甲状腺素对原发性甲状腺功能减退症认知功能损害的治疗效果

目的研究甲状腺素对成人原发性甲状腺功能减退症(甲减)患者认知损害的治疗效果。方法运用修订韦氏记忆量表和正背倒背任务检测26例初发成人原发性甲减患者治疗前、后及28例健康对照组的记忆功能。结果修订韦氏记忆量表检测显示,原发性甲减患者记忆商显著低于健康对照组,治疗后记忆商较治疗前明显提高(P<0.05),但仍低于健康对照组(P<0.05)。数字正背倒背任务检测,原发性甲减患者4位倒背数字任务正确率显著低于对照组(P<0.05),治疗后4位倒背数字任务正确率显著提高,与健康对照组未见明显差异(P>0.05)。结论原发性甲减患者存在记忆功能损害,甲状腺素替代治疗能够改善甲减患者的记忆功能。     

我院抗肿瘤及辅助治疗药物不良反应164例分析

目的 对我院肿瘤内科不良反应(ADR)的发生情况及特点进行分析,为临床合理用药提供参考.方法 采用回顾性分类统计,对164例报告涉及的患者年龄、性别、给药途径药物类别以及临床表现进行分析.结果 164例ADR中男性76例,女性88例;40岁以上154例;细胞毒类药物的发生率居首,占77.9％;ADR的临床表现以消化系统反应为主,其次为骨髓抑制.结论 开展ADR监测工作是医务人员,特别是临床药师的重要任务,加强ADR监测,保障患者用药安全.     

癌痛对抑郁及免疫功能的影响

目的:分析癌痛与抑郁和免疫功能之间的相关性。方法:收集我科室从2013年1月至2016年12月收治的73例晚期肿瘤患者,37例癌痛组,36例无癌痛组,进行数字疼痛强度量表(NRS)、抑郁自评量表(SDS)、生活质量、免疫功能等的调查分析比较。结果:癌痛与无癌痛的两组患者抑郁的发生比较有统计学意义(P＜0.05),癌痛程度与抑郁程度有相关性(P＜0.05);癌痛与无癌痛的两组患者生活质量的比较差异有统计学意义(P＜0.05)。癌痛与无癌痛的两组患者CD3+、CD4+、CD8+比较差异无明显统计学意义(P＞0．05)。结论:抑郁的发生与癌痛相关,抑郁程度和癌痛程度也有极大关联。癌痛可明显影响患者生活质量,但对免疫功能影响不明显。     

Acupuncture therapy improves health-related quality of life in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

BackgroundChronic obstructive pulmonary disease (COPD) is highly prevalent around the world and has a large impact on its patients, leading to a poor health-related quality of life (HRQL) and exercise capacity. Even under optimal medications, there are still many patients with poor HRQL. Body acupuncture therapy (BAT) is a non-invasive and a popular therapy. Therefore, we aimed to comprehensively analyze the effects of BAT in COPD.Materials and methodsEight electronic databases were searched. We included randomized controlled trials (RCTs) that evaluated the effect of BAT, medication (M), and pulmonary rehabilitation (PR). The primary outcome was HRQL evaluated by St. George's respiratory questionnaire (SGRQ) or COPD assessment test (CAT).ResultsOf the 922 articles, 12 studies were included with attesting a total of 798 participants. The result obtained indicated a significant improvement that favored the BAT + M group over the M group in CAT scores (MD: −4.77; 95% CI: −6.53 to −3.01; p < 0.00001).ConclusionsBAT is an effective adjunctive non-pharmacological treatment to improve HRQL in patients under medical treatment for COPD. We suggested that BAT should be considered as one of the methods of management in patients with COPD.     

张卫华教授“温通针法”治疗原发性痛经临床经验

The professor Wei-hua ZHANG's experiences in treatment of primary dysmenorrhea with “warming-unblocking needling method” was introduced in this paper. Prof. Zhang believes that obstruction is the crucial in pathogenesis of primary dysmenorrhea no matter of the excess or the deficiency syndrome. Warming and unblocking principle is the essential in treatment. Hence, an unique therapeutic method is innovated, named warming-unblocking needling method, including three-layer and two-direction warming needling technique at Sānyīnjiāo (三阴交 SP6), two-layer rotating warming- unblocking technique at Zhōngjí (中极 CV3) and one-layer and two-direction warming needling technique at Cìliáo (次髎 BL32). In this set of needling procedure, acupoint is viewed as a three-dimensional hierarchical structure. A layered and multidirectional needling technique is adopted at main acupoints to enhance the sensations of diqi and to generate heat effect in the local. Additionally, moxibustion is combined to intensify warming and unblocking effect. Simultaneously, the supplementary acupoints are used in response to symptoms. All of the acupoints coordinately warm up the uterus, promote meridian circulation and stop pain. Hence, this therapeutic method achieves relatively excellent effect and deserves to be promoted in practice.     

参苓白术散加减治疗脾虚型慢性腹泻疗效观察

目的 观察参苓白术散加减治疗脾虚型慢性腹泻的临床疗效。方法 将65例慢性腹泻患者随机分为观察组33例和对照组32例。对照组给予口服蒙脱石散治疗,观察组采用参苓白术散加减治疗。2周为1个疗程,2个疗程后观察两组患者的临床疗效、治疗前后症状积分变化以及不良反应情况。结果 两组治疗后各项症状积分与治疗前比较,差异具有统计学意义（P＜0.05）;两组治疗后各项症状积分差值比较,差异具有统计学意义（P＜0.05）;治疗后观察组在大便次数、大便性状、腹痛、食欲不振、倦怠乏力、脘腹痞满方面改善明显,临床疗效优于对照组（P＜0.05）。结论 参苓白术散加减治疗脾虚型慢性腹泻有较好的疗效。     

多发性硬化后阴痛1例

A female patient with vaginal pain induced by multiple sclerosis was treated by acupuncture. Her chief complaint: pricking vaginal pain during intercourse for 1 year. Electroacupuncture was applied to Shènshū (肾俞 BL23), Huìyáng (会阳 BL35), Cìliáo (次髎 BL32) and Zhōngliáo (中髎 BL33) on lumbosacral region. The disperse wave was adopted firstly, followed by the dense wave in stimulation. The stimulation intensity was determined by the patient's tolerance. The needles were retained for 50 min totally. After 2-month treatment, the sexual function of the patient was recovered to be normal. The sexual activity was normal in 1-year follow-up and vaginal pain was not recurred.     

Role of acupuncture in the treatment of insulin resistance: A systematic review and meta-analysis

Backgroundand purpose Acupuncture has gained increasing attention in the treatment of insulin resistance (IR). This study systematically reviews the efficacy of acupuncture on clinical IR outcomes.MethodsCochrane Central Register of Controlled Trials, Embase, Medline (via OVID), China National Knowledge Infrastructure (CNKI), Wan Fang and China Science and Technology Journal Database (VIP) were searched to collect randomized controlled trials (RCTs) of patients with IR treated by acupuncture. Meta-analysis was performed by RevMan 5.3.ResultsWith acupuncture, the homeostasis model assessment of insulin resistance (homa-IR) significantly decreased (mean difference (MD) = -1.04, 95% confidence interval (CI) −1.37 to −0.71; P < 0.00001), as did fasting blood glucose (FBG) (MD = −0.56, 95% CI -0.88 to −0.25; P = 0.0005), 2 h postprandial blood glucose (2hPG) (MD = −0.91, 95% CI -1.62 to −0.20; P = 0.01), and fasting insulin (FINS) (MD = −3.23, 95% CI -4.14 to −2; P < 0.00001). Meanwhile, the insulin sensitivity index (ISI) (MD = 0.36, 95% CI 0.18 to 0.53; P < 0.0001) increased, and fewer adverse events occurred.ConclusionAcupuncture may improve homa-IR, ISI, FBG, 2hPG and FINS with fewer adverse events than other treatments, making it a viable treatment for IR.