目的 观察耳穴压豆对新冠肺炎患者失眠的疗效.方法 选取2020年1月至3月在武汉市金银潭医院南一区住院的新冠肺炎失眠患者为研究对象,纳入64例,脱落2例,实际完成62例.试验组为常规治疗基础上联合耳穴压豆,对照组采用常规治疗.耳穴选择单侧耳,取心、神门、交感、神经衰弱区、上肺、下肺、平喘穴等穴位.每周两次,共观察14天.经失眠量表总分测评失眠疗效,焦虑自评量表探索性观察.结果 患者一般资料中氧疗组间比较差异具有统计学差异(x2=12.579,P=0.000);干预前后两组失眠严重程度指数量表总分变化值组间比较差异有统计学意义(Z=-3.662,P=0.000),根据氧疗进行分层分析,干预前后两组失眠严重程度指数量表总分变化值组间比较差异有统计学意义(t=3.877,P=0.000),试验组组内比较差异有统计学意义(Z=-4.247,P=0.000);干预前后两组焦虑自评量表组间比较差异无统计学意义(P>0.05);干预前后试验组焦虑自评量表总分组内比较差异有统计学意义(Z=-2.673,P=0.008).结论 耳穴贴压技术能有效改善新型冠状病毒肺炎患者的失眠症状,改善其因失眠导致的焦虑情绪,耳穴贴压技术值得推广应用.
目的 研究中药药枕联合中药泡洗治疗失眠临床应用效果.方法 将64例患者入院常规治疗一周后进行匹兹堡睡眠指数评估,在对患者中药泡洗联合中药药枕治疗一周后,再次进行匹兹堡睡眠指数评估,通过统计学方法对患者治疗前后数据进行分析.结果 患者治疗前平均睡眠时间4.375小时,经中药泡洗联合中药药枕治疗后,平均睡眠时间延长至5.916小时,两组差异具有统计学的意义(P<0.05).结论 中药药枕联合中药泡洗对失眠有明显的治疗效果.
To treat of severe coronavirus disease 2019 ( COVID-19) is crucial,patient of severe type will easily develop into critical type or even eventually death without timely and effective treatment. Traditional Chinese medicine ( TCM) pathogenesis of severe COVID-19 is complex,involving many factors such as toxin,dampness,cold,heat,dryness,stasis and deficiency. Based on the disease development rule analyzed and clinical experience we summarized,we adopt removing toxicity,clearing dampness,clearing heat and preventing asthma as the core therapies,with Huashi Baidu Fomula ( 化 湿 败 毒 方) as the basic prescription,with treatment based on syndrome differentiation according to different conditions. Meanwhile,TCM injections were combined to exert TCM characteristics of strengthening the body resistance to eliminate evil factors and multiple target effects,effectively alleviate the patients' clinical conditions,and finally achieve the goal of cure
Objective To construct the evaluation standard of curative effects of traditional Chinese medicine ( TCM) on coronavirus disease 2019 ( COVID-19) . Methods Relevant literature on TCM in the treatment of COVID-19 were retrieved to extract the clinical efficacy evaluation information. The actual clinical data from Wuhan Jinyintan Hospital and General Road Street Health Center of Wuhan were analyzed to obtain the indexes that can be used in evaluating TCM curative effects. Combined with literature reports and clinical data,evaluation index of the efficacy of TCM in the treatment of COVID-19 were screened,and based on the efficacy to reflect the body recover,combined with expert suggestion to set the corresponding weight,we put forward the selection principles of evaluation index of TCM in the treatment of COVID-19 and screen the evaluation indexes of curative effects. Results Based on comprehensive literature and clinical data analysis,following indexes can better reflect the recover of body after treatment with TCM,such as fever,cough,shortness of breath,fatigue,anorexia,nausea,chest tightness,tongue image finger tip oxygen saturation ( % ) ,lymphocyte count ( LY) ,lymphocyte percentage ( LY% ) ,neutrophil count ( NEUT) ,neutrophil percentage ( NEUT% ) ,C-reactive protein ( CRP) ,creatine kinase ( CK) ,creatine kinase isoenzyme ( CK-MB) ,lactate dehydrogenase ( LDH) and other laboratory tests and chest imaging examination. It is believed that the above indicators can be used as evaluation indicators of the efficacy of TCM in the treatment of COVID-19. Conclusion Curative effects evaluation scale of TCM in the treatment of COVID-19 was designed and completed,and curative effect evaluation index system and result evaluation standard were constructed. This standard will facilitate the subsequent collection of clinical data of TCM and provide a basis for scientific evaluation of the role and advantages of TCM in the treatment of COVID-19.
新型冠状病毒肺炎疫情发生以来,我国卫生管理部门强调在医疗救治中要积极发挥中医药作用,加强中西医结合诊疗能力,全国多地均发布中医药干预方案,涉及中药方剂共40种.为确保中药治病的安全性、有效性,提高治疗效果,加速疫情控制,从掌握中药正确的煎煮方法,保证中药药液质量;选择适宜的服药时间,增强疗效;选择合理的服药频次,维持有效血药浓度;选择适宜的饮食调护以助药力、调脾护胃4个方面进行分析总结.为临床护理人员中药汤剂用药护理提供参考依据,从而为新型冠状病毒肺炎的中西医结合治疗提供参考.
目的:本研究基于临床科研一体化技术平台数据库,用两种不同的数据挖掘技术对样本人群的冠心病中医证素、 证型分布规律进行探讨.方法:我们通过收集全国9家医院以冠心病为第一诊断的住院患者,根据朱文峰教授的"证候辨证素量表"对其症状、 舌脉赋值,使用SQL语句计算出相应证素,再利用Clementine数据挖掘软件中主成份/因子及聚类分析方法总结出冠心病患者的证型分布规律.结果:本研究最终纳入冠心病患者9368例,有7046例冠心病患者计算出证素值,其中心阳虚是冠心病患者的主要证候(占79.78%),其次是肺、 痰、 气虚、 血瘀、 胸膈、 阴虚、 气滞等;通过主成份/因子分析、 聚类分析两种不同的分析方法得出相同的结论,即冠心病患者证候类型主要表现为:心阳虚、 痰浊阻肺、气阴两虚、 肝肾阴虚(血虚)、 脾胃病变、 气滞、 血瘀这7类.结论:本文基于大样本数据平台,利用两种不同的数据分析方法研究样本人群冠心病中医证型分布情况,所得结果一致,可为今后中医证候的客观化研究提供有效参考.
目的:探讨穴位按压配合中药足浴对心脾两虚证不寐患者睡眠状况的影响.方法:将心脾两虚证不寐患者36例按入院时间分为干预组与对照组各18例,对照组予常规治疗、健康教育、中药足浴,干预组在对照组基础上按压神门、三阴交、心俞、脾俞、足三里,干预4周后对比2组患者睡眠质量指数情况.结果:干预组患者匹兹堡睡眠质量指数优于对照组,2组比较差异有统计学意义(x2=32.863,P=0.000).结论:穴位按压配合中药足浴可改善心脾两虚证不寐患者的睡眠状况.
目的 通过调查标本不合格现状,了解检验标本分析前质量现存问题.针对存在的质量问题,应用质量持续改进方法,总结质量持续改进在降低检验标本分析前质量不合格率中的实施效果.方法 收集2015年7—9月不合格标本资料并统计分析,了解检验标本分析前质量的控制现状,运用质量管理工具进行解析,确定其根本原因,并制定改进措施,对实施后的效果进行追踪验证.收集2016年1—3月不合格标本资料,运用统计学方法比较实施措施前后不合格标本率有无差异,判定改进效果,根据此实施效果,调整对策后再对2016年4—5月实施效果进行追踪.结果 质量持续改进活动前标本不合格率为6.0398‰,实施干预措施后,标本不合格率为3.6039‰,再次改进后标本不合格率为2.8988‰,不合格率明显下降,差异有统计学意义(P<0.05).结论 建立多部门合作体系,改善流程,进行环节控制,完善各部门间的沟通与交接,加强培训,是有效做好检验标本分析前质量控制的关键所在,护理部、检验、后勤、采供等多部门协同管理和质量持续改进活动有效的提高了检验标本分析前质量.