目的 探索以解语丹联合靳三针为基础的不同治疗方案对卒中后失语症（PSA）的治疗效果。方法 收集广州市第一人民医院神经内科、中医科PSA患者120例,随机分为解语丹组、靳三针组、联合组和对照组,每组各30例。试验组除给予常规卒中治疗外,分别给予解语丹、靳三针及解语丹联合靳三针治疗,对照组仅给予常规卒中治疗,治疗周期共12周。分别利用西方失语成套测验（WAB）、汉语失语检查量表（ABC）、副反应量表（TESS）于试验前、试验2周及12周时对患者进行评估,并进行药物安全性评价,观察解语丹联合靳三针治疗卒中后失语症的临床治疗效果。结果 经2周治疗后,试验组各组WAB中的失语指数（AQ）、操作指数（PQ）、大脑皮质指数（CQ）评分分别为68.14±7.23;67.26±7.23;69.73±6.97、15.47±3.91;15.92±6.35;18.06±7.83、66.84±7.85;65.78±6.75;70.35±6.73,均较治疗前及对照组有明显改善,比较差异有统计学意义（P<0.05）;试验组各组比较,联合组各项评分优于解语丹组和靳三针组,比较差异有统计学意义（P<0.05）;治疗12周后,试验组WAB的AQ、PQ、CQ评分分别为91.87±7.81;85.75±6.87;94.58±7.83、31.57±7.38;25.67±6.28;35.72±8.31、89.74±6.98;84.16±6.79;93.56±7.88,与治疗2周后比较,差异有统计学意义（P<0.05）。言语功能各亚项评分显示,联合组在口语表达、听理解、复述、命名等方面优于其他各组,两两比较差异有统计学（P<0.05）。试验各组在2周及12周时,TESS评分比较差异无统计学意义（P<0.05）。统计分析表明,解语丹联合靳三针治疗卒中后失语症,2周后起效12周后效果更为明显。结论 解语丹联合靳三针早期治疗PSA患者能有效提升认知功能,改善患者的言语功能,提高患者的人际交往和生活自理能力,且具有较好的安全性,无严重不良反应,可为临床治疗PSA提供一种新的方法。

Objective To compare the therapeutic effects of different treatment plans based on Jieyu Dan combined with Jin's Three Needle on aphasia patients after stroke．Methods A total of 120 patients with aphasia after stroke in the neurology and traditional Chinese medicine departments of Guangzhou First People's Hospital were collected and randomly divided into Jieyu Dan group,Jin's Three Needle group,combined group and control group,with 30 cases in each group．The treatment groups were treated with Jieyu Dan,Jin's Three Needle and Jieyu Dan combined with Jin's Three Needle respectively,in addition to conventional stroke treatment．The control group was only treated with conventional stroke treatment,with a total treatment period of 12 weeks．The Western Aphasia Battery（WAB）,Aphasia Battery of Chinese（ABC）and Treatment Emergent Symptom Scale（TESS）were used to evaluate patients before,at 2 weeks and 12 weeks of the trial,and drug safety was evaluated to observe the clinical therapeutic effect of Jieyu Dan combined with Jin's Three Needle in treating post stroke aphasia．Results After 2 weeks of treatment,the aphasia quotient（AQ）,performance quotient（PQ）,cortical quotient（CQ）scores of WAB in each group of the experimental group were 68.14±7.23,67.26±7.23,69.73±6.97;15.47±3.91,15.92±6.35,18.06±7.83;66.84±7.85,65.78±6.75,70.35±6.73,respectively,and all significantly improved compared to before treatment and the control group,with significant differences（P<0.05）．Compared with the experimental group,the combined group had better scores than the Jieyu Dan group and Jin's Three Needle group,with a statistically significant difference（P<0.05）．After 12 weeks of treatment,the AQ,PQ,and CQ scores of the experimental group's WAB were 91.87±7.81,85.75±6.87,94.58±7.83;31.57±7.38,25.67±6.28,35.72±8.31;89.74±6.98,84.16±6.79,93.56±7.88,respectively．Compared with 2 weeks of treatment,the difference was statistically significant（P<0.05）．The scores of each sub item of speech function showed that the combined group was significantly better than the other groups in terms of oral expression,listening comprehension,retelling,naming,etc．,with statistical significance（P<0.05）．At 2 and 12 weeks,there were no significant statistical differences in TESS scores among the experimental groups（P<0.05）．Statistical analysis showed that the combination of Jieyu Dan and Jin's Three Needle in the treatment of post-stroke aphasia had a more significant effect after 2 weeks and 12 weeks．Conclusions The combination of Jieyu Dan and Jin's Three Needle can effectively improve cognitive function and enhance patients' self-care ability in the early treatment of aphasia after stroke．The clinical efficacy is significant and has good safety,making it an effective treatment plan for aphasia after stroke．

目的 调查新疆疏附县基层医务人员对男童外生殖器畸形的认知及筛查能力,为制定新疆少数民族地区医务人员培训计划提供数据支持。方法 采用自行设计的问卷调查表,对新疆疏附县人民医院、乡卫生院及村医进行问卷调查,确定其对男童外生殖器畸形的认知程度。采用SPSS 13.0进行数据分析,比较维、汉两族医务人员的认知差异。结果 发放调查问卷400份,收回有效问卷365份,占91.25%。调查发现,新疆疏附县基层医务人员对外生殖器畸形相关知识认知正确率超50%的占参与问卷调查的54.79%。其中男性21.92%,女性32.87%。汉族医务人员对外生殖器畸形相关知识认知正确率超50%的占参与问卷调查的汉族医务人员50%,维族约57.40%,统计分析显示差异无统计学意义(P＜0.05);有关外生殖器畸形相关知识获取途径中,未参加相关知识培训占61.64%,参加过培训者38.36%;在临床实践中主动筛查新生儿外生殖器畸形者86.30%,发现外生殖器畸形病例者27.39%。结论 新疆疏附县基层医务人员普遍缺乏男童外生殖器畸形相关诊疗知识,在实际工作中发现并恰当处置此类疾病的能力亦相对欠缺。因此提高新疆少数民族地区基层医务人员对男童外生殖器畸形的诊断和治疗能力非常必要。

Objective To survey on the recognition and diagnosis capability of frontline healthcare workers in boy's genital malformation in Shufu, Xinjiang. Thereby to provide data support for the healthcare workers training there. Methods We designed a questionnaire and carried out a survey in Shufu people's hospital, township clinics and village doctors. Based on SPSS 13.0 data analysis, we made comparison on recognition difference between the Han and Uygur healthcare workers. Results 400 questionnaires were handed out, among them 365 were valid which accounted for 91.25%. The survey showed that there were 54.79% survey participators whose recognition correct rate was over 50% in Shufu, Xinjiang (21.92% for man, 32.87% for woman), 50% Han healthcare workers whose recognition correct rate was over 50% and that of 57.4% in Uygur peers.There was no significant difference in statistics(P<0.05). It accounted for 38.36% that participating in training as the access to relevant knowledge of genital malformation,but 61.64% was not. In clinical practice, 86.3% of survey participators screen the possibility of newborn genital malformation. And 27.39% of screened newborn have genital malformation. Conclusion The frontline healthcare workers in Shufu, Xinjiang at large are short of diagnosis knowledge on boy's genital malformation, as a result that they are difficult to recognize and give proper treatment on such cases in practice. The status thereby shows that it is critical to improve the diagnosis and treatment capability of frontline healthcare workers in boy's genital malformation in Xinjiang ethnic group area.

目的 探讨用捏脊联合中药外洗治疗脾胃气虚型儿童功能性消化不良的效果。方法 随机选取脾胃气虚型功能性消化不良的儿童120例,分为联合组、捏脊组、外洗组、对照组4个组,每组30例,分别采用捏脊、中药外洗、捏脊联合中药外洗、吗丁啉进行治疗,两周后观察4组治疗效果及唾液淀粉酶活性比值、D-木糖排泄率的变化,进行分析。结果 联合组的有效率优于捏脊组、外洗组、对照组,差异有统计学意义(P<0.05)。治疗后联合组的唾液淀粉酶活性比值比捏脊组、外洗组、对照组提高,差异有统计学意义(P<0.05)。治疗后D-木糖排泄率均较治疗前有增加,两两比较,联合组与对照组比较差异有统计学意义(P<0.05)。结论 捏脊联合中药外洗可改善脾胃气虚型儿童功能性消化不良,疗效良好,其机理同改善唾液淀粉酶活性有关。