目的:观察中医定向透药联合任务导向训练治疗中风后肢体功能障碍的临床疗效.方法:选取2018年9月～2021年9月收治的240例中风后肢体功能障碍患者,采用随机数字表法分为对照组(120例)和联合组(120例).对照组采用任务导向训练治疗,联合组在对照组基础上加用中医定向透药治疗.比较两组临床疗效、治疗前后的肢体功能恢复情况、躯体平衡控制能力、步行能力.结果:联合组总有效率98.33％,明显高于对照组的88.33％(P＜0.05).治疗后,两组上肢、下肢评分及Fugl-Meyer运动功能(FMA)评分均显著上升,且联合组上升更显著(P＜0.05).治疗后,两组Sheikh躯干控制能力评分和Berg平衡量表(BBS)评分均显著上升,且联合组上升更显著(P＜0.05).治疗后,两组10 m步行时间均明显缩短,6min步行距离均明显增加,且联合组优于对照组(P＜0.05).结论:采用中医定向透药联合任务导向训练治疗中风后肢体功能障碍患者效果明显,可显著改善患者肢体功能、躯体平衡控制能力、步行能力,值得临床推广.

目的:探讨水罐疗法联合白头翁汤灌肠对溃疡性结肠炎(UC)患者Th1/Th2免疫平衡及肠黏膜屏障功能的影响.方法:选取2020年2月～2022年5月期间湖南中医药大学第一附属医院收治的UC患者100例.根据随机数字表法分为对照组(n=50)和研究组(n=50).对照组患者接受白头翁汤灌肠,研究组在此基础上接受水罐疗法.对比两组疗效、中医证候评分、Th1/Th2免疫平衡及肠黏膜屏障功能变化情况.结果:研究组的总有效率明显高于对照组(P＜0.05).治疗后,两组里急后重、身热不扬、腹泻黏液脓血使、小便短赤、肛门灼热、腹痛、口干口苦等症状评分均降低,且研究组低于对照组同期(P＜0.05).治疗后,两组Th1/Th2相关指标白介素(IL)-2、γ-干扰素(IFN-y)均降低,且研究组较对照组低;IL-4、IL-10均升高,且研究组较对照组高(P＜0.05).治疗后,两组肠黏膜屏障功能指标二胺氧化酶(DAO)、D-乳酸(D-LA)均降低,且研究组低于对照组同期(P＜0.05).结论:水罐疗法联合白头翁汤灌肠治疗UC患者,总有效率高,可缓解中医证候,疗效显著,对调节患者的Th1/Th2免疫平衡及肠黏膜屏障功能具有重要作用.

目的:分析近15年中医药干预化疗后周围神经毒性(CIPN)的现状,揭示研究热点与前沿.方法:检索中国知网(CNKI)、万方数据(WANFANG DATA)、维普中文科技期刊数据库(VIP)、中国生物医学文献服务系统(SinoMed)四大数据库自2006年1月1日至2022年11月15日发表的与化疗后周围神经毒性主题相关的文献,运用CiteSpace5.8.R3软件绘制图谱并解读.结果:共纳入388篇文献,发文整体呈上升趋势;发文量最多的作者是娄彦妮;发文量最多的期刊是《新中医》;分别形成以娄彦妮、孙一予、姚丽秋为核心的3个研究团队;发文量最多的机构是北京中医药大学;且形成以广州中医药大学及其第一附属医院、上海中医药大学附属龙华医院与上海中医药大学为代表的一系列机构较为显著的合作群;该领域主要研究热点为中医药干预CIPN临床疗效观察、中医理论研究与改善免疫功能方面的研究.结论:作者及机构间研究合作较少;建议加强地区间机构间合作;目前研究主要集中于CIPN的中医药防治策略、中医干预方法对机体免疫功能指标等影响的机制研究.

Objective:To explore the teaching experience of clinical teaching teachers in master of integrated traditional Chinese and western medicine nursing, so as to provide a reference for improving the training quality of master of integrated Chinese and western medicine nursing.Methods:From March to May 2022, a total of 14 clinical teaching teachers of integrated traditional Chinese and western medicine nursing in the First Affiliated Hospital of Hunan University of were enrolled using the objective sampling method and investigated by the semi-structured face-to-face interview. Content analysis was used to analyze the interview results.Results:Five themes were extracted, namely, the practice ability of nursing graduate students needs to be improved, the evaluation methods of clinical practice ability of graduate students need to be more diversified, teaching benefits teachers as well as students; difficulties of teaching (conflicts between teachers' clinical work and teaching, unclear orientation of postgraduate clinical practice learning) , hope to get support (improve scientific research ability, improve theoretical knowledge of traditional Chinese medicine, guarantee the clinical practice and study time of graduate students) .Conclusions:A variety of practice approaches should be provided for the training in master of integrated traditional Chinese and western medicine nursing graduate students, to improve students' clinical practice ability and professional identity, strengthen clinical teacher training, improve teachers' ability, and continuously improve the clinical practice training model and the quality of talent training for nursing graduate students.

目的:对中医药领域中风早期康复的相关文献进行可视化分析,了解其研究热点和发展趋势.方法:计算机检索中国知网(CNKI)、万方数据(WANFANG DATA)、维普中文科技期刊数据库(VIP)自建库至2023年3月31日收录的中医药领域中风早期康复研究的文献.采用CiteSpace软件对研究作者、研究机构和关键词绘制可视化图谱.结果:共纳入1677篇文献,发文量呈波浪式上升,2018年发文量最多;发文期刊有《中西医结合心血管病杂志》《中医临床研究》等;主要涉及650位主要研究作者和550所研究机构,形成了以谢雁鸣和齐锡友为代表的2个主要研究团队,主要研究机构有北京中医药大学东直门医院、中国中医科学院等;关键词可归纳为疾病类型、研究内容和结局指标3类,高频关键词有脑卒中、偏瘫、中风等.结论:中医药治疗中风早期康复疗效显著且安全性高,是该领域的研究热点,通过中医药早期康复方法促进中风患者神经功能和肢体功能,提高生活质量是目前的研究趋势.

目的 应用德尔菲法构建中西医结合护理硕士专业学位(MNS)研究生的临床实践能力评价指标.方法 通过文献查阅形成中西医结合MNS研究生临床实践能力评价指标初稿,选择 28 名专家进行两轮德尔菲专家函询.结果 共进行两轮专家函询,最终构建的中西医结合MNS研究生临床实践能力评价指标包括 5 个一级指标(职业道德素养、中西医临床护理能力、护理科研能力、护理教学能力、护理管理能力)、16 个二级指标和 58 个三级指标.专家函询问卷的有效回收率均为 100%,专家权威系数分别为 0.94 和 0.97,肯德尔和谐系数分别为 0.146 和0.212(P＜0.01).结论 本方案构建科学、实用,可为中西医结合MNS研究生临床实践能力的培养、考核及评价提供参考依据.

目的:评价龙胆泻肝汤为基本方联合其他疗法干预带状疱疹后神经痛的效果.方法:计算机检索万方、CNKI、维普、中国生物文献数据库、PubMed、Embase等数据库,检索范围为自建库至2022年5月1日以龙胆泻肝汤为基本方联合其他疗法干预带状疱疹后神经痛的临床随机对照试验(RCTS),筛选符合要求的文献并进行数据整理和分析,采用RevMan 5.3软件进行Meta分析.结果:共纳入9篇RCT文献,其中试验组415例,对照组414例.Meta分析结果显示与对照组比较,龙胆泻肝汤能显著降低带状疱疹后神经痛状况.总有效率[OR=7.07,95％CI=(4.26,11.72),P<0.00001],治愈率[RR=1.73,95％CI=(1.34,2.23),P<0.0001],VAS改善情况[MD=?1.78,95％CI=(?2.49,?1.06),P<0.00001],生存质量改善情况[(MD=?1.14,95％CI=(?1.29,?0.98),P<0.00001],CD4+/CD8+变化情况[MD=0.27,95％CI=(0.20,0.34),P<0.00001].结论:龙胆泻肝汤联合其他疗法干预带状疱疹后神经痛具有显著疗效,可改善患者疼痛状况,改善患者睡眠质量,后期仍需大样本、高质量、多中心的临床随机试验进一步验证临床疗效.

Objective:The aim of this study is to investigate the efficacy of moxibustion combined with an ear acupoint pressing bean in the treatment of patients with phlegm stasis syndrome vertigo.Methods:60 patients with vertigo identified as phlegm stasis syndrome who were hospitalized in our department from May 2020 to May 2021 were selected and divided into a control group and a treatment group of 30 cases each according to the random number method. The control group was treated with conventional treatment and care, and the treatment group was treated with moxibustion combined with ear acupressing beans on top of the conventional group. The treatment effects, the dizziness disorder inventory (DHI), Pittsburgh sleep quality index (PSQI), Hamilton anxiety score (HAMA), TCM symptom score, and blood flow parameters (left vertebral artery flow velocity (LVA), right vertebral artery flow velocity (RVA), and basilar artery flow velocity (BA)) of the two groups were compared with each other during and after the treatment.Results:After implementation, the treatment efficiency of the treatment group was higher than that of the control group, and the treatment group had lower PSQI, HAMA, and DHI scores as well as TCM symptom scores such as vertigo, head heavy as a wrap, chest tightness, and nausea and vomiting than the control group (P < 0.05). In addition, LVA, RVA, and BA were all higher in the treatment group than in the control group after treatment (P < 0.05).Conclusion:Moxibustion combined with ear acupoint pressing bean treatment can clearly improve patients' sleep quality, psychological state, relieve patients' various symptoms caused by vertigo, improve blood flow parameters, and have better efficacy in the treatment of phlegm stasis syndrome vertigo.

目的:探讨水罐疗法联合康复新液保留灌肠对溃疡性结肠炎患者血清神经内分泌因子的影响.方法:选取2019年1月～2021年1月收治的80例溃疡性结肠炎患者,通过随机数字表法均分为传统组和试验组.传统组实施康复新液保留灌肠治疗,试验组在传统组基础上加用水罐疗法治疗.比较两组临床疗效,包括治疗前后的中医证候积分、肠道黏膜屏障功能、血清神经内分泌因子水平.结果:传统组总有效率80.00％,试验组总有效率95.00％,两组比较,有显著性差异(P＜0.05).治疗后两组腹泻、腹痛、里急后重、黏液脓血便、腹胀评分均显著下降,相比传统组,试验组明显更低(P＜0.05).治疗后两组二胺氧化酶(DAO)、D-乳酸(D-LA)水平均显著下降,相比传统组,试验组明显更低(P＜0.05).治疗后P物质(SP)水平均显著下降,相比传统组,试验组明显更低;血管活性肠肽(VIP)水平均显著提高,相比传统组,试验组明显更高(P＜0.05).结论:对溃疡性结肠炎患者应用水罐疗法联合康复新液保留灌肠治疗,疗效满意,可明显降低中医证候积分,改善肠道黏膜屏障功能和血清神经内分泌因子水平,值得推广.

隔离酒店是新型冠状病毒肺炎(简称新冠肺炎)外防输入、内防反弹的重要防线,隔离酒店一旦出现管理漏洞,容易成为风险隐患.本文从医学观察点集中隔离防控流程管理与培训、人员职责分工与防护、区域划分与管理、消毒隔离管理、医学观察人员管理等5个方面,探讨与总结公共卫生事件下集中隔离医学观察点防控管理流程与经验,为疫情防控工作提供参考与借鉴.

Objective:To explore the effect of head scraping combined with ear acupoint embedding beans in patients with stroke and insomnia due to heart-spleen deficiency.Methods:From September 2020 to September 2021, convenience sampling was used to select 60 stroke and insomnia patients treated in the Neurology Department, the First Affiliated Hospital of Hunan University of Chinese Medicine as the research object. The patients were randomly divided into the observation group and the control group, 30 cases in each. The control group was given oral alprazolam tablets, and the observation group was given the head scraping combined with ear acupoint embedding beans on the basis of the control group. Both groups were given intervention for 14 days. The clinical efficacy, Pittsburgh Sleep Quality Index (PSQI) score, and Self-Rating Anxiety Scale (SAS) score were compared between the two groups before and after the intervention.Results:After the intervention, the SAS and PSQI scores of the two groups were lower than those before the intervention, and the SAS and PSQI scores of the observation group were lower than those of the control group, with statistical differences ( P<0.05) . After the intervention, the total clinical effective rate of the observation group was 98.7%, which was higher than that of the control group (66.7%) , with a statistically significant difference ( P<0.05) . Conclusions:Head scraping combined with ear acupoint embedding beans can effectively improve the sleep quality and anxiety of stroke and insomnia patients with heart-spleen deficiency.

目的:了解湖南省中医专科护士科研能力现状及影响因素,为本地区中医专科护士的准入、培训、考核方案提供参考.方法:采用一般资料问卷和科研能力自评量表对120名中医专科护士进行问卷调查,运用多元线性回归分析中医专科护士科研能力的影响因素.结果:纳入的中医专科护士科研能力总分为(31.66±19.65)分,处于较低水平;不同职务、不同工作年限、是否参加了科研培训的中医专科护士科研能力得分比较,差异有统计学意义(P＜0.05).结论:湖南省中医专科护士科研水平仍有待提高,医院管理部门需重视专科护士科研能力的培养,根据中医护理专业的特点及对专科护士科研能力的要求,广泛开展科研培训,全面提升专科护士科研水平,促进中医护理的高质量发展.

Objective To investigate the insomnia status and the related influencing factors of clinical nurses fighting against coronavirus disease 2019 (COVID-19) in Wuhan, so as to provide references for targeted psychological intervention during the prevention and control of the COVID-19 epidemic. Methods Convenience sampling method was conducted among clinical nurses fighting against COVID-19 in the Zhongnan Hospital of Wuhan University from Mar. 3 to 7, 2020. General information questionnaire, Athens insomnia scale (AIS) and patient health questionnaire (PHQ-9) were used, and multivariate linear regression analysis was conducted to analyze the influencing factors of insomnia in clinical nurses fighting against COVID-19. Results A total of 521 questionnaires were collected, including 504 valid ones, with an effective rate of 96.74%. The AIS score was 6 (3, 9), of which 352 (69.84%) had sleep disorder;the PHQ-9 score was 6 (2, 9), of which 292 (57.94%) had different degrees of depression. Professional title, total working time at epidemic frontline, whether the direct relatives diagnosed as COVID-19 or not, fear of the COVID-19 epidemic and depression level were included in the regression equation (all P＜0.05), which explained 56.2% of the total variation of insomnia in clinical nurses fighting against COVID-19. Conclusion Insomnia is common among clinical nurses fighting against COVID-19 in Wuhan, and the related influencing factors are complex. Nursing administrators should pay attention to the insomnia status of clinical nurses fighting against COVID-19, and all-round and effective interventions should be carried out in time, so as to improve the sleep quality of nurses.

目的 探讨保护动机理论的健康教育在新型冠状病毒肺炎(简称新冠肺炎)医学观察人员中的应用效果.方法 便利抽样法选取2020年2月—5月新冠肺炎密切接触者、疫地返乡人员、结束抗疫任务的医护人员、确诊病例出院患者等集中隔离医学观察人员809例,基于保护动机理论的健康教育,根据疫情防控要求设计集中隔离防护知信行调查问卷,对比实施健康教育前后的效果.结果 广东省、四川省、湖南省、福建省共8个集中隔离点医学观察人员实施健康教育干预前后,疫情防控知识知晓程度、信念态度及行为依从性、健康状况比较,差异具有统计学意义(P<0.05).结论 运用保护动机理论对新冠肺炎医学观察人员进行健康教育,能增强其保护动机与健康信念,促进其建立健康行为,提高新冠肺炎知识水平,并做好自身防护.

目的 评价我国护士参加新型冠状病毒肺炎救治工作的真实体验.方法 检索VIP、Wanfang、CNKI、PubMed、Medline、CBM数据库,检索时限均从2019年12月1日—2020年4月30日,查找我国护士参与国内新型冠状病毒肺炎救治期间的救治体验的质性研究,采用meta整合方法对结果进行整合.结果 共纳入14篇文献,提炼出56个结果,9个类别和3个整合结果:抗击新型冠状病毒肺炎一线护士承受着多方面的压力;抗击新型冠状病毒肺炎一线护士期望多方面的支持与指导;抗击新型冠状病毒肺炎一线护士职业认同感、价值感得到满足.结论 我国护士在参与国内新型冠状病毒肺炎救治工作期间承受着巨大的身心压力,政府和社会应给予全方位的支持与指导,以促进其全身心投入抗击新型冠状病毒肺炎一线,充分发挥个人的职业与社会价值.

目的 探讨中医院实习护生中医护理能力培养方案的应用效果.方法 选取2017年12月-2019年12月实习的223名护生为研究对象,按实习年份不同,将研究对象分为对照组和干预组,其中2017年12月-2018年12月实习的109名护生为对照组,2019年1月-2019年12月实习的114名实习生为干预组.对照组采用传统实习教学方法,干预组在对照组基础上强化中医护理能力的培养,培养方案由岗前培训、临床实践、人文素养培养、考核4个部分构成,通过理论考核、操作技能考核、中医护理能力评估、满意度调查的形式对培养效果进行评价.结果 干预组护生中医理论知识和操作技能考核评分均高于对照组,差异有统计学意义(P＜0.05).干预组中医护理能力评估总分及各条目得分均高于对照组,差异有统计学意义(P＜0.05).干预组护生对方案中的教学课程安排、教学能力、培养方式、人文环境方面的满意率高于对照组,差异有统计学意义(P＜0.05).结论 培养方案可有效提高护生中医理论知识和操作技能水平,提升中医护理能力,提高护生满意度,对其他教学医院具有借鉴和参考价值.

目的 构建综合医院护理组织应对新型冠状病毒肺炎的应急能力管理体系,旨在为护理管理者规范疫情防控管理提供科学依据.方法 基于文献分析和理论研究构建管理体系条目池和初始问卷;应用德尔菲法结合层次分析法确定指标体系及其权重.结果 2轮专家函询问卷回收率分别为100％,权威系数为0.893和0.898,判断系数为0.953和0.950,熟悉系数为0.833和0.846,肯德尔和谐系数为0.082和0.300.最终构建的综合医院护理组织应急能力管理体系包括5个一级指标、16个二级指标和66个三级指标.结论 本研究构建的综合医院护理组织应对新型冠状病毒肺炎的应急能力管理体系科学性、可靠性、指导性较强,为综合医院护理组织进行科学防疫提供了科学的指导依据.