介绍陆金根教授论治功能性便秘的临床经验.陆教授认为本病多属本虚标实,病位在大肠,与脾、胃、肝、肺、肾等多脏腑功能失衡有关.治疗时在润肠通便的基础上,采用健脾和胃、疏肝理气、提壶揭盖、补肾益精等方法,疗效显著.

目的:探讨电针结合肌筋膜触发点穴位埋线治疗腰椎间盘突出症患者的临床效果.方法:试验组采用电针结合肌筋膜触发点穴位埋线方法进行治疗,对照组使用传统电针方法治疗,治疗周期为1个月.治疗前、每次治疗后及治疗完成后2个月使用日本骨科协会评分法(Japanese Orthopaedic Association Scores,JOA)评分和视觉模拟评分法(Visual Analogue Scale,VAS)评分进行评估.使用重复测量方差分析进行两组患者组内治疗前、第1、2、3、4次治疗及治疗后2个月的JOA评分和VAS评分比较,使用t检验进行两组患者组治疗前、第1、2、3、4次治疗及治疗后2个月的JOA评分和VAS评分比较.结果:两组术前JOA评分的差异无统计学意义,P=0.927;两组术前VAS评分的差异无统计学意义,P=0.283;组内比较显示:对照组术前和第1、2次治疗后JOA评分的差异无统计学意义,其余所有组内评分的差异均有统计学意义(P<0.05).VAS评分统计结果显示:对照组术前和第1次治疗后VAS评分的差异无统计学意义(P>0.05),其余所有组内评分的差异均有统计学意义(P<0.05).试验组总有效率优于对照组.结论:电针结合肌筋膜埋线法治疗腰椎间盘突出症效果较单用电针能更快减少患者的疼痛感和活动不适,疗效优于单独使用电针治疗,适合临床使用与推广.

Objective To evaluate the efficacy of low resistance thought induction psychotherapy (TIP) technique combined with acupuncture and oral Chinese medicine in treating chronic insomnia elderly patients with syndrome of heart-kidney imbalance. Methods One hundred sixty-four chronic insomnia patients with syndrome of heart-kidney imbalance were randomly divided into four groups with 41 cases in each group. The control group was treated with family doctor contract, sleep health education and Tianwang-Buxin decoction as the basic treatment, the group A was treated with acupuncture and the basic treatment, the group B was treated with TIP technique and the basic treatment, the group C was treated with the combination of acupuncture and TIP on the basic treatment. After one month' treatment, scores of Pittsburgh sleep quality index (PSQI) were used to evaluate sleep quality, sleep efficiency, and the clinical efficacy. Results After treatment, scores of sleep time, sleep efficiency, sleep time, sleep disturbance, daytime function of the group A, B, and C were significantly lower than those in the control group (F value were 44.322, 92.808, 107.131, 79.467, 98.638 respectively, all Ps<0.001), and the group C were significantly lower than those of the test group A and B (P<0.01). Scores of upset, dizziness, tinnitus, hot flashes, and night sweats, hand foot and heart fever, forgetfulness, sores on the tongue and dry stool of the group A, B, and C were significantly lower than those of the control group (F value were 103.32, 135.91, 93.35, 77.61, 57.514, 92.283, 126.097, 53.217, respectively, all Ps<0.001), and the group C were significantly lower than those of the test group A and B (P<0.01). The total clinical efficacy of TCM syndrome and insomnia in group A,B and C was significantly higher than that in the control group (χ2=16.169, P<0.01), and the group C was significantly higher than the group A and B (χ2=8.504, P<0.01). The total clinical efficacy of sleep efficiency in group A, B and C was significantly higher than that in the control group (χ2=14.078, P<0.01), and the group C was significantly higher than the group A and B (χ2=8.856, P<0.01). Conclusions TIP technique combined with acupuncture and oral Chinese medicine can improve sleep quality of chronic insomnia elderly patients with syndrome of heart-kidney imbalance.

目的 观察针刺手三里穴联合电针腰夹脊穴治疗慢性腰肌劳损的临床效果.方法 将92例患者随机分为观察组和对照组,每组46例.观察组给予针刺手三里穴联合电针腰夹脊穴治疗,对照组给予电针腰夹脊穴治疗,比较2组临床疗效.结果 观察组总有效率为93.48％,高于对照组的78.26％,差异有统计学意义(P<0.05).结论 针刺手三里穴联合电针腰夹脊穴较单用电针腰夹脊穴治疗慢性腰肌劳损疗效更好.

腰椎间盘突出症是临床常见疾病,属中医“痹症”“腰腿痛”的范畴.针刺治疗本病效果好,副作用小,安全性高,是临床常用且有效的方法之一,包括普通针刺、电针、温针、穴位注射、耳针、腹针、刺络拔罐、针力、皮内针、腕踝针等.现就针刺治疗腰椎间盘突出症临床应用现状做如下综述.