无论是在中医诊所还是洗浴中心、美容机构,拔火罐都是受人追捧的传统养生保健项目.不过,拔罐究竟应该怎么操作?什么人都可以拔火罐吗?拔罐后皮肤颜色越深就说明身体越差吗?今天就来揭晓答案.

目的:比较局远配穴与局部取穴治疗肩周炎的效果.方法:60例随机分为A组和B组各30例,B组予以局部取穴治疗,A组予以局远配穴治疗.结果:总有效率A组高于B组(P＜0.05).A组NRS评分低于B组,ASES评分高于B组(P＜0.05).镇痛效果优良率A组高于B组(P＜0.05).结论:局远配穴治疗肩周炎疗效更好.

目的 观察中药熏蒸联合针刺对中风后面瘫患者免疫及面神经功能的影响.方法 应用前瞻性随机对照方法将北京市鼓楼中医医院针灸科收治的107例脑梗死恢复期中枢性面瘫患者分为2组,对照组53例给予常规西医治疗、康复训练及针刺治疗,试验组54例在对照组治疗基础上给予中药熏蒸治疗,2组均治疗28 d.观察2组患者治疗前后House-Brackmann(H-B)面神经功能分级量表评分、面部残疾指数(FDI)评分、改良Barthel指数以及免疫球蛋白(IgA、IgG、IgM)、细胞免疫功能(CD3+、CD4+、CD8+、CD4+/CD8+)变化情况,统计2组患者治疗28 d后的临床治疗效果.结果 2组治疗后的H-B评分、FDI评分、改良Barthel指数均较治疗前显著改善(P均<0.05),试验组改善幅度均大于对照组(P均<0.05);2组治疗后IgA、IgG、IgM、CD8+均较治疗前显著降低(P均<0.05),CD3+、CD4+、CD4+/CD8+均显著提高(P均<0.05),试验组改善幅度均大于对照组(P均<0.05).试验组的临床总有效率为83.3％(45/54),对照组为64.2％(34/54),试验组明显高于对照组(P<0.05).结论 相较于常规及针刺治疗,加用中药熏蒸治疗中风后面瘫的疗效更显著,可以明显改善患者的面神经功能,增强日常生活能力;推测降低血清免疫球蛋白水平、提高免疫细胞功能是重要作用机制.

我国青少年近视率位于世界第一,此病中医病机认识主流源于内科脏腑辩证体系,强调整体虚证.但现代临床及体质调查多发现患者并无显著整体气阳虚证特点,故局部病机亟待补充.中医针刺治疗此病具有优势,针灸辩证相对重视局部病机,由此将现代针刺研究成果纳入局部病机认识中就可行且必要.最后将患者按不同年龄段、不同病程,分类总结病机.

目的 探讨腹针配合梅花针治疗干眼的疗效.方法 纳入干眼患者50例(100只眼),根据治疗方法不同分为针刺治疗组20例(40只眼)、假穴针刺组15例(30只眼)和药物组15例(30只眼).针刺治疗组予以“薄氏腹针”“梅花针”及眼球运动操治疗,假穴针刺组选取双侧“天枢穴旁、外陵穴旁、滑肉门穴旁非穴点”“梅花针”及眼球运动操治疗.每周治疗2次,共治疗8周(16次)为1个疗程.观察3组治疗前后眼部症状积分、泪膜破裂时间(BUT)、泪液分泌试验(SIT),并对比分析3组患者疗效.结果 治疗后针刺治疗组的SIT、3组患者的眼部症状积分与BUT均较治疗前改善(均P＜0.05),且针刺治疗组在改善SIT方面优于其他两组(P＜0.05).治疗后总有效率分别为75％、73％和33％,3组间比较差异有统计学意义(P＜0.05).结论 腹针配合梅花针疗法可治疗干眼,增加泪液分泌量(疗效优于其他两组),同时对于改善眼部症状及提高泪膜稳定性有一定作用.

Objective To observe the effect of catgut implantation at acupoint on treating cerebrovascular epilepsy and discuss the therapeutic mechanism. Methods 58 patients were divided into an observation group and a control group. The control group was treated with sodium valproate, and the observation group was treated with catgut implantation at acupoint on the basis of the control group.Epilepsy scoring, sodium valproate adverse reactions, the change of blood concentrations of sodium valproate and curative effect evaluation and so on were observed before and after the treatment. Results The basic control and excellent rate in the observation group were 16.7%and 73.3%, better than the control group of 10.7%and 53.6% respectively. The epilepsy scoring and sodium valproate adverse reactions after treatment in the observation group were superior to the control group [observation group is(5.05±1.5),(5.09±1.53),control group is(6.40±1.74),(10.85±1.91),P<0.05]. The number of patients with blood concentrations of sodium valproate in range 50-100 mg/L after treatment was increased in the observation group(Z=2.07, P=0.038). Conclusion Catgut implantation at acupoint combined sodium valproate was more effective than sodium valproate in treating cerebrovascular epilepsy, which can obviously alleviate the adverse reaction of drugs and increase blood concentrations of sodium valproate.

目的:系统评价口服三七制剂治疗缺血性中风急性期的临床疗效及安全性.方法:搜集口服三七制剂治疗缺血性中风急性期随机对照试验文献,筛选合格研究,应用Jadad评分法进行质量评价,运用异质性检验、Meta-分析等方法统计相关数据.结果:4项研究符合纳入标准,Jadad评分显示所有纳入研究均为低质量文献.Meta-分析结果显示,总有效率比较的合并相对危险度(RR)99％可信区间(CI)为1.23(0.81,1.86),其他效应指标统计结果稳定性较低.结论:目前尚无充分证据显示口服三七制剂可改善缺血性中风急性期患者的神经功能缺损、日常生活活动能力情况.

目的:比较葛根素注射液治疗不同类型中风的疗效优势.方法:运用系统评价方法,检索葛根素注射液治疗中风的随机对照试验,筛选合格研究,评价纳入研究质量,采用Meta分析、异质性检验、漏斗图分析、敏感性分析等方法,依据中风类型、分期分亚组统计相关数据.结果:23项研究符合选择标准,葛根素治疗缺血性中风急性期、出血性中风急性期RR(99％ CI) Meta-分析结果依次为1.21(1.14,1.28)、1.21(1.02,1.43),上述亚组失效安全数依次为270.73、1.81.结论:现有证据提示,葛根素注射液用于中风急性期较用于中风恢复期及后遗症期证据充分；用于缺血性中风急性期较用于出血性中风急性期证据充分.

目的 系统评价丹参酮ⅡA疗缺血性卒中急性期的临床疗效与安全性.方法 搜集丹参酮ⅡA治疗缺血性卒中急性期随机对照试验文献,筛选合格研究,采用Jadad评分法评价文献质量,运用异质性检验、Meta分析、敏感性分析等方法统计相关数据.结果 纳入符合标准研究9项.Meta分析结果显示,总有效率比较合并RR(99％ CI)为1.20(1.10,1.32),需治疗的患者数(99％CI)为6.67(4.35,12.5)；神经功能缺损评分、日常生活活动能力评分比较的WMD(99％ CI)分别为-3.82(-6.45,-1.19)、13.00(4.26,21.74).结论 Meta分析结果显示,丹参酮ⅡA可改善缺血性卒中急性期神经功能缺损,提高患者日常生活活动能力,安全性较高.

Objective:To observe the dynamic behavior changes and early intervention effects of Yi'nao Jieyu Formula after stroke in rats.Methods:Scoring by the Open-Field behavior in male Wistar rats were randomly divided into normal group,sham-operation group,MCI group,treatment group,control group,PSD group and VD group.Model was prepared by in vitro injection of the same germ-line microemboli from the external carotid artery of 0.3ml of allogeneic clot;sham operation group were injected the same dose of saline and intragastrically administrated with distilled water,Traditional Chinese Medicine group and western group were respectively administrated of four weeks with Yinao Jieyu Formula and Nimodipine after model prepared;PSD model was prepared by chronic unpredictable mild stress plus solitary housed from 7d to 21d after operation;VD group were collected by the water maze filtered on 28th day after operation.Shuttle box active avoidance response experiment was respectively done on the 1st,2nd and 4th week after success of model copying,and recording the initiative to escape(AAR),the number of passive avoidance(PAR),the number of electric shock time,and statistically analyzing.Results:The frequency of PAR and AAR were the lowest in VD group,the frequency of PAR and AAR of Chinese medicine group were lower than the sham-operation groups,the frequency of AAR and PAR had significant differences(P0.05,P0.01)between the two groups.Conclusion:Yi'nao Jieyu Formula can improve learning and memory function,and it's benefit to recovery of stroke cognitive function in rats.

目的 比较丹参制剂治疗不同类型卒中的疗效优势.方法 运用系统评价方法,检索丹参制剂治疗卒中的随机对照试验,筛选合格研究,评价纳入研究质量,采用Meta分析、异质性检验、漏斗图分析、敏感性分析等方法,依据卒中类型、分期分亚组统计相关数据.结果 45项研究符合选择标准,丹参酮ⅡA注射液、复方丹参注射液、丹红注射液治疗缺血性卒中急性期RR(99％ CI) Meta分析结果依次为1.20(1.10,1.32),1.20(1.05,1.38),1.22(1.14,1.31)；丹参注射液、复方丹参注射液治疗出血性卒中急性期1.30(1.15,1.47),1.26(1.10,1.43).5个亚组失效安全数依次为28.86,5.12,93.91,21.43,12.57.结论 丹参酮ⅡA注射液、复方丹参注射液、丹红注射液有益于缺血性卒中急性期,其中丹红注射液临床证据更为充分,其他依次为丹参酮ⅡA注射液、复方丹参注射液；丹参注射液、复方丹参注射液有益于出血性卒中急性期,其中丹参注射液临床证据更为充分.目前尚无证据支持丹参制剂可用于卒中恢复期及后遗症期.

Objective:To evaluate the effect and the safety of acanthopanex injection on acute cerebral ischemic stroke.Methods:Studies of randomized controlled trails(RCTs) of acanthopanex injection on acute cerebral ischemic stroke were identified.The methodological quality of inclusive trails were assessed by Jadad scale.The data was analysed by the heterogeneity test,meta analysis and funnel plot analysis.Results:16 RCTs whose Jadad score were lower than 3 were included.Meta-analysis indicated that the RR(99%CI) was 1.18(1.11,1.26),the NNT(99%CI) was 6.67(5,10) and the WMD(99%CI) was-8.54(-10.47,-6.60).Conclusion:The meta analysis shows that the acanthopanex injection is effective and safety for acute cerebral ischemic stroke.

[Objective]To understand the regularity of incidence of Hand Foot and Mouth Disease(HFMD),and figure out the focus of prevention based on incidence trend forecast for the year 2011. [Methods]SPSS and Excel was used to descriptively analyze the data from the National Disease Surveillance Information Management System. [Results]The higher level of floating population gathering was correlated to the higher incidence rate of HFMD(χ2=1740.82,P<0.01);the proportion of non-local registered permanent residents in total cases gradually increased year by year,with the higher amount of increase than local registered permanent residents;the length of time span of incidence increased with the earlier incident peak and longer-lasted period;EVT1 became the major virus. [Conclusion]The main tasks for dealing with the HFMD' s epidemic should be to strengthen management of floating population,to carry out health education and environmental remediation,to continually monitor pathogen,and to improve the capability of HFMD diagnosis and treatment.

Bell面瘫是临床上较为常见的疾病之一.临床观察与科学研究认为,面瘫的最佳治疗时机为急性期,急性期的治疗是提高疗效、降低后遗症发病率的关键,故寻找面瘫急性期最佳治疗方法有较大的临床意义.本课题对头穴电刺激联合体针治疗急性期重度Bell麻痹的疗效及安全性进行了综合评价,报道如下.

目的 观察红外光治疗仪与普通远红外线照射方法治疗腰椎间盘突出症的临床疗效及安全性.方法 采用单盲随机对照的方法,将60例腰椎间盘突出症患者分为治疗组和对照组各30例.在单纯针刺治疗的基础上,治疗组加用红外光治疗仪照射,对照组加用普通远红外线照射治疗,治疗后依据综合疗效评定标准、视觉模拟评分(VAS)、腰椎疾患综合评分(JOA评分)、仪器使用主观评价及安全性指标等进行对比观察.结果 两组治疗后治疗组治愈率优于对照组(P<0.05);两组患者与治疗前相比JOA评分均显著上升(P<0.01),VAS评分显著下降(P<0.01),治疗组JOA与VAS评分均优于对照组(P<0.01);两组治疗后自觉热力渗透度比较治疗组优于对照组(P<0.05).结论 针刺结合红外光治疗仪对腰椎间盘突出症的疗效优于针刺结合普通红外线照射,红外光治疗仪治疗时渗透度高可能是其疗效较好的原因之一.

Objective:To observe clinical effect with acupunture migraine therapy.Methods:55 cases of patients were randomly divided into acupuncture group and flunarizine group,and they were treated with acupuncture and flunarizine,respectively.Results:The effective rate was 58.6% and 26.9% in acupuncture group and flunarizine group respectively.Conclusion:Acupuncture treatment can effectively cure migraine.

目的:通过观察钟灸治疗急性期和静止期Bell麻痹的临床疗效,探讨针灸治疗Bell麻痹的最佳时机.方法:观察Bell麻痹急性期和静止期的症状积分、疗效评定标准的临床疗效.结果:针灸对于BeU麻痹的治疗,无论急性期还是静止期均有显著性疗效;针灸的治疗Bell麻痹远期疗效,急性期干预优于静止期干预;针灸治疗Beu麻痹早期治疗痊愈率高,后遗症少.结论:急性期是针刺治疗周围性面瘫的最佳时机

临床实践证明火针疗法对血瘀型带状疱疹后遗神经痛(Postherpetic Neuralgia,PHN)有明显的疗效,为了对火针治疗PHN进行深入研究,自2004年4月～2005年10月,我们将56例门诊血瘀型PHN患者随机分为火针治疗组和针刺对照组,进行对比临床疗效观察,现将观察结果报告如下.