吴茱萸敷脐配合穴位按摩对阑尾炎术后肠功能恢复的影响

目的：观察吴茱萸敷脐对阑尾炎术后肠蠕动的促进作用。方法：100例阑尾炎术后患者分为试验组（吴茱萸敷神阙穴配合穴位按摩组）50例，对照组（穴位按摩组）50例，分别观察记录肠鸣音出现时间及肛门排气时间。结果：试验组肠功能恢复时间比对照组缩短，两组比较差异有统计学意义（P ＆lt;0.05）。结论：吴茱萸敷神阙穴操作简单，方便易行，能促进肠蠕动，无不良反应，患者易于接受。     

Assessment of functional treatment versus plaster of Paris in the treatment of grade 1 and 2 lateral ankle sprains

Background

Despite the common occurrence of ankle sprains, no treatment is considered to be the gold standard for the management of such sprains. We assessed functional treatment versus plaster of Paris (POP) for the treatment of lateral ankle sprains, with pain and function employed as the outcome measures.

Materials and methods

126 Patients were eligible for inclusion. They were assigned to either the functional treatment Tubigrip (TG) group or the POP group after applying block randomization. Characteristics such as age, dominant ankle, and gender were assessed at baseline. Pain and functional assessments were done using the visual analog scale (VAS) and the Karlsson score (KS) at baseline (at the start of the study) and during the 2nd and 6th weeks, respectively. Data on other subjective parameters, such as the number of painkillers used, the number of days taken off work, and the number of sleepless nights, were requested from the patients at the end of the study. SPSS version 16 was used for analysis, and p < 0.05 was taken to indicate significance.

Results

60 Patients completed the trial in each group. The mean ages were 28.77 ± 6.72 in the TG group and 29.83 ± 6.30 in the POP group (p = 0.034). There was a slight female predominance. Right and left ankles were equally involved in the TG group, while left ankles were mainly involved in the POP group. Mean differences in VAS and KS between the two groups were statistically significant at the end of the study. The mean number of painkillers used by the patients in the TG group was higher than the number used in the POP group (p < 0.001). The mean number of days taken off work was 4.18 ± 1.73 days in the TG group, and 6.25 ± 2.73 days in the POP group (p < 0.001). The mean number of sleepless nights was higher in the POP group.

Conclusion

The results of our study indicate that functional treatment provides better functional support and pain reduction than a below-knee POP cast.

Level of evidence

Level I.     

3种方法治疗桡骨远端骨折的疗效比较

目的回顾性分析3种方法治疗桡骨远端骨折的疗效。方法回顾性分析自2010-05—2013-05诊治的桡骨远端骨折72例,其中21例采用手法复位石膏固定(石膏组),23例采用C型臂X线机透视下闭合复位外固定架固定(支架组),28例采用掌侧入路切开复位T-LCP内固定(内固定组)。结果支架组在放射学评分上优于石膏固定组,疗效评定与石膏固定组差异无统计学意义(P=0.007),内固定组在疗效及放射学评分方面均优于支架组及石膏组(χ2=10.023 4,P=0.040)。结论采用Henry入路T-LCP内固定治疗桡骨远端骨折能较好地恢复关节面平整、掌倾角及尺偏角,并发症少,较手法复位石膏固定及外固定架固定有明显的优势。     

张仲景石膏配伍规律探析

对张仲景经方中含石膏方剂进行统计分析,并结合各家方论和文献资料,揭示张仲景辨证组方中石膏的配伍规律,以资临床借鉴。     

高效液相色谱法测定癌痛宁巴布剂中乌头碱的含量

目的建立癌痛宁巴布剂中乌头碱的含量测定方法。方法高效液相色谱（HPLC）法,采用Kromasil C18柱（4．6mm×250mm）,流动相为甲醇-0．2％三乙胺（66：34）,测定波长为230nm,流速为1．0mL／min,柱温为30℃。结果乌头碱在0．126-0．630μg的范围内的范围内线性关系良好,r=0．9999,平均回收率为97．47％,RSD为1．2％。结论方法简便可行,重现性好．可用于癌痛宁巴布剂的质量控制。     

益肺止喘膏穴位贴敷防治儿童哮喘复发的临床研究

目的观察应用益肺止喘膏穴位贴敷防治儿童哮喘复发的临床疗效。方法将180例哮喘患儿随机分为2组,治疗组120例予益肺止喘膏穴位贴敷,对照组60例予酮替芬口服,观察患儿治疗前后的症状、体征及发病次数的变化,同时测定免疫球蛋白、T细胞亚群、肺功能、肺阻抗血流图。结果治疗组总有效率为92．5％,显著优于对照组（73．33％）,P〈0．01;治疗组在改善症状、体征及实验室检查指标方面,亦显著优于对照组。结论益肺止喘膏穴位贴敷能增强患儿免疫力,提高肺功能,改善肺循环,对防治儿童哮喘复发有显著疗效。     

活血止痛膏对兔骨骼肌急性钝挫伤后组织观察及IGFmRNA表达的影响

目的：通过光镜组织学观察评分、电镜超微机构观察和应用逆转录聚合酶链式反应（RT—PCR）技术对内源性胰岛素样生长因子（IGF—I、IGF一Ⅱ）mRNA的测定来探讨活血止痛膏剂对骨骼肌钝挫伤修复的作用及其可能机制。方法：将63只兔子随机分为活血止痛膏高剂量组、中剂量组、低剂量组、青鹏膏对照组、外伤对照组,每组12只,另取3只做正常对照组。采用“重物自由落体打击法”制作大白兔骨骼肌急性钝挫伤模型。分别在3天、6天、10天、13天处死大白兔,每组每个时间点处死3只兔子,每只兔子在两条后腿腓肠肌取标本,共计6个标本。结果：（1）光镜组织学观察评分：各个时间点与外伤对照组比较,青鹏膏剂组、活血止痛膏高、中剂量组（P〈0．05）;青鹏膏和活血止痛膏高剂量组优于活血止痛膏中剂量组（P〈0．05）。（2）电镜超微结构观察结果：青鹏膏组、活血止痛膏高、中剂量组较低剂量组和外伤组在3、6天可以更早更多看见激活的肌卫星细胞,在10天和13天青鹏膏组、活血止痛膏高、中剂量组肌组织趋于正常,活血止痛膏低剂量组和外伤组有瘢痕形成。（3）RT—PCR技术检测内源性胰岛素样生长因子（IGF—I、IGF一Ⅱ）mRNA的表达量：各个时间点内与外伤对照组比较,活血止痛膏高、中剂量组（P〈0．05）;活血止痛膏高剂量组优于活血止痛膏中剂量组（P〈0．05）。伤后各组IGF—I、IGF一ⅡmRNA含量在3、6、10、13天升高,其中第6天达高峰值。结论：（1）活血止痛膏可有效的改善兔骨骼肌钝挫伤后的组织学愈合过程和愈合质量。（2）活血止痛膏能促进骨骼肌钝挫伤后卫星细胞的激活,进一步促进新肌生成。（3）内源性IGF—I,IGF—II的mRNA随着兔骨骼肌钝挫伤不同修复时期,表达量也相应变化。（4）活血止痛膏对兔骨骼肌钝挫伤后的内源性IGF—I,IGF—II的mRNA表达量上调有明显的促进作用,从而有利于骨骼肌挫伤后愈合;并且该表达量与活血止痛膏有效浓度呈正相关。     

前列清巴布贴神阙穴敷贴治疗慢性非细菌性前列腺炎的临床研究

目的:比较神阙穴敷贴前列清巴布贴与关元穴、长强穴敷贴治疗慢性非细菌性前列腺炎的临床疗效。方法:将60例慢性非细菌性前列腺炎患者随机分为治疗组、对照Ⅰ组、对照Ⅱ组,分别给予口服舍尼通加神阙穴敷贴前列清巴布贴、口服舍尼通加关元穴敷贴前列清巴布贴、口服舍尼通加长强穴敷贴前列清巴布贴治疗。观察治疗前后各组患者NIH-CPSI评分、前列腺液参数及评分,比较其临床疗效。结果:治疗组总有效率为95%,比对照Ⅰ组和对照Ⅱ组均有优势(P<0.05);对照Ⅱ组优于对照Ⅰ组(P<0.05)。在改善前列腺液参数、降低NIH-CPSI症状积分方面,治疗组优于对照Ⅰ组和对照Ⅱ组(P<0.05)。结论:穴位敷贴前列清巴布贴外治慢性前列腺炎有较好的临床疗效,神阙穴敷贴比关元穴、长强穴敷贴效果更好。     

老年桡骨远端骨折个体化治疗的疗效观察

目的：比较老年患者桡骨远端骨折手术治疗和保守治疗的疗效。方法：总结分析45例年龄在55～70岁之间桡骨远端骨折的患者。按治疗方式分为保守组和手术组,保守组24例,平均年龄61.1岁;手术组21例,平均年龄60.4岁。两组进行cooney评分和按Lidstrom分型分类的比较。结果：所有病例总体临床疗效结果,按cooney等制订的评分标准,保守组总分为84.54±7.37,手术组总分为86.57±6.59,2组比较差异无统计学意义（P〉0.05）。2组治疗方案的Lid-strom分类分级,保守治疗组不满意率明显高于手术治疗组。结论：对于老年桡骨远端骨折两种方法都可以获得较为满意的临床疗效,但预后患者满意度上,手术治疗存在明显优势。     

卿仙止痛膏治疗腰肌劳损的Ⅲ期临床疗效观察

目的：评价卿仙止痛膏治疗腰肌劳损（风湿痹阻兼瘀血阻络）临床症状的有效性及安全性。方法：采用随机、双盲、安慰剂平行对照的方法将64例腰肌劳损患者随机分为卿仙止痛膏治疗组（治疗组）和安慰剂对照组（对照组）,将膏药贴于患处,24h换药1次,每次2贴,7d后观察患者治疗前后的临床症状、体征的变化,检测安全性指标：生命体征、血尿便常规、肝肾功能、心电图、不良反应。结果：治疗组总有效率为76．60％,对照组总有效率37．5％,治疗组疗效明显优于对照组（P〈0．05）;并且治疗组治疗后的疼痛、重着积分较对照组治疗后明显下降（P〈0．001）,而治疗后腰膝酸软、转侧不利积分较对照组治疗后也明显下降（P〈0．05）。结论：卿仙止痛膏治疗腰肌劳损疗效确切、安全。