呃逆,俗称“打嗝”,是以气逆上冲,喉间呃呃连声,声短而频,难以自制为主要临床表现的病症[1].西医学称之为“膈肌痉挛”.临床上一般将连续发作＞72h,经常规治疗无效的呃逆称为顽固性呃逆[2].目前临床治疗顽固性呃逆的方法很多,中医多采用中药口服、经穴针灸或特殊穴位药物注射、刺血拔罐等方法结合理疗治疗为主;西医多应用局部神经封闭和口服抗精神病药、抗抑郁药、中枢兴奋药、抗胆碱药等治疗为主.笔者临床中应用推拿手法治愈顽固性呃逆1例,取得佳效,现报告如下.

Objective:to observe the clinical curative effect of needle knife in combination with functional exercise to treat frozen shoulder.Methods:80 patients with frozen shoulder were divided into treatment group and control group,40 cases in each group.The treatment group used acupuncture combined with functional exercise,control group were treated by ac upuncture combined with functional exercise.Acupotomologic therapy 1 times a week,take the method of acupuncture treatment of local acupoints along meridians and acupoints combined with acupuncture,1 times daily,for 30min,functional exercise in the morning and 1 times,each time 10～20 min,for three weeks.In before and after treatment with ConstantMurley score method to evaluate the clinical curative effect of 2 groups:Constant shoulder score.Results:The treatment group of 40 cases,23 cases were cured,9 cases markedly effective,6 cases effective,2 cases ineffective.The cure rate:57.5％,the total efficiency of 95 ％;control group of 40 cases,1 cases of loss,11 cases were cured,10 cases markedly effective,12cases effective,6cases ineffective.The cure rate:27.5 ％,the total efficiency of 85.0 ％.After treatment,the Constant-Murley scores of 2 groups were higher than before treatment(P＜0.05).Compared with the 2 groups after treatment,the Constant-Murley score(P＜0.05),the cure rate and tbeeffective rate of the treatment group were higher than those of the control group.Conclusion:needle knife combined with functional exercise treatment of frozen shoulder clinical curative effect is distinct and is superior to the acupuncture combined with functional exercise.

Objective To provide clinical and experimental basis for the V-Y tendoplasty for the treatment of chronic achilles tendon rupture and describe the surgical techniques. Methods Seventy-three NewZealand white rabbits, in which chronic achilles tendon rupture model were established previouly, were treated with V-Y tendoplasty and Lindholm procedure. Postoperative histological studies and biomechanical test were carried out. Twelve patients who had a torn achilles tendon for an average of 135 days were treated with V-Y tendoplasty. The mean period of follow up was 6.5 years. The long term result was assessed with Arner-Lindholm method and radiological, ultrasonic examination were also performed. Results 1)The experimental studies showed that blood circulation of achilles tendon were not affected after the V-Y tendoplasty. The postoperative biomechanical characteristics of achilles tendon were more favorable than that of Lindholm procedure's. 2)According to Arner-Lindholm criteria 10 patients had the excellent results (83.3%), 2 patients had good results (16.7%). The percentage of excellent and good results were 100%. 3)The postoperative radiological and ultrasonic test results showed that there was overall thickening of whole achilles tendon. The array of tendon fibres was nearly normal. Calcification of achilles tendon were found in 2 patients. Conclusion V-Y tendoplasty might be a procedure of choice to treat chronic achilles tendon rupture.