社区卫生服务适宜技术项目0～36个月儿童健康管理指标体系的建立

目的按照客观、公正、高效、合理的甄选原则,结合适宜技术项目的开展情况,构建社区卫生服务适宜技术项目0～36个月儿童健康管理的指标体系。方法利用文献法、专家咨询法和德尔菲法进行指标的筛选与构建。结果最终构建的社区卫生服务适宜技术项目0～36个月儿童健康管理的指标体系包括一级指标3个,二级指标8个,三级指标40个。专家咨询的积极系数、权威程度及专家意见的协调程度均较高。结论本组指标的筛选方法较为合理,结果相对准确,具有较强的可操作性。     

中药穴位贴敷治疗支气管哮喘疗效观察

目的:比较中药穴位贴敷疗法与常规针刺治疗支气管哮喘的疗效差异.方法:将100例患者随机分为贴敷组和针刺组各50例.贴敷组应用三伏中药穴位贴敷治疗,穴取大椎、肺俞、膏肓、膻中、气海;针刺组于同期采用针刺疗法,穴取中府、天突、膻中、定喘、丰隆,观察两组远期疗效.结果:贴敷组总有效率为94.0%,针刺组总有效率为76.0%,两组疗效比较差异有统计学意义(P<0.05).结论:三伏天中药贴敷治疗支气管哮喘疗效明显优于常规针刺疗法.     

鱼腥草不同部位挥发油组分分析及其抗菌活性研究

目的 研究不同生长月份鱼腥草各部位挥发油含量变化,比较不同部位挥发性油组分和抗菌活性,为鱼腥草采收部位的选择提供依据和指导.方法 用水蒸气蒸馏法从不同部位的新鲜鱼腥草中提取并测定挥发油含量,用GC-MS分析挥发油组分.用药敏纸片法和肉汤稀释法测定抗金黄色葡萄球菌和藤黄八叠球菌活性.结果 不同月份和不同部位鱼腥草挥发油含量变化较大,根状茎在全年各月份含量均较高,地上茎、叶、花穗则只有在特定的月份才含有可检测的挥发油;各部位挥发油的抗菌活性以花穗最好,叶和根状茎次之,地上茎最差,其中与抗菌活性呈正相关的相对总含量依次为花穗＞根状茎＞叶＞地上茎,组分数则分别为13、10、13和12个.结论 鱼腥草药材品质与部位关系密切,其地上部分的最佳采收季节是花果盛期前后;全草采集时全年均要重视地下部分,在夏末地上部分开始衰老后更要以地下部分为主要采集部位.     

广西农村6～24月龄婴幼儿生长发育及影响因素

目的 了解广西壮族自治区农村地区6～24月龄婴幼儿的生长发育现状及其影响因素,为改善当地儿童生长发育水平提供参考依据。方法采用分层整群随机抽样方法,抽取广西横县、宾阳县和灵山县8个乡的1 198名6～24月龄婴幼儿家长进行问卷调查,并由经过统一培训的人员测量婴幼儿的身长、体重。结果 广西壮族自治区农村地区6～24月龄婴幼儿体重和身长均低于中国9市标准人群,且随年龄增加,儿童身长、体重差距逐渐增大;广西农村地区6～24月龄婴幼儿营养不良发生率为21.9%(262/1 198),其中低体重和生长迟缓的发生率分别为16.2%(194/1 198)和13.5%(162/1 198);不同月龄婴幼儿比较,生长迟缓和营养不良发生率差异均有统计学意义(P=0.000);多因素Logistic回归分析结果表明,≥12月龄、孩次为第2个及以后和不饮用开水是婴幼儿发生营养不良的危险因素,正常产是婴幼儿发生营养不良的保护因素。结论 广西农村地区婴幼儿低体重和生长迟缓发生率较高;月龄较大、早产儿和孩次靠后的婴幼儿是发生营养不良的高危人群。     

不同刺激强度穴位贴敷冬病夏治防治支气管哮喘的临床研究

目的:比较不同刺激强度穴位贴敷冬病夏治防治支气管哮喘的临床疗效,探讨最佳冬病夏治穴位贴敷组方和制作,为临床推广应用提供依据。方法:将396例患者随机分为贴敷1组(132例)、贴敷2组(132例)、贴敷3组(132例),给予不同刺激强度的穴位贴敷冬病夏治,比较和评价3组患者在临床症状、生命质量评分、皮肤反应、肺功能方面的差异。结果:治疗后临床总有效率贴敷1组86.67%、贴敷2组87.60%,明显优于贴敷3组52.14%(P0.01),且生命质量评分、肺功能一秒用力呼气容积(FEV1)、一秒钟用力呼气容积占用力肺活量比值(FEV1/FVC)的改善也优于贴敷3组(P0.05);而贴敷1组与贴敷2组之间比较无明显差异;但皮肤反应方面贴敷1组明显优于贴敷2组(P0.01)。结论:恰当的药物炮制和加入适当的促渗透药可以保持冬病夏治穴位贴敷的疗效,且能减轻皮肤副反应。     

Implementing a Care Pathway for small and nutritionally at‐risk infants under six months of age: A multi‐country stakeholder consultation

Nutritional vulnerability under the age of 6 months is prevalent in low‐ and middle‐income countries with 20.1% infants underweight, 21.3% wasted and 17.6% stunted in a recent review. A novel Care Pathway for improved management of small and nutritionally at‐risk infants under 6 months and their mothers (MAMI) has recently been developed to provide outpatient care at large coverage. We aimed to investigate stakeholders’ views on the feasibility of its implementation and to identify barriers and enablers. This was an early stage formative mixed‐methods study: an online survey plus in‐depth interviews with country‐level stakeholders in nutrition and child health from different geographical regions and stakeholder groups. 189 stakeholders from 42 countries responded to the online survey and 14 remote interviews were conducted. Participants expressed an urgent need for improved detection and care for small and nutritionally at‐risk infants under 6 months. Whilst they considered the MAMI Care Pathway feasible and relevant, they noted it was largely unknown in their country. The most mentioned implementation barriers were: community‐specific needs and health care seeking barriers, health workers’ lack of competence in breastfeeding counselling and the absence of a validated anthropometric screening method. Possible enablers for its implementation were: patients’ preference for outpatient care, integrating the MAMI care pathway into existing maternal and child health programmes and the possibility of a local pilot project. Adaptation to the local context was considered crucial in further scale‐up.     

The efficacy of low‐frequency ultrasound as an added treatment for chronic wounds: A meta‐analysis

We performed a meta‐analysis to evaluate the effect of low‐frequency ultrasound as an added treatment for chronic wounds. A systematic literature search up to May 2022 was performed and 838 subjects with chronic wounds at the baseline of the studies; 412 of them were using the low‐frequency ultrasound (225 low‐frequency high‐intensity contact ultrasound for diabetic foot wound ulcers, and 187 low‐frequency low‐intensity non‐contact ultrasound for a venous leg wound ulcers), and 426 were using standard care (233 sharp debridements for diabetic foot wound ulcers and 193 sham treatments for venous leg wound ulcers). Odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the effect of low‐frequency ultrasound as an added treatment for chronic wounds using the dichotomous, and contentious methods with a random or fixed‐effect model. The low‐frequency high‐intensity contact ultrasound for diabetic foot wound ulcers had significantly lower non‐healed diabetic foot wound ulcers at ≥3 months (OR, 0.37; 95% CI, 0.24‐0.56, P < .001), a higher percentage of diabetic foot wound ulcers area reduction (MD, 17.18; 95% CI, 6.62‐27.85, P = .002) compared with sharp debridement for diabetic foot wound ulcers. The low‐frequency low‐intensity non‐contact ultrasound for a venous leg wound ulcers had a significantly lower non‐healed venous leg wound ulcers at ≥3 months (OR, 0.31; 95% CI, 0.15‐0.62, P = .001), and higher percentage venous leg wound ulcers area reduction (MD, 18.96; 95% CI, 2.36‐35.57, P = .03) compared with sham treatments for a venous leg wound ulcers. The low‐frequency ultrasound as an added treatment for diabetic foot wound ulcers and venous leg wound ulcers had significantly lower non‐healed chronic wound ulcers at ≥3 months, a higher percentage of chronic wound ulcers area reduction compared with standard care. The analysis of outcomes should be with caution because of the low sample size of all the 17 studies in the meta‐analysis and a low number of studies in certain comparisons.     

中药敷贴、穴位注射预防支气管哮喘发作

目的　预防支气管哮喘的季节性发作。方法　根据祖国医学冬病夏治的原则 ,对 43例支气管哮喘患者 ,在夏季哮喘发作间歇期于定喘、肺俞、天突穴位进行中药敷贴 ,足三里穴位注射黄芪针剂 ,每疗程 3个月。统计用药前 1年和用药后 1年的发病率。结果　用药前的发病率为 10 0 %( 43 /4 3 ) ,其中发作 1次的发病率为 3 3 .49%( 2 3 /4 3 ) ,2次的发病率为 3 2 .5 6%( 14 /4 3 ) ,3次的发病率为 13 .95 %( 6/4 3 ) ;用药后的发病率分别为 2 7.91%( 12 /4 3 )、2 0 .93 %( 9/4 3 )、4.65 %( 2 /4 3 )、2 .3 3 %( 1/4 3 ) (P分别 <0 .0 0 5、0 .0 0 5、0 .0 0 5、>0 .0 5 ) ,且发作程度明显减轻。结论　中药敷贴、穴位注射对支气管哮喘发作有显著的预防作用