目的:观察小儿推拿联合耳穴贴压治疗小儿厌食症的临床疗效.方法:选择厌食症患儿240例,按随机数字表法分为对照组和治疗组各120例.对照组采取耳穴贴压治疗,治疗组采取推拿联合耳穴贴压治疗.7d为1个疗程,治疗2个疗程后评估2组临床疗效、中医证候积分、症状消失时间及微量元素水平.结果:治疗后,治疗组总有效率为91.67％,对照组为75.83％,2组比较,差异有统计学意义(P＜0.05).治疗前,2组中医症状积分比较,差异无统计学意义(P＞0.05);治疗后,2组中医症状积分均较治疗前明显降低(P＜0.05),且治疗组症状积分低于对照组(P＜0.05).治疗后,治疗组厌食、腹胀、便秘消失时间均短于对照组,差异有统计学意义(P＜0.05).治疗前,2组各微量元素钙、锌、铁含量比较,差异均无统计学意义(P＞0.05);治疗后,2组各钙、锌、铁含量明显均较治疗前升高(P＜0.05),且治疗组钙、锌、铁含量均高于对照组(P＜0.05).结论:小儿推拿联合耳穴贴压治疗厌食症可提高临床疗效,快速缓解患儿临床症状体征,改善其营养状态.

目的:观察小儿捏脊配合针刺四缝穴治疗小儿厌食症的疗效及对胃泌素(GAS)、瘦素、胃动素(MOT)、神经肽Y(NPY)、尿D-木糖排泄率的影响.方法:选择郑州市中医院儿科门诊就诊的小儿厌食症患儿220例,按1:1的比例随机分为两组.对照组110例给予醒脾养儿颗粒,1～2岁者给予4 g/次,2次/d;3～6岁者给予4 g/次,3次/d.治疗组110例给予小儿捏脊配合针刺四缝穴治疗.两组均治疗2周为1个疗程,共治疗2个疗程.结果:治疗组痊愈49例,显效34例,有效17例,无效10例,有效率为90.90％(100/110);对照组痊愈28例,显效36例,有效24例,无效22例,有效率为80.00％(88/110).两组疗效对比,差异有统计学意义(P<0.01).中医症状积分、身高、体质量及GAS、MOT、瘦素、NPY、尿D-木糖排泄率对比,治疗组治疗后优于对照组(P<0.05或P<0.01).结论:小儿捏脊配合针刺四缝穴治疗小儿厌食症疗效确切.

目的:基于针灸治疗中风后肩手综合征的高质量临床证据与多指标决策分析法,获得针灸治疗该病的最优干预方案.方法:全面检索国内外医学文献数据库,根据循证医学Jadad评分筛选出高质量临床证据,采用多指标决策分析法,构建标准化矩阵和加权标准化矩阵,计算各方案与理想解的相对贴近度,筛选出针灸治疗中风后肩手综合征的最优方案.结果:共纳入13项高质量RCT,筛选出针灸治疗中风后肩手综合征的最优方案为以调神止痛针法针刺耳穴神门、水沟、内关、患侧肩髃、肩贞、肩髎和阳陵泉,1次/d,共治疗24次.结论:现有的高质量临床证据和多指标决策分析法结果说明了针刺的疗效可能与整体和局部共同调节作用有关,治疗时选穴应以促进中风后神经功能恢复的头部穴位和改善肢体功能的局部穴位为主,兼顾整体调神止痛与局部疏通经络.

缺血性脑损伤后,炎症反应、Ca2+超载导致血管内皮细胞损伤、血管痉挛,侧支循环的机能和状态严重影响缺血脑组织的命运,血管新生促进脑血管微循环恢复,能有效挽救脑组织,保护神经元,增强脑缺血后神经功能的恢复.因此,缺血性脑卒中后血运重建对大脑神经功能恢复和脑组织损伤修复起着至关重要作用.多项研究证实,针刺能通过抑制炎症反应、缓解血管痉挛和促进血管新生等方面改善脑卒中后血流供应.本研究对缺血性脑卒中后血管损伤机制及针刺干预研究现状展开综述,为发挥针灸治疗优势提供科学依据.

血管新生与许多疾病密切相关,对疾病的发展及预后起到至关重要的作用.lncRNA是血管新生重要的调控分子,通过调控血管内皮细胞表型转变、血管内皮生长因子及miRNA的表达,参与缺血性脑卒中、肿瘤、动脉粥样硬化等疾病的病理恢复过程.文中综述了lncRNA的生物学功能及其在血管生成和血管疾病中的表达变化、调控作用的相关研究,以期为后续血管新生的机制研究及临床应用提供参考.

目的:基于临床证据,运用多指标决策分析法筛选出针灸治疗血管性痴呆的最优方案,为临床决策提供科学依据.方法:对中国知网、万方数据库、维普期刊全文数据库、PubMed、Cochrane Library和Embase自2009年1月1日至2018年12月31日发表的针灸治疗血管性痴呆的随机对照试验(RCT)进行全面的中英文检索.采用改良的Jadad量表对证据质量进行评价.采用极差变换法对确定的评价指标的量纲进行标准化处理,运用相对比较法确定每个指标的权重并对标准化矩阵进行加权处理,得出最优值和最劣值,计算各方案与最优值的相对贴近度,筛选出针灸治疗血管性痴呆的最优方案.结果:共纳入17项RCT,筛选出的针灸治疗血管性痴呆的最优方案为电针四神聪、百会、神庭、风池,每周治疗5次,共6周,30次.结论:基于现有临床证据和多指标决策结果,电针头穴为针灸治疗血管性痴呆的最优方案,临床可以通过指定刺激穴位而提高治疗该病的疗效.

目的:探讨中药塌渍疗法治疗哺乳期急性乳腺炎初期的效果.方法:选取60例哺乳期急性乳腺炎初期患者,按随机数字表法分为观察组和对照组各30例.对照组给予乳腺外科常规治疗与护理,观察组在对照组基础上给予中药塌渍治疗,比较2组患者临床疗效、疗程、疼痛评分、肿块大小分级、不良反应发生情况.结果:观察组总有效率为96.67％,显著高于对照组83.33％,差异有统计学意义(P＜0.05).观察组平均住院天数明显短于对照组,差异有统计学意义(P＜0.05).干预后,2组疼痛评分均较干预前降低,且观察组低于对照组(P＜0.05).干预后,观察组肿块大小分级低于对照组(P＜0.05).结论:中药塌渍治疗哺乳期急性乳腺炎初期效果显著,且绿色安全无不良反应,值得临床推广应用.

目的:探讨双歧三联活菌散联合膏药神阙穴贴敷治疗小儿厌食症的效果及对血清促人生长激素腺释放肽(Ghrelin)水平的影响.方法:将厌食症患儿随机分为治疗组43例,对照组44例,2组患儿均给以饮食调整,纠正不良饮食习惯,对照组给以膏药神阙穴贴敷,隔日贴敷1次;治疗组在对照组基础上联合双歧三联活菌散口服,1.0 9/次,3次/d,温水冲服,2周为1个疗程,共3个疗程.评估治疗前后中医证候积分变化,血清Ghrelin水平变化,并观察临床效果.结果:治疗结束,治疗组有效率95.2％,对照组有效率83.3％,2组相比差异有统计学意义;2组患儿中医证候积分较前明显减少,差异有统计学意义;2组患儿血清Ghrelin水平较前明显增加,但治疗组增加幅度更明显,差异有统计学意义.结论:双歧三联活菌散联合膏药神阙穴贴敷治疗儿童厌食症疗效佳,能显著改善患儿营养状况,其作用与升高血清Ghrelin水平有关.

目的 探讨自制膏药穴位贴敷治疗小儿厌食症的疗效及对食欲调节因子的影响.方法 选择2017年1月至8月在郑州市中医院儿科收治的厌食症患儿80例为研究对象,随机分为观察组和对照组各40例.两组患儿均给予纠正不良饮食习惯以及饮食调整等基础治疗.对照组口服双歧杆菌,每次1.0g,每日3次.2周为1个疗程,共4个疗程.观察组在对照组治疗基础上给予自制膏药穴位贴敷.膏药每周前3天每天贴敷1次,后4天暂停,2周为1个疗程,共4个疗程.观察两组临床治疗效果、治疗前后中医证候积分;治疗前后血清瘦素以及神经肽Y水平;停药6个月及1年后随访观察复发率.结果 观察组完成39例,失联1例;对照组完成38例,因胶布过敏退出治疗1例,厌食因继发性疾病引起1例退出研究.观察组总有效率为94.9％(37/39),显著高于对照组76.3％(29/38),差异有统计学意义(P＜0.05).两组治疗后中医证候积分均低于治疗前,差异有统计学意义(P＜0.05).观察组治疗后中医证候积分低于对照组,差异有统计学意义(P＜0.05).两组治疗后血清瘦素及神经肽Y水平均高于治疗前,差异有统计学意义(P＜0.05);观察组治疗后血清瘦素及神经肽Y水平均高于对照组,差异有统计学意义(P＜0.05).观察组患儿治疗后随访6个月和1年复发率均低于对照组,差异有统计学意义(P＜0.05).结论 膏药穴位贴敷联合双歧杆菌治疗儿童厌食症疗效佳,能显著改善患儿营养状况,且复发率低,其作用与升高血清瘦素及神经肽Y水平有关.

目的 观察三黄屏风膏贴敷联合双歧三联活菌散口服治疗小儿厌食症的临床疗效及对血清瘦素(LP)及神经肽Y(NPY)水平的影响.方法 将76例厌食症患儿随机分为治疗组和对照组,各38例.2组均给予饮食调整,纠正不良饮食习惯,对照组口服双歧三联活菌散,治疗组在对照组治疗方法的基础上联合三黄屏风膏贴敷,2周为1个疗程,4个疗程后统计疗效.结果 治疗组总有效率为94.7％,对照组为84.2％,2组比较差异有统计学意义(P＜0.05).与健康组比较,2组治疗前体质量、体质量指数(BMI)、LP和NPY均显著下降,差异均有统计学意义(P＜0.05).治疗后,2组上述指标均增加,与同组治疗前比较,差异有统计学意义(P＜0.05),且治疗组增加幅度更大(P＜0.05),更接近健康水平.治疗组随访6月和1年时复发率分别为2.8％,8.3％,对照组为18.8％和28.1％,2组复发率比较差异有统计学意义(P＜0.05).结论 三黄屏风膏贴敷联合双歧三联活菌散口服治疗儿童厌食症疗效满意,能显著改善患儿的营养状况,且复发率低,其作用与升高血清IP和NPY水平有关.

目的:观察妈咪爱联合三黄屏风膏治疗小儿厌食症的疗效及其对血清LP(瘦素)及NPY(神经肽Y)水平的影响.方法:将84例厌食症患儿随机分为观察组和对照组,每组42例,两组患儿均进行饮食调整,纠正不良饮食习惯,对照组妈咪爱口服,1.0g/次,2次/d,温水冲服,共4周.观察组在对照组基础上联合三黄屏风膏贴敷,连用3～4d,共4周.评价临床疗效,观察治疗前后体质量、BMI指数变化,放免法检测血清LP及NPY水平变化,统计6、12个月复发率.结果:观察组总有效率为95.2％,对照组总有效率为85.7％,两者相比差异有统计学意义(P＜0.05);两组患儿体质量及BMI指数较治疗前明显增加,观察组增加幅度更明显(P＜0.05).两组患儿血清LP及NPY治疗后较治疗前明显增加,观察组增加幅度更明显(P＜0.05).随访6～12个月,观察组复发率分别为2.5％、12.5％,对照组复发率分别为19.4％、25.0％,两组间差异有统计学意义(P＜0.05).结论:妈咪爱联合三黄屏风膏治疗儿童厌食症疗效佳,能显著改善患儿营养状况,且复发率低,其作用与升高血清LP及NPY水平有关.

OBJECTIVE:To observe the effects of micro-invasive embedding combined with montelukast sodium and simple montelukast sodium for children cough variant asthma (CVA). METHODS:A total of 240 patients were randomly assigned into an observation group and a control group, 120 cases in each one. Considering of cases dropping, 101 patients in the observation group and 105 cases in the control group were included. Montelukast sodium chewable tablets were applied before sleep for 3 months in the control group, 5 mg a time, once a day. Based on the treatment as the control group, micro-invasive embedding was used for 3 months in the observation group, twice in the first month and once in the other two months. The acupoints were Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1), and Zusanli (ST 36). Follow-up was conducted 9 months after treatment in the two groups. The cough score, serum immunoglobulin (IgE, IgG, IgA), platelet activating factor (PAF) were observed before and after treatment. The indices were compared before and after treatment and at follow-up, including pulmonary function indices[peak expiratory flow rate (PEF), forced expiratory volume at the 1st second (FEV1)], and small airway function indices[forced expiratory flow rate with remaining 25% vital capacity (MEF25%), forced expiratory flow rate with remaining 50% vital capacity (MEF50%), forced expiratory flow rate with remaining 75% vital capacity (MEF75%) and mid expiratory flow rate (MEF25%-75%)]. Also, the total effects were evaluated. RESULTS:①The total effective rate in the observation group was 93.1% (94/101), which was better than 87.6% (92/105) in the control group (P<0.05). The cough disappearance time of the cured children in the observation group was (10.38±2.64) d, and it was shorter than (10.72 ±2.60) d of those in the control group (P<0.05). After treatment, the cough score apparently decreased compared with those before treatment in the two groups (both P<0.05), with better result in the observation group (P<0.05). At follow-up, the recurrence frequency of the observation group was (1.43±1.20), and it was less than (1.91±1.71) in the control group (P<0.05). ②The levels of serum IgA and IgG after treatment in the two groups increased, and those of serum IgE and PAF decreased, compared with those before treatment. There was statistically significance except IgG in the control group before and after treatment (all P<0.05), with better Results in the observation group after treatment (all P<0.05). ③ Compared with those before treatment, all the pulmonary function indices were improved obviously after treatment and at follow-up in the two groups (all P<0.05), without statistically significance between the two groups (both P>0.05). ④ There was no statistically significance before and after treatment on small airway function indices in the two groups (all P>0.05). The indices at follow-up increased compared with those before treatment in the two groups (all P<0.05), with better Results in the observation group (all P<0.05). CONCLUSIONS:Micro-invasive embedding combined with montelukast sodium achieved de-finite effect for children CVA, which can improve the body's immune and microcirculation. The effect is better than that of simple montelukast sodium on improving small airway function, etc.

Objective: To observe effcacy of TCM constitution comprehensive intervention on hypertension in community. Methods: 76 cases took TCM constitution intervention, include emotion, diet, exercise and TCM physical identiifcation to massage. The changes of blood pressure, blood lipid were observed in 6 months of intervention. Results: The systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol were compared;P<0.05, difference was statistically signiifcant. Conclusion: TCM comprehensive intervention can signiifcantly improve hypertension, and regulate blood lipid.

目的：观察针刺治疗眼肌痉挛的临床疗效。方法：39例用针灸强刺激患侧后溪配合局部静留针进行治疗。结果：痊愈16例、显效22例、无效1例，总有效率97%。结论：针灸强刺激患侧后溪配合局部静留针治疗眼肌痉挛效果较好。

原发性痛经是妇科常见病、多发病。痛经是指妇女正值经期或经行前后出现周期性小腹疼痛或痛引腰骶，甚至剧痛致晕厥者，又称“经行腹痛”[1]，妇产科学将其分为原发性痛经和继发性痛经。西医多采用镇痛、镇静、解痉以及激素制剂等疗法，虽能暂时缓解疼痛，但远期疗效并不理想，且有一定的副作用。中医温针灸是针灸学理论、中药学和现代物理学相结合的产物，即在留针过程中将艾绒搓团捻裹于针柄上点燃，通过针体将热力传入穴位，具有温通经脉、行气活血的作用。中药热奄包疗法是将加热好的中药奄包置于身体的患病部位或身体的某一特定位置(如穴位上)。通过奄包的热蒸汽使局部的毛细血管扩张，血液循环加速，又可通过热蒸汤促使奄包内中药离子渗透到患者病痛所在，利用其温热作用和药物作用达到温经通络、调和气血、祛湿驱寒目的。经临床观察，温针灸配合中药热奄包治疗寒湿凝滞型痛经效果颇佳，现报道如下。

下肢静脉曲张属于周围静脉疾病,是临床上的常见病和多发病.除浅静脉曲张的症状之外,还常常伴有下肢皮肤营养障碍、下肢慢性溃疡、慢性湿疹、血栓性静脉炎等各种临床表现.西医主要还是以保守治疗和手术治疗为主,远期效果均不十分理想,而中医针刺疗法相对于手术治疗有一定的优势,副作用小,见效快,经济适用.笔者采用温针灸结合火针治疗下肢静脉曲张39例,总结报道如下.

Objective: Clinical effcacy of uricular pressure based on TCM physical identiifcation on pediatric multiple tic disorder was observed. Methods: Pediatric patients were selected and randomized into the treatment group and the control group. The control group received oral haloperidol tablets. The treatment group took uricular pressure based on TCM physical identiifcation more. Results: The total effciency in the treatment group was 92.1%, and in the control group was 76.2%, with a statistically signiifcant difference. Conclusion: Uricular pressure plus TCM physical identiifcation was effective on pediatric multiple tic disorder, and worthy of extensive application.

眼肌痉挛是指眼睑不自主的跳动,中医称之为“胞轮振跳”“筋惕肉瞤”[1].初起时眼轮匝肌呈间歇性、不规则性、无疼痛的阵发性痉挛,病情严重者,表现为强直性,可导致口角向同侧歪斜、口角抽搐.患者神经系统检查无阳性体征.此病以中、老年妇女多见,以单侧为主.西医以镇静药物治疗,疗效不佳.而中医针刺疗法副作用小,见效快,经济适用.笔者采用强刺激后溪治疗眼肌痉挛49例,疗效显著,总结报道如下.

Objective: To investigate clinical efifcacy of acupuncture and moxibustion on facial paralysis. Methods: 60 patients were treated by acupuncture and moxibustion, 1 time per day, 10 times as a course. After treatment, the efifciency in two groups was analyzed. Results: Acupuncture and moxibustion on facial paralysis shows a signiifcant effect, and is worthy of promotion.

Objective:To observe the clinical efficacy of TCM treatment for diarrhea. Methods:80 patients were randomly divided into treatment group 40 cases, treated in TCM treatment, and the control group was given Jinshuangqi and smecta both for 6 days. Results:The total efficiency of 95%was significantly better than the control group (total efficiency of 80%), P<0.05;at bloating, abdominal pain, vomiting, loss of appetite treatment group was better, P<0.05. Conclusion: The Yunpi Huashi therapy for children with diarrhea was effective.