目的 观察腰舒汤联合针灸推拿治疗气滞血瘀型腰椎间盘突出（LDH）的临床效果。方法 选取2023年1月～2025年12月收治的气滞血瘀型LDH患者104例，采用计算机随机分为参考组（52例采用针灸推拿治疗，因擅自使用方案外的药物剔除1例，）和综合组（52例采用腰舒汤联合针灸推拿治疗，因主动退出脱落1例）。比较两组中医证候评分、疼痛视觉模拟（VAS）评分、核因子-κB（NF-κB）信号通路指标、日本矫形外科学会（JOA）评分、腰背肌生物力学性能、脊旁肌横截面积（CSA）以及不良反应/事件发生率。结果 两组基线时中医证候评分、VAS评分、NF-κB信号通路指标、JOA评分比较差异不显著（P>0.05）；两组治疗后JOA评分均较基线时升高，同时综合组高于对应时间参考组（P<0.05）；两组治疗后中医证候评分、NF-κB信号通路指标、VAS评分均较基线时降低，同时综合组低于对应时间参考组（P<0.05）。两组基线时60°/s角速腰背肌生物力学性能比较差异不显著（P>0.05）；两组治疗后W、PT均较基线时升高，同时综合组高于对应时间参考组（P<0.05）；两组治疗后F/E均较基线时降低，同时综合组低于对应时间参考组（P<0.05）。两组基线时脊旁肌CSA比较差异不显著（P>0.05）；两组治疗后L3、L4、L5的Sm/Sv均较基线时降低，同时综合组低于对应时间参考组（P<0.05）；两组治疗后L3、L4的Se/Sv较基线时升高，同时综合组高于对应时间参考组（P<0.05）；两组治疗后L5的Se/Sv以及L3、L4、L5的Sp/Sv与基线时比较差异不显著（P>0.05）。两组不良反应/事件发生率比较，差异不显著（P>0.05）。结论 腰舒汤联合针灸推拿治疗气滞血瘀型腰椎间盘突出可缓解症状、抑制炎症、改善腰背肌功能与形态，且安全性相当。
目的：探讨填髓益精法联合环孢素A治疗再生障碍性贫血（AA）的临床疗效，及其对骨髓造血功能、免疫功能及生活质量的影响。方法：选取2021年1月—2026年1月收治的AA患者65例，随机分为对照组（21例）、中药组（23例）、综合组（21例）。对照组予环孢素A口服；中药组在对照组基础上加用填髓益精方口服；综合组在中药组基础上联合督灸、艾灸、耳针治疗。连续治疗24周，观察三组临床疗效、血常规、免疫指标、生活质量及不良反应。结果：对照组、中药组、综合组总有效率分别为76.19%、86.96%、85.71%，中药组与综合组均显著高于对照组（P<0.05）。治疗后，三组红细胞、血红蛋白、血小板均较治疗前升高（P<0.05），IL?2水平下降，CD3?、CD4?、CD4?/CD8?升高，中药组与综合组改善优于对照组（P<0.05）。生活质量评分综合组改善最优，三组不良反应发生率差异无统计学意义（P>0.05）。结论：填髓益精法联合环孢素A可有效提高AA临床疗效，改善骨髓造血与免疫功能，提升生活质量，安全性良好，值得临床推广。
Objective To investigate the clinical efficacy of traditional Chinese medicine (TCM) method of tonifying marrow and nourishing essence combined with cyclosporine A in the treatment of aplastic anemia (AA)， and its effects on bone marrow hematopoiesis， immune function and quality of life. Methods A total of 65 patients with AA admitted from July 2014 to January 2024 were randomly divided into control group (21 cases)， TCM group (23 cases) and comprehensive group (21 cases). The control group was treated with oral cyclosporine A; the TCM group was additionally given Tonifying Marrow and Nourishing Essence Decoction; the comprehensive group was further combined with governor vessel moxibustion， moxibustion and ear acupuncture on the basis of the TCM group. All patients were treated for 24 weeks. The clinical efficacy， blood routine， immune indexes， quality of life and adverse reactions were observed. Results The total effective rates of the control group， TCM group and comprehensive group were 76.19%， 86.96% and 85.71%， respectively. The TCM group and comprehensive group were significantly higher than the control group (P<0.05). After treatment， red blood cells， hemoglobin and platelets in the three groups were increased compared with those before treatment (P<0.05)， the levels of IL?2 were decreased， and CD3?， CD4? and CD4?/CD8? were increased. The improvements in the TCM group and comprehensive group were better than those in the control group (P<0.05). The quality of life score of the comprehensive group was the best， and there was no significant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion TCM method of tonifying marrow and nourishing essence combined with cyclosporine A can effectively improve the clinical efficacy of AA， ameliorate bone marrow hematopoiesis and immune function， and improve quality of life with good safety， which is worthy of clinical promotion.
登革热是由登革病毒引起、经伊蚊叮咬传播的急性传染病，近年来已在全球热带和亚热带地区广泛流行，严重威胁公共卫生安全。目前临床上尚缺乏特异性抗病毒药物和高效的疫苗，临床治疗主要以中西医结合为主要模式，且两者在发病机制阐释、诊疗策略制定等方面各有侧重且互为补充。本文系统梳理登革热西医领域的流行病学特征、病理基础与发病机制及现代医学治疗现状，同时深入阐述中医对该病的病因病机与病位认知、辨证论治体系及中医药治疗进展，旨在为临床诊疗优化与科研方向拓展提供参考。
Dengue fever is an acute infectious disease caused by the dengue virus. In recent years, it has prevailed widely in tropical and subtropical regions, posing a severe threat to public health security. Given the lack of specific antiviral drugs and high-efficiency vaccines for dengue fever, its clinical treatment is predominantly based on integrated traditional Chinese and Western medicine. The two medical systems exhibit distinct focuses and complementary advantages in the interpretation of pathogenesis and the formulation of diagnosis and treatment strategies. This paper systematically reviews the epidemiological characteristics, pathological basis, pathogenesis and current Western medical treatment status of dengue fever, and further elaborates the etiology, pathogenesis, lesion location, syndrome differentiation and treatment system, as well as research progress of traditional Chinese medicine for this disease. It aims to provide references for the optimization of clinical diagnosis and treatment and the expansion of scientific research directions on dengue fever.
目的：探讨免气腹、免全身麻醉腹腔镜辅助下腹股沟疝无张力修补术对患者术中生命体征稳定性及术后恢复的影响。方法：选取广州市从化区中医医院及花都区人民医院于2023年7月至2025年6月收治的腹股沟疝患者，按照手术方式的不同分为研究组与对照组。对照组行传统气腹全身麻醉腹腔镜下腹股沟疝无张力修补术（TEP 或 TAPP 术式），研究组行免气腹、免全身麻醉腹腔镜辅助下腹股沟疝无张力修补术。比较两组患者术中呼吸、循环功能变化，术后并发症发生情况，以及术后肛门排气时间、住院时间和住院费用。结果：两组患者一般资料比较，差异无统计学意义。研究组术中血压波动幅度小于对照组（P＜0.05），心率及血氧饱和度变化与对照组比较差异无统计学意义。亚组分析显示，研究组中采用 TAPP 术式的患者呼吸波动大于对照组中采用 TAPP 术式的患者（P＜0.05），而两组中采用 TEP 术式的患者呼吸波动差异无统计学意义（P＞0.05）。研究组手术时间短于对照组，术中出血量高于对照组（P＜0.05）。两组住院时间比较差异无统计学意义（P＞0.05），但研究组术后肛门排气时间更短、总住院费用更低（P＜0.05）。结论：免气腹、免全身麻醉腹腔镜辅助下腹股沟疝无张力修补术有助于缩短手术时间，促进术后胃肠功能恢复，并降低住院费用，具有一定的临床应用价值。
目的 探讨胸部肿瘤患者手术后早期排痰的效果，降低肺部并发症的发生率。方法 选择2024年6月—2025年7月在本院进行胸部肿瘤切除的60例术后患者作为研究对象。采用非同期回顾对照设计，以不同时间段病例分组，分为对照组（n＝30）和观察组（n＝30）。两组胸部手术后患者均给予常规围术期护理，观察组胸部手术后患者增加早期排痰护理。统计两组排痰效果［咳痰难度、血氧饱和度（SPO2）］变化、疼痛评分，并统计两组肺部相关并发症及住院时间进行比较。结果 观察组患者术后的SPO2水平高于对照组（P＜0.05），咳痰难度评分低于对照组患者（P＜0.05）。干预后第B、C时间点观察组患者的疼痛评分均低于对照组（P＜0.05）。观察组住院时间短于对照组（P＜0.05），胸部并发症总发生率低于对照组（P＜0.05），满意度高于对照组（P＜0.05）。结论 胸部肿瘤术后早期排痰有助于促进术后患者排痰，减少肺部相关发症，缩短住院时间。
Objective To investigate the efficacy of early expectoration management in reducing pulmonary complications for patients following thoracic tumor surgery．Methods Sixty patients undergoing thoracic tumor resection at our hospital between 2024 and 2025 were enrolled．A non-concurrent retrospective control design was adopted．Cases were grouped according to different time periods，divided into a control group（n=30）and an observation group（n=30）．The control group received standard perioperative care，while the observation group received additional early expectoration nursing interventions．Outcome measures included expectoration efficacy（assessed by cough difficulty score and oxygen saturation［SpO2］），pain scores，incidence of pulmonary complications，and hospital stay duration．Results Postoperative SpO2 levels were higher in the observation group than in the control group （P＜0.05），while cough difficulty scores were significantly lower（P＜0.05）．At time points B and C after the intervention，the pain scores of patients in the observation group were lower than those in the control group（P＜0.05）．The observation group demonstrated a significantly shorter hospital stay（P＜0.05），a lower overall incidence of thoracic complications（P＜0.05），and higher patient satisfaction than the control group（P＜0.05）．Conclusions Implementing early expectoration protocols after thoracic tumor surgery facilitates sputum clearance can reduce pulmonary complications，and shorten hospitalization time．
目的 评价新型穿戴式气压治疗仪预防深静脉血栓的临床疗效及安全性。方法 将156例脑梗死患者随机分为对照组和试验组，各78例。试验组使用新型穿戴式气压治疗仪（邦普医疗/VW100）进行气压治疗。对照组使用韩国元金压力治疗仪进行气压治疗。两组疗程均为10 d，观察临床疗效及安全性，比较两组深静脉血栓形成率、医护人员和患者的使用满意度。结果 治疗10 d后，试验组与对照组深静脉血栓未发生率差值为1.2%，相应的95%置信区间为–5.3%～7.9%，下限高于–10%，医护人员和患者对试验组的评价优于对照组（P＜0.001）。结论 新型穿戴式气压治疗仪预防深静脉血栓形成的临床疗效不劣于市面上已有的气压治疗仪，治疗过程中未见明显不良反应，临床使用安全有效。
Objective To evaluate the effectiveness and safety of new wearable pneumatic compression pump in preventing deep vein thrombosis．Methods One hundred and fifty-six patients with cerebral infarction were randomly divided into control and study group with 78 cases in each group．Study group was treated with the new wearable pneumatic compression pump（Bangpu Medical / VW100）．Control group was treated with pneumatic compression pump（Wonjin-POWER）．The course of both groups was 10 days，comparing the deep vein thrombosis rate and useage satisfaction of patients and staffs between the two groups．Results After 10 days of treatment，the difference between the incidence of deep venous thrombosis in the study and control group was 1.2%．The corresponding 95% confidence interval was（-5.3%，7.9%），and the lower limit was greater than -10%．The appraisal from medical staffs and the patients of study group was better than that of the control group（P＜0.001）．Conclusions The clinical effect of the new wearable pneumatic compression pump to prevent deep vein thrombosis is not inferior to the existing pneumatic compression pump，which clinical practice experience is better．There is no obvious adverse reactions in the treatment process，and the clinical practice is also safe and effective．
目的 研究胸腰椎骨质疏松性椎体压缩性骨折（OVCF）经皮椎体成形术（PVP）后腰背部疼痛缓解情况与骨水泥弥散分布的相关性。方法 选取2021年1月—2023年12月金沙县中医医院和毕节市第三人民医院185例因骨质疏松症导致的胸腰椎OVCF行PVP后的患者,根据术后胸腰椎正侧位X线片显示的骨水泥分布情况分为两组：骨水泥分布充分组（n=101例）和骨水泥分布不良组（n=84）, 两组均行PVP, 均行双侧穿刺入路。统计分析两组患者术前、术后及术后1周、3个月、6个月视觉模拟评分（VAS）、患者起床时间等情况。结果 185例患者术后随访半年, 骨水泥分布充分组101例, 骨水泥分布不良组84 例, 两组术后VAS评分均较前缓解（P<0.05）, 术后及术后1周、3个月、6个月的随访中分布充分组VAS评分分别为（7.17±0.76）（2.11±1.04）（1.4±0.78）（0.36±0.58）（0.05±0.22）分, 优于分布不良组（7.14±0.79）（2.37±0.79）（1.89±0.82）（0.68±0.76）（0.25±0.62）分（P<0.05）。结论 骨水泥的分布在一定程度上决定了PVP后患者腰背部残余痛的程度。尤其是骨水泥在椎体内均匀分布时, 可降低术后腰背疼痛的发生率。
Objective To study the relationship between pain relief situation in the lower back and bone cement distribution after percutaneous vertebroplasty（PVP）of thoracolumbar osteoporotic vertebral compression fracture（OVCF）．Methods A total of 185 patients with thoracolumbar OVCF caused by osteoporosis underwent PVP from January 2021 to December 2023 were selected in Jinsha County Hospital of Traditional Chinese Medicine and the Third People’s Hospital of Bijie City．Based on the distribution of bone cement shown in the anteroposterior and lateral X ray films of the thoracolumbar after the operation, they were divided into the group with adequate bone cement distribution（n=101 cases）and the group with poor bone cement distribution（n=84）．Both groups underwent PVP and bilateral puncture approaches．The Visual Analogue Scale（VAS）scores of the two groups of patients before the operation, after the operation, 1 week, 3 months, and 6 months after the operation, as well as the leaving bed time of the patients,were statistically analyzed．Results A total of 185 patients were followed up for half a year after the operation．There were 101 cases in the group with adequate bone cement distribution, and 84 cases in the poor distribution of bone cement group, There was no statistically significant difference in the preoperative general data between the two groups of patients（P>0.05）, and the postoperative VAS scores of both groups were decreased compared with those before operation（P<0.05）．The VAS scores of the adequate distributed group after the operation and in the follow-ups in 1 week, 3 months, and 6 months after the operation were（7.17±0.76）,（2.11±1.04）,（1.4±0.78）,（0.36±0.58） ,and（0.05±0.22）, respectively,better than the poor distribution group （7.14±0.79）,（2.37±0.79）,（1.89±0.82）,（0.68±0.76）,（0.25±0.62）, P<0.05．Conclusions The distribution of bone cement determines to a certain extent the degree of residual pain in the low back of patients after PVP．Especially when the bone cement is evenly distributed within the vertebral body, the incidence of postoperative low back pain can be reduced．
目的 探讨产时超声管理妊娠期糖尿病产妇产程的应用价值。方法 选择2022年1月1日—2023年12月31日在佛山市高明区人民医院妇产科分娩的妊娠期糖尿病初产妇共100例。患者签署知情同意书后, 按照1∶1比例采用随机数字表法分为对照组和研究组各50例。对照组采用阴道指诊检查判断产程和分娩方式。研究组采用经腹联合会阴超声测量检查判断产程及分娩方式。收集两组初产妇血糖、血常规、分娩方式、产后24 h出血量以及切口情况, 新生儿Apgar评分。结果 研究组阴道分娩率高于对照组（88.0% vs 72.0%, P<0.05）, 而阴道检查次数（4.18±0.8 vs 6.82±0.8, P<0.05）少于对照组、不良事件发生率（4% vs 16%, P<0.05）低于对照组。相对于对照组,研究组血红蛋白水平较高（104.10±5.25 vs 100.30±4.78, P<0.05）、而白细胞计数（11.40±1.49 vs 12.04±1.66, P<0.05）以及中性粒细胞百分比较低（72.79±4.04 vs 75.01±5.53, P<0.05）。结论 通过产时超声监测判断妊娠期糖尿病初产妇产程,能够降低阴道操作引起的感染等风险,提高阴道分娩率,有效降低产妇感染,提高产妇分娩满意度以及舒适度,改善母婴结局。
Objective To explore the application value of intrapartum ultrasound for labor management of pregnant women with gestational diabetes mellitus．Methods A total of 100 primiparous women with gestational diabetes mellitus who gave birth in the Obstetrics and Gynecology Department of Foshan Gaoming District People’s Hospital from January 1, 2022 to December 31, 2023 were selected．After signing the informed consent form, the patients were randomly divided into a control group and a study group with 50 cases in each group according to a ratio of 1∶1, using a random number table method．The control group underwent vaginal digital examination to assess the labor process and delivery method．For the study group, the labor process and delivery mode were determined using transabdominal ultrasound measurement．Blood glucose level,routine blood test results, delivery methods, 24-hour postpartum bleeding volume and incision conditions of two groups of primiparas, as well as the Apgar score of newborns were collected．Results The study group demonstrated a significantly higher vaginal delivery rate than the control group（88.0% vs 72.0%, P<0.05）, with fewer vaginal examinations（4.18±0.80 vs 6.82±0.80, P<0.05）and a lower incidence of adverse events（4% vs 16%, P<0.05）．Compared to the control group, the study group exhibited higher hemoglobin levels（[104.10±5.25]g/L vs [100.30±4.78] g/L, P<0.05）, but lower white blood cell counts（[11.40±1.49]×109/L vs [12.04±1.66]×109/L, P<0.05）and reduced neutrophil percentages（[72.79±4.04]% vs [75.01±5.53]%, P<0.05）．Conclusions Intrapartum ultrasound monitoring for assessing labor progression in primiparas with gestational diabetes mellitus reduces infection risks associated with vaginal procedures, increases vaginal delivery rates, effectively decreases maternal infections, enhances maternal satisfaction and comfort during delivery,and improves maternal-neonatal outcomes．
目的 研究并分析星状神经节阻滞联合银杏叶提取物治疗颈源性头晕的临床效果。方法 选取周口骨科医院100例颈源性头晕的住院患者作为研究对象,于2022年6月—2023年6月期间内收治,根据入院顺序奇偶号将其分为对照组与观察组,各50例,对照组实行星状神经节阻滞治疗,观察组在对照组基础上联合使用银杏叶提取物治疗,对比两组患者的临床症状（头痛、眩晕、耳鸣、视物模糊）改善程度、颈部疼痛量表、临床效果和不良反应发生率。结果 治疗30 d后,观察组临床症状评分低于对照组（P<0.05）。两组治疗前的数字分级法评分差异无统计学意义（P>0.05）,治疗15 d与30 d时,观察组数字分级法评分评分均低于对照组（P<0.05）。观察组患者的治疗总有效率高于对照组（P<0.05）;治疗期间,观察组的并发症发生率低于对照组,比较差异有统计学意义（P<0.05）。结论 颈源性头晕患者使用星状神经节阻滞联合银杏叶提取物治疗,能够明显改善疾病症状,缓解颈部疼痛感,有效提高临床效果,同时降低不良反应发生率。
Objective To analyze the clinical study of stellate ganglion block combined with Ginkgo biloba extract to treat cervical dizziness．Methods A total of 100 hospitalized patients with cervical dizziness at Zhoukou Orthopedic Hospital were selected as the study subjects,who were admitted between June 2022 and June 2023．They were divided into a control group and an observation group based on the odd and even numbers of admission,with 50 cases in each group．The control group received stellate ganglion block treatment,while the observation group received a combination of Ginkgo biloba extract treatment on the basis of the control group,The degree of improvement in clinical symptoms（headache,dizziness,tinnitus,blurred vision）,neck pain scale,clinical efficacy,and incidence of adverse reactions were compared between two groups of patients．Results After 30 days of treatment,the clinical symptom score of the observation group was lower than that of the control group（P<0.05）．There was no statistically significant difference in the numerical grading scores between the two groups before treatment（P>0.05）．On the 15th and 30th day of treatment,the observation group had lower numerical grading scores than the control group（P<0.05）．The total effective rate of treatment in the observation group was higher than that in the control group（P<0.05）．During the treatment period,the incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant（P<0.05）．Conclusions The use of stellate ganglion block combined with Ginkgo biloba extract in the treatment of patients with cervicogenic dizziness can significantly improve their disease symptoms,significantly alleviate their neck pain,effectively improve the clinical effect,while reducing the incidence of adverse reactions．
目的 观察环泊酚在老年患者无痛胃肠镜检查中的麻醉效果和不良反应。方法 选择80例65岁以上行无痛胃肠镜检查的老年患者,将患者随机分为环泊酚组（C组）40例和丙泊酚组（P组）40例。每例患者均静脉注射舒芬太尼0.08 μg/kg,30 s后C组给予环泊酚0.3 mg/kg、P组给予丙泊酚1.5 mg/kg。记录2组患者麻醉前（T0）、睫毛反射消失时（T1）、置入胃镜后即刻（T2）和操作结束时（T3）的心率（HR）和平均动脉压（MAP）;记录2组患者检查操作时间、清醒时间、追加药物次数及静脉注射痛、呼吸抑制、呛咳、体动等不良反应发生情况。结果 2组患者行胃肠镜检查操作时间、麻醉清醒时间和追加药物次数比较差异无统计学意义（P>0.05）。与T0时间点（102.6±14.1 mmHg）比较,P组患者的MAP在T1（86.0±12.5 mmHg）、T2（86.1±13.2 mmHg）、T3（92.8±12.6 mmHg）时间点明显下降,差异有统计学意义（P<0.05）;与C组T1（95.9±10.8 mmHg）、T2（96.3±9.6 mmHg）时间点比较,P组的MAP在T1（86.0±12.5 mmHg）、T2（86.1±13.2 mmHg）时均明显降低（P<0.05）。C组患者静脉注射痛、呼吸抑制的发生率明显低于P组（P<0.05）;2组体动和呛咳的发生率比较差异无统计学意义（P>0.05）。结论 环泊酚0.3 mg/kg在老年患者胃肠镜检查中能提供和丙泊酚1.5 mg/kg相似的麻醉效果,环泊酚组的老年患者发生注射痛、血压下降、呼吸抑制的比例更低。
Objective To observe the effect of ciprofol and propofol in painless gastroenteroscopy in elderly patients．Methods A total of 80 elderly patients aged 65 or above who underwent painless gastroenteroscopy were randomly divided into a group of 40 patients receiving ciprofol（Group C）and a group of 40 patients receiving propofol（Group P）．All patients were given sufentanil 0.08 μg/kg,and group C was given ciprofol 0.3 mg/kg,group P was given propofol 1.5 mg/kg after 30 seconds．The heart rate（HR）and mean arterial pressure（MAP）of two groups of patients before anesthesia（T0）,at the disappearance of eyelash reflex（T1）,after gastroscopy insertion（T2）,and at the end of the procedure（T3）were recorded．The operating time,anesthesia awakening time,number of additional medications and the adverse reactions such as injection pain,respiratory depression,cough,body movements were also recorded．Results There were no significant differences（P>0.05）in the gastroenteroscopy operating time,recovery time and number of additional medications between the two groups．Compared with T0 time point（102.6±14.1 mmHg）,the MAP of group P patients significantly decreased at T1（86.0±12.5 mmHg）,T2（86.1±13.2 mmHg）and T3（92.8±12.6 mmHg）time points（P<0.05）．Compared with Group C at T1（95.9±10.8 mmHg）,T2（96.3±9.6 mmHg）time points,the MAP of Group P decreased significantly at T1（86.0±12.5 mmHg）and T2（86.1±13.2 mmHg）time points（P<0.05）．The incidences of injection pain and respiratory depression in group C were significantly lower than those in group P（P<0.05）．There was no statistically significant difference in the incidences of body movements and cough between the two groups（P>0.05）．Conclusions Ciprofol 0.3 mg/kg combined with sufentanil can provide anesthesia effect similar to that of propofol 1.5 mg/kg combined with sufentanil in gastroenteroscopy of elderly patients．The proportions of injection pain,blood pressure decreasing and respiratory depression in elderly patients in the ciprofol group were lower．
