目的 探讨DPP-4抑制剂联合二甲双胍治疗2型糖尿病的临床疗效及安全性。方法 选取医院近3年收治的糖尿病病人70例,随机分为对照组(35例)和治疗组(35例),对照组给予二甲双胍治疗,治疗组给予二甲双胍联合DPP-4抑制剂控制血糖,经3个月治疗,比较治疗后血糖指标、胰岛功能指标及低血糖、不良反应情况。结果 对照组和治疗组治疗后FPG、2hPG、HbA1c水平均有降低,治疗组治疗后血糖检测指标优于对照组(P＞0.05)。胰岛功能监测显示治疗组治疗后空腹胰岛素、服糖后2小时胰岛素浓度升高优于对照组,胰高血糖素水平降低幅度大于对照组,治疗前后胰岛素及胰高血糖素均有变化,组间比较P＞0.05,有临床意义。治疗期间两组患者均未发生低血糖、药物不良反应。结论 DPP-4抑制剂联合二甲双胍可显著提高降糖效果,改善胰岛功能,并且无低血糖、药物不良反应发生。

目的 观察联合缩宫素与间苯三酚在基层医院分娩中疗效。方法 选用高明区人民医院2013年8月—2014年10月要求自然分娩的初产妇200例,随机分成两组,孕妇进入临产时,观察组予双管输液,予缩宫素2.5U+5%葡萄糖注射液静滴,另一静脉通路5%葡萄糖注射液250 mL+间苯三120 mg静滴;对照组仅予缩宫素2.5U+5%葡萄糖注射液静滴。比较两组产妇各产程时间、分娩方式、新生儿情况、产后出血量。结果 观察组第一产程、第二产程、第三产程时间均短于对照组(P＜0.01),剖宫产率3%及新生儿窒息率3%均低于对照组21%,和13%;P＜0.01;产后2小时出血量较对照组少(109.38±16.13)mL vs(185.00±30.71)mL, P＜0.01。结论 临产孕妇联合间苯三酚与缩宫素,可缩短产程,降低剖宫产率,降低新生儿窒息发生率,减少产后出血量,推荐基层医院使用。

Objective To investigate the effect of oxytocin combined with phloroglucinol in childbirth in primary hospital. Methods A total of 200 primiparas admitted to department of obstetrics in Gaoming people's hospital from August 2013 to October 2014　were selected as study subjects. The cases were randomly divided into observation group (100 cases) and control group (100 cases). In labor, cases in control group were given oxytocin 2.5 U and 5% glucose injection 500 mL, and were given 5% glucose injection 250 mL and phloroglucinol 120 mg by double tube intravenous infusion. Cases in observation group were only given oxytocin 2.5 U and 5% glucose injection 500 mL intravenous infusion. The duration of delivery、delivery mode、the condition of newborn and volume of bleeding after labor were compared between two groups. Results For the first、second and third stages of labor, duration of delivery in observation group were significantly shorter than that in control group (P＜0.01), Both cesarean delivery rate [3%(3/100)] and the incidence of neonatal asphyxia[3%(3/100)] in observation group were significantly lower than that in control group 21%(21/100)and 13%(13/100;P＜0.01). The volume of bleeding during two hours after labor in observation group was less than that in control group (109.38±16.13)mL vs 185.00±30.71 mL, P＜0.01. Conclusion In the stages of labor, the use of oxytocin combined with phloroglucinol can shorten the duration of delivery, reduce the cesarean delivery rate and the incidence of neonatal asphyxia and reduce the volume of bleeding after labor. It is worth recommending to use in primary hospital.

       目的   探究腕踝针联合揿针治疗带状疱疹后遗痛的临床疗效观察。方法   选取上海市黄浦区中西医结合医院2021年10月—2024年4月收治的80例带状疱疹后遗神经痛患者为研究对象，按随机数表法分为研究组、对照组，各40例。对照组采用口服甲钴胺治疗；研究组采用腕踝针联合揿针治疗。比较两组治疗疗效；治疗前后采用视觉模拟评分（VAS）与阿森斯失眠量表评分（AIS）、皮肤病生活质量指数（DLQI）、汉密尔顿抑郁量表评分（HAMD）、汉密尔顿焦虑量表评分（HAMA）。结果   研究组治疗总有效率为92.5%，对照组治疗总有效率为75%。比较差异有统计学意义（P＜0.05）。两组患者治疗后VAS、AIS均比治疗前改善，研究组VAS评分为（1.00±0.45）、AIS评分为（7.15±0.89），优于对照组VAS（2.15±0.36）和AIS（5.65±0.70），比较差异有统计学意义（P＜0.05）。相较于治疗前，两组患者DLQI评分均有改善，研究组［休闲活动评分（1.73±0.45）、人际交往评分（1.13±0.34）、工作学习评分（0.94±0.25）、自觉症状评分（1.83±0.38）、日常活动评分（0.98±0.28）］优于对照组［休闲活动评分（2.06±0.40）、人际交往评分（1.81±0.39）、工作学习评分（1.08±0.38）、自觉症状评分（2.01±0.34）、日常活动评分（1.10±0.30）］，差异有统计学意义（P＜0.05）。两组患者HAMD评分、HAMA评分，相较于治疗前均有改善，研究组HAMD评分为（34.63±2.61）、HAMA评分为（35.75±2.48），优于对照组HAMD评分（47.68±3.21）和HAMA评分（46.90±3.31），差异有统计学意义（P＜0.05）。结论   腕踝针联合揿针治疗带状疱疹后遗神经痛的临床疗效显著，可有效改善患者生活质量、疼痛程度、焦虑及抑郁程度，提升患者睡眠质量。

       Objective  To investigate the clinical efficacy of wrist and ankle acupuncture combined with thumbtack needle in the treatment of postherpetic herpes zoster pain．Methods  Eighty patients with postherpetic neuralgia admitted to Shanghai Huangpu District Hospital of Integrative Medicine from October 2021 to April 2024 were selected for the study，and were divided into a study group and a control group of 40 cases each according to the random number table method．The control group was treated with oral mecoblamin tables；the study group was treated with wrist and ankle acupuncture combined with thumbtack needle．The efficacy of treatment between the two groups was compared；before and after treatment，the visual analogue score（VAS）and Asens Insomnia Scale（AIS），Dermatological Quality of Life Index（DLQI），Hamilton Depression Scale（HAMD），Hamilton Anxiety Scale（HAMA）were compared．Results  The treatment efficiency was 92.5% in the study group and 75% in the control group．The difference was statistically significant（P＜0.05）．VAS scores and AIS scores of patients in both groups improved after treatment，and VAS score（1.00±0.45），AIS score（7.15±0.89）of the study group were better than VAS score（2.15±0.36），AIS score（5.65±0.70）of the control group．The differences were statistically significant（P＜0.05）．The DLQI scores of both groups improved after treatment，and the score of study group（leisure activity score［1.73±0.45］，interpersonal interaction score［1.13±0.34］，work-study score［0.94±0.25］，self-perceived symptom score［1.83±0.38］，daily activities score［0.98±0.28］）were higher than those of the control group（leisure activity score［2.06±0.40］，interpersonal score［1.81±0.39］，work-study score［1.08±0.38］，conscious symptom score［2.01±0.34］，daily activity score［1.10±0.30］）．The differences were statistically significant（P＜0.05）．HAMD scores and HAMA scores of patients in both groups，showed significant improvement after treatment，and HAMD scores（34.63±2.61）and HAMA scores（35.75±2.48）of the study group were better than HAMD scores（47.68±3.21）and HAMA scores（46.90±3.31）of the control group．The difference was statistically significant（P＜0.05）．Conclusions  The clinical efficacy of wrist and ankle acupuncture combined with thumbtack needle in the treatment of postherpetic pain is remarkable，effectively improving the quality of life，pain，anxiety and depression，and enhancing the quality of sleep of patients．

       目的 探讨术中未恢复窦性心律需要行电复律的心房颤动（房颤）患者在清醒和镇静两种状态下的安全性及有效性。方法 选择2022年1月—2023年12月100例接受射频消融术中行同步直流电复律的持续性房颤患者进行研究，采用随机数字表法将患者分为观察组（清醒状态）和对照组（镇静状态），其中观察组和对照组各为50例。观察两组患者接受电复律的成功率、复发率和不良事件发生率（呼吸抑制、低血压、谵妄、肺水肿、心律失常）等指标。结果 观察组和对照组首次电复律成功分别有48、49例，成功率分别为96%、98%，组间比较差异无统计学意义（P=0.558）。观察组术后30 min内有2例复发，对照组术后30 min内无复发，组间比较差异无统计学意义（P=0.153）。在不良反应方面，观察组共发生1例心律失常事件，1例低血压事件，不良反应的总发生率为4%。对照组共发生3例呼吸抑制事件、2例谵妄事件、1例心律失常事件、2例低血压事件，不良反应的总发生率为16%，组间比较差异有统计学意义（P=0.046）。结论 对持续性房颤患者在射频消融术中，处于清醒状态下行电复律也具有良好的临床疗效，可以减少不良事件的发生，安全性更高。

  Objective  To compare the safety and efficacy of awake state and sedation state in patients with atrial fibrillation（AF）who did not recover sinus rhythm and needed electrical cardioversion during operation．Methods  A total of 100 patients with persistent atrial fibrillation who underwent synchronous direct current cardioversion during radiofrequency ablation from January 2022 to December 2023 were selected and divided into the observation group（awake state）and the control group（sedation state）according to the random number table method，with 50 cases in each group．The success rate of electrical cardioversion，recurrence rate and incidence of adverse events（respiratory depression，hypotension，delirium，pulmonary edema，arrhythmia）were observed．Results  The first electrical cardioversion was successful in 48 and 49 patients in the observation group and the control group，and the success rates were 96% and 98%，respectively．There was no significant difference between the two groups（P=0.558）．There were 2 cases of  recurrence in the observation group and no  recurrence in the control group within 30 minutes after operation，and there was no significant difference between the two groups（P=0.153）．In terms of adverse reactions，there were 1 case of arrhythmia event and 1 case of hypotension event in the observation group，and the total incidence of adverse reactions was 4%．There were 3 cases of respiratory depression events，2 cases of delirium events，1 case of arrhythmia events，and 2 cases of hypotension events in the control group．The total incidence of adverse reactions was 16%，and the difference between the two groups was statistically significant（P=0.046）．Conclusions  Electrical cardioversion in awake state during  radiofrequency ablation of persistent atrial fibrillation has a good clinical efficacy and safety，which can reduce the occurrence of adverse events．