背景:免打结倒刺缝线应用于腰椎后路融合术,能否缩短缝合时间,降低切口并发症,临床尚无明确结论.目的:探索免打结倒刺缝线用于腰椎后路短节段融合术中在缩短缝合时间、降低切口并发症方面是否存在优势.方法:选择2018年1至12月北京中医药大学东直门医院收治的腰椎退行性疾病患者62例,均进行腰椎后路短节段开放融合手术,按随机数字表法分为试验组(n=33)与对照组(n=29),试验组采用免打结倒刺缝线缝合腰深筋膜层,对照组采用可吸收缝线缝合腰深筋膜层.比较两组切口长度、深筋膜和皮下皮肤缝合时间,利用渗漏试验分析缝合质量;定期观察手术切口愈合情况,记录相关并发症;术前及术后2周、6周、3个月,对比两组目测类比评分与Oswestry功能障碍指数评分改善情况.试验获得北京中医药大学东直门医院伦理委员会批准,批准号:DZMEC-KY-2018-11.结果与结论:①两组切口长度与皮下皮肤缝合时间比较差异无显著性意义(P>0.05);试验组深筋膜缝合时间少于对照组[(8.0±0.9),(11.6±1.7)min,P<0.05],渗漏试验阳性例数少于对照组(P<0.05);②试验组切口并发症发生例数少于对照组(P<0.05);③两组术后2周、6周、3个月的目测类比评分及Oswestry功能障碍指数评分均较术前逐渐下降(P<0.05);两组间术后2周、6周、3个月的目测类比评分及Oswestry功能障碍指数评分比较差异均无显著性意义(P>0.05);④结果表明,使用免打结倒刺缝线能够在腰椎后路短节段减压融合术后减少深筋膜缝合时间与切口并发症发生率.

目的 观察四妙升降散合方治疗慢性痛风的临床疗效.方法 选择2017年1-10月就诊于作者所在医院肾病内分泌科门诊的慢性痛风湿热瘀互结证患者80例,按随机数字表将患者分为治疗组和对照组各40例,治疗组有失访3例,对照组因肝功异常升高终止研究2例,最终治疗组37例、对照组38例.2组均给予基础治疗,治疗组给予四妙升降散合方口服,每次1袋,2次/d,饭后30 min沸水冲服;对照组给予苯溴马隆片口服,50 mg/次,1次/d.2组均治疗8周.对比2组疗效及治疗前后中医证候评分、血尿酸水平、肾功、肝功等.结果 治疗组总有效率94.5％,对照组为39.5％,差异有统计学意义(P＜0.05).治疗后,治疗组中医证候评分较治疗前降低(P＜0.01);与对照组比较,差异亦有统计学意义(P＜0.01).2组治疗后血尿酸水平均较治疗前下降(P＜0.05),且治疗组低于对照组(P＜0.05).2组治疗后VAS评分均较治疗前下降(P＜0.05),且治疗组低于对照组(P＜0.05).2组治疗前后肾肝、肾功能指标比较,差异无统计学意义(P＞0.05).2组治疗前后肾功、肝功指标比较差异无统计学意义(P＞0.05).结论 四妙升降散合方可有效缓解慢性痛风湿热瘀互结证患者关节疼痛,改善中医临床证候,降低血尿酸水平,且安全性高.

目的 观察针刺治疗颈椎后路椎管成形术后轴性症状的临床疗效.方法 60例颈椎后路椎管成形术后出现轴性症状的患者随机分为2组,分别为治疗组和对照组,每组30例.治疗组共30例采用中医针法治疗4周,对照组共30例采用塞来昔布口服治疗4周,分别于治疗前、治疗结束后2周进行评分,比较两组患者颈椎功能Northwick Park颈痛量表(Northwick park neck pain ques-tionnaire,NPQ)评分、疼痛视觉模拟评分和颈椎前凸角变化.结果 所有患者均获得随访,两组患者治疗前NPQ评分、疼痛视觉模拟评分和颈椎前凸角无明显差异.治疗结束后2周,治疗组NPQ评分和疼痛视觉模拟评分均低于对照组,差异具有统计学意义(P<0.05),治疗组颈椎前凸角优于对照组,差异具有统计学意义(P<0.05).结论 针刺治疗有效改善颈椎后路椎管成形术后轴性症状和颈椎生理前凸角,促进功能恢复.

病案质量是科室管理水平和技术水平的体现.病案的形成过程涉及到全院多个部门,应全院齐抓共管,这其中,尤以科室的自身管理最为重要.通过分析病案管理规范科室的管理经验,指出充分发挥科主任的主观能动性、严格落实三级医师查房制度、调动医疗助理的工作积极性是提高病案质量的有效方法.

In this article, experience of Professor Meng Xiankun for treating different diseases by acupuncturing the Sanshen points was analyzed. So acupuncturing the Sanshen points could harmonize Qi and Xue, relieve the symptoms, and improve clinical efifcacy.

Professor JIANG Liangduo is a famous Chinese medicine clinician, who is working in Dongzhimen hospital, Beijing university of Chinese medicine, he is good at treating intractable diseases. Sheng xiantang is one of the prescription that often used. Sheng xiantang was derived from<Yi xue zhong zhong can xi lu>, Zhang Xichun in qing dynasty,which including Huangqi, Zhimu Chaihu, Jiegeng, Shengma ifve TCM, the main treatment is subsidence of the atmosphere. The author sum up the experiences of Professor JIANG Liangduo using this prescription to treat miscellaneous disease.

<正>李秀敏(1940—),北京中医药大学附属东直门医院教授,主任医师,师从北京著名皮肤科中医前辈赵炳南、马海德、陈集舟等教授,从事皮肤病临床工作40余载,治学严谨,处方用药颇具匠心,疗效甚佳。笔者有幸随师侍诊,受益匪浅。现将其治疗老年带状疱疹的诊治思路介绍如下。1司外揣内,整体审察中医认为人体是一个有机的整体,人体体外与体内有

<正>痛风是由于先天遗传或后天获得性的多种因素造成嘌呤代谢紊乱,尿酸生成过多或/和尿酸排泄减少,致使血清尿酸浓度持续升高、高尿酸血症形成的病证。多余的尿酸以尿酸盐结晶的形式沉积于全身各组织器官中,沉积于关节及周围组织,可致急慢性痛风关节炎、痛风结节。细小的尿酸盐结晶长期刺激局部组织,形成痛风结石合并溃疡,而且此类溃疡很难愈合。西药降酸排酸疗法对于溃疡的治疗作用有限。痛风结合并溃疡是临床难治性疾病,导致患者行动不便,生活质量严重受损,通过整体与局部辨证相

Diabetic retinopathy(DR)is the most severe systemic complications of diabetes complications.Although Chinese medicine treatment can not cure DR,but in improve vision,slow progression of the disease,improve patient quality of life has its unique advantages.Through access to literature,in recent years,Chinese medicine treatment of DR research,mainly from the etiology and pathogenesis,syndrome differentiation type of treatment,specifically on the governance side,single herb preparations for treatment,in combination therapy,experimental research in the field are described.

Objective To know about the current situation of running medical record quality of traditional Chinese medicine;to analyze the existing defect of running medical record;to investigate the effective method on improving the electronic medical record quality of tradition Chinese medicine.Methods Having real-time monitoring on 1000 running medical record of traditional Chinese medicine selecting randomly through using electronic medical record system;having evaluation by using admission record,the first course of disease record,course of disease record,informed consent form;doctor's instruction, auxiliary examination and the completeness of tradition Chinese medicine content as quality control indexes;having statistical analysis on the problem during monitoring.Results In 1000 medical record,877 are class A,123 are class B,none is class C,the rate of class A medical record is 87.7%;the average defect number in non-operation departments and operation department is respectively 0.8 and 1.2;the defect rate of admission record ranks first;the dialectical problems of traditional Chinese medicine are most serious.Conclusion To attach importance to the standardization management of running medical records of traditional Chinese medicine is the premise of improving medical quality of traditional Chinese medicine hospital and ensuring the medical safety;it is the key point of developing traditional Chinese medicine and improving traditional Chinese medicine students training.

中医传统的治法八法中虽无透法,但在温病的治疗过程中透法却被广泛应用.它贯穿于各类温病治疗的始终,体现了温病的治疗特点.温病的治疗讲究透邪,给邪出路,适时恰当地选用透法对各类温病的转归及预后有重要意义.

Typhoid three cloudy three positive popular names six Confucian classics.Typhoid three cloudy three positive essence questions are the focal point questions,which all previous dynasties medicine argued.About experience sayings had channels and collaterals saying,the masculine and feminine elements saying and so on.The author from three cloudy three positive system physiologies and the pathological change,the crowd physique classification and the pathological change displays the aspect to discuss its essence.Supplies the clinical reference.

金匮要略>水气病之"少阳脉卑,少阴脉细,男子则小便不利,妇人则经水不通;经为血,血不利则为水,名曰血分."