目的 对比热敏灸联合“合谷刺法”与温灸针“合谷刺法”治疗肩周炎的疗效。方法 2015年7月—2017年1月,筛选康复科收治的慢性肩周炎患者120例,按照随机数字表达法分组,对照1组、对照组2组、观察组各入选40例。对照1组采取温针灸“合谷刺法”,对照2组采取传统取穴针刺疗法,观察组热敏灸联合“合谷刺法”。对比3组疗效,治疗前后肩关节功能ASES量表(American Shoulder and Elbow Surgeons shoulder index)、VAS肩关节疼痛评分、肩关节活动度。结果 3组均未见退出例。观察组愈显率82.5%高于对照1组50.0%、对照组2组55.0%,差异有统计学意义(P＜0.05),观察组整体疗效与对照2组差异无统计学意义(P＞0.05)。治疗后,观察组、对照1组、对照2组VAS肩关节疼痛评分低于治疗前,观察组治疗后差值高于对照1组、对照2组,ASES评分高于治疗前,观察组治疗前后差值高于对照1组、对照2组,差异有统计学意义(P＜0.05)。治疗后,观察组、对照1组、对照2组前屈上举角度、外展上举与后伸角度、水平内收外展角度高于治疗前,观察组高于对照1组、对照2组,差异有统计学意义(P＜0.05)。结论 热敏灸联合“合谷刺法”与温灸针“合谷刺法”在治疗肩周炎疗效肯定,但前者减轻疼痛、改善功能方面有明显的优势。

目的 对于急性脑梗死患者联用依达拉奉、阿加曲班注射液治疗的临床效果进行观察。方法 运用随机、开放以及对照原则,将发病12～48 h内的80位急性脑梗死患者,随机分为40例对照组、40例联合组,2组都以对症治疗以及常规治疗为基础,在此之上,对照组以依达拉奉进行治疗,联合组以依达拉奉辅以阿加曲班进行治疗,将2组最终治疗疗效作比较,对2组患者治疗前后血清hs-CRP、凝血功能状况、日常活动能力、血流变指标以及NIHSS评分的动态变化进行实时观察。结果 就总有效率而言,对照组的72.5%显著低于联合组的92.5%,P<0.05。经治疗,2组患者凝血功能指标、血清hs-CRP、血流变指标以及NIHSS评分均有所下降,联合组较之对照组降幅更为显著(P<0.05),较之2组治疗前后,差异无统计学意义(P>0.05)。2组都不曾有不良反应出现。结论 应用依达拉奉辅以阿加曲班进行治疗急性脑梗死患者,可显著提升临床疗效,促进患者神经功能及日常活动能力恢复,减少炎症反应发生,改善预后,且无明显不良反应。

目的 探讨盐酸普萘洛尔凝胶外涂治疗婴幼儿浅表性血管瘤的疗效及安全性。方法 选取我院2015年5月—2017年5月收治的60例患有浅表性血管瘤的婴幼儿为研究对象,随机分为观察组和对照组,各30例。对照组口服盐酸普萘洛尔片治疗,观察组采用质量浓度为5 g/L的(20 g∶100 mg)盐酸普萘洛尔凝胶外涂方法治疗,疗程3个月。观察两组患者治疗效果及不良反应情况。结果 治疗后,采用Achauer评定疗效,观察组Ⅰ级患儿1例,Ⅱ级患儿6例,Ⅲ级患儿12例,Ⅳ级患儿8例,Ⅴ级患儿3例,总有效率为96.67%(29/30),对照组Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级、Ⅴ级分别为2例、8例、10例、6例、4例,总有效率为93.33%(28/30),两组患者差异无统计学意义(P>0.05);两组患者治疗后血管瘤血流峰值及阻力系数较治疗前均得到改善(P<0.05),而两组间差异均无统计学意义(P>0.05);不良反应情况,除观察组发生3例涂抹部位发红外,两组患者均未发生严重不良反应。结论 采用盐酸普萘洛尔凝胶外涂治疗婴幼儿浅表性血管瘤疗效显著,安全可靠,临床上值得进一步推广。

Objective To evaluate the efficacy and safety of Propranolol hydrochloride gel in the external application treatment of superficial hemangioma in infants. Methods We selected 60 infants with superficial hemangioma treated in our hospital from May 2015 to May 2017 and to randomly divide them into the observation group and the control group, each with 30 cases. The control group was treated with Propranolol hydrochloride tablets, and the observation group was treated with 0.5% (20 g∶100 mg) Propranolol hydrochloride gel external application method, the course of treatment was 3 months.We observed the therapeutic effects and adverse reactions of the two groups. Results After treatment, with the Achauer evaluation, patients with grade Ⅰ had 1 case, grade Ⅱ 6 cases, grade Ⅲ 12 cases, grade Ⅳ 8 cases, Ⅴ-grade 3 cases, and the total effective rate was 96.67% (29/30), while the grade Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ in the control group included 2 cases, 8 cases, 10 cases, 6 cases, 4 cases, and the total effective rate was 93.33% (28/30), there was no significant difference between the two groups (P>0.05); The hemangioma peak flow and resistance coefficient of patients in the two groups were significantly improved than that before the treatment (P<0.05), and all with no statistically significant difference between the two groups (P>0.05). As to the adverse reactions, except the applying parts of 3 cases having rubefaction occurred in the observation group, two groups of patients had no serious adverse reactions. Conclusion External application of Propranolol hydrochloride gel in the treatment of superficial hemangioma in infants is effective, safe and reliable. It is worthy of further promotion in clinic.

目的 探讨八段锦联合呼吸训练对社区慢性阻塞性肺疾病(COPD)患者的疗效研究。方法 选取本社区2016年6月—2017年4月期间收治的重度及极重度稳定期COPD患者70例。随机分为A组(25例)、B组(23例)和C组(22例)。A组患者采用八段锦联合呼吸训练治疗,B组患者仅采用呼吸锻炼,C组患者不采用锻炼方式。记录对比三组患者治疗前后的肺功能、六分钟步行距离和圣乔治呼吸评分。结果 A组和B组患者肺功能均比治疗前及比C组改善(P＜0.05),且A组改善更明显(P＜0.05);A组和B组步行距离均比治疗前及C组增加(P＜0.05),且A组比B组增加程度更大(P＜0.05);A组和B组圣乔治呼吸评分均比治疗前及C组降低(P＜0.05),且A组比B组降低更多(P＜0.05)。结论 对COPD患者,八段锦联合呼吸训练可改善患者肺功能和运动能力,缓解呼吸困难,对患者活动及生活各方面的影响。具有较好的临床效果,值得临床推广应用。

Objective To study the effect of Baduanjin exercise combined with breathing training on patients with chronic obstructive pulmonary disease (COPD) in community. Methods We selected 70 patients with severe and extremely severe COPD at stable period in the community from June 2016 to April 2017. The patients were randomly divided into group A (25 cases), group B (23 cases) and group C (22 cases). Patients in group A were treated with Baduanjin exercise combined breathing training, while group B patients only used breathing exercise, and group C patients did not have exercise. We recorded and compared the lung function, six-minute walking distance and St Georges breathing score before and after treatment in the three groups. Results The pulmonary function of patients in group A and group B had been improved more than that before the treatment and of group C (P<0.05), and group A had been improved (P<0.05); the walking distance in group A and group B increased more than that before the treatment and of group C (P<0.05), and group A increased a greater degree than that of group B (P<0.05); The St Georges breathing score in group A and group B decreased than before the treatment and of group C (P<0.05); and group A decreased more than that of group B (P<0.05). Conclusion The Baduanjin exercise combined with breathing training may improve the pulmonary function and athletic ability of the patients with COPD, relieve dyspnea, reduce the influence of the illness on the activities activities of daily living of the patients. It has good clinical effect and is worthy of clinical application.

目的 探讨腔镜手术治疗老年肺癌的疗效及对肺功能的影响。方法 我们纳入90例老年肺癌患者作为研究对象,随机抽签分为2组,各45例。观察组45例行胸腔镜肺癌切除术,对照组45例行传统开胸肺癌切除术。比较两组患者手术时间、术中出血量、胸腔引流时间、淋巴结清扫数量、术后住院时间、疼痛评分、肺功能及术后并发症情况。结果 两组手术时间、淋巴结清扫数量无差异(P>0.05);观察组术后胸腔引流时间、术中出血量、疼痛评分、住院时间少于对照组(P＜0.05)。观察组术后并发症总发生率低于对照组(P＜0.05)。观察组术后一秒用力呼气容积、用力肺活量、肺活量、一秒用力呼气容积与用力肺活量比值恢复情况优于对照组(P＜0.05)。结论 腔镜微创手术用于老年肺癌患者能够显著降低围术期并发症,缩短患者术后恢复时间,且有助于改善肺功能。

Objective To investigate the efficacy and safety of endoscopic surgery in the treatment of elderly patients with lung cancer. Methods 90 elderly patients with lung cancer in our hospital were divided into two groups,45 cases in each group. The observation group was treated with thoracoscopic lung resection in 45 cases, the control group of 45 cases received conventional open lung cancer resection. The operation time, intraoperative blood loss, thoracic drainage time, lymph node dissection, postoperative hospital stay, pain score, pulmonary function assessment and postoperative complications were compared. Results There were no significant differences in the operation time and lymph node dissection between the two groups (P>0.05). The thoracic drainage time,intraoperative blood loss pain score and hospitalization time in the observation group were lower than those in the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05). The forced expiratory volume, forced vital capacity, vital capacity, one-second forced expiratory volume and forced vital capacity of the observation group were better than those in the control group after operation(P<0.05). Conclusion Endoscopic minimally invasive surgery may significantly reduce perioperative complications in elderly patients with lung cancer, shorten the postoperative recovery time and improve lung function.

目的 观察PNF技术配合寰枢椎复位对颈源性眩晕的临床疗效。方法 48例颈源性眩晕患者随机分为2组,PNF组24例给予寰枢椎旋转复位配合PNF技术治疗;对照组24例单纯给予旋转复位,分别在疗程结束后1天、1个月、半年回访。治疗前后应用颈性眩晕症状及功能评估量表和VAS视觉模拟疼痛评定量表进行疗效评定。结果 2组在短期治疗效果上没有显著的临床差别,但在中长期的疗效巩固、预防复发上,PNF组优于单纯寰枢椎旋转复位组。结论 PNF技术配合旋转复位能提高颈源性眩晕的临床疗效。

Objective To observe the clinical effect of PNF technique on cervicogenic vertigo. Methods 48 patients with cervicogenic vertigo were randomly divided into two groups, 24 patients in the PNF group; 24 patients were treated with atlantoaxial rotation and PNF. The control group (24 cases) was treated with rotational reduction. Before and after treatment, the curative effect of cervical vertigo and function evaluation scale and VAS visual analogue pain rating scale were used to evaluate the curative effect. Results There was no significant clinical difference between the two groups in the short-term treatment effect. But in the long-term effect of consolidation, prevention of recurrence, PNF group was superior to the simple atlantoaxial rotation reduction group. Conclusion PNF technique combined with rotational reduction may improve the curative effect of cervicogenic vertigo.

目的 探讨逍遥散治疗首发抑郁症的疗效与5-HT2A受体基因多态性的关联。方法 采用病例对照研究方法,以120例首发抑郁症患者(研究组)和120例正常人(对照组)为研究对象,研究组予逍遥散治疗,疗程8周。于治疗前后采用汉密顿抑郁量表评定。采用高温连接酶检测反应法(LDR)检测5-HT2A受体基因,分析其与抗抑郁药物疗效的关系。结果 5-HT2A受体基因(T102C)T／C基因型、C／C基因型频率及等位基因频率与对照组相比差异无统计学意义(P﹥0.05)。不同基因型的疗效无差异(P﹥0.05)。结论 5-HT2A受体基因(T102C)多态性与逍遥散治疗抑郁症的疗效无关联。

目的 探讨通络熄风汤联合西医基础治疗对缺血性脑卒中急性期的临床疗效观察及其安全性。方法 选择2013年4月—2015年4月之间于我院收治的缺血性脑卒中急性期患者112例随机分为联合组(n=56)与对照组(n=56)。两组缺血性脑卒中急性期患者均采用常规治疗,联合组在此基础上服用通络熄风汤。比较两组治疗总有效率,神经功能缺损积分,ADL评分,血清NSE水平及用药安全性。结果 联合组总有效率(91.07%)高于对照组(75.00%)(P<0.05);神经功能缺损评分治疗后联合组与对照组低于治疗前(P<0.05);神经功能缺损评分治疗后联合组低于对照组(P<0.05);ADL评分治疗后联合组与对照组高于治疗前(P<0.05);ADL评分治疗后联合组高于对照组(P<0.05);血清NSE水平治疗后联合组与对照组低于治疗前(P<0.05);血清NSE水平治疗后联合组低于对照组(P<0.05);联合组与对照组在用药期间均无发现有严重药物不良反应。结论 通络熄风汤联合西医基础治疗对缺血性脑卒中急性期的临床疗效明显,并且用药安全性良好。

目的 探讨鼻—空肠营养管在小儿急性胰腺炎中的疗效观察及护理。方法 采用回顾性分析法,选取2013年2月—2015年5月期间我院收治的116例急性胰腺炎患儿的临床资料,按照营养支持方法的不同将患儿分为对照组和观察组,每组58例。对照组患儿肠功能恢复后给予经口进食,观察组给予鼻—空肠营养管进行营养支持;并给予患儿针对性的护理措施。比较分析两组患儿的治疗效果。结果 观察组患儿平均住院时间、平均花费、并发症发生率、手术率及死亡率等指标均低于对照组(P＜0.05),差异有统计学意义。结论 鼻—空肠营养管应用于小儿急性胰腺炎具有较好的效果,降低患儿并发症发生率、手术发生率,缩短住院时间,减少住院消费,促进患儿康复。

Objective To observe the clinical efficiency of nasal jejunal nutrition in children with acute pancreatitis and explore the effective nursing. Methods The clinical characteristics of 116 children with acute pancreatitis from February 2013 to May 2015 in our medical center were retrospectively analyzed. Based on nutritional support, the patients were divided into two groups: the control group consisted of 58 patients receiving oral feeding after the recovery of bowel function, and the experiment group consisted of 58 patients with nasal jejunal nutrition. And all the patients were treated with special care on case-by-case. The efficiency was then compared between the two groups. Results Compared with the control group, the length of hospital stay, cost of care, the incidence of complications, the surgical proportion and the mortality were significantly decreased in the experiment group (P<0.05). Conclusion In the children with acute pancreatitis, application of nasal jejunal nutrition is more effective, leading to decrease incidences of complications and surgical proportion, shorten the length of hospital stay, reduce patients' cost, and finally help rehabilitation.

目的 评估大光斑低能量Q开关Nd:YAG激光治疗黄褐斑的疗效和安全性。方法 采用Q开关Nd∶YAG激光器以波长1064 nm,光斑6～7 mm,能量2.0～2.5 J/cm²,对黄褐斑患者进行治疗,以治疗处呈现微红为治疗终点,每月1次,治疗5次,共治疗黄褐斑36例。结果 36例患者中基本治愈8 例(22.23%),显效15例(41.67%),好转9例(25%),无效4例(11.11%),前两者之和为总有效率,达63.89%。患者耐受性好,无明显副作用。结论 大光斑低能量Q开关Nd:YAG激光为治疗黄褐斑提供了安全有效的方法。

Objective To evaluate the efficacy and security of Q-switched laser with Large Spot and Low Fluence for the treatment of melasma. Methods Thirty-six patients with melasma were enrolled in study. 1064 nm Q-switched Nd:YAG laser was used with light spot of 6-7 mm and 2.0-2.5 J/cm² in fluence.Treatments are ended when the melasma area turns slight red. Subjects were received a total of 5 treatments at one month intervals. Results Thirty-six patients completed the trial. 22.23% of patients achieved 90% to 100% clearance and 41.67% achieved 60% to 90% clearance. The total efficient rate reached 63.89% .Side effects was minimal and all the patients tolerated the treatment well. Conclusion Q-switched Nd:YAG laser with Large Spot and Low Fluence provides a safe and effective treatment method for melasma.