Objective:To observe the effect of foot massage combined with pelvic floor muscle training on the clinical symptoms, bladder residual urine volume and quality of life of patients with urinary incontinence after stroke.Methods:90 cases of post stroke urinary incontinence were divided into the control group（n=42） and the observation group（n=48） by odd even number grouping method.The control group was given pelvic floor muscle training, and the observation group was given foot movement sensation area by pressing moxibustion on the basis of pelvic floor muscle training.The differences of urination diary, clinical symptom score, urodynamic index, urinary incontinence quality of life scale（I-QOL） score and activity of daily living scale（ADL） score between the two groups were compared, and the curative effects of the two groups were recorded.Results:There was no significant difference in urination diary and urodynamics between the two groups before treatment（P＞0.05）.Compared with that before treatment, the diurnal and nocturnal micturition frequency and bladder residual urine volume in the two groups decreased after treatment, and lower in the observation group（P＜0.05）.The maximum urine flow（MFR）,urine volume（TV）,average single urine volume, and relative urinary resistance（RVR） in the two groups increased after treatment, and were higher in the observation group（P＜0.05）.There was no significant difference in I-QOL score, clinical symptom score and ADL score between the two groups before treatment（P＞0.05）.Compared with that before treatment, ADL score, total I-QOL score and its three dimension scores in the two groups increased after treatment, and higher in the observation group（P＜0.05）.The clinical symptom score of the two groups decreased after treatment, and that of the observation group was lower（P＜0.05）.The total effective rate in the observation group was 91.67%（44/48）,higher than 76.19%（32/42） in the control group, with a statistical difference（P＜0.05）.Conclusion:Moxibustion foot movement sensation area combined with pelvic floor muscle training can reduce the clinical symptoms of urinary incontinence after stroke, improve urodynamics, promote the recovery of bladder function, and improve the quality of life of patients.

目的 探讨百会实按灸结合通督调神针法治疗脑卒中后眩晕的临床疗效.方法 选取脑卒中后眩晕患者80例,根据随机数字表法分为对照组和观察组各40例,两组均在脑卒中对症治疗及康复治疗的基础上进行,对照组采用口服盐酸倍他司汀治疗,观察组采用百会实按灸结合通督调神针法治疗,两组均连续治疗2w.比较两组总体疗效及安全性、眩晕评估评分量表(DARS)、眩晕障碍评定量表(DHI)、眩晕病中医证候评价量表评分、经颅多普勒诊断/监护系统检测(TCD)检测指标.随访3个月,评估患者复发率.结果 观察组治疗有效率显著高于对照组(P<0.05);治疗前两组椎-基底动脉平均血流速度、DARS、DHI、中医证候评分差异无统计学意义(P>0.05),治疗后两组椎-基底动脉平均血流速度显著增加,且观察组显著快于对照组(P<0.05);治疗后两组DARS、DHI、中医证候评分显著降低,且观察组显著低于对照组(P<0.05);观察组复发率显著低于对照组(P<0.05);两组治疗后未见实验室检查结果 异常,无严重不良反应事件.结论 百会实按灸结合通督调神针法治疗脑卒中后眩晕能扩张椎-基底动脉,增加脑血流量,改善血流动力学指标,可较快改善患者眩晕症状,减轻眩晕程度,对中医证候及总体疗效也有较好治疗效果,并具有不易复发的优点,安全性高.

针灸是临床上治疗中风失语症常用方法,其有效性得到广泛的认可.中医学中失语的发病、诊察和治疗都与"舌"有关,"舌"的作用尤为特殊.以"舌"的中医属性、舌与脏腑经络的关系为切入点,结合失语的经络辨证,浅谈针灸治疗中风失语症的理论依据及机制,发现中医的"舌"不仅反映疾病本身,更能以此作为依据,准确提供治疗方向,同时又能作为治疗的作用靶点,从整体和局部、从标到本治疗失语症.

OBJECTIVETo observe the effects of acupuncture on resting-state functional connectivity (rs-FC) in patients with refractory peripheral facial paralysis, and to preliminarily explore the central mechanism of acupuncture for this disease.METHODSTwenty patients with refractory peripheral facial paralysis were selected as subject and treated with acupuncture at Qianzheng (EX-HN 16), Fengchi (GB 20), Cuanzhu (BL 2), Dicang (ST 4), Jiache (ST 6), Shuigou (GV 26), Chengjiang (CV 24), Yifeng (TE 17), Touwei (ST 8), Sibai (ST 2), Yingxiang (LI 20) and Hegu (LI 4), once every other day, three times a week, 15 times as a course of treatment. The 1-course treatment was given. The score of Sunnybrook (Toronto) facial grading system was used to evaluate the clinical efficacy before and after the treatment. In addition, 20 healthy volunteers were selected as control. For patients, the resting-state functional magnetic resonance imaging (rs-fMRI) scans were performed before and after treatment, for healthy volunteers, the scans were performed when they were recruited. The brain magnetic resonance images were analyzed with left primary motor area (LMⅠ) and right primary motor area (RMⅠ) as regions of interest. The differences of rs-FC between patients with refractory peripheral facial paralysis before and after treatment and healthy volunteers were compared.RESULTSCompared before treatment, the Sunnybrook score was increased after the treatment (P<0.05). Compared with healthy volunteers, the functional connection between bilateral primary motor areas (MⅠ) and multiple brain areas were enhanced in patients before treatment, and most of brain areas were located in the anterior motor area (middle frontal gyrus, superior frontal gyrus), posterior central gyrus, anterior cuneiform lobe, middle temporal gyrus, inferior temporal gyrus and cerebellum lobe. Compared before treatment, the left inferior frontal gyrus was the strong functional connection area between LMⅠ and whole brain after acupuncture treatment, and there was no significant difference between RMⅠ and resting-state whole brain. Compared with healthy volunteers, the functional connections between bilateral MⅠ and multiple brain regions were enhanced after acupuncture, and most of the main brain regions were consistent with those before treatment.CONCLUSION(1) Acupuncture could effectively improve the clinical symptoms of refractory peripheral facial paralysis. (2) The brain function of patients with refractory peripheral facial paralysis has been changed before acupuncture, which may be caused by the reactive compensation of the brain. (3) Acupuncture could enhance the functional connection between LMⅠ and left inferior frontal gyrus to promote the compensatory response, which may be one of the central mechanisms of acupuncture for refractory peripheral facial paralysis.

目的:运用Meta分析方法系统评价益气活血法治疗脑梗死恢复期气虚血瘀证的临床效果.方法:运用RevMan5.3软件对符合条件的2009年-2017年国内外发表的有关益气活血法治疗脑梗死恢复期气虚血瘀证临床试验的相关文献进行Meta分析.结果:试验组在对照组常规治疗的基础上加用益气活血方药治疗后,脑梗死恢复期气虚血瘀证的治疗总有效率比数比(OR)合并值达4.21,95％可信区间[3.06,5.78],神经功能缺损评分标准化均数差(SMD)合并值-3.20,95％可信区间[-3.52,-2.89].结论:益气活血法不仅可以提高脑梗死恢复期气虚血瘀证患者的临床治疗效果,还可以明显改善神经功能缺损症状.

目的 评价地黄饮子治疗帕金森病阴阳两虚型患者临床疗效.方法 收集60例就诊于安徽省中医院门诊及住院的帕金森病阴阳两虚型患者,随机数字表法分为试验组和对照组,每组各30例.对照组给予常规西医治疗,试验组给予常规西药治疗+地黄饮子,60天为总疗程,比较两组患者治疗后的临床疗效、治疗前后帕金森氏病综合评分量表(UPDRS)评分、中医症候评分,评价其临床疗效.结果(1)治疗后,对照组总有效率为66.7％,试验组总有效率为86.7％,临床疗效比较差异有统计学意义(P<0.05).(2)两组治疗前UPDRS评分、中医症候评分比较无显著性差异(P>0.05);治疗20天、40天、60天后,两组UPDRS评分均较前降低,且试验组评分低于照组,差异有统计学意义(P<0.05).治疗后试验组运动症状评分及非运动症状评分均低于对照组,差异有统计学意义(P<0.05).结论 西药基础治疗配合地黄饮治疗帕金森病阴阳两虚型疗效显著.

头痛是临床上一种常见的疾病,头痛有很多种,其中又以偏头痛尤为常见,临床上常迁延不愈,以一侧或双侧发作性中重度、搏动样头痛为主要表现,有些患者可能会出现一些伴随症状,如胃肠道反应及羞明等.据统计,偏头痛的发病率高达15.1％,情况严重时会影响患者的日常工作及生活,因此寻找治疗偏头痛的最佳方案对偏头痛患者尤其重要.对于偏头痛的治疗不能只是单纯地缓解头痛急性发作时的症状,还需要减少头痛的发作次数、程度.西医疗法治标不治本,容易反复,副作用大,效果欠佳且治疗费用昂贵,而中医疗法可以明显减轻患者发病的次数、程度等,现今已得到了大家的广泛认可.本文旨在将近5年来偏头痛的中医治疗新进展综述如下.

Objective:To summarize the relevant literature on the treatment of refractory facial paralysis with acupuncture and moxibustion.Methods:To summarize the methods and efficacy of acupuncture in treatment of refractory facial paralysis.Results:There are many methods to treat refractory facial paralysis with acupuncture and moxibustion therapy,and the clinical effect is good.Conclusion:Acupuncture has a good effect on the treatment of refractory facial paralysis,but there are still some problems to be solved.