论著

尼达尼布联合格隆溴铵治疗合并肺纤维化的慢性阻塞性肺疾病患者的效果及对肺功能影响

Efficacy and effect on pulmonary function of nintanib combined with glycopyrrolate in the treatment of chronic obstructive pulmonary disease with pulmonary fibrosis

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      目的 合并肺纤维化的慢性阻塞性肺疾病(COPD)是COPD的特殊亚型,患者兼具气流受限与肺组织纤维化病理特征,临床症状更严重、肺功能下降更快,且现有单一治疗方案难以同时改善气流受限与纤维化进展,预后较差。基于此,本研究旨在分析尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD患者的效果及对肺功能的影响,为优化临床治疗方案提供依据。方法 选取2022年3月—2024年12月收治的96例合并肺纤维化的COPD患者,采用前瞻性随机对照研究设计,应用随机数字表法分为试验组与对照组。所有患者均采取常规治疗,对照组48例采取尼达尼布治疗,试验组采取尼达尼布联合格隆溴铵治疗。两组均治疗24周后,比较治疗前后症状评分、肺功能、纤维化指标、炎症指标,并分析两组治疗安全性。结果 治疗后,两组CAT评分、mMRC评分及VAS降低(P<0.05);且与对照组比较,试验组CAT评分、mMRC评分及咳嗽VAS评分较低(P<0.05)。治疗后,两组FVC、FEV1、DLCO及FEV1/FVC比值均较治疗前改善(P<0.05);且与对照组比较,试验组FVC、FEV1、DLCO及FEV1/FVC比值较优(P<0.05)。治疗后,两组血清KL-6、SP-D水平及CT纤维化评分均降低(P<0.05);且与对照组比较,试验组血清KL-6、SP-D水平及CT纤维化评分较低(P<0.05)。治疗后,两组血清IL-6、TNF-α及TGF-β1水平降低(P<0.05);且与对照组比较,试验组血清IL-6、TNF-α及TGF-β1水平较低(P<0.05)。试验组总不良反应发生率为8.33%(4/48),对照组为10.42%(5/48),两组比较差异无统计学意义(P>0.05)。结论 尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD效果良好,可减轻患者临床症状,改善肺功能与肺纤维化,降低机体炎症反应,安全性较高。

   Objective To analyze the effects of the combination of nintedanib and glycopyrrolate in treating chronic obstructive pulmonary disease(COPD)patients with associated pulmonary fibrosis and its impact on lung function,providing a basis for optimizing clinical treatment strategies.Methods Ninety-six COPD patients with pulmonary fibrosis admitted from March 2022 to December 2024 were selected,and divided into experimental group and control group using a random number table method.Using a prospective randomized controlled study design,all patients received conventional treatment,with 48 cases in the control group receiving treatment with nintedanib and the experimental group receiving treatment with nintedanib combined with glycopyrrolate bromide.After 24 weeks of treatment in both groups,the symptom scores,lung function,fibrosis indicators,and inflammation indicators were compared before and post-treatment,and the drug safety of the two groups was analyzed.Results Post-treatment,CAT score,mMRC score and VAS decreased in both groups(P<0.05).Compared with the control group,CAT score,mMRC score and cough VAS score were lower in the experimental group(P<0.05).Post-treatment,FVC,FEV1,DLCO and FEV1/FVC ratio of both groups improved compared with that before treatment(P<0.05).Compared with the control group,FVC,FEV1,DLCO and FEV1/FVC ratio of the experimental group were better(P<0.05).Post-treatment,serum KL-6,SP-D levels and CT fibrosis scores of both groups decreased(P<0.05).Compared with the control group,serum KL-6,SP-D levels and CT fibrosis scores of the experimental group were lower(P<0.05).Post-treatment,serum IL-6,TNF-α and TGF-β1 levels in both groups decreased(P<0.05).Compared with the control group,serum IL-6,TNF-α and TGF-β1 levels in the experimental group were lower(P<0.05).The incidence of total adverse reactions in the experimental group was 8.33%(4/48),and that in the control group was 10.42%(5/48).There was no difference between the two groups(P>0.05).Conclusions The combination of nintedanib and glycopyrrolate has a significant effect on the treatment of COPD complicated with pulmonary fibrosis,which can alleviate its clinical symptoms,improve lung function and pulmonary fibrosis,reduce the body’s inflammatory response,which is relatively safe.

维生素B2联合蓝光照射对新生儿黄疸康复进程及肝脏功能的影响研究

Study on the Effects of Vitamin B2 Combined with Blue Light Irradiation on the Recovery Process and Liver Function in Neonatal Jaundice

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目的:探讨维生素B2(VB2)联合蓝光照射对新生儿黄疸康复进程及肝脏功能的影响。方法:选取2024年5月—2025年10月收治的150例黄疸患儿,应用随机数字表法分为常规组和试验组,每组75例。常规组接受蓝光照射治疗,试验组在常规组基础上口服VB2治疗。比较两组患儿的氧化应激反应[谷胱甘肽过氧化物酶(GSH-Px),8羟基脱氧鸟苷(8-OHdG)、晚期蛋白氧化产物(AOPP)、超氧阴离子(O2-)]、肝脏微循环[血管性血友病因子(vWF)、可溶性血栓调节蛋白(sTM)、肝动脉阻力指数(HA-RI)、门静脉血流速度(PVV)]、胆红素排泄[总胆红素(TBil)、间接胆红素(IBil)]、肝脏功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]、康复进程[光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间]及治疗安全性。结果:治疗后,试验组的GSH-Px高于常规组,8-OHdG、AOPP、O2-均低于常规组(P<0.05);试验组的vWF、sTM、HA-RI均低于常规组,PVV高于常规组(P<0.05)。试验组的TBil、IBil、ALT、AST分别为(80.52±5.47)μmol/L、(68.52±5.49)μmol/L、(30.25±5.48)U/L、(32.14±5.22)U/L,均低于常规组[(85.19±6.44)μmol/L、(74.37±6.52)μmol/L、(35.29±6.17)U/L、(38.55±6.48)U/L],差异有统计学意义(P<0.05)。试验组的光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间分别为(3.05±0.33)d、(4.22±1.39)d、(5.41±1.27)d、(5.12±0.49)d,均低于常规组[(3.68±0.36)d、(5.36±1.45)d、(6.28±1.33)d、(6.51±0.54)d],差异有统计学意义(P<0.05)。试验组的不良反应发生率与常规组比较,差异无统计学意义(P>0.05)。结论:VB2联合蓝光照射可减轻黄疸患儿的氧化应激反应并改善肝脏微循环,对促进胆红素排泄、改善肝脏功能均有积极影响,在促进患儿康复同时未显著增加治疗风险。其安全性较高,可进一步推广。
Objective: To investigate the effects of vitamin B2 (VB2) combined with blue light irradiation on the recovery process and liver function of neonatal jaundice. Method: 150 children with jaundice admitted from May 2024 to October 2025 were selected and randomly divided into a control group and an experimental group using a random number table method, with 75 cases in each group. The conventional group received blue light irradiation treatment, while the experimental group received oral VB2 treatment on the basis of the conventional group. Compare the oxidative stress response of two groups of children [glutathione peroxidase (GSH Px) higher than the control group, 8-hydroxydeoxyguanosine (8-OHdG), advanced protein oxidation products (AOPP), superoxide anion (O2-)], liver microcirculation [von Willebrand factor (vWF), soluble thrombomodulin (sTM), hepatic artery resistance index (HA-RI), portal vein blood flow velocity (PVV)], bilirubin excretion [total bilirubin (TBil), indirect bilirubin (IBil)], liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], rehabilitation process [phototherapy time, bilirubin recovery time to normal, jaundice regression time]. Hospitalization rehabilitation time and treatment safety. Result: After treatment, the GSH Px levels in the experimental group were higher than those in the control group, while 8-OHdG, AOPP, and O2- levels were lower than those in the control group (P<0.05); The vWF, sTM, and HA-RI of the experimental group were lower than those of the control group, while PVV was higher than that of the control group (P<0.05). The TBil, IBil, ALT, and AST of the experimental group were (80.52 ± 5.47) μ mol/L, (68.52 ± 5.49) μ mol/L, (30.25 ± 5.48) U/L, and (32.14 ± 5.22) U/L, respectively, which were lower than those of the conventional group [(85.19 ± 6.44) μ mol/L, (74.37 ± 6.52) μ mol/L, (35.29 ± 6.17) U/L, (38.55 ± 6.48) U/L], and the difference was statistically significant (P<0.05). The phototherapy time, bilirubin recovery time, jaundice resolution time, and hospital rehabilitation time of the experimental group were (3.05 ± 0.33) days, (4.22 ± 1.39) days, (5.41 ± 1.27) days, and (5.12 ± 0.49) days, respectively, which were lower than those of the conventional group [(3.68 ± 0.36) days, (5.36 ± 1.45) days, (6.28 ± 1.33) days, and (6.51 ± 0.54) days], and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the experimental group was not significantly different from that in the control group (P>0.05). Conclusion: VB2 combined with blue light irradiation can alleviate oxidative stress response and improve liver microcirculation in children with jaundice. It has a positive effect on promoting bilirubin excretion and improving liver function, and does not significantly increase treatment risk while promoting the recovery of children. It has high safety and can be further promoted.

动态社交行为技巧练习联合生物反馈对学龄ADHD患儿临床症状及社会功能的影响

Effect of dynamic social behavior skills training combined with biofeedback on clinical symptoms and social function of school-age ADHD children

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目的 探讨动态社交行为技巧练习联合生物反馈对学龄注意缺陷多动障碍(ADHD)患儿临床症状和社会功能的影响。方法 回顾性选取我院2021年1月~2024年3月收治的81例学龄ADHD患儿作为研究对象,按照治疗方法不同分为对照组(40例)、观察组(41例),对照组接受生物反馈治疗,观察组接受动态社交行为技巧练习联合生物反馈治疗。比较两组临床疗效、临床症状、社会功能、脑电波频率[β波、θ波、感觉运动节律(SMR)波]。结果 观察组总有效率90.24%较对照组的72.50%高(P<0.05);治疗后观察组对抗性行为、多动-冲动、注意力不集中评分均低于对照组(P<0.05);治疗后观察组家庭、学习与学校、生活技能、自我管理、社交活动及风险活动评分均低于对照组(P<0.05);治疗后观察组β波、SMR波均高于对照组,θ波低于对照组(P<0.05)。结论 动态社交行为技巧练习联合生物反馈对学龄ADHD患儿临床疗效确切,可进一步改善患儿临床症状、社会功能。
Objective To explore the effect of dynamic social behavior skills training combined with biofeedback on clinical symptoms and social function in school-age children with attention deficit hyperactivity disorder (ADHD). Methods A total of 81 school-age children with ADHD admitted to our hospital from January 2021 to March 2024 were retrospectively selected as the research objects. According to different treatment methods, they were divided into control group (40 cases) and observation group (41 cases). The control group received biofeedback therapy, and the observation group received dynamic social behavior skills training combined with biofeedback therapy. The clinical efficacy, clinical symptoms, social function, brain wave frequency [β wave, θ wave, sensorimotor rhythm ( SMR ) wave] were compared between the two groups. Results The total effective rate of the observation group was 90.24% higher than that of the control group (72.50%) (P<0.05). After treatment, the scores of antagonistic behavior, hyperactivity-impulsion and inattention in the observation group were lower than those in the control group (P<0.05). After treatment, the scores of family, learning and school, life skills, self-management, social activities and risk activities in the observation group were lower than those in the control group (P<0.05). After treatment, the β wave and SMR wave in the observation group were higher than those in the control group, and the θ wave was lower than that in the control group (P<0.05). Conclusion Dynamic social behavior skill training combined with biofeedback has definite clinical efficacy in school-age children with ADHD, which can further improve their clinical symptoms and social functioning.

活血通络汤联合恩格列净对射血分数降低型心力衰竭患者中医证候积分及心功能的影响

Effects of Huoxue Tongluo Decoction combined with empagliflozin on traditional Chinese medicine syndrome scores and cardiac function in patients with heart failure with reduced ejection fraction

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目的 探讨活血通络汤联合恩格列净治疗射血分数降低型心力衰竭(HFrEF)患者的疗效,并分析其对中医证候积分、心功能的影响。方法 选取2024年8月~2025年8月于本院诊治的150例HFrEF患者进行回顾性分析,依据治疗方案不同将其分为对照组、观察组,其中采取恩格列净治疗的75例患者作为对照组,采取活血通络汤联合恩格列净治疗的75例患者作为观察组。统计对比两组临床疗效及治疗前后中医证候积分、Lee氏心衰积分、心功能、6 min步行试验(6MWT)、心衰因子[心肌肌钙蛋白I(cTnI)、可溶性人基质裂解素2(sST2)、N末端B型利钠肽原(NT-proBNP)]、血流动力学、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、正五聚蛋白-3(PTX-3)]、氧化应激指标[谷胱甘肽过氧化物酶-3(GPX-3)、丙二醛(MDA)、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、总抗氧化能力]。比较两组不良反应与再住院率。结果 观察组总有效率高于对照组(P<0.05);观察组治疗后中医证候积分、Lee氏心衰积分低于对照组(P<0.05);观察组治疗后LVEDD、LVESD、LVEDV、LVESV及血清cTnI、sST2、NT-proBNP水平低于对照组,LVEF、6MWT高于对照组(P<0.05);观察组治疗后血流动力学改善程度优于对照组(P<0.05);治疗后,与对照组比较,观察组血清IL-6、CRP、IL-1β、PTX-3、MDA、LPO水平降低,GPX-3、SOD、总抗氧化能力水平升高(P<0.05);观察组再住院率低于对照组(P<0.05),且两组不良反应比较无明显差异(P>0.05)。结论 活血通络汤联合恩格列净治疗HFrEF患者,可提高治疗效果,改善临床症状、心功能,调节血流动力学,并可降低炎症反应,抑制氧化应激反应,减少再住院的发生,且具有一定安全性。
Objective To explore the therapeutic effect of Huoxue Tongluo Decoction combined with empagliflozin on patients with heart failure with reduced ejection fraction (HFrEF), and analyze its influence on traditional Chinese medicine syndrome scores and cardiac function. Methods A retrospective analysis was performed on 150 HFrEF patients treated in our hospital from August 2024 to August 2025. The patients were divided into control group and observation group according to different treatment regimens, 75 patients receiving empagliflozin alone constituted the control group, while another 75 cases treated with combined Huoxue Tongluo Decoction and empagliflozin were assigned to the observation group. The clinical efficacy, as well as the traditional Chinese medicine syndrome scores, Lee heart failure score, cardiac function 6-minute walk test (6MWT), heart failure factors [cardiac troponin I (cTnI), soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)], hemodynamic parameters, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-1β (IL-1β) and pentraxin-3 (PTX-3)], oxidative stress indexes [glutathione peroxidase-3 (GPX-3), malondialdehyde (MDA), superoxide dismutase (SOD), lipid peroxide (LPO) and total antioxidant capacity] before and after treatment were compared between the two groups. Adverse reactions and readmission rate were also compared. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, traditional Chinese medicine syndrome scores and Lee heart failure score in observation group were lower (P<0.05). LVEDD, LVESD, LVEDV, LVESD and serum levels of cTnI, sST2, NT-proBNP decreased, while LVEF and 6MWT increased in observation group (P<0.05). The improvement of hemodynamics in observation group was superior to control group after treatment (P<0.05). After treatment, serum levels of IL-6, CRP, IL-1β, PTX-3, MDA and LPO were decreased, while GPX-3, SOD and total antioxidant capacity were increased in observation group compared with control group (P<0.05). The readmission rate was lower in observation group (P<0.05). No significant difference was found in adverse reactions between the two groups (P>0.05). Conclusion Huoxue Tongluo Decoction combined with empagliflozin can elevate therapeutic efficacy, relieve clinical symptoms, improve cardiac function and hemodynamic status, reduce inflammatory and oxidative stress responses, and cut down readmission incidence with favorable safety in HFrEF patients.

活血通络汤联合恩格列净对射血分数降低型心力衰竭患者中医证候积分及心功能的影响

Effects of Huoxue Tongluo Decoction combined with empagliflozin on traditional Chinese medicine syndrome scores and cardiac function in patients with heart failure with reduced ejection fraction

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目的 探讨活血通络汤联合恩格列净治疗射血分数降低型心力衰竭(HFrEF)患者的疗效,并分析其对中医证候积分、心功能的影响。方法 选取2024年8月~2025年8月于本院诊治的150例HFrEF患者进行回顾性分析,依据治疗方案不同将其分为对照组、观察组,其中采取恩格列净治疗的75例患者作为对照组,采取活血通络汤联合恩格列净治疗的75例患者作为观察组。统计对比两组临床疗效及治疗前后中医证候积分、Lee氏心衰积分、心功能、6 min步行试验(6MWT)、心衰因子[心肌肌钙蛋白I(cTnI)、可溶性人基质裂解素2(sST2)、N末端B型利钠肽原(NT-proBNP)]、血流动力学、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)、正五聚蛋白-3(PTX-3)]、氧化应激指标[谷胱甘肽过氧化物酶-3(GPX-3)、丙二醛(MDA)、超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、总抗氧化能力]。比较两组不良反应与再住院率。结果 观察组总有效率高于对照组(P<0.05);观察组治疗后中医证候积分、Lee氏心衰积分低于对照组(P<0.05);观察组治疗后LVEDD、LVESD、LVEDV、LVESV及血清cTnI、sST2、NT-proBNP水平低于对照组,LVEF、6MWT高于对照组(P<0.05);观察组治疗后血流动力学改善程度优于对照组(P<0.05);治疗后,与对照组比较,观察组血清IL-6、CRP、IL-1β、PTX-3、MDA、LPO水平降低,GPX-3、SOD、总抗氧化能力水平升高(P<0.05);观察组再住院率低于对照组(P<0.05),且两组不良反应比较无明显差异(P>0.05)。结论 活血通络汤联合恩格列净治疗HFrEF患者,可提高治疗效果,改善临床症状、心功能,调节血流动力学,并可降低炎症反应,抑制氧化应激反应,减少再住院的发生,且具有一定安全性。
Objective To explore the therapeutic effect of Huoxue Tongluo Decoction combined with empagliflozin on patients with heart failure with reduced ejection fraction (HFrEF), and analyze its influence on traditional Chinese medicine syndrome scores and cardiac function. Methods A retrospective analysis was performed on 150 HFrEF patients treated in our hospital from August 2024 to August 2025. The patients were divided into control group and observation group according to different treatment regimens, 75 patients receiving empagliflozin alone constituted the control group, while another 75 cases treated with combined Huoxue Tongluo Decoction and empagliflozin were assigned to the observation group. The clinical efficacy, as well as the traditional Chinese medicine syndrome scores, Lee heart failure score, cardiac function 6-minute walk test (6MWT), heart failure factors [cardiac troponin I (cTnI), soluble suppression of tumorigenicity 2 (sST2) and N-terminal pro-B-type natriuretic peptide (NT-proBNP)], hemodynamic parameters, inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-1β (IL-1β) and pentraxin-3 (PTX-3)], oxidative stress indexes [glutathione peroxidase-3 (GPX-3), malondialdehyde (MDA), superoxide dismutase (SOD), lipid peroxide (LPO) and total antioxidant capacity] before and after treatment were compared between the two groups. Adverse reactions and readmission rate were also compared. Results The total effective rate of observation group was higher than that of control group (P<0.05). After treatment, traditional Chinese medicine syndrome scores and Lee heart failure score in observation group were lower (P<0.05). LVEDD, LVESD, LVEDV, LVESD and serum levels of cTnI, sST2, NT-proBNP decreased, while LVEF and 6MWT increased in observation group (P<0.05). The improvement of hemodynamics in observation group was superior to control group after treatment (P<0.05). After treatment, serum levels of IL-6, CRP, IL-1β, PTX-3, MDA and LPO were decreased, while GPX-3, SOD and total antioxidant capacity were increased in observation group compared with control group (P<0.05). The readmission rate was lower in observation group (P<0.05). No significant difference was found in adverse reactions between the two groups (P>0.05). Conclusion Huoxue Tongluo Decoction combined with empagliflozin can elevate therapeutic efficacy, relieve clinical symptoms, improve cardiac function and hemodynamic status, reduce inflammatory and oxidative stress responses, and cut down readmission incidence with favorable safety in HFrEF patients.

利多卡因联合艾司氯胺酮对肺部手术患者苏醒质量及术后认知功能的影响

Effects of lidocaine combined with esketamine on recovery quality and postoperative cognitive function in patients undergoing lung surgery

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目的:探讨利多卡因复合艾司氯胺酮对肺部手术患者苏醒质量及认知功能的影响。方法:选取2023年7月至2025年6月本院收治的100例拟行肺部手术患者,按随机数字表法分为观察组和对照组,各50例。对照组采用常规麻醉方案维持麻醉,观察组在常规麻醉基础上复合利多卡因及艾司氯胺酮辅助麻醉。比较两组患者苏醒质量[拔管后30min Riker镇静躁动评分(SAS)、苏醒时间、拔管时间]、认知功能[术前及术后1d、3d简易精神状态检查表评分(MMSE)]、围术期血流动力学指标[麻醉药物输注前(T0)、气管插管时(T1)、拔管后5min(T2)平均动脉压(MAP)、心率(HR)]及术后72h不良反应发生率。结果:观察组拔管后30min SAS评分、术后1d、3d的MMSE评分高于对照组,苏醒时间、拔管时间低于对照组;观察组T0、T1、T2各时间点MAP、HR无显著差异(P>0.05);对照组T1、T2时MAP、HR高于T0(P<0.05);两组不良反应发生率无显著差异(P>0.05)。结论:利多卡因复合艾司氯胺酮应用于肺部手术,可提升患者苏醒质量、保护术后认知功能,维持围术期血流动力学稳定,且安全性良好。
Objective : To investigate the effect of lidocaine combined with esketamine on recovery quality and cognitive function in patients undergoing lung surgery. Methods : A total of 100 patients receiving pulmonary resection at our hospital between July 2023 and December 2025 were enrolled and randomized via a random number table into two equal arms (n=50 per group): observation and control. The control group was treated with routine anesthesia to maintain anesthesia, and the observation group was treated with lidocaine and esketamine on the basis of routine anesthesia. The recovery quality [ Riker sedation agitation score ( SAS ) at 30 min after extubation, recovery time, extubation time ], cognitive function [ simple mental state examination score ( MMSE ) before operation and 1 d, 3 d after operation ], perioperative hemodynamic indexes [ mean arterial pressure ( MAP ), heart rate ( HR ) before anesthesia drug infusion ( T0 ), tracheal intubation ( T1 ), 5 min after extubation ( T2 ) ] and the incidence of adverse reactions at 72 h after operation were compared between the two groups. Results : In the observation group, the SAS score measured 30 minutes post-extubation and the MMSE scores at 1 day and 3 days post-operation were significantly higher than those in the control group. Conversely, both recovery and extubation times were shorter in the observation group compared to the control group. No significant differences in MAP and HR were observed at T0, T1, and T2 within the observation group (P > 0.05). In contrast, within the control group, MAP and HR at T1 and T2 were notably elevated compared to T0, with the differences being statistically significant (P < 0.05). Conclusion : The application of lidocaine combined with esketamine in lung surgery can improve the quality of recovery, protect postoperative cognitive function, maintain perioperative hemodynamic stability, and has good safety.

子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病患者的康复效果分析

Analysis of rehabilitation effect of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy

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目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病(CSR)患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者(154例)为研究对象进行回顾性分析,根据干预方案分为参照组(77例,采取颈椎功能康复训练)、研究组(77例,采取子午流注穴位按摩联合颈椎功能康复训练)。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分(VAS)与颈椎功能障碍指数量表评分(NDI)、颈椎功能活动度、血液流变学指标[血浆黏度(PV)、全血低切黏度(LSWBV)、纤维蛋白原(FIB)、全血高切黏度(HSWBV)]。结果 与参照组总有效率(83.12%)相比,研究组(96.10%)明显升高(P<0.05);研究组干预后各中医证候积分均较参照组低(P<0.05);干预后,研究组VAS、NDI评分均低于参照组(P<0.05);研究组干预后颈椎活动度高于参照组(P<0.05);干预后,研究组LSWBV、PV、FIB、HSWBV水平均较参照组低(P<0.05);研究组干预后3个月复发率为2.72%(2/74),低于参照组的14.06%(9/64)(χ2=4.588,P<0.05)。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果,改善临床症状、颈椎功能、颈椎活动度,调节血液流变学,降低颈椎疼痛程度、复发率。
Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.

闭合复位弹性髓内钉固定术对小儿股骨骨折康复进程及关节功能的影响研究

Study on the effect of closed reduction and elastic intramedullary nail fixation on the rehabilitation process and joint function of pediatric femoral fractures

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目的:探讨闭合复位弹性髓内钉固定术(CR-ESIN)对股骨骨折患儿康复进程及关节功能的影响。方法:回顾性选取2024年4月~2025年6月至我院行内固定术治疗的102例股骨骨折患儿为研究对象,依据手术方案不同,将行CR-ESIN治疗的51例患儿列为CR-ESIN组,将剩余51例行传统切开复位接骨板内固定术(ORIF)治疗的患儿列为ORIF组,比较两组患儿的治疗情况、康复进程,手术并发症发生情况,关节功能恢复情况及内固定物取出阶段负担。结果:在不同手术方案下,CR-ESIN组的手术耗时、术中出血量、术后住院时间、支具使用时间、完全负重时间分别为(60.29±5.44)min、(50.52±5.49)mL、(6.22±1.34)d、(4.15±1.33)周、(6.81±1.34)周,均低于ORIF组[(76.33±8.29)min、(190.48±20.51)mL、(8.17±1.65)d、(6.32±1.48)周、(7.82±2.17)周](t=11.552,47.076,6.552,8.322,2.828;P<0.05)。CR-ESIN组的手术并发症发生率5.88%(3/51)低于ORIF组19.61%(10/51)(x2=4.320;P<0.05)。CR-ESIN组的髋关节前屈活动度、后伸活动度、儿童下肢功能量表(PODCI)评分分别为(132.44±22.52)°、(20.39±4.47)°、(75.14±6.29)分,均高于ORIF组[(120.28±20.37)°、(17.55±3.12)°、(70.31±5.36)分],术后双侧股骨长度差(1.52±0.39)cm低于ORIF组(3.08±0.44)cm(t=2.860,3.721,4.174,18.948;P<0.05)。CR-ESIN组的取出手术切口长度、取出手术耗时、取出手术出血量、再骨折率均低于ORIF组(t/x2=31.706,8.298,38.448,4.883;P<0.05)。结论:CR-ESIN能提高股骨骨折患儿手术效率并降低出血风险,与传统ORIF相比,此术式有利于加快患儿康复进程、降低术后并发症发生率、促进关节功能恢复并减轻内固定物取出阶段负担。
Objective:To explore the effects of closed reduction elastic intramedullary nail fixation (CR-ESIN) on the rehabilitation process and joint function of children with femoral fractures.Methods:A retrospective study was conducted on 102 children with femoral fractures who underwent internal fixation surgery in our hospital from April 2024 to June 2025. Based on different surgical plans, 51 children who underwent CR-ESIN treatment were included in the CR-ESIN group, and the remaining 51 children who underwent traditional open reduction plate internal fixation (ORIF) treatment were included in the ORIF group. The treatment status, rehabilitation process, incidence of surgical complications, joint function recovery, and burden during the removal of internal fixation materials were compared between the two groups of children.Results:Under different surgical plans, the surgical time, intraoperative blood loss, postoperative hospitalization time, brace use time, and complete weight-bearing time of the CR-ESIN group were (60.29 ± 5.44) min, (50.52 ± 5.49) mL, (6.22 ± 1.34) d, (4.15 ± 1.33) weeks, and (6.81 ± 1.34) weeks, lower than the ORIF group [(76.33 ± 8.29) min, (190.48 ± 20.51) mL, (8.17 ± 1.65) d, (6.32 ± 1.48) weeks, and (7.82 ± 2.17) weeks] (t=11.552,47.076,6.552,8.322,2.828; P<0.05). The incidence of surgical complications in the CR-ESIN group was 5.88% (3/51) lower than the ORIF group 19.61% (10/51) (x2=4.320; P<0.05). The hip flexion range of motion, extension range of motion, and PODCI scores of the CR-ESIN group were (132.44 ± 22.52) °, (20.39 ± 4.47) °, and (75.14 ± 6.29) points, higher than the ORIF group [(120.28 ± 20.37) °, (17.55 ± 3.12) °, and (70.31 ± 5.36) points]. The length difference between the bilateral femurs was (1.52 ± 0.39) cm, which was lower than the ORIF group (3.08 ± 0.44) cm (t=2.860,3.721,4.174,18.948; P<0.05). The length of the surgical incision, the duration of the extraction surgery, the amount of bleeding during the extraction surgery, and the rate of re fracture in the CR-ESIN group were all lower than the ORIF group (t/x2=31.706,8.298,38.448,4.883; P<0.05).Conclusion:CR-ESIN can improve the surgical efficiency and reduce the risk of bleeding in children with femoral fractures. Compared with traditional ORIF, this procedure is beneficial for accelerating the recovery process of children, reducing the incidence of postoperative complications, promoting joint function recovery, and reducing the burden of internal fixation removal stage.

子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病患者的康复效果分析

Analysis of rehabilitation effect of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy

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目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病(CSR)患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者(154例)为研究对象进行回顾性分析,根据干预方案分为参照组(77例,采取颈椎功能康复训练)、研究组(77例,采取子午流注穴位按摩联合颈椎功能康复训练)。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分(VAS)与颈椎功能障碍指数量表评分(NDI)、颈椎功能活动度、血液流变学指标[血浆黏度(PV)、全血低切黏度(LSWBV)、纤维蛋白原(FIB)、全血高切黏度(HSWBV)]。结果 与参照组总有效率(83.12%)相比,研究组(96.10%)明显升高(P<0.05);研究组干预后各中医证候积分均较参照组低(P<0.05);干预后,研究组VAS、NDI评分均低于参照组(P<0.05);研究组干预后颈椎活动度高于参照组(P<0.05);干预后,研究组LSWBV、PV、FIB、HSWBV水平均较参照组低(P<0.05);研究组干预后3个月复发率为2.72%(2/74),低于参照组的14.06%(9/64)(χ2=4.588,P<0.05)。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果,改善临床症状、颈椎功能、颈椎活动度,调节血液流变学,降低颈椎疼痛程度、复发率。
Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.

达格列净改善PCI术后T2DM-UA患者心功能探索性研究

An Exploratory Study on Dapagliflozin in Improving Cardiac Function in T2DM-UA Patients After PCI

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目的 探讨达格列净在行经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)后2型糖尿病(Type 2 Diabetes Mellitus,T2DM)伴不稳定型心绞痛(Unstable Angina,UA)患者中的应用价值及短期心功能改善效果。方法 本研究为单中心、随机对照试验,纳入90例PCI术后2型糖尿病合并不稳定型心绞痛患者,随机分为达格列净组(n=43)和二甲双胍组(n=47),规范调整降糖药物保证降糖强度一致。治疗期间及治疗后6-12个月通过心脏彩超测量左心室射血分数(Left Ventricular Ejection Fraction,LVEF)、左室舒张末期内径(Left Ventricular End-Diastolic Diameter,LVEDD),并采集静脉血样检测N端B型利钠肽前体(N-terminalpro-Brain Natriuretic Peptide,NT-proBNP)水平,以评估心功能变化。 结果 PCI治疗后的6-12个月随访中,观察组NT-proBNP(P<0.01)显著降低,左心室射血分数LVEF(P<0.01)显著提升。与对照组相比:观察组NT-ProBNP水平明显下降(P<0.01),且低于对照组。结论 在PCI术后合并不稳定型心绞痛的T2DM患者中,加用达格列净治疗可显著改善NT-proBNP和LVEF等心功能替代指标,且安全性良好。
Objective:To explore the application value of dapagliflozin and its short-term cardiac function improvement effect in patients with type 2 diabetes mellitus (T2DM) combined with unstable angina (UA) after percutaneous coronary intervention (PCI). Methods: This was a single-center, randomized controlled trial. A total of 90 patients with type 2 diabetes mellitus (T2DM) complicated with unstable angina (UA) after percutaneous coronary intervention (PCI) were enrolled and randomly assigned to a dapagliflozin group (n=43) and a metformin group (n=47). Hypoglycemic agents were adjusted routinely to ensure consistent glycemic control intensity between the two groups. During treatment and at 6–12 months after treatment, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were measured by echocardiography, and venous blood samples were collected to determine the level of N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) for the evaluation of cardiac function changes. Results: During the 6-month follow-up after PCI treatment, the N-terminal pro-brain natriuretic peptide (NT-proBNP) level in the observation group decreased significantly (P<0.01), and the left ventricular ejection fraction (LVEF) increased significantly (P<0.01).Compared with the control group, the NT-proBNP level in the observation group was notably lower (P<0.01) and also remained below that of the control group. Conclusion: For type 2 diabetes mellitus (T2DM) patients complicated with unstable angina pectoris after PCI, adjuvant treatment with dapagliflozin for 6 months can significantly improve cardiac function surrogate markers such as NT-proBNP and LVEF, with favorable safety profile.
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