A comparison of written materials vs. materials and counselling for women with sexual dysfunction and multiple sclerosis

Aim. Evaluate whether symptoms of vaginal dryness, low libido, less intense or delayed orgasm could be improved in women with multiple sclerosis who took part in an education or education plus counselling programme. Background. Sexual dysfunction, a prevalent symptom in women with multiple sclerosis, can negatively affect quality‐of‐life. Methods. Women attending a large multiple sclerosis clinic were invited and 62 were randomized into one of two groups. Group 1 received written materials on primary, secondary and tertiary sexual dysfunction in multiple sclerosis as well as additional resources (books, websites, list of local psychologists specializing in sexual counselling). Group 2 received the same written materials as well as three counselling sessions from the clinic nurse, the latter two by telephone. The primary outcome measures were the expanded disability status scale and the multiple sclerosis intimacy and sexuality questionnaire‐19. Repeated‐measures analysis of variance was used to evaluate sexual dysfunction score over time and to compare two groups. Results. At baseline, total expanded disability status scale scores were not correlated with primary, secondary or tertiary sexual dysfunction. Total multiple sclerosis intimacy and sexuality questionnaire‐19 score was correlated with use of anti‐cholinergic medications [r (54) = 0·28, P < 0·05], but no other medications, alcohol or tobacco use. Both groups had equivalent and significant reductions in primary sexual dysfunction [F (1) = 14·79, P < 0·001] postintervention. There was a trend towards an interaction effect for tertiary sexual dysfunction [F (1) = 2·88, P = 0·096], in the direction of group 2 (education and counselling). Subjectively, women welcomed the opportunity to discuss sexual concerns and noted that the written information allowed a framework for initiating discussion with their spouses. Conclusion. Relatively straightforward interventions provided by a clinic nurse may help women cope with the symptoms of sexual dysfunction associated with multiple sclerosis. Women who do not benefit from basic interventions could then be referred to an expert sexual dysfunction practitioner. Relevance to clinical practice. Women with multiple sclerosis experience many disease‐related physical and emotional challenges of which sexuality is only one. Sensitivity to sexual dysfunction and being willing to approach the topic is appreciated by women with multiple sclerosis. Nurses do not require in‐depth expertise to offer some basic suggestions which may significantly improve life quality and assist the woman with multiple sclerosis to talk about or cope with sexuality issues.     

应用Tei指数对冠心病患者左室功能的研究

目的：探讨应用Tei指数评价冠心病患者左室功能的临床意义。方法：选取行冠脉造影确诊的冠心病患者36例,根据左室射血分数（LVEF）分两组,A组LVEF50％（20例）;B组LVEF〈50％（16例）,正常对照组为C组。研究对象行超声心动图检查,测量左室射血分数（LVEF）、Tei指数。结果：A组和B组的Tei指数均显著高于C组,具有极显著性差异。B组Tel指数显著高于A组（P〈0．01）。结论：Tei指数能早期、敏感、简便、客观反映左室整体功能。     

基于数据挖掘和“方-药-性-效”的藏医治疗慢性胃炎用药规律研究＊

目的 鉴于慢性胃炎是藏医优势病种且有较好的疗效，研究藏医治疗慢性胃炎的用药规律，为藏医临床与科研提供参考。方法 多中心收集藏医治疗慢性胃炎2613例有效临床医案，统一归纳藏医诊断确定归类分型，采用Gephi 0.9.2、SPSS Statistics 23、SPSS Modeler18等软件的描述性统计、Apriori算法、K-均值聚类分析方法，结合藏医“味性化味”药性理论进行分析，构建藏医治疗慢性胃炎的“方-药-性-效”复杂网络。结果 本研究涉及的慢性胃炎的藏医诊断可归纳为四种证型，其中隆型472例、赤巴型811例、培根型974例，其他证型356例。涉及藏药方剂共有137首，其中五鹏丸（1012次）、仁青芒觉（864次）、六味能消散（811次）等频次最高；关联规则分析发现，五味金色散和六味能消散关联最高。其中隆型以六味木香散等平隆助动、促进胃肠蠕动类方剂为主；赤巴型以五味金色散等清热凉血、消炎治疮类方剂为主；培根型以五味石榴散等平培根、助胃火类方剂为主。组方中诃子、木香、红花等使用频次最多，设置“支持度 ≥ 40%，置信度 ≥ 80%”时诃子、石榴子、木香等关联最强。药性分析发现，甘味、苦味、辛味等偏盛，十七效中以凉、钝、重、糙等为主，其中凉效、钝效可对治热、锐特性引起的胃热、胃肠糜烂等疾病，并分析方剂对治三因的比值，发现主要对治赤巴，其次为隆和培根。结论 通过构建“方-药-性-效”的研究模式，发现藏医对慢性胃炎的诊疗具有一定的规律可循，慢性胃炎在藏医诊断中可分为四种证型，总体治疗具有以“清血热-抑胃液-养胃火-通胃隆”四位一体的隐形用药规律，其中隆型以镇隆平气为主，赤巴型以清热凉血为主，培根型以平寒温胃为主，藏医临床治疗慢性胃炎提供有益参考。