The Role of Therapeutic Alliance in Network Therapy: A Family and Peer Support-Based Treatment for Cocaine Abuse

The therapeutic alliance is a well-studied construct factor that is important to outcome in many forms of individual therapy. Therapeutic alliance has been rarely studied in group therapy and results in addiction treatment have been mixed. In this paper, we studied the presence of a therapeutic alliance in Network Therapy: an approach that uses peer and family support in addiction treatment. Twenty-one participants undergoing Network Therapy for cocaine addiction were observed on videotape, and were rated on therapeutic alliance using the Working Alliance Inventory and the Penn Helping Alliance Rating Scale. Results showed a significant positive correlation between therapeutic alliance and outcome as measured by the percentage of cocaine-free urine toxicology screens and by eight consecutive cocaine-free urines.     

Cyclical Etidronate Therapy for Prevention of Postmenopausal Bone Loss: A 1-Year Open-Label Follow-Up Study

The objective of this study was to evaluate whether the pharmacological activity of cyclical etidronate therapy is sustained beyond the dosing period. A group of 121 postmenopausal women who had completed a 2-year, double-blind, placebo-controlled parallel study with etidronate or placebo (400 mg/day for 14 days every 3 months) and calcium agreed to participate in a 1-year open-label follow-up study to evaluate the effect of discontinuing etidronate treatment. Fifty-nine subjects in the former etidronate group and 62 in the placebo group received 500 mg/day of elemental calcium; 54/59 and 58/62 subjects, respectively, completed the study. Outcomes of the study were bone mineral density (BMD), measured by dual energy X-ray absorptiometry (DXA), and biochemical markers of bone turnover (urinary deoxypyridinoline/creatinine and serum osteocalcin). To determine whether there was a residual effect of previous therapy we compared mean percentage changes from baseline (year 0) to year 3 for both spinal and femoral neck BMD and markers of bone turnover in the former cyclical etidronate and placebo groups. To evaluate the carryover effect of treatment we compared the percent change from year 2 to year 3 for the same variables. Mean percentage change (SEM) from year 2 to year 3 for spinal BMD in the former cyclical etidronate group was −2.87% (0.48%) versus −0.99% (0.36%) in the placebo group (P= 0.0022). In the femoral neck, the BMD changes were −0.86% (0.42%) versus −1.01% (0.41%) (NS). Biochemical markers increased within 6 months toward baseline levels. Mean percentage changes from baseline (year 0) in both spinal and femoral neck BMD were significantly different between groups 1 year after treatment discontinuation. No differences between groups were maintained in deoxypyridinoline and osteocalcin. It is concluded that following withdrawal of cyclical etidronate therapy bone loss resumes at a normal and moderately accelerated rate in the proximal femur and lumbar spine, respectively. A positive effect on BMD at both cortical and trabecular sites is maintained for 1 year after treatment withdrawal. Received: 8 May 1999 / Accepted: 10 December 1999     

针灸治疗变应性鼻炎的临床研究概述

将近10年来同内有关针灸治疗变应性鼻炎临床研究的文献进行了综述，整理了针灸对该病的各种治疗方法，总结了变应性鼻炎针灸治疗的规律，评价了针灸治疗该病的疗效及安全性，探讨了今后对变应性鼻炎的临床研究重点。     

张家维教授针灸治疗小儿多动症380例临床研究

目的　探讨针灸治疗小儿多动症的临床疗效、对异常脑电图的改变情况、疗效与证型的关系、疗效与年龄的关系等。方法　将 5 92例患者分为针灸组及中药组。结果　针灸组总有效率为 84 .4 % ,中药组为 78.77% ,前者疗效优于后者 (P<0 .0 5 ) ;针灸组对异常脑电图的改变率优于中药组 (P<0 .0 5 ) ;针灸组中肝肾不足型、肝郁气滞型两型间的疗效有显著性差异(P<0 .0 1) ;肝郁气滞型较佳。疗效与年龄之间有非常显著性关系 (P<0 .0 1) ,年龄小者针刺疗效较佳。结论　针灸治疗小儿多动症可取得较好疗效 ,其总有效率及对异常脑电图的改善优于内服中药 ,肝郁气滞型及年龄小者疗效较好     

祛瘀法治疗疮疡病的临床体会

运用祛瘀法为主，结合清热、化湿、养阴、理气法以及祛腐、生肌、拖线、灌注等内外合治法，治疗臁疮、窦瘘、脱疽、股肿等疮疡疾病，并附验案四则。     

中药治疗多囊卵巢综合征58例超声观察

目的 :通过超声检测探讨中医治疗多囊卵巢综合征 (PCOS)中医治疗的临床疗效。方法 :多囊卵巢综合征患者 98例 ,随机分成中药治疗组和西药治疗组 ,经超声监测其卵泡发育情况。结果 :患者排卵期间子宫内膜厚度及卵泡发育检测结果两组间差异无显著意义 ;妊娠率差别有显著性意义。结论 :中药治疗多囊卵巢综合征可以调整月经周期 ,提高妊娠率 ,应用超声波对多囊卵巢综合征患者的检查有助于了解卵巢和子宫内膜的动态变化。     

镇颤舒胶囊合美多巴治疗帕金森病42例临床研究

目的 :探讨镇颤舒胶囊治疗帕金森病的临床疗效。方法 :选符合纳入标准的帕金森病患者 84例 ,采用数字表法随机分为两组。治疗组 4 2例采用自拟镇颤舒胶囊、辅以美多巴片 ,对照组 4 2例单用美多巴 ,均治疗 6个月。结果 :治疗组显效 30例 ,有效 10例 ,无效 2例 ,总有效率为 95 .2 % (95 % CI=83.8%～ 99.4 % ) ;对照组显效 2 0例 ,有效 12例 ,无效 10例 ,总有效率为 76 .2 % (95 % CI=6 3.3%～ 89.1% )。两组综合疗效比较有显著差异 (u=2 .2 32 0 ,P=0 .0 2 6 0 )。结论 :治疗组效果优于对照组 ,其收益为 OR=0 .16 (95 % CI=0 .0 3～ 0 .78) ,NNT=5 (95 % CI=2 .94～ 2 4 .5 1)。     

醒脑开窍针法对脑梗死模型大鼠脑组织c-fos基因表达的影响

[目的1揭示醒脑开窍针法治疗脑梗死的分子调控机制。[方法]采用Northern杂交技术，观察局灶性脑缺血模型大鼠脑组织c—fos mRNA的转录水平及醒脑开窍针法的干预作用。[结果]局灶性脑缺血模型大鼠脑组织c—fos基因的表达因部位和时间的不同而异，在皮层不同时程段，c—fos mRNA的表达呈上升趋势，海马区c—fos tuRNA的表达呈下降趋势，纹体区在1、3、6h下降，24、48h略有上升趋势。醒脑开窍针法能使皮层和纹体c—fos mRNA的表达峰值在各个时段均较模型组增高，使海马区l、3hc—fos基因表达峰值降低，6、24、48h基因表达上调。[结论]醒脑开窍针法可促使神经细胞对缺血损伤产生不同的适应性变化，从而增强脑组织的修复能力，加速神经元网络的重建，以恢复其正常功能。     

益气活血方内服与灌肠治疗子宫内膜异位症的临床研究

[目的]探讨中药内服与灌肠治疗子宫内膜异位症的临床疗效。[方法]中药口服加灌肠组采用自拟益气活血、温通散瘀为治则的口服及灌肠中药综合治疗 ,并与口服中药组、丹那唑组对照比较 ,均连续治疗3个月。治疗前后观测子宫内膜异位症的症状、体征及B超检查。[结果]3组有效率及受孕率比较有显著性差异 (P<0.05) ,中药口服加灌肠组有效率及受孕率均优于口服中药组(P<0.05) ,受孕率优于丹那唑组 (P<0.05)。[结论]益气活血方内服与灌肠治疗子宫内膜异位症疗效满意。     

中西医结合治疗母婴血型不合50例疗效观察

目的:观察中西医结合治疗母婴ABO血型不合的临床疗效。方法:将80例患者随机分为2组。对照组30例以维生素C、维生素E治疗;治疗组50例在对照组治疗基础上配合中药煎剂茵芪合剂(药用茵陈、黄芪、栀子、黄芩、白术、续断等)治疗。结果:治疗组治愈37例,好转12例,无效1例,新生儿黄疸未发生,治愈率74.00％,总有效率98.00％。对照组治愈7例,好转13例,无效10例,新生儿黄疸发生4例,治愈率23.33％,总有效率66.67％。治疗组治愈率、总有效率明显高于对照组,差异有非常显著性意义(P<0.01)。2组治疗后IgG抗A(抗B)抗体效价比值均明显下降。与治疗前比较,差异均有显著性意义(P<0.05)。结论:中西医结合治疗母婴ABO血型不合疗效显著,可有效防治新生儿ABO溶血病的发生。