在临床上虽规范口服阿司匹林,但仍发生血栓栓塞事件的现象被称为阿司匹林抵抗(AR).西医应对AR的策略有疗效欠佳、价格昂贵、出血风险高等弊端.现基于"从瘀论治"理论,分析了瘀血在脑卒中AR的形成过程中的重要意义,并系统地探讨了活血化瘀药治疗脑卒中AR的作用机制,旨在提高中医对脑卒中AR的认识,更好地发挥中医药在治疗AR方面的优势.

目的:超声引导下针刺肌筋膜疼痛触发点治疗腰臀部肌筋膜疼痛综合征(MPS)的临床疗效观察与评价.方法:选取2020年6月至2020年7月收治的腰臀部肌筋膜疼痛综合征患者30例,采用超声引导下针刺激痛点治疗,观察患者治疗前、首次治疗后和疗程结束后VAS评分,激痛点处弹性模量(E),激痛点与同水平正常组织应变比(SR).结果:患者VAS治疗前后对比差异有统计学意义(P＜0.05);激痛点处弹性模量治疗前、首次治疗与疗程后差异有统计学意义(P＜0.05);激痛点与同水平肌肉组织应变比(SR)治疗前、首次治疗与疗程后比较,差异有统计学意义(P＜0.05).结论:超声引导下针刺治疗腰臀部肌筋膜疼痛综合征能改善局部软组织弹性,改变局部形变能力,且具有较好的临床疗效,值得临床推广应用.

目的:通过对病因病机的分析,初探新型冠状病毒肺炎的辨证论治,以期对本病的中医诊疗提供临床思路.方法:通过对《温病学》研习、深入疫区中医专家对本病的分析及各省卫建委发布的新型冠状病毒感染的肺炎中医药治疗方案,对本病的辨证论治进行探析.结果:早期多以感受湿邪疫毒之气为主,且偏寒湿,治疗以散寒除湿,透邪芳香辟秽为主;随着病情进展,湿郁化热,湿毒热充斥肺脏,损伤肺络,热壅肠腑,治疗以清热解毒,化湿通腑为主;若上述两个阶段未遏制,则病邪进一步深入,导致内陷心包,出现内闭外脱之证,闭症以泻火除湿,开窍醒神为主,脱症以回阳救逆为主;恢复期正虚邪恋,正虚则以气阴两虚和脾气亏损为要,余邪仍以湿为患,故在治疗上益气养阴,健脾利湿.结论:新型冠状病毒肺炎致病因素以“湿”邪为主,“湿、毒、瘀、闭”为主要病机,肺脾为主要病位,治疗上以化湿解毒,避秽化浊,开窍醒神为主,全程应重视固护脾胃,避免过度使用寒凉药物.

目的:运用有限元分析方法,对智能气囊小夹板通过动力气囊压垫调整压强纠正桡骨远端手法复位后残余成角移位的角度大小进行量化研究,以期验证智能气囊小夹板纠正残余成角移位的可行性,指导临床创新与应用.方法:采用Mimics 15.0、Imageware 13.0、Ansysworkbench 15.0等有限元分析软件仿真建造桡骨远端AO C3.1型骨折掌侧成角30°移位、旋转成角30°移位模型,通过生物力学云图分布特点,分析其残余移位纠正后的固定稳定性及动力气囊压垫压强,调整压强大小与纠正残余成角移位角度大小的量化关系.结果:残余移位纠正后,腕部生物力学云图分布主要集中在桡腕关节处.纠正5°掌侧成角移位,需要调整气囊压垫的压强大小为4.7 kPa,纠正5°旋转成角为3.3 kPa.结论:智能气囊小夹板可通过动力气囊压垫压强的调整,纠正桡骨远端AO C3.1型骨折手法复位后残余成角移位,且复位后固定稳定,并防止骨折再移位.

目的 了解西安地区骨质疏松症的患病现状,分析引起该疾病的影响因素及中医证型分布规律,为该地区骨质疏松的中西医防治工作提供依据.方法 选取2017年6月～2019年6月我院就诊的500例患者作为研究对象,根据双能X线骨密度测定分为骨量正常组、骨量减少组和骨质疏松组,比较三组不同临床特征,并分析骨质疏松组中医证型分布规律.结果 经骨密度测定,骨量正常组146例,骨量减少组228例,骨质疏松组126例.三组性别、年龄、运动量、父母脆性骨折史比较,差异有统计学意义(P<0.05);三组BMI、饮酒、饮用浓茶、糖尿病史比较,差异无统计学意义(P>0.05).骨质疏松组中医证型分布中肝肾不足41例(33.84％),脾肾两虚40例(33.05％),脾肾两虚兼血瘀45例(37.19％),不同证型间分布比较,差异无统计学意义(P>0.05).结论 西安地区骨质疏松症与性别、年龄、运动量、家族史因素相关,临床应根据以上因素给予重点关注;中医证型以肝肾不足、脾肾两虚及脾肾两虚兼血瘀为主,中医防治骨质疏松当以肾为本,调和肝、脾、肾三脏,辅以活血化瘀.

BACKGROUND: Osteoporosis, known as "a quiet epidemic disease", is an "invisible killer" that impairs the health of the elderly. Fracture as the most dangerous complication of osteoporosis is not only a medical problem, but also a serious social problem. OBJECTIVE: To summarize the selection, establishment methods, characters and evaluation of the animal model of osteoporosis. METHODS: A computed-based search of CBM, WanFang, VIP, CNKI and PubMed databases was conducted for the relevant articles published from January 1986 to December 2016 using the keywords of "osteoporosis, animal models" in English and Chinese, respectively. Finally 39 articles were included for result analysis after reading the title and abstract. RESULTS AND CONCLUSION: Animal experiments play an important role in the studies of osteoporosis, so a desirable animal model should hold similarity, reliability, repeatability, applicability, controllability, efficacy and economy. Osteoporosis is a progressive and long-lasting disease that has different characteristics at different stages. But an animal model only simulates one etiology, one stage, major symptoms and pathophysiological changes, and cannot exhibit the whole pathological changes. The current study suggests that animal species and modeling methods can affect the characters of models, and there is a lack of standards for animal age, feeding methods, modeling time and assessment.

目的:观察活络止痛软膏局部涂擦结合运动疗法治疗肩周炎的临床疗效.方法:将160例肩周炎患者随机分为治疗组和对照组各80例,治疗4周后比较两组的临床症状积分和疗效.结果:治疗组总有效率为97.5％,对照组总有效率为96.3％,两组临床疗效比较,差异无统计学意义(P＞0.05);两组治疗前后疼痛VAS评分均降低,差异有统计学意义(P＜0.05);两组患者治疗后肩关节功能Constant Murley评分均增加,差异均有统计学意义(P＜0.05);治疗后两组疼痛VAS评分、肩关节功能Constant Murley评分比较,差异均无统计学意义(P＞0.05).结论:活络止痛软膏结合运动疗法治疗肩周炎有一定疗效,能有效缓解疼痛.

Objective:To survey curative effects ofHuoLuo ZhiTong ointment combined with acupuncture in treating knee osteoatthritis (KOA) of liver-kidney deficiency pattern.Methods:All 160 patients were randomized into two groups,80 cases each group.Both groups adopted acupuncture,the affected knees of the observation group were painted with HuoLuo ZhiTong ointment,5 g each time,twice to three times each day,and softly rubbed for three to five minutes.The ones in the control group with Votalin ointment,5g each time,twice to three times each day,and softly rubbed for three to five minutes.Both groups were treated for four weeks externally.Results:Total effective rates of the observation group and the control group were 92.50％ and 91.25％,and the difference had no statistical meaning (P＞0.05).The difference had statistical meaning in the comparisons of clinical manifestation scales and syndrome scales between before and after treating within two groups (P＜0.05);the difference had no statistical meaning in the comparison between both groups after treating (P＜0.05).Conclusion:HuoLuo ZhiTong ointment combined with acupuncture could effectively relieve the symptoms of KOA patients,and the therapy could obtain notable effects.

目的 观察采用中药熏蒸、外敷及患肢皮肤牵引配合髋关节功能锻炼综合疗法治疗强直性脊柱炎性髋关节滑膜炎的临床疗效.方法 治疗组给予中药熏蒸、中药外敷、下肢牵引、关节功能锻炼等综合疗法治疗,对照组给予柳氮磺胺吡啶片,塞来昔布治疗.结果 治疗后2组患者Harris评分均有改善,治疗组高于对照组(P＜0.05),治疗组临床疗效优于对照组(P＜0.05).结论 中药熏蒸、外敷,结合患髋下肢牵引和关节功能锻炼等综合疗法能有效改善强直性脊柱炎所致髋关节滑膜炎的临床症状,疗效可靠,且无明显不良反应,值得临床应用推广.

Osteoporosis is a systemic skeletal disease,characterized by reduced bone strength and increased risk for fractures,which is known as the "silent epidemic" and the "invisible killer" of old people which taken away the health of the elderly.The medical profession has put the three diseases,including the prevention and treatment of osteoporosis and the prevention of fracture,the treatment of high blood pressure and the prevention of stroke,the treatment of hyperlipidemia and the prevention of myocardial infraction,of equal importance.Along with our country entering into an ageing population,the incidence of osteoporosis (OP) rises year by year.Primary osteoporosis is a systemic bone disease common in the elderly,more common in women than men,and is common in postmenopausal women and the elderly,mainly includes type Ⅰ postmenopausal osteoporosis and type Ⅱ senile osteoporosis.In recent years,the treatment of osteoporosis has made significant progress,Chinese and Western medicine combined treatment for osteoporosis has become the new trend for future research.In this article,the current status and research progress of traditional Chinese and Western medicine combined treatment for primary osteoporosis were summarized.

目的 观察分析42例外用滑膜膏联合口服四妙丸治疗创伤性踝关节滑膜炎的临床疗效.方法 将84例创伤性踝关节滑膜炎患者随机分为治疗组42例和对照组42例,治疗2周后比较两组的疗效和临床症状积分.结果 经过治疗,两组病人的病情均明显好转,治疗后两组临床疗效比较差异无统计学意义(P＞0.05).结论 外用滑膜膏联合口服四妙丸的内外兼治疗法能够有效缓解患者创伤性踝关节滑膜炎的症状,疗效显著,值得临床推广使用.

目的:观察活络止痛软膏配合体外冲击波治疗足底筋膜炎的临床疗效.方法:将足底筋膜炎患者124例随机分为治疗组和对照组各62例,2组均予体外冲击波疗法,2次/周,4次为1个疗程,治疗组、对照组在此基础上分别外用活络止痛软膏、双氯芬酸二乙胺乳胶剂5 g/次,2～3次/d,足底涂擦并轻揉3～5分钟,使药物全部吸收,治疗2周后,比较2组的疗效及临床症状积分.结果:治疗后2组患者的疼痛积分均较治疗前好转(P＜0.05),治疗后2组临床疗效和疼痛积分比较差异无统计学意义(P＞0.05).结论:活络止痛软膏配合体外冲击波疗法能够有效缓解足底筋膜炎症状,与双氯芬酸二乙胺乳胶剂配合体外冲击波疗法效果相当.

目的：探讨外敷滑膜膏配合口服四妙丸治疗踝关节滑膜炎的临床疗效及安全性。方法：2012年1月至2014年12月，采用外敷滑膜膏配合口服四妙丸治疗踝关节滑膜炎患者42例，男19例、女23例。年龄18～42岁，中位数28岁。单侧病变41例，其中左侧20例、右侧21例；双侧病变1例。病程2～14 d，中位数4．5 d。治疗后随访观察踝关节功能恢复及不良反应发生情况。结果：所有患者均获随访，随访时间1～13个月，中位数3个月。1例患者用膏药后局部出现瘙痒等轻微皮肤过敏症状，涂擦皮炎平软膏后症状消失。采用参照《中医病证诊断疗效标准》中膝关节滑膜炎疗效标准制定的标准评价疗效，治愈29例、好转12例、无效1例。结论：外敷滑膜膏配合口服四妙丸治疗踝关节滑膜炎，具有操作简单、效果明显、不良反应少等优点，有助于促进踝关节功能恢复，值得临床推广应用。

目的：观察通经止痛中药熏蒸为主对腰椎间盘突出症急性期的治疗效果。方法：选择我院收治的103例急性腰椎间盘突出症患者随机分为两组，对照组51例，单纯采用手法回纳治疗；治疗组52例采用通经止痛中药熏蒸协同手法回纳治疗，对两组患者临床疗效，治疗前后脊柱曲度异常程度以及髓核对神经根、硬囊膜的压迫程度进行对比观察。结果：与治疗前及对照组相比，治疗后治疗组的临床总有效率显著升高（P＜0．05），VAS评分显著降低（P＜0．05），脊柱曲度异常程度及髓核对神经根、硬囊膜的压迫程度显著改善（P＜0．05）。结论：通经止痛中药熏蒸协同手法回纳治疗对腰椎间盘突出症急性期效果良好，能减轻疼痛，改善压迫症状。

目的:观察跌打止痛膏联合RICE基础疗法治疗急性踝关节扭伤的临床疗效.方法:将76例急性踝关节扭伤患者随机分为治疗组和对照组各38例,在RICE疗法治疗基础上,治疗组予局部外敷跌打止痛膏,对照组外用云南白药膏,治疗2周后比较两组的临床症状积分和疗效.结果:总有效率治疗组为94.74％,对照组为92.11％,两组差异无统计学意义(P＞0.05);治疗后两组临床症状积分比较,差异无统计学意义(P＞0.05).结论:跌打止痛膏有良好的消肿止痛功效,治疗急性踝关节扭伤疗效与云南白药相当,值得临床推广使用.

目的:观察强腰活络方治疗腰椎间盘突出症的临床疗效.方法:120例患者被随机分配进入对照组和观察组,每组各60例.对照组给予推拿治疗,观察组在对照组治疗的基础上服用强腰活络方.结果:对照组有效率为75.00％,观察组有效率为86.67％,两组有效率比较,差异具有统计学意义(P＜0.05).治疗后VAS评分及Oswestry功能障碍指数、JOA评分与本组治疗前比较,具有统计学差异(P＜0.05);治疗后组间比较,差异具有统计学意义(P＜0.05).结论:强腰活络方能改善腰椎间盘突出症临床症状,临床疗效显著.

Objective:To discuss curative effects of HuoLuo ZhiTong ointment,manipulation and functional exercise in the treatment for osteoarthritis(OA).Method:All 90 patients were randomized into the treatment group and the control group,both groups accepted manipulation and functional exercise,the treatment group were applied with HuoLuo ZhiTong ointment locally and the control group with diclofenac diethylamine emulgel,especially the pain point,after the drug was applied,massaging the local slightly for two to three minutes,twice per day,clinical symptom scale and therapeutic effects were compared after treating for four weeks.Result:The difference had no statistical meaning in clinical symptom scale and therapeutic effects in both groups after treating(P>0.05),but the d ifference had statistical meaning when one group before treating was compared with the one after treating(P<0.05).Conclusion:HuoLuo ZhiTong ointment,manipulation and functional exercise are effective in the treatment for OA,similar to clinical effects of diclofenac diethylamine emulgel.

膝关节骨性关节炎(Knee Osteoarthritis,KOA)好发于中老年人,是骨伤科临床的常见多发病,属中医痹证范畴.我们采用本院制剂活络止痛软膏局部涂擦治疗肝肾不足、筋脉瘀滞型膝关节骨性关节炎49例,取得了满意的疗效,现报告如下. 1 临床资料 1.1 一般资料 所有病例来自于西安市中医医院2012年1月-2012年10月骨伤科门诊,膝OA患者共100例,随机分成治疗组与对照组.治疗组49例:男21例,女28例;病程3月～110月;年龄41～75岁,平均59.5岁.对照组51例:男23例,女28例;病程3月～110月;年龄42～73岁,平均58.6岁.两组患者年龄、性别、病程、治疗前临床表现积分等比较差异无统计学意义(P＞0.05).

目的探讨尺骨冠状突骨折及合并证的诊断与治疗。方法从2003年1月～2008年4月,诊治疗冠状突骨折58例,根据骨折脱位情况采用保守及手术治疗。结果随访6月～36月。未见关节不稳情况。结论冠状突骨折合并其它骨折脱位是一种较复杂的损伤,恢复肘关节的基本结构和肱尺关节的稳定性是治疗的关键。

目的:观察利湿消肿、散寒止痛类中药熏洗配合关节镜手术治疗膝骨性关节炎的疗效。方法:采用消肿止痛熏洗方(川草乌、威灵仙、桑枝、木瓜、红花、伸筋草、透骨草等)配合关节镜手术(镜下骨赘切除)治疗本病46例。结果:优良率76.7%。结论:本方法对本病具有清除骨赘,扩大骨关节,缓解肿痛的疗效。