基于数据挖掘分析《外台秘要》中胸痹心痛病的用药规律

目的运用数据挖掘技术分析王焘所著《外台秘要》中胸痹心痛病的辨治用方,探讨其治疗胸痹心痛病的用药规律及配伍特点。方法筛选符合纳入标准的处方建立数据库,对中药频数和性味归经、分类进行统计,运用SPSS 25.0软件对高频中药(频次≥8次)进行系统聚类分析,运用IBM SPSS Modeler 18.0软件Apriori算法进行关联规则分析,并检索中国知网中已发表的运用数据挖掘方法分析古籍治疗胸痹心痛病用药规律的相关文章,进行比较。结果本研究中总共纳入75首处方,共78味中药,总用药频次413次,高频药物(≥8次)共17味,占比23.08%。性味最高频的分别是温性、辛味;归经以脾胃经为主;药物分类排名前三位为温里药、补虚药、化痰止咳平喘药;高频药物系统聚类出3个药物组,关联规则分析得出16个药对关联组和12个角药关联组。共检索出相关文章5篇,涉及宋、明、清三朝。结论《外台秘要》对于胸痹心痛病的治疗,强调标本兼顾,以辛温散寒温阳、甘温补益气血为主,临证根据病证变化,施以化痰、理气、清热等法,同时顾护脾胃。历代医家研究胸痹心痛病均尊仲景之法,并在此基础上不断完善发展。     

传统针刺手法治疗耳鸣耳聋研究概况

<正>耳鸣是指患者自觉耳内嗡嗡作响,音调高低不一,间歇出现,偶可持续存在;耳聋是指不同程度的听力减退。两者分属于不同的病证,但因在临床上常前后或合并出现,故将其合称为耳鸣耳聋^[1-2],《医学入门》亦有"耳聋为耳鸣之极,耳鸣为耳聋之渐"之说。作为临床常见病与多发病,耳鸣耳聋具有复杂性和难治性的特点^[3]。随着生活习惯、环境的改变,     

Clinical effects of Angle's Ⅱ1 cases in Alignment with Incognito System

Objective The aim is to reveal the dentofacial changes of Angle Ⅱ1 cases during alignment phase using Incognito lingual orthodontic appliance. Methods Nineteen patients (8 Male and 11 female, aging from 12y to 23y) with Angle Ⅱ1 malocclusion were selected for lingual orthodontic treatment with four premolars extraction. Customized lingual orthodontic appliance (IncognitoTM) was used. Cephalometric radiographs and alginate impressions were taken before treatment and at the end of alignment. The comparison between pre-treatment and post-alignment were analyzed by Paired-Sample Wilcoxon Signed Rank Test through SPSS Statistical Package.Results From the Cephalometric analysis, the following changes were found significantly different (P＜0.05). U1/SN decreased 7.70°. U1/NA decreased 7.94°with 2.85 mr. L1/NB decreased 4.60°with 1.8mm. MP/SN increased 1.52°. L6-MP increased 0.51 mm. L1-MP decreased 1.29mm. OB decreased 1.18mm. From the model analysis, the following changes with significant differences were demonstrated. Upper and lower intercanine widths and lower intermolar widths increased 2.39mm,2.60mm and 1.26mm respectively. Upper arch depth from molar to incisor decreased 2.42mm. The curve of spee became shallow by 1.11mm. Conclusion During alignment phase, the upper and lower incisors tipped lingually with profile improved. The overbite decreased with lower incisors intruded, and the lower molars extruded with mandibular plane angle increased. It implied that lingual appliance would be helpful for lower angle cases with deep overbite, and cautions should be taken from the initial phase during lingual orthodontic treatment in high angle cases.     

Clinical effects of Angle's Ⅱ1 cases in Alignment with Incognito System

Objective The aim is to reveal the dentofacial changes of Angle Ⅱ1 cases during alignment phase using Incognito lingual orthodontic appliance. Methods Nineteen patients (8 Male and 11 female, aging from 12y to 23y) with Angle Ⅱ1 malocclusion were selected for lingual orthodontic treatment with four premolars extraction. Customized lingual orthodontic appliance (IncognitoTM) was used. Cephalometric radiographs and alginate impressions were taken before treatment and at the end of alignment. The comparison between pre-treatment and post-alignment were analyzed by Paired-Sample Wilcoxon Signed Rank Test through SPSS Statistical Package.Results From the Cephalometric analysis, the following changes were found significantly different (P＜0.05). U1/SN decreased 7.70°. U1/NA decreased 7.94°with 2.85 mr. L1/NB decreased 4.60°with 1.8mm. MP/SN increased 1.52°. L6-MP increased 0.51 mm. L1-MP decreased 1.29mm. OB decreased 1.18mm. From the model analysis, the following changes with significant differences were demonstrated. Upper and lower intercanine widths and lower intermolar widths increased 2.39mm,2.60mm and 1.26mm respectively. Upper arch depth from molar to incisor decreased 2.42mm. The curve of spee became shallow by 1.11mm. Conclusion During alignment phase, the upper and lower incisors tipped lingually with profile improved. The overbite decreased with lower incisors intruded, and the lower molars extruded with mandibular plane angle increased. It implied that lingual appliance would be helpful for lower angle cases with deep overbite, and cautions should be taken from the initial phase during lingual orthodontic treatment in high angle cases.     

Incognito系统矫治安氏Ⅱ1类错[牙合]在排齐阶段的临床效应研究

目的 探讨应用Incognito个体化舌侧矫正系统进行拔牙矫治的早期临床效应.方法 选取19例（8名男性,11名女性,年龄12-23岁）安氏Ⅱ1类（包括亚类）,毛氏Ⅱ2＋Ⅳ1＋Ⅰ1类患者,减数四颗前磨牙,使用Incognito个体化舌侧矫正系统进行矫治.采用Wilcoxon符号秩检验法,对治疗前和排齐整平结束时的X线头影测量和模型测量变化进行对比研究.结果 X线头影测量结果显示：排齐后,U1/SN减少7.70°,U1/NA减少7.94°,U1-NA减少2.85mm,L1/NB减少4.60°,L1-NB减少1.8mm,MP/SN增加1.52°,L6-MP距增加0.51mm、L1-MP距减小1.29mm、OB减小1.18mm,且差异均有显著性（P＜0.05）.模型测量结果示：上、下颌尖牙间宽度分别增加2.39mm和2.60mm,下颌第一磨牙间宽度增加1.26mm,上颌全牙弓长减小2.42mm,spee曲线曲度减小1.11mm,且差异均具显著性（P＜0.05）.结论 应用Incognito个体化舌侧矫正器进行拔牙矫治,早在舌侧矫治的排齐阶段就已经出现明显的切牙的内收、下切牙压低、磨牙伸长、下颌后旋、和牙弓宽度的增加.该研究提示我们,对于低角深覆[牙合]病例,舌侧矫治有助于在早期打开咬[牙合],整平深spee曲线,改善侧貌.但对于高角深覆[牙合]和前牙牙轴较直的病例,从舌侧矫治初期即要针对可能产生的不利变化进行积极的处理.     

Incognito个体化舌侧矫治器的结构和特点综述

随着成人正畸需要的增加,隐形矫治已经越来越多地被正畸医师所关注.舌侧矫治技术始于上世纪70年代,近十余年来,舌侧矫治技术的倡导者和先驱们通过大量的临床实践和探索已使舌侧矫治技术成为一种成熟、高效的固定矫治技术,同时也是口腔正畸临床领域中的一项热门技术.     

《口腔正畸学》十年临床论著质量评估

目的 对<口腔正畸学>近10年所有发表的临床论著进行循证医学质量评估,了解发表的临床论著的质量,为今后的国内口腔正畸临床试验、文献发表以及口腔专业期刊质量控制提供参考.材料与方法手工检索1999～2008年<口腔正畸学>发表的临床论著,提取分析论著的基本信息,对临床试验的设计进行分类评价,采用CONSORT(临床试验统一报告标准)建立的临床试验评价标准来进行质量评估.结果 十年共发表论著295篇,临床论著占69.8%(206/295篇).有基金支持论著占29.5%(87/295篇),临床论著中基金支持比例为18.0%(37/206篇).临床论著中,院校署名占85%(175/206篇),非院校署名仅占15.0%(31/206篇).在试验设计中,21.8%(45/206篇)为前瞻性研究,随机对照试验仅占3.4%(7/206篇).对于方法学质量的评价,大多数论著由于方法学部分相关信息的缺失,无法进行全面的评价.即使对于随机对照临床试验,在明确随机方法,分配方式的隐藏、盲法以及基线数据分析等主要质量控制标准也不完善.结论 正畸临床试验应该在试验设计及论著写作两方面进行提高.     

关闭拔牙间隙阶段个体化舌侧矫治器三维有限元模型的建立

目的建立关闭拔牙间隙阶段牙列-牙周膜-上颌骨-个体化舌侧矫治器的整体三维有限元模型,为进一步探讨舌侧矫治过程中生物力学机制奠定基础。方法采用螺旋CT扫描,分别应用Mimics10．01软件、Geomagic Studio 9软件、ANSYS10．0软件,建立牙列-牙周膜-上颌骨-个体化舌侧矫治器的整体三维有限元模型。结果建成的个体化舌侧矫治器的三维模型包含38个实体模型与个体化舌侧矫治器实际情况相近,网格划分后．共包含节点471208个,单元279744个。结论利用CT扫描技术与计算机辅助设计技术及三维有限元方法的结合,建立关闭拔牙间隙阶段个体化舌侧矫治器的整体三维有限元模型较真实的模拟了临床实际情况。为进一步研究个体化舌侧矫治技术关闭拔牙间隙阶段的牙齿移动生物力学机制提供有效平台。     

正畸治疗前倾阻生的下颌第三磨牙的根吸收风险研究

目的：探讨矫治前倾阻生下颌第三磨牙后牙根的改变和根吸收的影响因素,为临床医师提供风险预测的依据。方法：样本共10例（女性8名,男性2名,年龄15～32岁）,下颌第一恒磨牙已拔除或无保留价值,且伴同侧下颌第三磨牙前倾至水平阻生。矫治采用直丝弓矫治器,利用口内辅弓法后推下颌第三磨牙,再通过竖直簧直立第三磨牙。直立前、后拍摄全口曲面断层片进行测量。采用两相关样本非参数检验（Wilcoxon Signed Ranks Test）对矫治前后牙根长度的改变进行对比分析。结果：经过治疗,10例病例都取得满意的疗效。矫治后成人组阻生磨牙根长度有所减少,但未见统计学差异。青少年组牙根长度增加,差异具有显著性（P〈0.05）。结论：通过正畸手段直立阻生磨牙具有可行性和可靠性,为科学的权衡各种治疗方法提供帮助,为患者提供安全、有效的治疗方案。     

不锈钢微螺钉种植体支抗的稳定性研究

目的 研究不锈钢微螺钉种植体作为支抗的稳定性,并对各类影响因素进行分析.方法 选取97例正畸患者,年龄在13岁到42岁之间,平均年龄20岁,共植入176颗不锈钢微螺钉种植体支抗.分别按植入部位(上颌颧牙槽嵴区、上颌磨牙根间区和下颌外斜线区)、骨面型(高角和非高角)和年龄(成人和青少年)进行分组.统计分析使用SPSS 18.0软件包.采用卡方检验比较植入部位、骨面型、年龄对脱落的单独影响.采用多因素logistic回归分析植入部位、骨面型、年龄对脱落的综合影响.结果 51颗脱落,总脱落率为29％.植入部位和骨面型对脱落率的影响具有统计学意义(P＜0.05);成年和青少年脱落率的差别无统计学意义(P＞0.05).与颧牙槽嵴相比,上颌磨牙间更容易脱落,其脱落的风险是颧牙槽嵴脱落风险的4.93倍;外斜线的脱落风险与颧牙槽嵴的脱落风险的差别无统计学意义(P＞0.05);与非高角相比,高角脱落的风险较高,为2.25倍.结论 不锈钢微种植体支抗适合植入骨质相对致密的区域,如上颌颧牙槽嵴区和外斜线区,尤其是非高角患者.