目的:探讨岭南伤科验方联合椎旁封闭治疗骨质疏松性中位胸椎骨折PVP术后残余痛的临床疗效.方法:选取2021年1月至2022年1月我院收治的40例骨质疏松性中位胸椎骨折PVP术后残余痛患者,按照随机数字法,分为对照组与治疗组各30例.治疗组采用岭南伤科验方口服,配合椎旁封闭.对照组采用龙血竭胶囊口服,配合病变椎体两侧膀胱经的穴位针刺,疗程14天.比较治疗前后胸背痛视觉模拟评分法(VAS)、卧床下地时间、Oswestry功能障碍指数(ODI).结果:与治疗前相比,两组VAS评分、卧床下地时间、ODI明显下降,比较有显著性差异(P<0.05),且治疗组比对照组改善明显(P<0.05).结论:岭南伤科验方联合椎旁封闭治疗骨质疏松性中位胸椎骨折PVP术后残余痛的疗效优越,且安全性良好.

目的:探讨胶七散联合鸡尾酒疗法对晚期膝骨关节炎患者全膝关节置换术隐性失血及术后功能恢复的影响.方法:选择晚期膝骨关节炎行全膝关节置换术治疗的患者76例,随机分成治疗组与对照组各38例,常规完善术前检查、准备后由同一组医师完成全膝关节置换术,手术结束在松开止血带前关节腔注射鸡尾酒(氨甲环酸3 g与肾上腺素0.25 mg溶于50 mL生理盐水配制而成),术后予相同的抗凝、局部冰敷、指导功能康复锻炼等治疗.治疗组在对照组基础上,于术前3d至术后第7天服用胶七散(三七粉、阿胶粉各6 g).比较两组患者总失血量、显性失血量、隐性失血量、异体输血率、不良事件情况、住院总天数、功能恢复情况等指标.结果:两组患者围手术期显性失血量、异体输血率、开始直腿抬高时间及术后不良事件比较,差异无统计学意义(P＞0.05).总失血量、隐性失血量、住院总天数及术后3个月美国特种外科医院膝关节功能评分比较,治疗组优于对照组,差异有统计学意义(P＜0.05).结论:胶七散联合鸡尾酒疗法可减少晚期膝骨关节炎患者全膝关节置换术的总失血及隐性失血,有利于术后功能恢复.

目的 观察岭南正骨手法闭合复位结合平行双针内固定治疗复杂型儿童肱骨髁上骨折的临床疗效.方法 选择34例复杂型(GartlandⅢ型及Ⅳ型)肱骨髁上骨折患儿,采用岭南正骨手法闭合复位后,采用经皮平行双针固定骨折端,术后用石膏托固定肘关节于伸肘110°前臂旋后位.定期随访,观察患儿骨折愈合情况、肘关节功能及并发症发生率.结果 34例均闭合复位成功,均获随访.所有患儿均未发生血管损伤、Volkmann挛缩、肘内翻畸形等并发症;随访18个月时Flynn肘关节功能评分为优25例、良6例、一般3例,优良率为91.2％(31/34).结论 采用岭南正骨手法闭合复位结合平行双针内固定治疗复杂型儿童肱骨髁上骨折,可有效地恢复骨折端的生物力学稳定性,局部创伤小,骨折愈合良好,肘关节功能恢复满意.

目的:通过观察肾俞募配穴埋线法对SD大鼠去势后的骨组织形态、骨密度、骨代谢、细胞因子及OPG/RANK/RANKL系统的影响,探讨肾俞募配穴埋线法对大鼠去势后抑制骨质流失的相须效应及分子机制.方法:50只SD大鼠随机分为5组:假手术组(Sham)、模型组(OVX)、俞穴埋线组(双肾俞)(OVX+S)、募穴埋线组(双京门)(OVX+M)、俞募配穴埋线组(双肾俞、双京门)(OVX+ SM),采用埋线法进行干预.12周后处死大鼠,采用HE染色观察各实验组大鼠股骨组织形态,骨密度仪器测量骨密度,自动化分析仪测量血清中的Ca、P、ALP、E2、PTH,ELISA检测血清中的IGF-1、IL-6、TNF-α,RT-PCR及Western blot检测骨组织中OPG、RANKL mRNA及蛋白表达.结果:12周后,OVX+S组、OVX +SM组的骨密度、骨组织形态、血清E2、IGF-1水平明显优于OVX组(P＜0.05,P＜0.01),血清ALP、PTH、IL-6、TNF-α明显低于OVX组(Ca、P除外)(P ＜0.05,P＜0.01),而OVX+ SM组更明显(P ＜0.05,P＜0.01),OVX+M组效果较差(P ＜0.05,P＞0.05).在骨组织中RANKL、OPG基因mRNA与蛋白表达的比值也是如此(P ＜0.05,P＜0.01).结论:肾俞募配穴埋线法在大鼠去势后抑制骨质流失具有比较好的相须效应,其作用可能通过OPG/RANK/RANKL系统抑制破骨细胞的吸收来完成的.

Objective To analyze the clinical features of middle thoracic osteoporotic vertebral compression fractures (OVCF) and evaluate the efficiency of percutaneous vertebroplasty (PVP) on them.Methods Forty-six cases of OVCFs in middle thoracic vertebra were retrospectively analyzed between December 2013 and March 2017,which were treated by PVP of unilateral puncture.Clinical features of the OVCFs were analyzed based on pathography,clinical manifestation and physical sign,underlying diseases,bone mineral density and imaging.The scores of visual analogue scale (VAS) of chest and back pain,activities of daily living (ADL),the middle vertebral height ratio and Cobb angle of injured vertebra were compared preoperatively,3 d and 1 month postoperatively.Results Clinical features of middle thoracic OVCFs were chest pain,back pain and difficulty of getting out of bed and laying down.Some had difficulty in lying on the back and turning over (excluding abnormal cardio-pulmonary function).Most of them did not have the traumatic history,but they had low bone mineral density and multiple segments of old fractures in low thoracic and lumbar spine.There were significant differences in the scores of VAS and ADL before operation,3 days and 1 month after operation (P ＜0.05),and the indexes 3 days and 1 month after operation were obviously improved,compared with that before operation.Furthermore,the scores of VAS and ADL 1 month after the operation were better than that 3 day after the operation.But there were no statistic difference in the middle vertebral height ratio and Cobb angle before the operation,3 days and 1 month after the operation (P ＞0.05).Conclusion PVP is effective and safe to treat OVCF in middle thoracic vertebra.But for some cases with chest pain,especially in patients with difficulty in lying on the back,further treatments are needed.

目的:观察软组织微创术治疗髂腰韧带损伤的临床疗效.方法:选取2013年8月～2015年8月髂腰韧带损伤患者70例,随机分为治疗组和对照组各35例.治疗组采用软组织微创术,对照组采用手法推拿加针灸治疗,两组均每天治疗1次,3次为1个疗程,治疗结束后比较两组临床疗效.结果:治疗组总有效率显著高于对照组(P＜0.05).结论:软组织微创术治疗髂腰韧带损伤的临床疗效较满意,且无毒副作用,治疗过程痛苦小,易被患者接受,值得临床推广.

Objective:To investigate the efficacy of minimally invasive lysis of the positive points and fat pads on neck and shoulder for cervical spondylosis. Methods:30 cases of patients with cervical spondylosis were all treated by minimally invasive lysis of the positive points and fat pads on neck and shoulder, and observed their efficacy. Results:1 case was cured, 20 cases had marked effect, 6 cases turned better and 3 cases invalid, the total effective rate was 90.0%. Conclusion:The treatment of minimally invasive lysis has a good effect on the cervical spondylosis that caused by cervical biomechanical imbalance, which is one of the effective treatments for cervical spondylosis.