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 探讨胰岛素抵抗对缓解期双相障碍患者转归和社会功能的影响。方法 对双相I型患者90例以及正常对照组30例进行体质量指数、空腹血糖、胰岛素等测定,计算胰岛素抵抗指数;长期治疗应答回顾标准量表评估治疗应答、大体社会功评估量表评估社会功能,分析胰岛素抵抗对双相患者转归和社会功能的影响。结果 患有2型糖尿病或胰岛素抵抗的双相障碍患者治疗应答反应差(2.50和2.93 vs 4.77,F=5.636,P<0.01;OR=6.07和4.78,P<0.01),双相发作次数多(0和0.03 vs 0.33,F=59.475,P<0.01),社会功能更差(GAF:56.90和53.23 vs 73.93,F=6.010,P<0.05;OR=1.59和4.82,P<0.01)。治疗应答、社会功能与胰岛素抵抗指数呈负相关(r=-0.383和-0.307,P<0.01)。社会功能与治疗反应、非典型抗精神病药物和药物副反应相关(r=0.467, -0.314,-0.407,P<0.05或P<0.01)。结论 共病糖尿病或胰岛素抵抗可能是双相障碍治疗抵抗、社会功能损害的一个重要的因素。

Objective To investigate the effect of insulin resistance on outcome and social function in patients with bipolar disorder at remission stage. Methods The body mass index(BMI),the levels of fasting plasma glucose,insulin and glyeosylated hemoglobin were detected in 90 BD patients without diabetes(BD group)and 30 normal controls (NC group). Alda scale was used to assess treatment response, and Global Assessment of Functioning Scale was used to assess social function. The effect of insulin resistance on outcome and social function was analyzed. Results Patients with bipolar disorder with type 2 diabetes or insulin resistance have poor response to treatment(2.50,2.93 vs 4.77,F=5.636,P<0.01;OR=6.07& 4.78,P<0.01), more recurrences (0,0.03 vs 0.33,F=59.475,P<0.01;OR=1.59&4.82,P<0.01), and worse social function (GAF:56.90,53.23 vs 73.93,F=6.010,P<0.05). Treatment response and social function were negatively correlated with insulin resistance index (r=-0.383,-0.307,P<0.01), and social function was associated with treatment response, atypical antipsychotics, and side effects (r=0.467, -0.314,-0.407,P<0.05 or P<0.01). Conclusion Diabetes mellitus or insulin resistance may be important factor in therapeutic resistance and social function to patients with bipolar disorder.

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 探讨治疗青年原发性高血压,联合使用硝苯地平控释片(CCB)与厄贝沙坦(ARB)对降压效果、肾功能及不良反应的影响。方法 2012年1月—2015年1月到我院就诊的青年原发性高血压患者共计180例。将患者按照首次就诊顺序编号,分为A、B两组各90例。A组患者CCB治疗,B组患者CCB联合ARB治疗。两周后比较两组患者降压效果、肾功能及不良反应发生率。结果 两组患者治疗前的收缩压、舒张压无差异(P>0.05); 治疗两周后,收缩压、舒张压均有下降,与治疗前相比,差异有统计学意义(P<0.05)。 B组患者血压下降幅度更大。两组患者间治疗后收缩压、舒张压的比较,差异具有统计学意义(P<0.05)。 两组患者治疗前24 h尿蛋白、24h尿白蛋白无显著性差异(P>0.05), 经两周治疗后,两项指标均有下降,与治疗前相比,差异有统计学意义(P<0.05)。 B组患者下降幅度更大。两组患者治疗后24 h尿蛋白、24 h尿白蛋白比较,差异有统计学意义(P<0.05)。 两组患者各项不良反应发生率均相当(P>0.05)。结论 在青年原发性高血压治疗中,联合使用CCB与ARB,能提高降压效果,改善肾功能,不增加不良反应,值得临床推广。

目的 比较经阴道射频刀消融和经皮微波消融治疗单发黏膜下型子宫肌瘤短期临床效果的差异。方法 回顾性分析2013年3月—2014年3月21例经阴道射频刀消融治疗单发黏膜下型子宫肌瘤和 24 例经皮微波消融治疗单发黏膜下型子宫肌瘤的临床资料。结果 经阴道射频刀消融治疗单发黏膜下型子宫肌瘤和经皮微波消融治疗单发黏膜下型子宫肌瘤的临床结果差异有统计学意义(P＜0. 05) ,手术时间分别为(50.8±10.7)min,(60.4±11.3)min,术后住院时间为(2.5±1.2)天,(4.7±0.8)天。结论 经阴道射频刀消融术及经皮微波消融术治疗单发黏膜下型子宫肌瘤都使瘤体缩小并取得良好的短期临床效果,各有优、缺点,临床应视瘤体的具体情况选择。

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 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.

目的 通过观察隔姜灸神厥穴并同时口服黄芪汤治疗脓毒症急性肾损伤患者的效果分析,初步探讨该方法能否改善患者的APACHEⅡ评分,入住重症监护病房的时间有没有缩短,14天内死亡率有否差异。方法 以2014年1月—2015年8月于我院确诊的脓毒症急性肾损伤患者为研究对象,观察常规治疗(对照组)及常规治疗基础上给予隔姜灸神厥穴同时口服黄芪汤治疗(治疗组)对脓毒症急性肾损伤患者危重情况的影响。结果 治疗组患者的危重指标(APACHEⅡ评分)明显改善,患者治疗5天后组间比较差异有统计学意义(P<0.05);两组患者入住重症监护病房的时间比较,患者治疗第四周χ²=4.5241,P=0.0334,差异有统计学意义(P<0.05);14天死亡率差异无统计学意义(P>0.05)。结论 隔姜灸神厥穴同时口服黄芪汤治疗能有效改善脓毒症急性肾损伤患者的APACHEⅡ评分,入住重症监护病房的时间减少。

目的 评价综合营养干预措施与传统的单纯药物治疗对花都区老年原发性骨质疏松 (OP)患者生命质量的影响。方法 采用随机法将符合标准的OP患者随机分配到干预组(A组)和对照组(B组)接受相应的干预处理。干预组给予综合营养干预措施,而对照组只给予单纯的抗骨质疏松药物。结果 干预组人群干预前后生命质量的8个维度中的6个维度得分与干预前比较,差别有统计学意义(P<0.05)。 对照组人群生命质量的8个维度中只有2个维度与干预前比较,得分间差别有统计学意义(P<0.05)。结论 综合营养干预措施可以提高老年OP患者的生命质量。