中风后顽固性呃逆的治疗体会

目的:探讨中风后发生顽固性呃逆的特点及治疗。方法:通过对32例患者的临床症状及治疗情况进行总结。结果:32例患者中第1天治愈未复发者11例,好转者15例,占81.25%。治疗一周后评价治愈者26例,好转4例,无效2例,总有效率93.75%。结论:中风后发生顽固性呃逆患者,及时采用穴位贴敷、"止呃降逆汤"等联合治疗,能够得到很好地控制,并防止对中风病情的加重。     

中医针灸治疗顽固性呃逆患者的临床效果

目的 探讨中医针灸治疗顽固性呃逆的临床疗效。方法 收集2017年4月～2018年4月我院78例顽固性呃逆病例,随机分为治疗组与对照组,各39例,对照组采取常规方法治疗,治疗组则采用中医针灸治疗,分析比较两组患者24 h的临床疗效及1周复发率。结果 治疗组总有效率92.3%,对照组总有效率74.3%,差异具有统计学意义(P0.05);治疗组复发率10.2%,对照组复发率23.1%,差异具有统计学意义(P0.05)。结论 中医针灸治疗顽固性呃逆能明显改善临床症状及降低复发率,可有效改善患者的心理状态,可在临床广泛推广应用。     

Stimulus and site specific induction of hiccups in the oesophagus of normal subjects

Background—Hiccups that are induced by a largemeal have been suggested to result from gastric overdistension. Therole of the oesophagus in precipitating hiccups has never been defined.
Aims—To determine the involvement of oesophagealmechanoreceptors in the hiccup reflex.
Methods—Ten normal healthy subjects wereprospectively evaluated at a university affiliated hospital. Controlledinflation of a polyethylene bag in the proximal and distal oesophaguswas carried out using slow ramp and rapid phasic distensions, by an electronic distension device.
Results—Hiccups were induced in four subjects onlyduring rapid phasic distensions and only in the proximal oesophagus.The mean (SEM) minimal volume threshold for the hiccup reflex was 32.5 (4.8) ml, which was above the perception threshold. Hiccups appearedduring inflation and resolved after deflation.
Conclusions—Sudden rapid stretch of themechanoreceptors in the proximal oesophagus can trigger the hiccupreflex in normal subjects. Only rapid distensions above a determinedvolume threshold will predictably induce hiccups in a given subject.This mechanism may play a role in the physiological induction of hiccups.

Keywords:hiccups; oesophageal mechanoreceptors; electronicdistension device; phasic distension; ramp distension; perceptionthresholds

     

穴位注射治疗腹部术后呃逆41例

目的探寻腹部术后呃逆的有效疗法。方法将腹部术后呃逆患者随机分为药物肌肉注射组、单纯针刺组（双侧内关、足三里针刺）、穴位注射组（双侧内关、足三里分别注射维生素B1和B6）。结果治疗1、2、3次后,单纯针刺组、穴位注射组有效率显著高于药物肌肉注射组（P〈0.05,或P〈0.01）。治疗1、2次后,穴位注射组有效率显著高于单纯针刺组;治疗3次后,两组有效率无显著性差异。结论穴位注射是治疗腹部术后呃逆的有效手段之一。     

中西医结合治疗有机磷农药中毒后伴发顽固性呃逆10例

临床上运用中西医结合治疗有机磷农药中毒后伴发顽固性呃逆患者10例,疗效满意,值得临床推广。     

经皮穴位电刺激治疗血液病患者顽固性呃逆的临床观察

[目的]观察经皮穴位电刺激治疗血液病患者顽固性呃逆的疗效。[方法]将2010年1月至2013年12月住院的血液病患者用化疗或糖皮质激素治疗后并发顽固性呃逆的57例随机分为两组,试验组予经皮穴位电刺激治疗,对照组予利他林足三里穴位注射治疗,比较两组治疗后呃逆症状的改善情况及不良反应。[结果]试验组和对照组疗效差异无显著性（P〉0.05）,但是试验组不良反应比较轻微。[结论]经皮穴位电刺激疗法是一种治疗顽固性呃逆的有效方法,值得临床进一步推广。     

Intractable hiccups and sleep apnea syndrome in multiple sclerosis: report of two cases

Two cases of multiple sclerosis associated with intractable hiccups (IH) and sleep apnea syndrome (SAS) are reported. Lesions were detected in the tegmentum of the medulla oblongata by magnetic resonance imaging. In one case, high dose methylprednisolone was remarkably effective for the IH. For the SAS, amitriptyline was effective in one case. The IH and SAS are thought to be important symptoms when a lesion occurs in the tegmentum of the medulla oblongata, including the paramedian and lateral reticular formations. If IH appears in conjunction with a lesion in the tegmentum of the medulla oblongata, one must be vigilant for the development of SAS.     

Possible azithromycin-associated hiccups

OBJECTIVE: To report a case of persistent hiccups associated by azithromycin therapy. CASE SUMMARY: A 76-year-old man presented with persistent hiccups after beginning azithromycin for the treatment of pharyngitis. Hiccups were persistent and exhausting. Discontinuation of azithromycin and therapy with baclofen finally resolved hiccups. No organic cause of hiccups was identified despite extensive investigation. DISCUSSION: Pharmacotherapeutic agents have been uncommonly associated with hiccups. Corticosteroids (dexamethasone and methylprednisolone), benzodiazepines (midazolam) and general anaesthesia have been the specific agents mentioned most frequently in the literature as being associated with the development of hiccups. Few cases of drug-induced hiccups have been reported related to macrolide antimicrobials. Using the Naranjo adverse effect reaction probability scale this event could be classified as possible (score 5 points), mostly because of the close temporal sequence, previous reports on this reaction with other macrolides and the absence of any alternative explanation for hiccups. Our hypothesis is that a vagal mechanism mediated by azithromycin could be the pathogenesis of hiccups in our patient. CONCLUSIONS: Diagnosis of drug-induced hiccups is difficult and often achieved only by a process of elimination. However, macrolide antimicrobials have been reported to be associated with hiccups and vagal mechanism could explain the development of this side-effect.     

沉香粉治疗肝癌介入术后顽固性呃逆临床观察

目的:观察沉香粉联合甲氧氯普胺治疗原发性肝癌介入术(TACE)后顽固性呃逆的治疗效果。方法:选择原发性肝癌介入术后顽固呃逆患者56例,随机分治疗组和对照组两组,每组28例。治疗组采用口服沉香3g,研粉冲服,3次/d;联用肌注甲氧氯普胺注射液10mg,1次/d。对照组采用常规肌注甲氧氯普胺注射液10mg1,次/d。所有病例按显效、有效和无效标准进行评定。结果:治疗组28例病人中治疗有效27例(96.4%),对照组28例病人治疗有效20例(71.4%),两组比较,差异有统计学意义(P<0.05)。结论:原发性肝癌介入术后出现顽固性呃逆的患者使用沉香粉联合甲氧氯普胺注射液治疗,效果显著。