棘突不共线在颈椎"骨错缝、筋出槽"诊断中的临床应用

目的:研究X线平片对椎体旋转诊断的应用价值。方法:自2010年5月至2011年6月收集颈椎病患者129例,行颈椎X线正位平片检查,其中119例存在棘突不共线纳入测量,另10例棘突均共线不纳入测量。纳入测量病例中男28例,女91例,年龄24～65岁,平均(48.53±14.32)岁。纳入病例行CT检查,记录X线平片中观察到的棘突不居中的椎体节段及个数,再对棘突不居中的椎体节段行CT后多平面重建,观测相应节段椎体旋转及棘突偏歪的情况,统计分析X线平片检查中观测到的不居中的棘突个数与椎体旋转之间的关系。结果:不共线棘突个数为1～6个时,椎体旋转率分别为45.45%,46.67%,56.86%,62.07%,77.14%,85.19%。结论:不共线棘突数越多,相应椎体旋转可能性越大。     

针刀治疗腕管综合征的病例对照研究

目的:研究针刀治疗腕管综合征的疗效。方法:2014年7月至2016年12月,60例门诊收治的腕管综合征患者分为两组,针刀治疗组(治疗组)和支具药物组(对照组),每组30例。治疗组男8例,女22例;平均年龄(49.38±7.43)岁。对照组男7例,女23例;平均年龄(50.23±8.71)岁。治疗前两组患者的年龄、性别、病程、感觉神经传导速度(SCV)、感觉神经动作电位波幅(SNAP)、运动传导末端潜伏期(DML)差异无统计学意义。治疗组患者采用针刀治疗1~2次;对照组患者口服塞来昔布、维生素B1、维生素B12,并采用支具固定;疗程结束后观察两组患者SCV、SNAP、DML变化。结果:两组患者治疗后,SCV分别为(48.63±7.33)、(41.24±6.15)m/s,SNAP分别为(9.89±3.71)、(8.22±2.19)m/s,DML分别为(5.11±2.28)、(6.13±2.23)m/s,均较治疗前改善,且治疗组优于对照组。结论:针刀疗法可以减轻患者症状,具有可行性,适合在临床中推广使用。     

西医院校以学生为中心开设针灸学理论与实践课程的探索

针灸学属于西医院校本科生中医学必修课的一个重要组成部分。由于该课程内容过多,与其分配的课时不匹配,缺乏相关课前辅导,概念非常抽象,使得大部分西医专业学生都感到难以理解,造成学习上的困难,且该问题长期无法得到圆满解决。文章从“以学生为中心”的理念出发,结合针灸学课程的特点和对授课对象五年制与八年制临床医学专业西医学生的学情分析,提出在西医院校开设针灸学理论与实践本科课程。通过对课程目标、课程安排、课程内容、课程评价等方面的探索,使该课程内容能更好地契合学生特点,以期更好地实现教学目标。     

Warm needling moxibustion plus functional exercises for knee osteoarthritis

Objective

To observe the clinical efficacy of warm needling moxibustion plus functional exercises in treating knee osteoarthritis (KOA).

Methods

Totally 108 eligible KOA patients were intervened by warm needling moxibustion plus functional exercises. The warm needling moxibustion was given 3 times a week, successively for 4 weeks. The visual analogue scale (VAS) was adopted to evaluate the pain intensity of the knee joint. After 4-week treatment, the change of VAS score, range of motion (ROM) of knee, and Lysholm score were observed, and the clinical efficacy was also estimated.

Results

After treatment, the VAS score dropped obviously, and the ROM and Lysholm score increased markedly; the total effective rate was 83.3%.

Conclusion

Warm needling moxibustion plus functional exercises is effective in treating KOA, as it can relieve the knee joint pain and improve the joint motion.

     

西医院校的中医教育现状与对策

西医院校本科生必修课中医学的教育问题历年来都困扰着中医教育人士,并且长期无法得到圆满的解决。文章总结近年来西医院校中医教育中存在的问题并归纳出具有针对性的策略,以期摸索出一种全新的教育模式,来改善目前西医院校本科生必修课中医学的教学现状,从而更好地实现教学目的。     

椎动脉磁共振血管成像对手法诊治椎动脉型颈椎病的研究

目的：探讨椎动脉磁共振血管成像（MRA）在椎动脉型颈椎病临床手法诊治中的重要作用,为椎动脉型颈椎病的临床诊治提供思路。方法：2007年5月至2010年12月,研究符合椎动脉型颈椎病诊断标准的患者（观察组,53例）和正常人（对照组,30例）的颈椎MRA中椎动脉走行及管径情况,其中观察组男19例,女34例;年龄26-72岁,平均（52．51±11．29）岁;对照组男10例,女20例;年龄25～70岁,平均（48．11±12．21）岁。比较两组受试者椎动脉走行及管径异常发生率的差异性,并结合X线、MRI、MRA资料对观察组的椎动脉走行及管径异常改变的因素及特点进行分析。结果：与对照组相比,观察组椎动脉走行及管径异常的发生率达81．13％（43／53）,两者比较差异有统计学意义（P=0．000）;且椎动脉走行及管径异常改变形式较复杂和多样化,其中以局部迂曲狭窄最为常见,累计占47．18％（25／53）;局部迂曲狭窄因素以椎间关节错缝为主,占43．41％（23／53）。结论：椎动脉型颈椎病患者容易发生椎动脉走行及管径异常改变,而MRA可有效诊断椎动脉的异常改变。     

Acupuncture for dry eye syndrome: a meta-analysis of randomized controlled trials

Objective

To summarize and critically assess the evidence from randomized controlled trials (RCTs) of acupuncture in treating dry eye syndrome (DES) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Cochrane Collaboration recommendations.

Methods

A search of PubMed, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Embase was made from their inception to August 2016, as well as Chinese, Japanese, and Korean databases. Two reviewers independently selected RCTs and assessed the methodological quality. Meta-analysis and the level of evidence were processed by RevMan 5.3 and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results

After selection, 8 trials were subjected to our systematic review. The methodological quality was low generally. The 3-10 weeks follow-up showed that acupuncture improved the tear film break-up time (BUT) (MD=1.33, 95% CI=1.01-1.66, 619 participants). The mean difference of Schirmer’s test was 1.73 mm (95%CI=1.28-2.18, 618 participants) between the acupuncture group and the control group. The subjective variables exhibited no significant differences.

Conclusion

The low methodological quality of the trials does not suggest drawing firm conclusions on the value of acupuncture therapy for DES. Acupuncture treatment may have some effects on the tear film BUT and Schirmer’s test, but not on the subjective symptoms. Well-planned large-scale high-quality RCTs are needed to make it clear whether acupuncture is effective in treating DES.

     

针刀治疗棘上韧带慢性损伤的临床观察

目的:研究针刀治疗棘上韧带慢性损伤的疗效。方法:对两组各64例棘上韧带慢性损伤患者分别行针刀和手法治疗,观察两组治疗方法的疗效。结果:针刀组和手法组有效率分别为96.9%和93.8%,经统计学观察差异无统计学意义;两组痊愈率分别为85.9%和51.6%,经统计学观察差异有统计学意义(P<0.05)。与手法组相比,针刀组改善疼痛作用明显优于手法组。结论:针刀治疗是治疗棘上韧带慢性损伤的一种简单、有效的方法。     

针灸治疗顽固性面瘫的临床研究进展

对近年来针灸治疗顽固性面瘫的临床研究进展进行综述。分别从顽固性面瘫的病因病机、常用的治疗方法以及针灸治疗顽固性面瘫穴位的选择进行整理和分析,并尝试探讨目前临床治疗中的问题以及提出更好地解决方法。为今后的科研和临床提供参考依据。     

鼻三针联合穴位贴敷治疗肺虚感寒型变应性鼻炎的临床研究

目的 采用多中心随机对照研究观察鼻三针联合穴位贴敷治疗肺虚感寒型变应性鼻炎的临床疗效.方法 将160例符合纳入标准的肺虚感寒型变应性鼻炎患者随机分为两组(治疗组79例,对照组81例).治疗组用鼻三针联合穴位贴敷进行治疗,对照组采用安慰治疗.比较两组患者治疗前、治疗2周后、治疗后、治疗后4周、治疗后8周以及治疗后12周的...