本文总结1例耳穴压丸联合耳灸器灸法治疗耳石症复位后残余头晕患者的护理经验。在常规治疗护理的基础上，对患者进行护理评估，为患者实施了个体化的中医技术操作—耳灸器灸法联合耳穴压丸疗法，对患者头晕残余症状、睡眠质量、焦虑状态进行干预，中医治疗后患者的残余头晕症状、睡眠质量、焦虑状态得到了明显的改善，眩晕障碍量表（DHI）、匹兹堡睡眠质量指数量表（PSQI）、汉密尔顿焦虑量表（HAMA）分值均下降明显，耳穴压丸联合耳灸器灸法以中医理论为基础，有温通经脉、扶正祛邪、促进气血津液运行，濡养脑髓，可改善患者的预后，加速患者的康复进程，改善患者的焦虑状，提高患者的生活质量。

目的 观察穴位贴敷与推拿治疗脑梗死后便秘的 效果。方法 筛选脑梗死后便秘的患者78例,分为对照组、穴位贴敷组(贴敷组)和推拿组(推拿组),三组患者人数分别为22例、31例和25例。对照组采用常规中西医治疗及护理；在此基础上,贴敷组患者采中药神阙穴贴敷；推拿组患者采用穴位推拿手法。干预2周,每日观察三组患者的排便情况,于治疗第7和14天对比三组患者的排便频率。采用Barthel指数(BI)评价患者日常生活活动能力。结果 治疗第1周,贴敷组患者排便频率高于推拿组和对照组,差异有统计学意义(P＜0.05)；治疗第2周,贴敷组患者排便频率高于同期的对照组(P＜0.05)；三组治疗第2周排便频率均较第1周均升高。三组患者出院时BI均较入院时均升高。结论 穴位贴敷治疗和推拿手法治疗能改善脑梗死后便秘患者排便频率,其中穴位贴敷治疗效果更明显。

Objective To explore the rehabilitation effect of Traditional Chinese Medicine (TCM) ointment and rubbing technique on motor function in patients with hemiplegia in recovery stage of stroke. Methods Totally 60 patients with hemiplegia in recovery stage of stroke were randomly divided into observation group and control group, with 30 cases in each group. The observation group received TCM ointment and rubbing technique on the basis of routine treatment and care; while the control group only received routine treatment and care. After 2 weeks of intervention, the motor function and living ability were assessed and compared between two groups. Results After 2 weeks of intervention, the scores of motor function evaluation scale (MAS) and Barther Index (ADL) increased in both two groups, and scores in the observation group were significantly higher than those in the control groups , with a significant differnce (P＜0. 05) . Conclusion TCM ointment and rubbing technique can promote the recovery of motor function and quality of life in patients with hemiplegia after stroke.

目的 探讨中药水罐联合常规康复训练治疗中风后肩手综合征的临床疗效.方法 选择在北京中医药大学东直门医院脑病二科收治的96例中风恢复期存在肩手综合征患者,依据随机信封分为水罐组和对照组,水罐组在对照组常规康复训练及治疗的基础上,加用中药水罐治疗,20 min/次,每日1次,连续治疗14 d;以简化的Fugl-Meyer运动功能评定量表(FMA)评价患者上肢运动功能和视觉类比评分量表评(VAS)价患肢疼痛作为主要疗效指标,生活质量评分(SS-QOL)和治疗满意度为次要疗效指标评价治疗前后两组的疗效及满意度.结果 与本组治疗前比较,两组FMA和SS-QOL评分均有提高(P<0.01),VAS评分降低(P<0.01).与对照组比较,水罐组在治疗2周后FMA和SS-QOL评分均有提高(P<0.01),VAS评分降低(P<0.01).水罐组的患者满意度高于对照组,但差异无统计学意义(P>0.05).结论 中药水罐在治疗中风后肩手综合征的疗效确切,方法简便易行,患者依从性与满意度良好,适宜临床推广应用.

Objective To investigate the effect of Traditional Chinese Medicine (TCM) nursing in prevention of pulmonary infection in patients with hypertensive cerebral hemorrhage. Methods Totally 120 patients with hypertensive cerebral hemorrhage were divided into control group (n = 60) and observation group (n = 60) according to different types of nursing care. Patients in the control group received routine care, and those in the observation group received TCM nursing on basis of routine care. The effective rate of nursing intervention between two groups was analyzed and compared. Results The total effective rate of nursing intervention in the observation group was higher than that in the control group (96. 67% vas. 73. 33%, P<0. 01). Conclusion In nursing management of patients with hypertensive cerebral hemorrhage, the TCM nursing intervention is potentially effective to prevent the pulmonary infection and improve the nursing efficiency.

Objective To investigate the effect of Shenfu injection in treating patients with acute internal watershed cerebral infarction. Methods Totally 154 patients with AIWCI admitted to the Department of Encephalopathy of Dongzhimen Hospital from October 2018 to October 2020 were divided into the experimental group (n=96)and the control group(n=58). All cases received a comprehensive treatment including anti-platelet aggregation, lowering blood lipid, regulating blood pressure, replenishing blood volume, improving microcirculation and protecting brain cells. Patients in the experimental group were additionally given Shenfu injection for 14 days as a course of treatment. Before and after treatment, the National Institutes of Health Stroke Scale (NIHSS) was used to score the neurological impairment, and transcranial doppler (TCD) was used to measure the blood flow velocity of the middle cerebral artery at the affected side. Results The blood flow velocity of middle cerebral artery in 2 groups was increased after treatment, and the experimental group had a better improvement in Peak systolic velocity (Vs) and end-diastolic flow velocity (Vd) compare with the control group(P<0. 01). The NIHSS score of the experimental group was lower than that of the control group after treatment (P＜0. 05). The overall response rate in the experimental group was higher than that of the control group(P＜0. 05). Conclusion Shenfu injection can significantly improve the blood flow velocity of the distal artery responsible for internal watershed cerebral infarction caused by middle cerebral artery stenosis, and reduce the severity of neurologic impairment.

Sleep disorder is a common complication of stroke in elderly patients with a high prevalence, and can aggravate the condition, affect the prognosis, and reduce the quality of life of patients.Chinese traditional medicine nursing has unique characteristics in the prevention and treatment of post-stroke sleep disorders.This article reviews related research and summarizes the current research status of the theory, the prevention and treatment and the nursing characteristics technology of Chinese traditional medicine nursing in post-stroke sleep disorders.This article provides a reference for the development of related research and clinical nursing care.

克雅氏病(Creutzfeldt-Jakob disease,CJD)又称皮质-纹状体-脊髓变性,是由朊蛋白传播的致命性中枢神经系统变性疾病[1],具有传染性和100％的病死率[2].现已证实克雅氏病与疯牛病(即牛海绵状脑病)关系密切[3,4].由于该病病情变化快,诊断困难,传播途径多且隐匿,并发症发生率高,预后极差,无有效治疗方法,主要采取对症治疗,所以临床护理难度大[5,6].东直门医院脑病科于2017年4月-2018年5月收治2例确诊的克雅病患者,现将治疗护理体会总结如下.

目的 评价补肾化瘀糖肾方联合西药治疗糖尿病肾病Ⅳ期气阴虚夹瘀证的临床疗效.方法 将82例糖尿病肾病Ⅳ期气阴虚夹瘀证患者随机分为中药组和对照组各41例,两组均采用西医基础降糖、保肾治疗,中药组在此基础上加服补肾化瘀法中药治疗.4周为1个疗程,连续治疗3个疗程后统计两组患者临床疗效,并于治疗前后检测患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、血尿酸(UA)、血肌酐(SCr)、24小时尿蛋白定量、中医症状积分,并在此基础上计算各指标治疗前后升降率.结果 中药组临床疗效总有效率为78.05％,对照组为58.54％,中药组优于对照组(P＜0.01).两组患者治疗后FPG、HbA1c、TG、UA、SCr、24小时尿蛋白定量、中医症状积分均较治疗前显著改善(P＜0.05或P ＜0.01).中药组FPG、HbA1c治疗前后升降率与对照组比较差异无统计学意义(P＞0.05),TG、UA、SCr、24 h尿蛋白定量、中医症状积分升降率差异有统计学意义(P＜0.01). 结论 补肾化瘀糖肾方联合西药治疗糖尿病肾病Ⅳ期气阴虚夹瘀证疗效确切,在控制血糖的同时具有保护肾功能、改善脂代谢和临床症状等优势.