目的 探讨夏科氏关节病的分期、发病机制、影像学检查、发病部位的临床表现及治疗方向.方法 分析夏科氏关节病的临床资料,检索 2011 年至 2022 年国内外发表的相关文献,逐一分析检索文献纳入研究,总结其临床表现、治疗方法及随访预后.结果 检索共获得 302 篇文献,最终纳入 11 篇.夏科氏关节病发病机制复杂,临床以糖尿病病史患者多累及足踝部病变为多见;脊髓损伤、脊髓痨多累及脊柱;梅毒感染好发于膝关节,其次是髋关节;脊髓空洞症神经病变多发生在肩部,其次是肘和腕关节.结论 夏科氏关节病患者的治疗原则是在控制原发病平稳的基础上,再进行病变部位的处理.

骨质疏松症是较为常见的增龄性骨重塑障碍性疾病,具备高患病率、高致残率特征,现已成为重要的社会健康问题.中医学将其病机关键概括为机体内稳态失衡、五行生克制化削弱(正常承制关系缺失)及脏腑结构功能紊乱,进一步衍生出扶正防"害"、驱邪治"亢"的干预理念.此外,在疾病进展过程中单一因素致病或单个脏器受邪少见,很大程度上都存在复杂病理网络关系并不断凸显出多器官沟通的连锁效应.基于此,本文以中医学经典理论为基点,全方位、多角度剖析骨质疏松症发病进程中的病理生理机制,以期能不断丰富中医药对抗疾病的科学内涵,并为更深层次临床应用及基础研发提供理论依据.

目的 观察等速离心训练联合股内侧肌神经电刺激对膝骨性关节炎(KOA)患者股内侧肌肌力及表面肌电信号变化的影响.方法 采用随机数字表法将2019年1月至2020年7月我院治疗的60例KOA患者分为等速离心训练联合股内侧肌神经电刺激组(试验组)和单纯等速离心训练组(对照组),每组30例.治疗前及治疗4周后采用等速肌力测试系统测试两组患者的股内侧肌峰力矩(PT)、单次最大做功(TW)、平均功率(AP);采用表面肌电仪测试两组患者的股内侧肌(VM)及股外侧肌(VL)的中位频率(MF),计算股内、外侧肌收缩均方根比值(RMS VM/VL).结果 治疗4周后,两组的PT、TW、AP均升高,且试验组高于对照组,差异具有统计学意义(P<0.05).治疗4周后,试验组的VM MF、VL MF、RMS VM/VL及对照组的VM MF、VL MF均较治疗前明显提高,差异具有统计学意义(P<0.05);治疗4周后,试验组的VM MF、RMS VM/VL显著高于对照组,差异具有统计学意义(P<0.05).结论 等速离心训练结合股内侧肌电刺激治疗,可有效提高KOA患者股内侧肌肌力、肌耐力,优化股内、外侧肌运动协调性,且明显优于单纯等速离心训练.

膝关节骨性骨关节炎(knee osteoarthritis,KOA)是中老年人常见的骨科疾患,是导致关节疼痛、肿胀、畸形、功能障碍甚至残疾的疾病之一,随着人口老龄化的快速发展,发病率有逐渐增高的趋势.研究证实,通过增强肌力、提高本体感觉输入、恢复膝关节动力稳定系统是KOA康复的关键[1].等速肌力训练现已广泛应用于体育训练和康复医学领域,有研究已经证实离心训练在改善肌力方面具有一定的优势[2].电刺激系统可提高肌肉组织的活性,募集更多的运动单位参与活动,从而提高肌肉的收缩力量[3].本研究采用等速离心训练和股内侧肌电刺激相结合,取得良好疗效,报告如下.

目的:观察矩阵针灸配合开窍聪耳方治疗突发性聋的临床疗效.方法:62例突发性聋患者,治疗采用①矩阵针灸取穴;或②开窍聪耳方取穴进行治疗.(①②取穴隔天交替使用,配穴随症加减.结果:经矩阵针灸配合开窍聪耳方治疗,治愈率为64.5％,总有效率91.9％.结论:矩阵针灸配合开窍聪耳方治疗突发性耳聋临床疗效显著.

OBJECTIVE:To compare the clinical efficacy of the acupuncture technique of Jingou Diaoyu combined with speech rehabilitation training and speech rehabilitation training alone for post-stroke motor aphasia.METHODS:A total of 70 patients with post-stroke motor aphasia were randomly divided into an observation group and a control group, 35 cases in each group. The patients in the control group were treated with basic treatment and speech rehabilitation training; on the basis of the control group, the patients in the observation group were treated with the acupuncture technique of Jingou Diaoyu at Yamen (GV 15), Jinjin (EX-HN 12), Yuye (EX-HN 13), and Hegu (LI 4) etc., once a day, 6 days per week, for a total of 4 weeks. The speech function score, aphasia grade, daily life speech ability score of the two groups before and after treatment were observed, and the clinical efficacy was evaluated.RESULTS:The total effective rate was 94.3% (33/35) in the observation group, which was superior to 80.0% (28/35) in the control group (P<0.05). In addition to listening comprehension, each score of speech function in the two groups was significantly increased after treatment (P<0.05), and the increasing in the observation group was greater than that in the control group (P<0.05). After treatment, the aphasia grade of the two groups were improved (P<0.05), and the aphasia grade in the observation group was significantly better than that in the control group (P<0.05). After treatment, the scores of daily life speech ability in the two groups were significantly improved (P<0.05), and the increasing in the observation group was greater than that in the control group (P<0.05).CONCLUSION:The acupuncture technique of Jingou Diaoyu combined with speech rehabilitation training could improve the speech function of patients with post-stroke motor aphasia, and its curative effect is superior to the speech rehabilitation training alone.

目的:观察艾灸配合中药对脊髓损伤后多种抗生素耐药的尿路感染患者的临床疗效.方法:将80例患者随机分为治疗组和对照组各40例,对照组患者采用国际通用的康复治疗方案积极干预,治疗组患者在对照组基础上加用艾灸配合中药治疗.结果:治疗20天后,治疗组患者整体疗效和愈显率均明显优于对照组,差异具有统计学意义(P＜0.05);治疗结束后2周和6周时随访,治疗组及对照组整体疗效均有下降,但治疗组疗效相对稳定,优于对照组(P＜0.05);停止治疗6周后,对照组疗效回落至治疗10天后的疗效状态,而治疗组仍能维持较好的疗效(维持在治疗20天后的疗效状态),治疗组整体疗效和愈显率明显优于对照组,差异具有统计学意义(P＜0.05).结论:中医药的介入能明显提高对多种抗生素耐药的尿路感染患者的整体疗效,且治疗结束后整体疗效相对平稳,再次发生尿路感染的概率变小.

目的观察合谷刺法治疗膝关节骨性关节炎的临床疗效。方法将符合纳入标准的56例膝关节骨性关节炎患者随机分为治疗组和对照组，治疗组采用合谷刺法治疗，对照组采用毫针常规针刺治疗。结果治疗组的总有效率为93.3%，对照组总有效率为65%，差异有统计学意义(<0.05)。结论合谷刺法治疗膝关节骨性关节炎的临床疗效明显优于普通针刺，疗效肯定，方便实用，可推广应用。

Objective To investigate the effect of preoperative rehabilitation on early function of joints after total hip arthroplasty by comparing with non-preoperative rehabilitation.Methods Between March 2010 and November 2011,98 patients with hip disease were recruited in study.Of 98 patients,49 received preoperative rehabilitation for 2 weeks in trial group,and 49 did not receive preoperative rehabilitation in control group.There was no significant difference in gender,age,disease duration,disease cause,preoperative visual analogue scale(VAS) score,and preoperative Harris score between 2 groups(P > 0.05).Results There was no significant difference in VAS score at each time point after operation between 2 groups(P > 0.05),but significant differences were found in Harris score(P < 0.05).At 3 days after operation,compliance evaluation results showed that 36 cases were of full compliance,and 13 cases were of partial compliance in trial group;27 cases were of full compliance,14 cases were of partial compliance,and 8 cases were of non-compliance in control group;there was significant difference between 2 groups(Z=2.286,P=0.002).The ambulation time was within 7 days in trial group,and was within 7 days in 47 cases and more than 7 days in 2 cases in control group;there was significant difference between 2 groups(Z=3.840,P=0.000).Conclusion Preoperative rehabilitation plays an important role in compliance,decreased bed rest time,and hip function improvement in patients after total hip arthroplasty.