高压氧联合电针八髎穴对脊髓损伤神经源性膀胱患者尿动力学的影响

目的：分析高压氧（HBO）联合电针八髎穴治疗对脊髓损伤神经源性膀胱患者尿动力学的影响。方法：将60例脊髓损伤神经源性膀胱患者,按随机数字表法分成对照组20例、电针组20例、联合组20例,各组均接受常规膀胱功能训练,电针组增加电针治疗,联合组增加电针治疗及高压氧治疗,分别于治疗前和治疗8周后通过尿流动力学检查及排尿日记评价3组患者的膀胱功能,并进行统计学分析。结果：治疗前3组患者的充盈期逼尿肌压(Pdet)、膀胱顺应性（BC）、最大尿流率(Qmax)、残余尿量（RV）组间差异均无统计学意义。治疗8周后,3组患者BC及Qmax明显高于治疗前(均P＜0.05),Pdet及RV明显低于治疗前(均P＜0.05)。治疗后组间比较,电针组及联合组患者BC及Qmax明显高于对照组(均P＜0.05),Pdet及RV显著低于对照组(均P＜0.05);联合组BC及Qmax明显高于电针组(均P＜0.05),Pdet及RV显著低于电针组(均P＜0.05)。治疗后,3组患者日平均排尿次数、日平均尿失禁次数均明显少于治疗前(均P＜0.05),日平均单次尿量、下尿路症状（LUTS）评分均明显高于治疗前(均P＜0.05)。治疗后组间比较,电针组及联合组日平均排尿次数、日平均尿失禁次数均明显少于对照组(均P＜0.05),日平均单次尿量、LUTS评分均明显高于对照组(均P＜0.05);联合组日平均排尿次数、日平均尿失禁次数均明显少于电针组(均P＜0.05),日平均单次尿量、LUTS评分均明显高于电针组(均P＜0.05)。结论：高压氧联合电针八髎穴治疗能有效改善脊髓损伤神经源性膀胱患者尿动力学及排尿功能,提高生存质量,该方法值得临床推广。     

经皮穴位电刺激镇痛在乳腺癌根治术中的应用

目的 观察经皮穴位电刺激(Transcutaneous electrical acupoint stimulation,TEAS)用于乳腺癌根治术的镇痛效果.方法 择期行乳腺癌根治术患者60例,ASA分级Ⅰ或Ⅱ级,年龄30～60岁,体重50～80kg,采用随机数字表法,按1∶1比例分为对照组(GA组)和经皮穴位电刺激组(EA组),各30例.GA组在进行手术操作前,选择双侧合谷穴(LI4)、内关穴(PC6)和足三里(ST36)连接华佗电子治疗仪(V型),不进行穴位电刺激;EA组连接华佗电子治疗仪(V型)进行穴位电刺激30min.麻醉诱导:靶控输注异丙酚,血浆靶浓度4μg/ml,静脉注射芬太尼3μg/kg和维库溴铵0.1mg/kg.喉罩插管后行机械通气,维持PETCO2 35～45mmHg.麻醉维持:靶控输注异丙酚,血浆靶浓度2～4μg/ml,微量泵输注瑞芬太尼10～25μg·kg-1·h-1,维持Narcotrend在D2～E1 (46～20)之间,根据Narcotrend监测结果及血流动力学调整异丙酚和瑞芬太尼泵注速度.分别于电针前(T0)、电针结束时(T1)、诱导前(T2)、插管后5min(T3)、切皮前即刻(T4)、手术结束(T5)、拔管后即刻(T6)、拔管后5min (T7),记录HR、MAP、PETCO2、SpO2、Narcotrend数值.记录患者苏醒时间、拔管时间、术中麻醉药物瑞芬太尼和异丙酚用量、术后VAS评分及术后恶心呕吐(PONV)的发生率.结果 与GA组比较,EA组T3～T5时HR、MAP更平稳,瑞芬太尼用药量明显减少,苏醒时间、拔管时间缩短,PONV发生率降低(P＜0.05).结论 在乳腺癌改良根治手术中,TEAS复合全麻有良好的镇痛镇静作用,能减少麻醉药用量,减轻全麻术后的不良反应.     

中药穴位敷贴治疗儿童哮喘基础和临床研究现状

从基础研究和临床研究2个方面,包括中医理论研究、实验研究、总体疗效、改善症状、调理体质、疗程时间等,总结了中药穴位敷贴治疗儿童哮喘的研究现状。指出今后研究可设计大样本以便随机对照临床试验研究,同时可在穴位敷贴对儿童中医体质的改善方面开展,以期探讨穴位敷贴的中医作用机制。     

大椎穴贴敷配合盐酸西替利嗪片治疗过敏性鼻炎60例临床疗效观察

目的观察大椎穴贴敷配合盐酸西替利嗪片治疗过敏性鼻炎的临床疗效。方法针对过敏性鼻炎患者60例为研究对象,根据就诊号先后次序排序后,再采用数字随机表将其分成治疗组和对照组,对照组采用盐酸西替利嗪片口服治疗,治疗组采用盐酸西替利嗪片口服治疗联合大椎穴穴位贴敷治疗,两组治疗前、后采用“症状量化评分表”量化症状,对比分析两组患者的治疗效果。结果治疗组总有效率93.3%,对照组总有效率90.0%。两组治疗量化结果显示:治疗后,患者过敏性鼻炎症状明显改善,治疗组治疗效果稍优于对照组,经过统计学软件SPSS 23.0分析,差异性存在统计学意义(P<0.05)。结论在采用不同治疗方法治疗过敏性鼻炎患者过程中,观察发现:贴敷大椎穴对鼻塞症状改善明显,能够补充口服盐酸西替利嗪片在缓解鼻塞上的不足,故选择采用安全易行的大椎穴贴敷联合盐酸西替利嗪片口服治疗过敏性鼻炎能够起到令人满意的治疗效果,在临床中值得推广使用。     

Effect of auricular point pressing therapy on postoperative pain of fracture: A protocol for systematic review and meta-analysis

Background:In clinical practices, postoperative fracture patients are often treated with analgesics. As one of the alternative therapies for nondrug analgesia, auricular point pressing has advantages of simple operation, easy to use, no injury and adverse reactions, and great potential for development. In this study, the effect of auricular point pressing therapy on postoperative pain of fracture was objectively evaluated through the method of meta-analysis, so as to provide evidence for clinical applications.Methods:PubMed, Web of Science, Cochrane Library, EMBASE, Wan fang Database, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, and Chinese Biomedical Literature Database were systematically searched and randomized controlled trials on auricular point pressing in the treatment of postoperative pain after fracture were includes. After independent literature screening, data extraction and quality evaluation by 2 researchers, the original data was retrieved, merged, and analyzed. RevMan 5.3 software was adopted for meta-analysisResults:This study could provide high-quality evidence to evaluate the effect of auricular point pressing therapy on postoperative pain of fracture.Conclusion:This systematic review explored whether auricular point pressing therapy is effective on the intervention of postoperative pain after fracture.OSF Registration Number:DOI 10.17605/OSF.IO/AZ4JQ.     

The clinical efficacy of acupoint sticking combined with massage to treatment functional dyspepsia: A protocol of systematic review and meta-analysis

Background:The objective of this meta-analysis was to summarize and identify the available evidence from studies to estimate the clinical value of acupoint sticking combined with massage (ASM) in the treatment of functional dyspepsia (FD), and provide clinicians with evidence on which to base their clinical decision making.Methods:This review will include all studies comparing clinical efficacy of ASM in the treatment of FD. The search strategy will be performed in 10 databases. We will not establish any limitations to language and publication status, published from inception to the August 2020. Two reviewers will screen, select studies, extract data, and assess quality independently. Outcome is alleviation of global dyspeptic symptoms, alleviation of individual dyspeptic symptoms, quality-of-life improvement, and safety. The methodological quality including the risk of bias of the included studies will be evaluated. We will carry out statistical analysis using RevMan 5.3 software.Results:This study will summarize current evidence to assess the efficacy and safety of ASM in the treatment of FD.Conclusion:The findings of this study will provide helpful evidence for the clinician, and will promote further studies, as well as studying the value of ASM.Registration number:INPLASY2020110072 (DOI number: 10.37766/inplasy2020.11.0072).     

经皮穴位电刺激对反复着床失败冻融胚胎移植患者的影响

目的观察经皮穴位电刺激(transcutaneous electrical acupoint stimulation,TEAS)对胚胎移植后反复着床失败的患者冻融胚胎移植周期子宫内膜、妊娠结局的影响。方法将176例反复着床失败行冻融胚移植的患者随机化分为两组:观察组82例:常规冻胚移植前内膜准备,月经第10天起给予TEAS;对照组94例:常规冻融胚移植前内膜准备,不予其他干预措施。比较两组患者移植前与月经第10天内膜增厚差值、生化妊娠率、临床妊娠率、胚胎着床率的差异。结果观察组生化妊娠率大于对照组,但差异无统计学意义;观察组内膜生长差值、着床率、临床妊娠率均大于对照组,且差异有统计学意义(P0.05)。结论 TEAS可提高反复着床失败患者的子宫内膜容受性,提高此类患者冻融胚移植成功率。     

丁桂儿脐贴穴位敷贴预防经尿道前列腺电切术后膀胱痉挛的效果观察

目的探讨丁桂儿脐贴穴位敷贴联合电切灌洗液冲洗在预防经尿道前列腺电切术(TURP)术后膀胱痉挛中的应用效果。方法80例行TURP治疗的患者随机分为观察组和对照组,各40例。对照组于术中、术后采取(35.50±1.50)℃电切灌洗液持续冲洗,观察组在对照组基础上在围术期采用丁桂儿脐贴进行穴位敷贴。观察2组术后膀胱痉挛发生情况。结果观察组术后膀胱痉挛发生率7.50%(3/40),低于对照组25.00%(10/40),差异有统计学意义(P<0.05)。结论丁桂儿脐贴穴位敷贴联合电切灌洗液冲洗能有效预防TURP术后膀胱痉挛。     

隔姜灸联合中药穴位贴敷辅助治疗脾胃虚寒型胃脘痛的效果及护理

目的观察隔姜灸联合中药穴位贴敷辅助治疗脾胃虚寒型胃脘痛中的效果,总结护理措施。方法将50例脾胃虚寒型胃脘痛患者随机分为对照组和观察组,各25例。对照组给予常规治疗和护理,观察组在对照组基础上给予隔姜灸联合中药穴位贴敷干预。对比2组临床疗效。结果观察组治疗有效率96.00%(24/25),高于对照组的76.00%(19/25),差异有统计学意义(P<0.05)。结论隔姜灸联合中药穴位贴敷治疗脾胃虚寒型胃脘痛能有效改善患者临床症状,对提高治疗效果有积极作用。