目的:观察艾灸对直肠癌术后低位前切除综合征(LARS)相关腹泻的临床疗效.方法:选取2019年3月—2020年12月在上海市嘉定区中医医院外科病房就诊的直肠癌术后LARS相关脾虚型腹泻患者80例,根据随机数字表法分为对照组和治疗组,每组40例.对照组口服思密达,1次/d,每次1袋,持续治疗2周;治疗组用艾条温和灸足三里(双)、关元、神阙,每穴20 min,1次/d,持续治疗2周.采用徐氏肛门功能评价、LARS量表评价、中医症候评价以及临床疗效评价,分别对对照组和治疗组停药后1周、2周以及1个月后的情况进行疗效评估.结果:在干预结束第1周后,2组患者在肛门功能、LARS量表、中医症候评分中差异无统计学意义(P>0.05);治疗2周、1个月后,治疗组的肛门功能评分[(6.15±1.97)分、(9.29±0.58)分]高于对照组[(3.99±1.48)分、(4.67±1.74)分],差异有统计学意义(P<0.05);治疗2周、1个月后,治疗组的LARS评分[(15.50±9.61)分、(20.11±9.60)分]低于对照组[(3.94±5.16)分、(16.85±9.57)分],治疗组的中医症候评分[(6.62±3.95)分、(10.09±4.11)分]低于对照组[(3.65±2.66)分、(8.83±4.28)分],差异有统计学意义(P<0.05);在干预结束后,治疗组的有效率为90％,高于对照组的63％,差异有统计学意义(P<0.05).结论:艾灸可有效改善直肠癌术后LARS相关腹泻患者的肠胃功能,且相比于药物,艾灸的疗效更持久,有效提高了患者的脾胃功能,改善了脾虚症状.

目的:观察中西医结合治疗巨大下肢溃疡的临床疗效.方法:通过中药方剂内服外用及配合手术的方式治疗.结果:12例患者共15处活动性溃疡,溃疡发生部位以小腿内踝为多见,术后随访1 a～2a,所有患者下肢溃疡未见复发,临床症状改善明显,无严重并发症.结论:中药内治外洗结合大隐静脉手术治疗下肢巨大溃疡疗效确切.

Objective:To compare the mid-to long-term recurrence rate for lower extremity varicose veins treated by endovenous laser ablation ( EVLT) or convention surgical technique.Methods:The data were reviewed in 187 patients (212 limbs),122 males and 75 females;mean age (57.14 ±7.4) years undergone endovenous laser ablation of the great saphenous vein between May 2009 and May 2011.And another 172 patients(185 limbs);106 males and 66 females;mean age (56.53 ±8.1 years) received conventional surgery in 2009 for the varicose veins were includes as controls.Two groups of the pa-tients were followed up for 36 months on average,and compared for the relapse in 2 to 3 years.Results:Both groups remained no significant difference in 2 to 3 years regarding the relapse(P>0.05).Conclusion:EVLT is not superior to the conventional surgery for lower extremity varicose veins.

目的：探讨痛风性关节炎缓解期的病因病机分析及辨证施治。方法通对痛风性关节炎缓解期的中医病因病机认为脾肾阳虚为本，痰湿瘀痹阻经络为标，对痛风性关节炎缓解期制定以温阳化浊为基本的治疗方法。结果患者症状复发时间延长。结论在临床中通过温阳化浊法治疗痛风性关节炎缓解期取得良好治疗效果。

目的:观察无创经络功治疗下肢慢性静脉功能不全的有效性、安全性、依从性.方法:运用无创经络功治疗60例CVI患者,疗程为3个月,结束后3个月随访,评定治疗前后患者症状、体征、医技检验情况及随访结果.结果:56例完成治疗,52例完成随访,治疗过程中无不良反应出现;治疗后组、随访组跟治疗前组比较:95％的CI均无重叠,按α=0.05水准认为差别有统计学意义;治疗后与治疗前、随访与治疗前在症状评分、踝与小腿周径测量值、股总静脉与腘静脉持续返流时间、全血黏度(rt200)比较差异有显著统计学意义(P＜0.05);随访与治疗后在在症状评分、踝与小腿周径测量值、股总静脉与腘静脉持续返流时间、全血黏度(rt200)比较差异无统计学意义(P＞0.05).结论:无创经络功治疗下肢慢性静脉功能不全具有较好的有效性、安全性、依从性,且简单易学,重复性强,适宜推广.

Objective:To evaluate the efficacy of endovenous laser ablation(EVLA) in treatmenr of patients with venous ulcer in the lower extremity.Methods:There was a retrospective analysis of witch 25 patients with venous ulcers were treated with EVLA.Results:Tere were 33 ulcers in 25 patients treated with EVLA.78.79%(26/33) ulcers occurred in the medial malleolus.Followed up for 6-24 months,averaged 14 months.There was no recurrence.Clinical symptoms were improved significantly and without major complications.Conclusions:EVLA for the superficial reflux around the ulcer region is an effective method in managing venous ulcers.We must correct deep vein obstruction and reflux in the prevention of venous ulceration recurrence.

评价腔内电凝治疗下肢静脉曲张的临床效果和安全性