目的：探讨飞腾八法治疗围绝经期妇女抑郁状态的效果。方法：将符合标准的60例围绝经期妇女抑郁患者按照简单随机的方法分为两组：对照组（普通针刺组）和治疗组（飞腾八法组），每组30例。分别于治疗前后对两组患者的汉密尔顿抑郁量表（HAMD）评分以及改良Kupperman（KI）评分进行评估；总共治疗8周。结果：两组组内比较，患者治疗前HAMD评分,差异无统计学意义（P＞0.05）；KI评分比较，差异无统计学意义（P＞0.05）。治疗后评分与同组治疗前比较，HAMD评分与KI评分均明显降低，差异显著（P＜0.01），有统计学意义；两组组间比较：治疗组与对照组在改善HAMD评分方面比较，要优于对照组，差异有统计学意义（P＜0.05）；在改善KI评分方面，治疗组亦优于对照组，差异有统计学意义（P＜0.01）。两组疗效比较：两组患者治疗组总有效率为90.0%，对照组为66.67%；治疗组疗效比对照组优，差异有统计学意义（P＜0.05）。结论：飞腾八法能够明显改善围绝经期妇女抑郁状态，并能够改善其围绝经期症状。

根据国务院体医融合政策和中医传承创新发展政策,设立运动指导门诊势在必行.运动处方属于中医"治未病"范畴,运动指导门诊属于中医"治未病"专病门诊.运动处方组成四要素:运动方式、频率、强度、时间,包括有氧运动处方、抗阻运动处方和柔韧运动处方.中医特色运动处方有八段锦、易筋经、五禽戏等运动处方对高血压、代谢性疾病、关节炎、恶性肿瘤、骨质疏松等疾病是预防大有裨益.

目的 探讨聂氏加味导赤汤治疗糖尿病合并泌尿系感染的临床疗效.方法 选取2017年1月—2019年6月门诊的糖尿病合并泌尿系感染的患者64例,采用随机信封法分为治疗组32例和对照组32例.对照组在降糖的基础上加用左氧氟沙星片控制感染,治疗组在对照组的基础上加用聂氏加味导赤汤,比较2组患者治疗2周后的临床疗效,治疗结束后随访6个月,比较2组患者的复发率.结果 治疗2周后,治疗组总有效率为93.75％,对照组总有效率为73.33％,2组间比较,P<0.05,差异有统计学意义.治疗结束后随访6个月,治疗组复发率为6.3％,对照组复发率为30.0％,2组间比较,P<0.05,差异有统计学意义.2组患者治疗后空腹血糖比较,P<0.05,治疗组血糖控制优于对照组.结论 在西医稳定血糖、抗感染的常规疗法基础上联合聂氏加味导赤汤治疗糖尿病合并泌尿系感染患者,在控制感染、降低血糖及缩短用药疗程方面具有明显优势,并且可以减少临床复发率.

目的 观察聂氏加味导赤汤治疗尿道综合征的临床疗效.方法 将60例尿道综合征患者随机分为治疗组30例和对照组30例,治疗组采用聂氏加味导赤汤治疗,对照组采用常规西药舒乐安定及谷维素治疗,观察比较2组中医证候积分、SF-36生活质量评分及不良反应.结果 治疗组有效率为100％,对照组有效率为41.38％,组间比较差异有统计学意义(P<0.05).治疗组中医证候积分治疗前后组内比较及与对照组组间比较,差异均有统计学意义(P<0.05);2组SF-36生活质量评分组间比较差异有统计学意义(P<0.05).结论 聂氏加味导赤汤治疗尿道综合征有较好的临床疗效.

应用莱斯特评估包(Leicester assessment package,LAP)训练和评估中医全科医师,能使其形成并强化整体性服务、以病人为中心照顾、全面性照顾等全科医学服务理念.LAP评估包可以提升中医全科医师的应诊能力:培养问诊技巧、提升基本医疗管理能力、培养解决问题的技巧、建立密切的医患关系.

目的 观察补阳还五汤加减治疗社区脑卒中后疲劳患者的临床疗效.方法 本研究于2016年6月～2018年6月将符合入组标准的63例北京社区脑卒中患者,随机分为对照组和治疗组.对照组接受内科常规药物对症治疗.治疗组在补阳还五汤的基础上根据患者的症状进行加减.4周后对患者的疲劳严重度、生存质量和日常生活能力进行评分,与治疗前评分进行比较分析.结果 入组的脑卒中后疲劳患者经过治疗后,疲劳严重度评分、生存质量评分和日常生活能力评分均较治疗前改善(P<0.05);补阳还五汤治疗组患者在改善疲劳严重度评分、日常生活能力评分方面优于对照组(P<0.05),两组在改善生存质量改善方面效果相近(P>0.05).结论 应用补阳还五汤加减治疗脑卒中后疲劳,能显著改善患者的疲劳程度和日常生活能力,提高生存质量,对临床指导具有较好的参考意义.

目的:观察中药复方治疗高血压患者伴发失眠症的临床疗效.方法:从家庭医生式服务签约高血压患者数据库中,筛选失眠症75例.随机分对照组25例,治疗组26例,贴敷组24例;治疗组和贴敷采用中药复方干预.观察3组匹兹堡睡眠质量指数(PSQI)、抑郁自评量表(SDS)、焦虑自评量表(SAS)和血压的改变.结果:治疗4周后,治疗组PSQI分值显著低于对照组(P<0.01),贴敷组PSQI分值也显著低于对照组(P<0.05).治疗组有效率72.6％,贴敷组有效率66.5％.结论:中药复方治疗高血压伴发失眠症疗效明显;改善睡眠质量同时,有利于改善患者的血压水平,也有利于改善患者焦虑状态.

目的:观察孙氏清带汤坐浴治疗带下病湿热蕴结证的临床疗效.方法:将100例带下病湿热蕴结证患者随机分为治疗组48例和对照组52例,对照组采用皮肤康洗液坐浴治疗,治疗组采用孙氏清带汤坐浴治疗.观察比较2组中医证候积分、阴道局部症状积分、SF-36积分及不良反应.结果:2组中医证候积分、阴道局部症状积分治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P＜0.05);2组SF-36积分比较,差异无统计学意义(P＞0.05).结论:孙氏清带汤坐浴治疗带下病湿热蕴结证有较好的临床疗效.

目的 探讨健身气功八段锦降低社区老年人跌倒风险的疗效.方法 将符合纳入标准的120例老年人随机分为2组,对照组60例依原常规生活,不安排进行特殊的运动训练;治疗组60例采用健身气功八段锦功法进行锻炼,2组疗程均为30d,比较2组治疗前后以及组间的Morse跌倒危险因素评估、Berg平衡量表评分、“起立-行走”计时测试时间、焦虑自评量表SAS评分以及SF-36健康调查量表等指标的改善情况.结果 治疗组治疗前后各项评估指标相比较,均有显著性差异(P＜0.05);经过治疗后,治疗组与对照组相比较,治疗组各项评估指标均明显优于对照组(P＜0.05).结论 健身气功八段锦锻炼在一定程度上能够有效降低社区老年人的跌倒风险.

目的 了解带下病湿热蕴结症患者的生存质量及其影响因素.方法 采用SF-36量表对符合纳入标准的16～60岁的带下病湿热蕴结证患者进行问卷调查,分析其生存质量状况和影响因素.生存质量的影响因素分析,采用多元逐步回归分析.结果 SF-36各维度得分分别为:PF:90.54±10.82、RP:69.29±34.94、BP:86.68±17.01、GH:63.05±24.47、VT:69.61±18.77、MH:74.64±19.52、SF:81.71±17.11、RE:78.12±30.25.影响患者PCS、MCS和SF-36总分的因素主要是“是否有合并病症”和“中医证候得分”.结论 带下病湿热蕴结证患者的生存质量相对偏低,其影响因素主要有“是否有合并病症”和“中医证候得分”.

Objective To observe the effectiveness of Traditional Chinese Medicine (TCM) integrated treatment programon prevention and treatment of cognitive impairment after stroke in commnity.Methods 160 patients with mild and moderate cognitive impairment after stroke were randomly divided into two groups.80 cases(4 cases fell off) in intervention group were treated by TCM integrated treatment program, and 80 cases(6 cases fell off) in control group were treated by medicine and rehabilitation.The Mini Mental Status Examination (MMSE), the Montreal Cognitive Assessment scale (MoCA) and Activities of Daily Living (ADL) before and after 3 months intervention and 1 year after stroke were conducted to evaluate the clinical curative effect.Results The scores of MMSE, MoCA and ADL after 3 months intervention and 1 year after stroke were increased in two groups (P<0.05).The scores of MMSE, MoCA and ADL1 year after stroke were higher than those after 3 months intervention in two groups (P<0.05).The scores of MMSE, MoCA and ADL after 3 months intervention and 1 year after stroke were higher than those in control group at the same period (P<0.05).The improvement of cognitive function was positively correlated with the improvement of daily living activity.Conclusion TCM integrated treatment program can increase MMSE, MoCA and ADL on cognitive impairment after stroke in community, can improve the level of cognitive function and daily living activities in a certain extent, and comprehensively improve the patient's quality of life.

Objective:This study was aimed to observe the clinical effect of modified Buyang Huanwu decoction in treating patients from community with post-stroke fatigue.Methods:Forty-four eligible patients from community with post-stroke fatigue were randomly assigned to the control group (24 cases) and the treatment group (20 cases). Patients in the control group were administered with routine treatment, while patients in the treatment group were given modified Buyang Huanwu decoction according to their signs and symptoms. After 4 weeks, the severity of fatigue (FSS) and quality of life were assessed.Results:Compared to pre-treatment, both twogroups showed significant improvement in fatigue severity and quality of life (P<0.05, P<0.01); the treatment group demonstrated significant better effect on FSS compared to the control group (P<0.01).Conclusion:The modified Buyang Huanwu decoction can significantly ameliorate fatigue, improve quality of life in patients with post-stroke fatigue and reveal good clinical efficacy.

脑卒中后患者存在认知障碍的比率为50％～75％.目前临床上西医对脑卒中后认知功能障碍主要是药物治疗和认知功能训练,但尚无统一有效的标准.近年来,关于中医药治疗脑卒中后认知障碍的临床与实验研究均取得较大进展.因此本文从中药、针刺、艾灸、推拿四个方面对中医药治疗脑卒中后认知障碍的文献进行总结和归纳.总结出目前中医药研究普遍存在的问题及今后的研究方向,为进一步充分发挥中医药治疗脑卒中后认知功能障碍的特色优势奠定了基础.

本文针对近5年来,分别对外阴熏洗法、阴道纳药法、肛门导入法、中药外敷法、多种外治法联合运用、药物外治法联合药物内服法六个方面有关带下病药物外治法的相关报道进行综述,分析目前带下病药物外治法的现状.

Objective To study the TCM constitution of senile dementia. Methods Patients with senile dementia were evaluated with the questionnaire in Fangzhuang Community Health Service Center and Community Stations. The data were analysed by descriptive analysis. Results: Among 143 cases with senile dementia,the first four types of constitutions were Qi Deficiency( 38. 5%),Yin Deficiency( 28. 7%),phlegm-dampness( 18. 2%) and blood stasis( 15.4%). The constitutions of Qi Deficiency was the most among patients of different sexes and culture degrees. The constitutions of Qi Deficiency were the most among patients of 60 ~ 70 and 80 years old,and The constitutions of Yin Deficiency were the most among patients of 60 and 70 ~ 80 years old. Conclusion: The constitutions of Qi Deficiency,Yin Deficiency,phlegm-dampness and blood stasis maybe the risk constitutions for senile dementia. There was a certain positive effect of improving those constitutions in preventing senile dementia.

Objective To study traditional Chinese medicine syndromes of the patients with senile dementia in the community.Methods The 143 patients with senile dementia in the community health service center and community station were given questionnaires and the data were analyzed by descriptive analysis. Results Among the 143 patients with senile dementia,the most basic traditional Chinese medicine syndromes were kidney deficient and encephala reduction,followed by heart and liver deficiency,sputum turbid blocking aperture,heart-spleen deficiency,qi-stagnancy and blood stasis,of which 77 cases were totally deficiency syndromes,17 cases were totally excessive syndromes and 49 cases were deficiency-excess complications. There were 70 cases of single syndrome,and the types were ordered from more to less as follows: kidney deficient and encephala reduction,sputum turbid blocking aperture,heart and liver deficiency,heartspleen deficiency,qi-stagnancy and blood stasis. There were 73 cases of composite syndromes,and the types were ordered from more to less as follows: kidney deficient and encephala reduction,heart and liver deficiency,sputum turbid blocking aperture,heart-spleen deficiency,qi-stagnancy and blood stasis. Conclusion The mechanism of senile dementia was complex and was induced by the interplay of many pathological factors. It was rare to be induced by a single mechanism. The basic mechanism of senile dementia was deficiency in origin and enrichment in symptom. For deficiency in origin,kidney deficient and encephala reduction were the most outstanding; for enrichment in symptom,sputum turbid blocking aperture played an important part.

目的 探讨社区中医药综合干预措施对脑卒中后认知障碍患者的疗效.方法 根据认知障碍的分组标准将患者分为3层,其中无认知障碍组50例、轻度认知障碍组30例和轻度血管性痴呆组30例.每层患者按照入组顺序随机分为干预组和非干预组,分别比较每层患者干预前后及干预组与非干预组之间的MMSE量表评分、MOCA量表评分和ADL指数评分,评价中医药综合干预对脑卒中后认知障碍的临床疗效.结果 无认知障碍、轻度认知障碍、轻度血管性痴呆3组患者中的干预组干预前后,干预组与非干预组之间MMSE评分比较P ＜0.05;轻度认知障碍组和轻度血管性痴呆组患者干预组与非干预组之间MOCA评分比较P＜0.05,差异有统计学意义.结论 社区中医药综合干预能提高患者的MMSE和MOCA评分,能在一定程度上改善脑卒中患者的认知功能水平,尤其是对轻度认知障碍和轻度血管性痴呆的患者效果更好.

痴呆是危害老年人身心健康的重要疾病之一.目前,对痴呆尚无较好的治疗方法.因此,痴呆同许多其他疾病一样,重在早发现、早预防.为了解居民对痴呆的知晓程度,我们进行了此项调查.

脑卒中是一组突然起病,以局灶性神经功能缺失为共同特征的急性神经系统疾病[1].在我周,脑卒中患者已达500万以上,且每年约有150万人新发病,其中大部分的患者脑卒中出院后回到社区中.由于我国仍处于社会主义发展的初级阶段,与两方发达国家相比,经济、医疗保险、社会福利等制度均不完善.因此,在我国社区中,仅有小部分的脑卒中患者能得到的社区康复服务,其中多为简单地接受传统医学的针灸治疗[2].因此,以"低成本,广覆盖"为原则,立足于社区资源,制定适宜的脑卒中社区康复方案,提高卫生保健工作的社会效益,是目前卫生工作的迫切任务之一[3].

<正>1资料与方法1.1调查对象的选择本研究采用分层整群抽样方法抽取来自福建省福州市7个、厦门市3个社区卫生服务中心的部分管理人员、康复医师,填写自拟《福建省社区康复投入及普及力度调查研究表》。