mit gelenknahen Schmerzen gaben bei hoch differenzierter Befragung weniger ausgedehnte Schmerzen in der Vergangenheit an als bei globaler Einschätzung. Patienten mit Rückenschmerzen berichteten bei differenzierter Befragung zum aktuellen Schmerz über weniger ausgedehnte Schmerzen als bei globaler Befragung.Schlussfolgerung Die Angaben zur Schmerzausdehnung variieren vor allem bei Patienten mit ausgedehnten Schmerzen in Abhängigkeit von der Differenziertheit der Befragung. In diesen Fällen ist die Wahrscheinlichkeit erhöht, dass sich die Beschwerdesymptomatik zumindest teilweise erst in der Reaktion auf die situativen Befragungsbedingungen konstituiert und daher nicht auf andere Befragungsbedingungen generalisiert werden kann.