改良式无烟铺灸改善脊髓损伤患者腹胀便秘的效果研究

目的:探讨改良式无烟铺灸疗法对脊髓损伤患者腹胀便秘的疗效。方法:选择我院 2021年 1月—2022年 1月收治的脊髓损伤后腹胀便秘患者 70例,按随机数字表分两组,每组 35例。对照组的患者给予常规方法治疗,观察组在该基础上增加改良式无烟铺灸治疗。比较两组排便间隔的时间、每次排便所需时间、每周排便次数、治疗前后两组患者慢性便秘严重程度评分量表(CSS)得分、便秘患者生活质量自评问卷(PAC-QOL)评分及总有效率。结果:经治疗后,观察组患者排便间隔的时间、每次排便所需时间、CSS得分及 PAC-QOL评分均显著低于对照组患者(P<0.05);观察组患者每周排便次数及治疗总有效率显著高于对照组患者(P<0.05)。结论:常规方法联合铺灸治疗对于脊髓损伤患者腹胀便秘的治疗效果确切,可有效缓解患者腹胀便秘症状,改善患者生存质量水平,值得临床推广应用。     

《针灸临床实践指南》国际需求的调查:一项横断面研究

ObjectiveThis study aims to get the medical management of acupuncture and moxibustion in the countries and regions where the society members of World Federation of Acupuncture-Moxibustion Societies (WFAS) are located, including the educational background of acupuncture and moxibustion practitioners and the local clinical practice of acupuncture and moxibustion, and the demands of the content and evidence types of Clinical Practice Guidelines (CPGs) of acupuncture and moxibustion in accordance with WFAS standards, so as to provide requirements and reference principles for the development of CPGs of acupuncture and moxibustion in accordance with WFAS standards.MethodsThe convenient sampling method was used to collect the questionnaires, and the WFAS secretariat distributed the questionnaires to 294 contacts of society members from 70 countries and regions in the form of Questionnaire Star four times in April 2020, July 2020, March 2021, and April 2021 respectively. They were then distributed to individual members of acupuncture-moxibustion societies by the contacts. The study content involved the basic information of respondents, including their nationality, occupation, educational background of acupuncture and moxibustion, their local clinical practice and medical management of acupuncture and moxibustion, as well as their demand for CPGs of acupuncture and moxibustion, etc. After the questionnaires were collected, the data were analyzed and described by quantitative research method.ResultsIn all, 302 respondents from 37 countries of six continents responded. The 302 respondents were members of the WFAS society members. (1) Basic information of respondents. They all had acupuncture and moxibustion learning experience, among which, 76.5% (231/302) had the education background of acupuncture and moxibustion professional college training, and 88.4% (267/302) had experience of acupuncture and moxibustion clinical practice. Acupuncturists or traditional Chinese medicine doctors accounted for 63.9% (193/302), western medicine doctors, nurses, and pharmacists accounted for 18.2% (55/302), and researchers and teachers accounted for 6.3% (19/302). (2) Local clinical practice and medical management of acupuncture and moxibustion. The level of clinical practice of acupuncture and moxibustion varies greatly among the regions where the WFAS society members lived. Among them, more countries in Europe have not included acupuncture and moxibustion in medical insurance than those in other continents (x²=26.049, P < 0.01), and more countries have not included acupuncture and moxibustion in public hospital treatment system than those in other continents (x²=113.488, P < 0.01). (3) Demand for CPGs of acupuncture and moxibustion. A total of 93.0% (281/302) respondents believed that WFAS CPGs of acupuncture and moxibustion would be helpful for their local practice. The order of their demand and concern for WFAS CPGs was: acupuncture manipulation > latest progress of acupuncture treatment > choice of acupuncture therapies > safety of acupuncture and moxibustion > combination of acupuncture and other programs. A total of 87.4% (264/302) respondents believed that ancient classics could guide clinical practice, and the ancient literature should be used as evidence for the development of guidelines.ConclusionThe respondents are those future practitioners of CPGs of acupuncture and moxibustion conforming to WFAS standards. Commonly they have clinical practice experience and professional education background. They believe that guidelines will be of help to the clinical practice of acupuncture and moxibustion, hope that WFAS CPGs would recommend effective guidelines for acupuncture manipulation and provide the latest progress in acupuncture treatment and so on, and they believe that classical ancient books can guide their clinical practice. It indicates the necessity and feasibility of formulating the WFAS CPGs of acupuncture and moxibustion. In view of the results of this study, it is suggested that the formulation process of WFAS CPGs of acupuncture and moxibustion should take into account the clinical practice level of acupuncture and moxibustion in each region, as well as its legislation and management situation of acupuncture and moxibustion, so as to meet the needs of users as much as possible.     

推拿联合脐灸治疗小儿脾虚质腹泻的临床研究

目的 探讨推拿联合脐灸治疗小儿脾虚质腹泻的临床价值。方法 纳入2020年5月至2021年9月脾虚质腹泻患儿105例,采用随机数字表法将患儿分为联合组、推拿组和脐灸组各35例。联合组予以推拿联合脐灸治疗,推拿组予以推拿治疗,脐灸组予以脐灸治疗。治疗3个月后比较两组患儿临床疗效、中医体质积分、炎症因子水平。结果 治疗后,联合组临床疗效高于推拿组和脐灸组,主症及次症中医体质积分联合组低于推拿组和脐灸组(P<0.05);治疗后,联合组白介素-4低于推拿组和脐灸组,联合组干扰素-γ水平高于推拿组和脐灸组(P<0.05)。推拿组和脐灸组间上述指标比较,差异无统计学意义(P>0.05)。结论 推拿联合脐灸应用于小儿脾虚质中可有效改善患儿脾虚体质,降低炎症水平,提高临床疗效。