Objective:To investigate the effects of anxiety and depressive symptoms in mediation of pain catastrophizing on disability in patients with low back pain.Methods:A cross-sectional survey was conducted among 97 patients with low back pain in the Changjiang Subdistrict community health center from July to October 2021. Oswestry Disability Index, pain catastrophic subscale in Coping Strategies Questionnaire-24, Generalized Anxiety Disorder Scale-short version, Patient Health Depression Questionnaire-short version were used to evaluate the activity dysfunction, pain catastrophic cognition and anxiety and depression levels of patients,respectively. Path analysis was implemented to test the mediation model, and the indirect effects were assessed using the bootstrap procedure with bias-corrected 95 %CI. Results:Results suggested significant positive correlations among pain catastrophizing, anxiety, depressive symptoms and disability of patients. In addition, both anxiety and depressive symptoms significantly mediated the impact of pain catastrophizing on disability (standardized indirect effects were 0.183 and 0.197, P<0.05). Patients with higher levels of pain catastrophic cognition showed higher levels of anxiety and depressive symptoms (β=0.757, 0.720; P<0.01), and reported more severe motor dysfunction (β=0.241, 0.274; P<0.05). Conclusions:Our findings suggest that anxiety and depression may be the psychological pathways through which pain catastrophizing predicts disability in patients with low back pain. Effective psychological interventions, such as emotion regulation and stress reduction strategies should be considered in treatment and supportive care for patients with low back pain.

目的:探讨对社区慢性病高血压患者采取家庭医生工作室方式药学服务管理的效果.方法:选取2018年12月-2020年8月社区慢性病高血压患者130例,随机分为两组,各65例.对照组以家庭医生工作室为主,实施疾病防治工作;干预组实施家庭医生工作室和药学服务管理措施.比较两组患者高血压疾病认知度、高血压复发情况、满意度以及生活质量评分.结果:干预组管理后高血压疾病认知度、生活质量评分、患者满意度高于对照组,高血压复发率低于对照组,差异有统计学意义(P＜0.05).结论:对社区慢性病高血压患者采取家庭医生工作室方式的药学服务管理,可使患者用药情况得到改善,使社区慢性病的控制率提升,进而保证社区居民的医疗效果.

目的 观察药学服务、运动锻炼联合生物节律干预社区慢性阻塞性肺疾病(COPD)的效果及卫生经济学效应.方法 选择2017年9月1日-2018年8月30日于上海市宝山区张庙街道长江路社区卫生服务中心确诊的COPD稳定期患者140例,采用随机数字表法分为干预组和对照组各70例.对照组采用系列药学服务和运动锻炼措施,干预组在对照组的基础上联合顺应四季生物节律(BR)的日常生活行为干预.比较2组干预前后效果及费用成本.结果 干预后,2组症状、体征评分、体质指数(BMI)、1 s用力呼吸容积(FEV1)占预计值百分比、6 min步行距离(6MWD)、稳定期用药种类、年就诊数、年度医药费用、COPD患者生活质量评估测试(CAT)评分及一般自我效能感量表评分均优于治疗前,且干预组优于对照组(P<0.05).结论 药学服务、运动锻炼联合BR干预社区COPD的效果较好,具有良好成本效果的卫生经济学效应.

目的:探究运用药学服务对高血压患者进行合理用药干预的临床效果.方法:2018年12月-2020年8月收治高血压患者130例,随机分为两组,各65例.对照组采用常规干预方式;观察组采用药学服务干预方式.比较两组干预效果.结果:观察组干预后血压水平及生活质量评分均优于对照组,差异有统计学意义(P<0.05);观察组用药依从率高于对照组,差异有统计学意义(P<0.05).结论:在对高血压患者进行合理用药干预过程中,采用药学服务干预方式可产生更为突出的临床效果.

目的 分析家庭制度下的中医适宜技术服务模式在社区老年人睡眠障碍治疗中的临床疗效.方法 选取患有睡眠障碍的老人120例,按每季度分批收集患者,随机分为干预组(60例)与对照组(60例),每批实施期为3个月.干预组:在患者原治疗睡眠障碍的基础上,进行健康生活方式宣教1次,同时采用睡前温水泡脚,自我按压印堂、百会、太阳、内关、神门、三阴交、涌泉为主,依次按压各50次,每日1次,共3个月.对照组:在患者原治疗睡眠障碍的基础上,进行健康生活方式宣教1次,分别对2组匹兹堡睡眠质量指数(Pittsburgh sleep quslity index,PSQI)评分进行对比.结果 发现干预组总有效率高于对照组,差异有统计学意义(P＜0.05).结论 中医适宜技术服务模式可以改善居民中睡眠障碍患者的睡眠质量,提高患者的生活质量.

上海市宝山区长江路社区卫生服务中心家庭医生制服务发展较快,中医药技术服务需求不断增加,以睡眠障碍的中医药技术为切入点,中心不断加强提供中医药技术服务人才建设的全科团队培养,逐步完善中医药技术奖励绩效考核体系,以期探索整合出一套适合城市社区家庭医生责任制下的中医药技术服务的运行模式,为家庭医生责任制中医药技术服务的进一步优化提供参考.

目的 观察运动锻炼药学服务联合干预社区慢性阻塞性肺疾病(COPD)的效果.方法 于2013年11月-2015年12月选取本地区部分确诊的处于稳定期的COPD患者140例作为研究对象,将其随机分为PR组和P组各70例.P组接受系统的合理用药教育,PR组除接受P组相同的合理用药教育外,另开展"421"运动锻炼法.比较干预前后2组患者用药种类、年就诊数、年医药费、肺功能相关体检指标、BODE指数.结果 干预前,2组用药种类、年就诊数、年医药费用差异均无统计学意义(P>0.05);干预后,2组上述指标均有所改善,且PR组优于P组,差异均有统计学意义(P<0.05).干预前2组肺功能相关指标比较差异无统计学意义(P>0.05),干预后PR组指标如症状、体征、肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC、每分钟最大通气量(MVV)均有改善,与P组相比较差异有统计学意义(P<0.05).干预前,2组患者BODE指数、体质指数(B)、气流阻塞程度(O)、呼吸困难程度(D)、运动能力(E)比较差异无统计学意义(P>0.05);干预后PR组上述指标均优于P组,差异有统计学意义(P<0.05).结论 运动锻炼联合药学服务干预社区COPD患者有良好的综合效应,值得推广应用.

ObjectiveTo investigate the clinical efficacy of acupuncture kinesitherapy plus conventional acupuncture in treating cervical spondylosis.MethodSixty-eight patients with cervical spondylosis were randomly allocated to treatment and control groups, 34 cases each. The treatment group received acupuncture kinesitherapy plus conventional acupuncture and the control group, conventional acupuncture alone. Both groupswere treated three times a week for a total of two weeks. The VAS score was recorded in the two groups of patients before and after treatment. The clinical therapeutic effects were evaluated after treatment.Result There was a statistically significant pre-/post-treatment difference in the VAS score in the two groups of patients (P<0.01). There was a statistically significant post-treatment difference in the VAS score between the treatment and control groups (P<0.01). The total efficacy rate and the recovery rate were 100.0% and 73.5%, respectively, in the treatment group and 91.2%and 52.9%, respectively, in the control group. There were statistically significant differences in the total efficacy rate and the recovery rate between the two groups (P<0.05).ConclusionAcupuncture kinesitherapy plus conventional acupuncture has a goodtherapeutic effect on pain symptoms in cervical spondylosis patients. Its therapeutic effect is better than that of conventional acupuncture alone.