综合性医院2491例病房针灸会诊临床资料分析——一份来自山东大学齐鲁医院的研究报告

目的:统计2014年度山东大学齐鲁医院2491例病房针灸会诊情况,分析针灸在综合性医院中的适用概况,为针灸学的临床与科研提供方向和思路。方法:通过病房信息管理系统查询山东大学齐鲁医院针灸推拿科2014年1月1日至2014年12月31日会诊记录单与患者入院记录,并进行整理,对会诊病例的学科分布、会诊病症及原发疾病所属系统进行分析,以频数统计。结果:会诊病例中共涉及15个二级学科,其中神经病学、外科学数量最多,共1399例,两者占会诊总量59.00%;会诊病症达111种之多,主要集中在术后并发症、神经脑血管病以及关节肌肉病等方面;会诊病症的原发疾病涉及各个系统,仍以神经系统疾病、肌肉骨骼系统和结缔组织疾病、泌尿生殖系统疾病占比较高,三者占会诊病症原发疾病所属系统的73.89%。结论:针灸学科与神经病学、外科学等临床学科相互融合、联系密切,还需加强同儿科学、肿瘤学的合作;针灸在治疗术后并发症及神经-肌肉系疾病方面有较大优势。     

Effect of acupuncture plus medium-frequency electric stimulation on bladder function after radical hysterectomy for cervical cancer

Objective

To observe the effect of acupuncture plus medium-frequency electric stimulation on bladder function after radical hysterectomy for cervical cancer.

Methods

A total of 170 patients confirmed by biopsy and surgical pathology and treated with radical hysterectomy for cervical cancer were randomly divided into an acupuncture group, an observation group and a control group by random digital table. Fifty-six cases in the acupuncture group were treated with acupuncture after surgery, one session each day, till the extubation day; 58 cases in the observation group were treated with acupuncture plus medium-frequency electric stimulation after surgery, one session each day, till the extubation day; and 56 cases in the control group didn’t receive any intervention, and the catheter was retained till the extubation day. On the postoperative day 14, all groups were dealt with catheterization to determine the residual urine volume, in order to observe the occurrence rate of urinary retention and the recovery of bladder function and to compare the differences of the therapeutic effects among the groups.

Results

The occurrence rates of urinary retention were respectively 16.1%, 20.7% and 46.4% in the acupuncture group, observation group and control group, with significant differences (P<0.05). When comparing the acupuncture group and the observation group with the control group, there were significant differences (both P<0.05). In comparison between the acupuncture group and the observation group, there was no significant difference (P>0.05). The recovery rates of bladder function in the three group were respectively 42.9%, 60.3% and 41.1% without significant differences (P>0.05). Moreover, there were no significant between-group differences (P>0.05), but acupuncture plus medium-frequency electric stimulation showed a better tendency.

Conclusion

The single application of acupuncture therapy is effective and able to prevent urinary retention after radical hysterectomy for cervical cancer. Acupuncture plus medium-frequency electric stimulation can effectively enhance the recovery of bladder function and reduce the residual urine volume in the bladder to the maximum.

     

针刺对360例子宫全切术后患者膀胱功能影响分析

ObjectiveTo analysis the clinical curative effect on bladder function recovery after radical hysterectomy with acupuncture and acu-physiotherapy.MethodsA total of 564 cervical cancer patients in the gynecology department who received radical hysterectomy from January 2011 to December 2017 in Qilu Hospital of Shandong University were collected. According to the inclusion and exclusion criteria, we studied 360 case records at last, with 120 cases respectively. Patients got treatment of acupuncture [acupuncture at Zhōngwǎn (中脘 CV12), Tiānshū (天枢 ST25), Shuǐdào (水道 ST28), Tàichōng (太冲 LI3), Sānyīnjiāo (三阴交 SP6), Zúsānlǐ (足三里 ST36) and Yīnlíngquán (阴陵泉 SP9)], or acu-physiotherapy with two large-size electrodes placed on the bladder area above the pubic symphysis besides acupuncture, from the 3rd day after operation once a day till the 14th day that removing the indwelling catheter. And the blank group got no other auxiliary treatment except scrubbed the meatus orifice with iodophor twice a day. We tested the residual urine volume 6 h later after removement of indwelling catheter. Residual urine volume more than 100 mL was defined as urinary retention, and the volume less than 50 mL was defined as adequate bladder emptying.ResultsWe analyzed patients’ age, the International Federation of Gynecology and Obstetrics (FIGO) stage, operation duration, amount of hemorrhage, depth of myometrium infiltration, cancer embolus, parametrium invasion, lymphatic metastasis, treating methods and residual urine volume recorded in case records, and there was no significant difference between every two groups (P >0.05). The incidences of urinary retention of the acupuncture group, the acu-physiotherapy group and the blank group were 24.17%, 21.67%, and 44.17%, indicating that both treating methods have significant effects (P <0.05), and acupuncture group was a little better than acu-physiotherapy group. The bladder function recovery rates of the 3 groups were 44.17%, 56.67%, and 40.83% correspondingly, which had significant difference between acu-physiotherapy group and blank group (P <0.05). Both acupuncture and acu-physiotherapy could reduce the incidence of urinary retention for the patients of Ib1 and IIa1 stages (P <0.01), whilst for patients of Ib2 and IIa2 stages, neither of the two methods was effective (P >0.05).ConclusionBoth acupuncture and acu-physiotherapy could prevent urinary retention after radical hysterectomy for local early cervical cancer (Ib1 and IIa1 stages) effectively, and acupuncture was a little more effective than acu-physiotherapy group. Acupuncture together with modulated medium frequency eletro-therapy could improve the cure rate of bladder function and minimize the residual urine volume.     

后新冠时代西医院校中医课程教学目的转变及方法探讨

在当前以西医为主导的临床诊疗背景下,中医药能够在此次新型冠状病毒肺炎疫情处置中发挥重大作用,得益于数十年来国家在西医院校开设中医课程、普及中医知识的举措。然而,西医院校中医课程教学仍然存在许多问题,其原因是多方面的,需要中医教师反思并寻求破题之法,使中医课程在西医院校中真正落地生根,使西医学生了解中医,相信中医,并在未来临床工作中主动使用中医,成为中医学乃至中华文化的传播者及代言人。     

补母泻子法治疗肩周炎病案一则

肩关节周围炎简称肩周炎，是肩关节周围软组织退行性、非化脓性炎症，其发病与肩部受凉、过度劳累、慢性劳损有关，常于中年后发作。针灸治疗该病疗效显著，传统针灸多采用局部配合循经远端取穴法，疗效尚可。笔者在临床中根据中医理论补母泻子法治疗肩周炎一则，取得较好疗效，现报道如下。