目的 研究同轴微导管聚乙烯醇颗粒（PVA）栓塞治疗动脉性下消化道出血患者的应用效果。方法 本研究为前瞻性研究,选择河南科技大学第一附属医院2022年1月—2023年6月收治的118例动脉性下消化道出血患者为研究对象,以计算机随机分组法将其分为常规组和试验组,各59例。两组均行数字减影血管造影检查明确出血情况,常规组予以内镜下注射止血治疗,试验组经同轴微导管PVA栓塞进行止血治疗,比较两组患者的治疗效果及预后情况。结果 在不同治疗方案下,试验组的技术成功率、临床成功率分别为89.83%（53/59）、84.75%（50/59）,均高于常规组[71.19%（42/59）、64.41%（38/59）]（χ²=11.071、10.911,P<0.05）;试验组的止血时间、凝血酶原时间（PT）、凝血酶时间（TT）分别为（50.25±10.37）min、（10.25±2.31）s、（16.33±4.47）s,均低于常规组[（55.36±10.72）min、（12.44±3.61）s、（19.35±4.23）s]（t=2.632、3.925、3.769,P<0.05）;试验组治疗后的动脉搏动指数（PI）、阻力指数（RI）分别为（1.12±0.33）（0.51±0.21）,均低于常规组[（1.65±0.41）（0.73±0.22）]（t=7.735、5.556,P<0.05）;试验组治疗7、14、30 d后的再出血率分别为5.08%（3/59）、8.47%（5/59）、10.17%（6/59）,均低于常规组[20.34%（12/59）、25.42%（15/59）、28.81%（17/59）]（χ²=10.495、10.207、11.071,P<0.05）;试验组的并发症发生率8.47%（5/59）低于常规组22.03%（13/59）,差异均具有统计学意义（χ²=7.113,P<0.05）。结论 与常规内镜下止血相比,同轴微导管PVA栓塞可显著提升动脉性下消化道出血患者的止血成功率,对缩短患者止血时间、促进凝血系统恢复、降低再出血风险及相关并发症发生风险均有积极意义。

Objective To study the effect of coaxial microcatheter PVA embolization in the treatment of patients with arterial lower gastrointestinal bleeding．Methods This study is a prospective study,118 patients with arterial lower gastrointestinal bleeding admitted between January 2022 and June 2023 were selected as the study subjects．They were randomly divided into a conventional group（59 cases）and an experimental group（59 cases）using computer randomization．Both groups underwent digital subtraction angiography examination to determine the bleeding situation．The conventional group received conventional endoscopic hemostasis treatment,while the experimental group received coaxial microcatheter PVA embolization for hemostasis treatment．The treatment efficacy and prognosis were compared between two groups．Results Under different treatment plans,the technical success rate and clinical success rate of the experimental group were 89.83%（53/59）and 84.75%（50/59）,respectively,which were higher than those of the conventional group [71.19%（42/59）and 64.41%（38/59）]（χ²=11.071、10.911,P<0.05）．The hemostatic time,PT,and TT of the experimental group were（50.25±10.37）min,（10.25±2.31）seconds,and（16.33±4.47）seconds,respectively,which were shorter than those of the conventional group [（55.36±10.72）min,（12.44±3.61）seconds,and（19.35±4.23）seconds]（t=2.632、3.925、3.769,P<0.05）．The arterial PI and RI of the experimental group after treatment were（1.12±0.33） and（0.51±0.21）,lower than those of the conventional group [（1.65±0.41）and（0.73±0.22）]（t=7.735、5.556,P<0.05）．The rebleeding rates of the experimental group after 7 days,14 days and 30 days of treatment were 5.08%（3/59）,8.47%（5/59） and 10.17%（6/59）,respectively,which were lower than those of the conventional group [20.34%（12/59）,25.42%（15/59） and 28.81%（17/59）]（χ²=10.495,10.207,11.071,P<0.05）．The incidence of complications in the experimental group was 8.47%（5/59）,which was lower than that in the conventional group 22.03%（13/59）（χ²=7.113,P<0.05）．Conclusions Compared with conventional endoscopic hemostasis,coaxial microcatheter PVA embolization can significantly improve the success rate of hemostasis in patients with arterial lower gastrointestinal bleeding,shorten the hemostasis time,promote coagulation system recovery,reduce the risk of rebleeding and related complications,with a positive significance．

目的 探讨无管化微创PCNL（经皮肾镜取石术）治疗嵌顿性输尿管上段结石的效果。方法 将中山大学附属第一医院惠亚医院2019年12月—2021年12月收治的95例嵌顿性输尿管上段结石患者按照随机数字表法分组,给予对照组47例患者经尿道输尿管镜碎石术（TURL）治疗、观察组48例患者无管化微创PCNL治疗,观察两组手术一般状况、血清学指标、肾脏血流动力学以及并发症发生情况。结果 观察组手术时间、术后血尿以及住院时间均短于对照组,观察组术中出血量少于对照组,观察组结石清除率高于对照组（P<0.05）;术后1 d观察组肾损伤分子-1（KIM-1）、中性粒细胞明胶相关脂脂质运载蛋白（NGAL）以及胱抑素C（Cys-C）水平低于对照组（P<0.05）;两组肾动脉收缩期血流速度（V_s）以及舒张末期血流速度（V_d）对比差异无统计学意义（P>0.05）;观察组并发症发生率（4.16%）低于对照组（19.15%）（P<0.05）。结论 无管化微创PCNL可改善嵌顿性输尿管上段结石手术一般状况,减轻患者肾脏损伤,提高结石清除率,不影响肾脏血流,且并发症更少。

Objective To explore the effect of tubeless minimally invasive（percutaneous nephrolithotomy,PCNL）in the treatment of impacted upper ureteral stones．Methods A total of 95 patients with impacted upper ureteral stones admitted to our hospital from December 2019 to December 2021 were grouped according to the random number table method．Control group of 47 cases were treated with transurethral ureteroscopy lithotripsy（TURL）,48 patients in the observation group were given tubeless minimally invasive PCNL treatment．The general surgical conditions,serological indicators,renal hemodynamics and complications of the two groups were observed．Results The operation time,postoperative hematuria and hospitalization time of the observation group were shorter than those of the control group,the intraoperative bleeding volume of the observation group was less than that of the control group,and the stone free rate of the observation group was higher than that of the control group（P<0.05）．One day after surgery,the levels of kidney injury molecule-1（KIM-1）,lipocalin（NGAL）and cystatin C（Cys-C）in the observation group were lower than those in the control group（P<0.05）;the renal artery systolic blood flow velocity（V_s）and end-diastolic blood flow velocity（V_d）had no statistical significance（P>0.05）;the incidence of complications in the observation group（4.16%）was lower than that in the control group（19.15%）（P<0.05）．Conclusions Tubeless minimally invasive PCNL can improve the general conditions of surgery,reduce kidney damage,increase stone free rate,does not affect renal blood flow,and has fewer complications．

目的 基于最佳矫正视力（BCVA）、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼（AACG）的疗效。方法 回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象,依据1∶1匹配原则,将接受常规小梁切除术的56例患者作为对照组,接受改良小梁切除术的56例患者作为观察组,统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果 术后3个月,观察组视力为（0.63±0.04）logMAR,高于对照组（0.50±0.03）logMAR,眼压为（16.22±2.28）mmHg,低于对照组（19.95±2.31）mmHg（t=19.457、8.600,均P<0.05）;观察组浅前房发生率为8.93%,低于对照组的26.79%（χ²=6.087,P=0.014）;观察组角膜水肿状况优于对照组（Z=2.737,P=0.006）;观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%,均低于对照组17.86%、23.21%、32.14%、35.71%（χ²=8.166、7.292、3.953、9.818,均P<0.05）。结论 较常规小梁切除术,改良小梁切除术治疗AACG患者,有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生,且安全性较高。

Objective To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma（AACG）based on best-corrected visual acuity（BCVA）and degree of corneal edema．Methods A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects． According to the 1∶1 matching principle,56 patients receiving conventional trabeculectomy were selected as control group,and 56 patients receiving modified trabeculectomy were selected as observation group．Perioperative BCVA,intraocular pressure,postoperative shallow anterior chamber formation,degree of corneal edema and complications were analyzed．Results At three months postoperatively,visual acuity in the observation group was（0.63±0.04）logMAR,which was higher than that in the control group（0.50±0.03）logMAR,and intraocular pressure was（16.22±2.28）mmHg,which was lower than that in the control group（19.95±2.31）mmHg（t=19.457,8.600,P<0.05）;the incidence of shallow anterior chamber in the observation group was 8.93%,which was lower than that of the control group（26.79%）（χ²=6.087,P=0.014）;the corneal edema status in the observation group was better than that of the control group（Z=2.737,P=0.006）;the rates of choroidal detachment,filtering channel obstruction,hyphema,and iris inflammation in the observation group were 1.79%,5.36%,16.07%,and 10.71%,respectively,which were lower than those of the control group（17.86%,23.21%,32.14%,and 35.71%）（χ²=8.166,7.292,3.953,and 9.818,P<0.05）．Conclusions Compared with conventional trabeculectomy,modified trabeculectomy can improve visual acuity,reduce intraocular pressure,relieve corneal edema,and reduce the occurrence of shallow anterior chamber in patients with AACG,with higher safety．

随着糖尿病发病率不断攀升,人们逐渐聚焦于糖尿病合并骨质疏松。围绕此疾病,国内外学者开展了广泛而深入的研究,临床实践聚焦于两点：糖尿病的精准治疗和骨质疏松的有效干预。在确保血糖稳定的基础上,致力于抑制骨吸收、促进骨形成。在此治疗理念指导下,临床医生应当更加全面了解血糖管理与抗骨质疏松药物的作用机制并合理应用,更大程度改善患者的临床症状及预后。然而,药物作用机制复杂,联合应用存在潜在药物相互作用问题。未来研究方向包括探索更安全有效的联合治疗方案,更加精确化地治疗以提高临床疗效。文章分析了降糖药物及抗骨质疏松药物对疾病的疗效,并展望未来的研究方向,旨在为临床实践提供更为深刻与全面的指导。

As the incidence of diabetes mellitus continues to rise,people are also gradually focusing on diabetes mellitus combined with osteoporosis,which puts patients at a higher risk of fragility fracture．Scholars at home and abroad have conducted extensive and in-depth research around this condition,and clinical practice has focused on two points：first,the precise treatment of diabetes,and second,the effective intervention of osteoporosis．On the basis of ensuring blood glucose stabilization,we are committed to inhibiting bone resorption and promoting bone formation．Under the guidance of this therapeutic concept,we should have a more comprehensive understanding of the mechanism of action of blood glucose management and anti-osteoporosis drugs and apply them rationally,aiming to improve the clinical symptoms and prognosis of patients to a greater extent through dual intervention． However,the mechanism of action of different drugs is complex,and there are potential drug-drug interactions and safety issues associated with their combined use．Future research directions should include exploring safer and more effective combination therapies,developing novel drugs,and more precise and individualized treatments to improve clinical efficacy．This article analyzes the efficacy of glucose-lowering drugs and anti-osteoporosis drugs on the disease and looks forward to future research directions,aiming to provide more profound and comprehensive guidance for clinical practice．

目的 探讨便携式超声仪超声重点评估（e-FAST）技术在批量伤员军地联合院前救治中的应用效果。方法 抽取2021年5月—2023年10月中国人民解放军联勤保障部队第九八八医院中心急诊科收治的80例批量伤员,均开展军地联合院前救治,按照治疗方案不同分为观察组和对照组,每组患者40例,其中对照组在救治现场行基于创伤严重程度（CRAMS）评分,进行常规急救处置,救护车返院后行CT检查并进行相应伤情治疗,观察组救治现场行CRAMS评分,进行常规急救处置,院前接诊医师在现场或救护车上使用便携式超声仪按照e-FAST流程检查相应部位,初步诊断后进行相应伤情治疗,对比两组患者治疗效果,两组患者诊断时间、初次医疗接触—进入手术室时间及入院诊断与出院时确定性诊断的符合率、两组患者治疗前后CRAMS评分及CRAMS≤8分抢救成功率。结果 观察组治疗有效率为95.0%,对照组为85.0%,对比差异无统计学意义（χ²=2.222,P=0.136）;观察组患者的诊断时间（13.56±2.36）min、初次医疗接触—进入手术室时间（30.42±8.99）min均短于对照组[（23.64±5.69）、（52.27±12.60）min],差异有统计学意义（t=10.349、8.928,P<0.05）;观察组患者入院诊断与出院时确定性诊断的符合为97.5%,对照组患者入院诊断与出院时确定性诊断的符合为95.0%,差异无统计学意义（χ²=0.346,P=0.556）;治疗后两组患者的CRAMS评分均升高,且观察组（9.87±2.62）分高于对照组（8.60±2.98）分,差异有统计学意义（t=2.024,P=0.046）;观察组患者CRAMS≤8分的抢救成功率为97.50%,对照组CRAMS≤8抢救成功率为85.00%,观察组患者CRAMS≤8分的抢救成功率高于对照组（χ²=3.914,P=0.048）。结论 本研究从军地联合救治批量伤员切入,瞄准部队医院军民融合战略发展路线,本文针对便携式超声仪e-FAST应用范围前移,明显地提高急救人员院前救治能力,提高抢救成功率,值得临床参考。

Objective To explore the application effect of portable ultrasound e-FAST technology in the pre hospital treatment of batch wounded soldiers in military civilian joint hospitals．Methods Eighty batch wounded patients admitted to the emergency department of 988 Hospital from May 2021 to October 2023 were selected,all of whom underwent military civilian joint pre hospital treatment．They were divided into an observation group and a control group according to different treatment plans,with 40 patients in each group．The control group received CRAMS scores at the treatment site for routine first aid treatment,CT scans after ambulance return to the hospital for corresponding injury treatment,the observation group received CRAMS scores at the treatment site for routine first aid treatment,and the pre-hospital attending physician used a portable ultrasound instrument to examine the corresponding parts on site or in the ambulance according to the e-FAST process．After preliminary diagnosis,corresponding injury treatment was carried out．The treatment effects of the two groups of patients were compared,and the diagnosis time and initial diagnosis of the two groups of patients were compared．The time from medical contact to entering the operation room,the compliance rate of discharge and admission diagnoses,the CRAMS score before and after treatment,and the success rate of rescue with CRAMS ≤ 8 for both groups of patients were compared．Results The effective rate of treatment in the observation group was 95.0%,while in the control group it was 85.0%,which difference was not statistically significant（χ²=2.222,P=0.136）．The time to diagnosis（13.56±2.36）min,time to the operating room（30.42±8.99）min were shorter than that in the control group[（23.64±5.69）,（52.27±12.60）min],with significant difference（t=10.349,8.928,P<0.05）．The consistency between the admission diagnosis and the definitive diagnosis at discharge of the observation group patients was 97.5%,while the consistency of the control group patients was 95.0%．There was no significant difference between the groups（χ²=0.346,P=0.556）．After treatment,the CRAMS scores of both groups of patients increased,the observation group（9.87±2.62）was higher than that of the control group（8.60±2.98）（t=2.024,P=0.046）．The success rate of CRAMS ≤ 8 rescue in the observation group was 97.50%,while the success rate in the control group was 85.00%．The success rate of CRAMS ≤ 8 rescue in the observation group was higher than that in the control group（χ²=3.914,P=0.048）．Conclusions This study focuses on the joint treatment of batch wounded soldiers by military and civilian forces,aiming at the development path of military civilian integration strategy in military hospitals．The application scope of portable ultrasound e-FAST has been moved forward,which significantly improves the pre hospital treatment ability of emergency personnel and improves the success rate of rescue．It is worth clinical reference．

目的 评价现有关于干预组仅涉及不同针具针刺或联合常规针刺治疗腰椎间盘突出症系统评价的方法学质量,以比较不同针具针刺治疗腰椎间盘突出症的治疗效果。方法 通过CNKI（中国知网）、万方数据库、VIP（维普）、PubMed、Web of Science等数据库以及其他相关电子资源,对诊断、治疗腰椎间盘突出症的多种针灸技术进行全面的研究。使用AMSTAR2软件,对所有参与的系统性评估结果进行地分析,并根据不同的检测结果,确定文献筛选标准。通过Revman5.4和Cochrance风险偏倚工具,以及Stata16.0的网格Meta分析,挑选了3 381个满足纳入排除要求的随机对照试验。结果 以Stata 16.0统计软件制作排序图可知,杵针+电针的临床有效率SUCRA=81.6%排名第一;目测类比评分显示,银质针SUCRA（用于评估疗效的指标）=95%,排名第一。结论 根据现有的研究证据,杵针+电针以及银质针优于其他9种干预措施,但确切的结果仍需要大量的随机对照试验来证明。

Objective To evaluate the methodological quality of the existing systematic evaluation of the intervention group involving only different needle sets of acupuncture or combined with conventional acupuncture in the treatment of lumbar disc herniation,in order to compare the therapeutic effect of different needle sets of acupuncture in the treatment of lumbar disc herniation．Methods Through CNKI,Wanfang database,VIP,PubMed,web of science and other databases as well as other relevant resources,a variety of acupuncture techniques for the diagnosis and treatment of lumbar disc herniation were comprehensively studied．Through the use of AMSTAR2 software,all participating systematic evaluation results were effectively analyzed,and according to different test results,which literature meets the requirements were determined．Through revman5.4,Cochrane risk bias tool,and grid meta-analysis of stata16.0,3 381 RCTs meeting the inclusion and exclusion requirements were selected．Results According to the ranking chart made by stata16.0 statistical software,the clinical effective rate of pestle needle + electroacupuncture ranked first with sucra=81.6%．According to the visual analogy score,the silver needle sucra=95%,ranking first．Conclusions According to the existing research evidence,pestle needle + electroacupuncture and silver needle are better than the other nine interventions,but the exact results still need a large number of randomized controlled trials to prove．

目的 对比乏白细胞富血小板血浆（LP-PRP）与富白细胞富血小板血浆（LR-PRP）联合体外冲击波疗法（ESWT）治疗慢性非止点跟腱腱病（NIAT）的临床价值。方法 选取2021年12月—2023年12月赣州市人民医院收治的80例慢性NIAT患者,以随机数表法分为两组,即对照组和观察组各40例,观察组予LP-PRP联合ESWT治疗,对照组予LR-PRP联合ESWT治疗;于治疗前、第一次治疗后1个月、3个月比较两组疼痛度[视觉模拟量表（VAS）评分]、跟腱病变程度[维多利亚体育研究所跟腱评估问卷（VISA-A）]、跟腱功能（Arner-Lindholm跟腱功能评分）,并比较两组并发症的发生率。结果 两组在治疗后1个月、3个月的VAS评分下降,VISA-A评分升高,且观察组治疗后3个月的VAS评分（1.05±0.31）分低于对照组的（1.82±0.45）分,VISA-A评分（83.35±5.58）分高于对照组的（76.28±5.35）分（F组间与时点交互=338.478、106.663,均P<0.05）;治疗后3个月,观察组跟腱功能（优、良、差各有24、13、3例）优于对照组（优、良、差各有14、16、10例）,差异有统计学意义（Z=2.529,P=0.012）。两组治疗后1个月时VAS评分、VISA-A评分及跟腱功能比较差异无统计学意义（均P>0.05）。结论 与LR-PRP比较,LP-PRP联合ESWT治疗慢性NIAT更有利于减轻患者跟腱疼痛度及病变程度,改善患者跟腱功能。

Objective To compare the clinical value of leukocyte-poor platelet rich plasma（LP-PRP）and leukocyte-rich platelet rich plasma（LR-PRP）combined with extracorporeal shock wave therapy（ESWT）in the treatment of chronic non -insertional Achilles tendinopathy（NIAT）．Methods Eighty patients with chronic NIAT admitted to Ganzhou People's Hospital from December 2021 to December 2023 were randomly divided into two groups using a random number table method：a control group and an observation group,with 40 patients in each group．The observation group received LP-PRP combined with ESWT treatment,while the control group received LR-PRP combined with ESWT treatment．The pain level（Visual Analog Scale[VAS]score）,degree of Achilles tendon lesion（Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire[VISA-A]）,and Achilles tendon function（Arner Lindholm Achilles tendon function score）between the two groups were compared before treatment,one month after the first treatment,and three months after treatment,as well as the incidence of complications between the two groups．Results The VAS scores of both groups decreased and the VISA-A scores increased one and three months after treatment．The VAS score of the observation group（1.05±0.31）was lower than that of the control group（1.82±0.45）three months after treatment,while the VISA-A score of the observation group（83.35±5.58）was higher than that of the control group（76.28±5.35）（interaction between group and time point F=338.478,106.663,both P<0.05）．After three months of treatment,the Achilles tendon function of the observation group（24 cases of excellent,13 cases of good,and three cases of poor）was better than that of the control group（14 cases of excellent,16 cases of good,and 10 cases of poor）,and the difference was statistically significant（Z=2.529,P=0.012）．There was no statistically significant difference in VAS score,VISA-A score,and Achilles tendon function between the two groups one month after treatment（all P>0.05）．Conclusions Compared with LR-PRP,LP-PRP combined with ESWT was more beneficial in reducing the degree of Achilles tendon pain and lesions in patients with chronic NIAT,and improving Achilles tendon function．

目的 评估无托槽隐形矫治应用在正畸拔牙患者中的效果及对牙根吸收、可溶性细胞间黏附分子-1（sICAM-1）的影响。方法 纳入2022年1月—2024年8月的70例正畸拔牙患者,按照治疗方法分组,即对照组（35例,给予固定矫治）、观察组（35例,给予无托槽隐形矫治）,评价组间牙根吸收情况、牙周指标、炎症因子、矫治时间。结果 治疗结束时,两组均出现牙根吸收情况,但是观察组无牙根吸收>3 mm病例,而对照组存在牙根吸收>3 mm、>4 mm病例,P<0.05。治疗前,两组牙周指标[龈沟出血指数（SBI）、牙龈指数（GI）、菌斑指数（PLI）]、炎症因子[白介素-1β（IL-1β）、sICAM-1]比较差异无统计学意义（P>0.05）。治疗后,两组SBI、GI、PLI、IL-1β、sICAM-1升高,且观察组SBI、GI、PLI、IL-1β、sICAM-1低于对照组（P<0.05）。与对照组比较,观察组矫治时间更长（P<0.05）。结论 对正畸拔牙患者进行无托槽隐形矫治,虽然治疗时间长,但是可以抑制牙根吸收,减轻炎症反应,提高牙周健康水平。

Objective To evaluate the effect of clear aligner treatment on orthodontic tooth extraction patients and its impact on root resorption and soluble intercellular adhesion molecule-1（sICAM-1）．Methods Seventy orthodontic extraction patients from January 2022 to August 2024 were included and divided into two groups according to treatment methods：a control group（35 cases,receiving fixed orthodontic treatment）and an observation group（35 cases,receiving clear aligner treatment）． The root resorption,periodontal indicators,inflammatory factors,and orthodontic treatment time between groups were evaluated．Results At the end of treatment,both groups showed root resorption,but there were no cases of root resorption>3 mm in the observation group,while there were cases of root resorption>3 mm and>4 mm in the control group,P<0.05．Before treatment,there was no difference in periodontal indicators（gingival bleeding index[SBI],gingival index[GI],plaque index[PLI]）,inflammatory factors（interleukin-1 β[IL-1 β],sICAM-1） between the groups,P>0.05．After treatment,SBI,GI,PLI,IL-1 β,sICAM-1 increased in both groups,but SBI,GI,PLI,IL-1 β,sICAM-1 were lower in the observation group,P<0.05．Compared with the control group,the observation group had a longer orthodontic treatment time,P<0.05．Conclusions Although the clear aligner treatment time for orthodontic extraction patients is longer,it can inhibit root resorption,reduce inflammatory reactions,and improve periodontal health．

目的 探讨中医药治疗小儿腺样体肥大（AH）的研究现状、研究热点及趋势,为本领域研究者提供借鉴。方法 检索中国知网（CNKI）数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量,运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果 共纳入文献395篇,年发文量整体呈现波动上升的趋势;发文量最多的作者为姜之炎;发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队;研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论 AH领域研究内容主要以内治法、外治法、作用机制为主;研究热点逐渐从临床研究转向作用机制等实验研究;应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。

Objective To explore the research status,research hotspots,and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children,to provide a reference for researchers in this field．Methods The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1,2005,to January 31,2024．Excel 2019 was applied to analyze the number of published papers,and CiteSpace 6.2.R6 software was applied to analyze its authors,institutions,and keywords．Results A total of 395 papers were included,and the annual number of papers showed a fluctuating upward trend．The author with the largest number of papers was JIANG Zhiyan．Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers．The core research teams including JIANG Zhiyan,YU Jingmao,and YAN Zhaojun were initially formed．The research institutions were mainly Chinese medicine colleges and their affiliated hospitals．High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods,clinical efficacy．Conclusions The research content in this field is mainly based on internal treatment,external treatment,and mechanism．The focus has gradually shifted from clinical research to experimental research such as mechanism．The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend．

腹腔镜手术后除躯体创伤疼痛,部分患者还可能经历痛苦的术后内脏痛,不仅使患者术后体验不佳,疼痛应激甚至可能加重机体的内环境紊乱,不利于患者的术后康复。内脏痛是来源于内脏器官和组织的疼痛,其产生与脏器的平滑肌痉挛、扩张、缺血、化学炎症刺激等密切相关。在这个过程中,许多离子通道和受体在调节内脏伤害性刺激信号的传导上发挥作用。目前,临床上术后镇痛治疗方案多样,但如何针对性地控制术后内脏痛是临床医生需要面对和解决的问题。为此,该文对腹腔镜术后内脏痛发生的相关机制、内脏感觉的神经传导及临床特征、治疗进展进行综述。

In addition to physical trauma,patients undergoing laparoscopic surgery may also experience postoperative visceral pain．This pain not only impacts the patient's postoperative experience,but can also worsen the body's internal environment and hinder recovery．Visceral pain originates from internal organs and tissues．It is closely related to smooth muscle spasms,dilations,ischemia,and chemical inflammatory stimulation of organs．In this process,numerous ion channels and receptors regulate the transmission of visceral nociceptive stimulus signals．At present,there are multiple clinical treatment options available for postoperative pain management．However,clinicians must overcome the challenge of controlling postoperative visceral pain．This article provides a review of the relevant mechanisms of visceral pain following laparoscopic surgery,the neural conduction of visceral sensation,clinical characteristics and treatment advancements．