功能性电刺激联合循环运动系统对老年脑卒中后肌肉衰减综合征患者肢体功能、平衡能力以及认知功能的影响

摘要 目的：研究功能性电刺激联合循环运动系统对老年脑卒中后肌肉衰减综合征患者肢体功能、平衡能力以及认知功能的影响。方法：选择2020年6月到2021年6月在我院进行康复治疗的老年脑卒中后肌肉衰减综合征患者64例,据其治疗方式的不同分为对照组和研究组,两组患者均给予常规康复治疗,对照组患者在常规治疗的基础上加用功能性电刺激治疗,而研究组在对照组基础上加用脑循环系统治疗仪进行治疗,比较两组患者临床治疗疗效。使用运动功能评分法（FMA）和上肢功能评定（STEF）评价肢体患者功能,使用平衡量表（BBS）和Fuglg-Meyer平衡量表（FM-B）评价患者平衡能力,使用自拟认知量表评价患者认知功能。结果：（1）研究组患者临床治疗总有效率较对照组高（93.75 % vs 75.00 %,P<0.05）;（2）两组患者治疗后FMA和STEF评分均显著增高（P<0.05）,并且研究组患者治疗后BBS和FM-B评分显著高于对照组患者（P<0.05）;（3）两组患者治疗后BBS和FM-B评分均显著增高,并且研究组患者治疗后BBS和FM-B评分显著高于对照组患者（P<0.05）;（4）两组患者治疗后认知功能评分均升高,并且研究组患者较对照组患者高（P<0.05）。结论：功能性电刺激联合循环运动系统对老年脑卒中后肌肉衰减综合征患者具有显著的临床治疗效果,可显著改善患者肢体功能、平衡能力和认知功能。     

瑞舒伐他汀对冠心病患者血脂水平及颈动脉粥样硬化斑块硬化程度的影响

目的:探讨瑞舒伐他汀对冠心病患者血脂水平以及颈动脉粥样硬化斑块硬化程度的影响。方法:选择2013年2月至2014年12月我院收治的132例冠心病患者作为研究对象,将其随机分为研究组(66例)和对照组(66例),研究组应用瑞舒伐他汀(rosuvastatin calcium,RC)治疗,对照组采用常规药物治疗,观察和比较两组患者的血脂水平变化情况及颈动脉粥样硬化斑块硬化(IMT)程度的改善情况。结果:两组的总胆固醇(total c holesterol,T C)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、甘油三酯(triglyceride,T G)水平较治疗前均有降低,高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)水平较治疗前有升高,研究组变化更显著,组间差异有统计学意义(P0.05)。两组颈动脉粥样硬化斑块硬化程度较治疗前有改善,研究组优于对照组,差异有统计学意义(P0.05)。研究组与对照组治疗总有效率分别为98.5%、71.2%,差异有统计学意义(P0.05)。结论:瑞舒伐他汀能够有效降低冠心病患者的血脂水平,并能改善其颈动脉粥样硬化的程度。     

经皮穴位电刺激联合下肢康复机器人在膝关节前交叉韧带损伤重建术后康复中的应用效果分析

摘要 目的：探讨经皮穴位电刺激联合下肢康复机器人在膝关节前交叉韧带损伤重建术后康复中的应用效果。方法：选取我院2019年1月到2022年12月收治的120例采取膝关节前交叉韧带损伤重建术的患者作为研究对象,分为观察组与对照组,每组60例。对照组采取常规术后康复治疗,观察组采取经皮穴位电刺激联合下肢康复机器人康复治疗,对比两组患者康复治疗效果,位置觉和运动觉,疼痛情况与肿胀情况,膝关节功能以及生活质量。结果：观察组治疗总有效率高于对照组（P＜0.05）;治疗前两组患者患肢肿胀值、视觉模拟量表（VAS）评分对比无差异（P＞0.05）,治疗后均降低,且观察组较对照组低（P＜0.05）;两组患者的治疗前膝关节75度、45度、15度位置觉,伸膝、屈膝运动觉对比无差异（P>0.05）,治疗后两组患者膝关节75度、45度、15度位置觉,伸膝、屈膝运动觉均下降,且观察组较对照组低（P＜0.05）;治疗前两组患者膝关节主观（IKDC）评分、膝关节功能（Lysholm）评分对比无差异（P＞0.05）,治疗后均降低,且观察组较对照组低（P＜0.05）;两组患者治疗前生活质量相关评分对比无差异（P＜0.05）,治疗后均升高,且观察组较对照组高（P＜0.05）。结论：经皮穴位电刺激联合下肢康复机器人在膝关节前交叉韧带损伤重建术后康复中应用效果显著,能够改善患者膝关节位置觉和运动觉,减轻远期疼痛情况与肿胀情况,提升膝关节功能,患者生活质量较好。     

Growth hormone secretion during sleep. I. Comparison with GH responses to conventional pharmacologic stimuli in pubertal and early pubertal short subjects. Effects of treatment with human GH in patients with discrepant measurements of GH secretion

Growth hormone (GH) was measured in 215 short children (147 males and 68 females, 123 prepubertal, 92 at early pubertal stages), comparing GH responses to classical pharmacologic stimulation tests and spontaneous GH secretion during sleep. GH secretion during sleep, but not GH responses to stimuli, was higher in early pubertal than in prepubertal subjects. The patients were classified into five groups, according to the agreement between GH responses to stimuli and GH secretion during sleep: group I, normal GH-secreting children; group II, completely GH-deficient; group III, partially GH-deficient; group IV, with normal secretion during sleep and low responses to stimuli; group V, with the reverse situation. 30% of the patients were in groups IV and V, both at prepubertal and early pubertal stages. 46 patients of groups II-V were treated with extracted human GH(hGH). The growth rate was enhanced in groups IV and V, to the same extent as in groups II and III. Four points can be concluded: (1) the rise of GH secretion during sleep is an early event at the onset of puberty; (2) the discrepancy between the GH responses to classical stimuli and GH secretion during sleep are of pathological significance; (3) disturbances of GH secretion might be diagnosed by measuring GH secretion during sleep rather than by using conventional stimulation tests; (4) a trial course of hGH treatment could be proposed in patients with both kinds of discrepancies between GH responses to stimuli and GH secretion during sleep.     

反馈式功能性电刺激对脑梗死患者上肢运动功能影响的fMRI研究

目的:利用功能核磁共振成像(f MRI)技术探究反馈式功能性电刺激对脑梗死患者上肢运动功能的影响,为脑梗死患者的康复提供最佳治疗方案。方法:选取2010年1月至2014年12月我院收治的脑梗死患者42例,随机分为I、II、III组,各14例,3组患者均接受常规康复治疗和药物治疗,在此基础上,I组行反馈式功能电刺激治疗,II组行单纯功能性电刺激治疗,疗程均为28天。治疗前后对所有患者进行上肢功能Fugl-Meyer运动量表评估和腕背屈关节活动度测量,并于治疗后3 d内对患者大脑M1区的激活强度进行f MRI检查。结果:3组患者的运动功能均较治疗前有所改善,其中Fugl-Meyer运动量表评分和腕背屈关节活动度的测量结果显示,I、II组测量结果明显好于III组,I组测量结果明显好于II组,差异具有统计学意义(P0.05)。患者大脑M1区激活强度对比,I、II组明显强于III组(P0.05),I组测量明显强于II组,差异均有统计学意义(P0.05)。结论:脑梗死康复期患者采用功能性电刺激治疗有助于受损脑功能重组,其中反馈式功能性电刺激强调人的主观性运动,较单纯性电刺激效果更好。     

Prophylactic effect of bestatin on the onset of invasive mole — clinical and fundamental studies

This study was performed to determine whether bestatin (Ubenimex) has clinical prophylactic effects on the onset of invasive mole and a direct inhibitory effect on the growth of hydatidiform molar cells. A total of 49 patients with hydatidiform mole treated at Nagoya University Hospital from 1984 to 1990 were randomly divided into two groups, a bestatin administered-group and a bestatin non-administered group. Patients in the bestatin group were given 30 mg of bestatin orally and daily for three months just after their molar deliveries. There was no significant difference in age, gravidity, parity and gestational weeks between the two groups. There was also no significant difference in the duration of human chorionic gonadotropin (hCG) negative conversion in patients without invasive mole between the two groups. However, the incidence of invasive mole in the bestatin group (2/25, 8%) was significantly lower than that of the non-bestatin group (7/24, 29.2%). Nevertheless, there was no significant difference between the two groups in such immunological parameters as PHA skin test, PPD skin test, PHA stimulation index (PHA-SI), white blood cell (WBC) count lymphocytes % per WBC, OKT 3% per lymphocytes, OKT 4% per lymphocytes, OKT4/OKT8 and Leu 11% per lymphocytes. In vitro studies were performed with primary cultured hydatidiform moles. The result was that bestatin inhibited the secretion of hCG and³H-thymidine uptake of hydatidiform molar cells. Thus, a possibility was suggested that bestatin directly inhibits the growth of hydatidiform molar cells and prevents the onset of invasive mole.     

Recall antigen delayed-type hypersensitivity skin testing: standardization of self-reading by patients

Summary In order to evaluate a self-reading system for the measurement of immunocompetence in cancer prognosis, a battery of delayed-type hypersensitivity skin tests with antigens including dermatophytin, candida, Varidase (streptokinase-streptodornase), mumps, and purified protein derivative (PPD) was administered to 50 cancer patients. The resulting erythema and induration were read by both technicians and patients at 24 and 48 h after placement of the tests. In addition, another group of 85 cancer patients received two identical candida skin tests placed at the same time on either the same or the opposite arm. The results from these two groups of patients indicated that patients' readings correlated well with technicians' readings, with most of the correlation coefficients being greater than 0.8. The weakest correlations were with antigens producing a large response. There was significant variability in the two identical simultaneously placed skin tests, and the correlation coefficients were much lower. The relevance of these data to serial skin testing is discussed.     

低频脉冲刺激穴位疗法联合规律有氧运动对2型糖尿病周围神经病变患者感觉阈值、神经传导速度和血液流变学的影响

摘要 目的：探讨低频脉冲刺激穴位疗法联合规律有氧运动对2型糖尿病周围神经病变（DPN）患者感觉阈值、神经传导速度和血液流变学的影响。方法：选取2020年1月~2022年1月期间贵州中医药大学第二附属医院收治的DPN患者136例。根据随机数字表法分为对照组（n=68,常规治疗联合规律有氧运动）和研究组（n=68,对照组基础上接受低频脉冲刺激穴位疗法）,两组以14 d为1个疗程,均治疗2个疗程。对比两组疗效、感觉阈值、神经传导速度和血液流变学变化。结果：研究组的临床总有效率91.18%（62/68）高于对照组75%（51/68）（P<0.05）。两组治疗2个疗程后腓总神经感觉神经传导速度（SCV）、胫神经SCV、腓总神经运动神经传导速度（MCV）、胫神经MCV均升高,且研究组的变化程度大于对照组（P<0.05）。两组治疗2个疗程后全血黏度值(高切、低切)、红细胞压积、血浆黏度、血小板黏附率均下降,且研究组的变化程度大于对照组（P<0.05）。两组治疗2个疗程后神经症状积分、神经反射、感觉功能和总分均下降,且研究组的变化程度大于对照组（P<0.05）。结论：低频脉冲刺激穴位疗法联合规律有氧运动治疗DPN患者,可提高神经传导速度,改善感觉阈值和血液流变学。     

Relation between the site of primary intracranial tumors and mitogenic responses of blood lymphocytes

Summary The possible relation between the site of primary intracranial tumors and mitogenic responses of blood lymphocytes was analyzed in 115 patients who had not undergone surgery or received any radiation or chemotherapy. Some of the patients had however received corticosteroid treatment. PHA responses were impaired in nonsteroid treated patients with tumors affecting the left cerebral hemisphere. They were normal in patients with tumors affecting the right cerebral hemisphere or central structures of the brain or tumors growing in the posterior fossa of the skull. Lymphocyte responses to PPD were normal in patients with hemispheric or posterior fossa tumors. However, the PPD response was sharply reduced in patients with central tumors. The results could not be explained by different histological tumor types or anticonvulsant medication in the various patient groups. In addition, the capacity of sera to promote mitogen stimulation of lymphocytes did not differ significantly between the patient groups. It is speculated that intracranial tumors may interfere with the function of certain centers in the brain which are involved in the regulation of lymphocyte responses.     

中晚期直肠癌患者的心理压力调查及干预措施探讨

目的:分析中晚期直肠癌患者的心理健康情况,探讨改善患者心理应激的干预措施,为直肠癌的临床护理工作提供可借鉴的方法。方法:选取2009年1月-2013年1月在我院接受治疗的中晚期直肠癌患者89例作为研究对象,随机分为两组。其中,对照组42例患者采用常规护理模式,而干预组47例患者在此基础上接受健康指导。分别于干预前后对患者的心理健康状况及生存质量进行问卷调查,比较并分析调查结果。结果:实施护理干预前,两组患者各项评分无显著差异(P0.05);实施护理干预后,两组患者的心理健康评分均有所改善,差异具有统计学意义(P0.05)。干预组患者接受健康指导后的各项指标评分均显著优于对照组患者,差异具有统计学意义(P0.05)。两组患者干预后的生理机能、社会功能及情感功能评分均获得提高,但干预组患者效果更为明显,差异具有统计学意义(P0.05)。结论:中晚期直肠癌患者的心理压力对预后产生消极影响,医护人员应积极对患者进行心理疏导,帮助其积极配合治疗,从而获得良好的疗效。     

连续肾脏替代治疗对脓毒症患者血清中TNF-alpha、IL-6 和IL-8 表达的影响

目的：探讨连续肾脏替代治疗（CRRT）对脓毒症患者血清中肿瘤坏死因子alpha（TNF-alpha）、白介素-6（IL-6）和白介素-8（IL-8）的 影响。方法：将我院2013 年1 月-2014 年6 月间收治的80 例脓毒症患者随机分为观察组与对照组各40 例,两组患者均给予脓毒 症常规治疗,观察组另给予CRRT 治疗。观察比较两组患者治疗前1 天,治疗后24 h,72 h空腹静脉血TNF-alpha、IL-6、IL-8 水平。结 果：观察组治愈率为85.0%（34/40）,明显高于对照组的55.0%（22/40）,差异有统计学意义（P<0.05）;治疗24h、72h 后两组患者 TNF-alpha、IL-6和IL-8 水平均明显下降,其中观察组下降更显著,差异均有统计学意义（P<0.05）。结论：CRRT 能有效降低脓毒症患 者血清中TNF-alpha、IL-6 和IL-8 水平,有助于对炎症反应的正向调节。     

针刺结合功能性电刺激对急性脑卒中后吞咽困难患者吞咽功能的影响

目的:探索针刺结合功能性电刺激对急性脑卒中后吞咽困难患者吞咽功能的影响,以寻求一种更加有效的治疗方法。方法:选取2010年7月至2014年7月我院神经内科、急诊科收治的93例急性脑卒中后合并吞咽障碍的患者作为研究对象,随机分为三组,每组31例。三组在脑卒中常规药物治疗及吞咽康复训练的基础上,A组接受针刺治疗,B组接受功能性电刺激治疗,C组接受针刺联合功能性电刺激治疗。比较治疗前后洼田氏饮水试验评分及疗效。结果:治疗后三组评分均较治疗前下降,差异均具有统计学意义(均P0.05),且C组评分相比A、B组更低,差异均具有统计学意义(P0.05);C组总有效率为93.5%,明显高于A组的67.7%和B组的74.2%,差异均有统计学意义(P0.05)。结论:针刺治疗联合功能性电刺激治疗卒中后吞咽障碍疗效显著,优于单纯针刺治疗及单纯功能电刺激治疗。     

放化疗与介入性动脉化疗治疗局部晚期宫颈癌的临床研究

目的:比较分析放化疗与介入性动脉化疗治疗局部晚期动脉宫颈癌的临床效果。方法:选择我院局部晚期宫颈癌患者97例,依据治疗方法分为常规组(行传统放化疗)55例和介入组(行介入性动脉化疗)42例。观察治疗后肿瘤大小、近期疗效、根治性手术率、术后并发症,对生活质量指数进行评分,评价两种方法的临床效果。结果:治疗后,两组患者近期疗效比较差异无统计学意义(P0.05);介入组肿瘤直径明显小于常规组,而根治性手术率明显高于常规组,差异均具有统计学意义(P0.05);介入组患者日常生活、健康、总体情况以及总的评分均明显高于常规组,差异具有统计学意义(P0.05),同时介入组并发症较少。结论:放化疗与介入性动脉化疗治疗局部晚期动脉宫颈癌近期临床疗效均较好,但介入性动脉化疗具有较高的根治性手术率以及生活质量,且并发症少。     

Comparison of stimulated growth hormone levels in primed versus unprimed provocative tests. Effect of various testosterone doses on growth hormone levels

OBJECTIVE: To show the importance of priming prior to growth hormone (GH) stimulation tests in the diagnosis of GH deficiency, the effect of different doses and schedules of testosterone (T) on GH levels. PATIENTS AND METHODS: Eighty-four prepubertal and early pubertal boys whose heights were 2 SD below the mean and height velocities <4 cm per year and who failed in GH stimulation tests were included in the study. The boys were divided into two groups: the first group consisting of 41 boys was primed with 62.5 mg/m(2) (low dose testosterone - LDT) and the second group consisting of 43 boys with 125 mg/m(2) depot testosterone (conventional dose testosterone - CDT) intramuscularly 1 week before the stimulation test. Twenty-one boys out of 36 who failed in GH stimulation tests after one dose T injection were treated with three doses of 62.5 mg/m(2) T (multiple dose testosterone - MDT) injections monthly and retested. RESULTS: The GH levels increased from 4.80 +/- 2.78 to 11.50 +/- 8.84 ng/ml and from 4.76 +/- 2.46 to 12.98 +/- 8.30 ng/ml by priming with LDT and CDT respectively. The increment of mean GH levels by both LDT and CDT were found to be similar (p = 0.443). The peak GH levels were found to be elevated >10 ng/ml in 22/41 (54%) and 26/43 (60%) who received LDT and CDT respectively (p = 0.528). The mean GH level of 21 boys who received MDT was increased from 5.38 +/- 2.50 ng/ml (by priming with one dose T) to 10.19 +/- 6.13 ng/ml (p = 0.004). Twelve (57%) of 21 boys who received MDT responded to GH stimulation test >10 ng/ml. The T level increased from 0.71 +/- 0.97 to 4.54 +/- 2.80 ng/ml by LDT (p < 0.001) and from 0.65 +/- 0.71 to 7.18 +/- 3.18 ng/ml by CDT (p < 0.001). The increment of T level was higher by CDT than LDT (p = 0.001). There was no correlation between T and peak GH levels after priming. CONCLUSION: LDT is as effective as CDT in priming of GH stimulation tests. The ones who failed in GH stimulation tests after one dose T injection can be primed with MDT. The stimulated GH level after priming was related neither to the plasma level of T nor the dose of T.     

Chronic Application of MTII in a Rat Model of Obesity Results in Sustained Weight Loss

Objective: To examine the effects of a cafeteria diet and a chronic treatment with melanocortin agonist (MTII) on mature weight-stable female rats. Research Methods and Procedures: Ex-breeder Chbb:Thom rats (350 to 400 g) were divided into two groups: highly palatable food (HPF) and normal rat chow (RC). Both groups had ab libitum access to rat chow. The HPF group had access to chocolate bars, cookies, cheese, and nuts (∼20 g/d). After 21 days, the rats in each group were then divided into control and treated groups. Mini-pumps delivering saline or MTII (1 mg/kg per day) for minimally 28 days were implanted. Oxygen consumption was measured for 17 days in a second group of rats implanted with mini-pumps containing MTII (1 mg/kg per day) or saline. Results: HPF rats ate less (<50%) rat chow than RC rats. After 20 days, the HPF group had reached a plateau and weighed significantly more (p < 0.005) than the RC group (411.7 ± 9.3 g; n = 17 vs. 365.1 ± 9.4 g; n = 16). HPF rats and RC rats receiving MTII reduced their pellet intake and body weight in the initial 2 weeks of treatment (day 14, RC-saline: −1.6 ± 1.8 g; RC-MTII, −22.5 ± 3.7 g; HPF-saline, −7.1 ± 1.7 g; HPF-MTII, −30.7 ± 4.8 g). Subsequently, pellet intake returned to pre-implantation values, although body weights remained reduced in both HPF and RC groups. Oxygen consumption was increased in rats treated with MTII. Discussion: This suggests that MTII initially reduced body weight by limiting food intake; however, maintenance of weight is most likely due to increased energy expenditure under conditions of normal and highly palatable diets in mature animals.     

腕踝针联合热敏灸治疗中风后肢体功能障碍效果及对生活质量的影响

摘要 目的：评价腕踝针联合热敏灸治疗中风后肢体功能障碍的效果及对患者生活质量的影响。方法：选入我院2022年6月到2023年2月收治的中风后肢体功能障碍患者60例,根据康复方案不同分为常规组和联合组,各30例,常规组予以常规药物治疗及康复训练,联合组在常规组基础上采用腕踝针联合热敏灸治疗。评价两组的临床疗效、生活质量等,并进行统计比较。结果：联合组治疗总有效率96.67%,高于常规组的70.00%（P＜0.05）;相较于治疗前,两组治疗后PAR、Hcy、D-D水平降低（P＜0.05）,而联合组降低幅度较常规组大（P＜0.05）;两组治疗前SIAS、SS-QOL得分无差异（P＞0.05）,而治疗后,联合组SIAS、SS-QOL得分高于常规组（P＜0.05）。结论：腕踝针联合热敏灸可有效提高中风后肢体功能障碍的康复效果,调节PAR、Hcy、D-D水平,改善整体功能及患者生存质量。     

阿米洛利对脑梗死急性期患者血清炎症因子水平的影响

目的:探讨阿米洛利对脑梗死急性期患者血清ox-LDL、炎症因子及MMP-9水平影响及其意义。方法:选取我院诊治的急性脑梗死患者120例,随机分为对照组和实验组,每组60例。两组患者均给予常规对症治疗,实验组在对照组的治疗基础上加用盐酸阿米洛利片。采用酶联免疫吸附法(ELISA)及免疫透射比浊法分别测定两组患者血清ox-LDL、炎症因子及MMP-9水平,并对患者神经功能缺损程度进行评分。结果:治疗后,两组患者神经功能均较治疗前明显改善,且实验组明显优于对照组,差异均具有统计学意义(P0.05);治疗后,两组患者血清ox-LDL及MMP-9水平均低于治疗前,且实验组低于对照组,差异具有统计学意义(P0.05);治疗后,两组患者血清炎症因子TNF-α、IL-6及hs-CRP水平均低于治疗前,且实验组低于对照组,差异具有统计学意义(P0.05)。结论:阿米洛利能够降低脑梗死急性期患者ox-LDL、TNF-α、IL-6、hs-CRP及MMP-9水平,减轻炎症反应,改善患者的神经功能。     

脑卒中痉挛性患者经颅磁刺激联合物理治疗后上肢功能恢复状况的临床观察

摘要 目的：探讨脑卒中痉挛性患者经颅磁刺激联合物理治疗后上肢功能改善状况的临床观察。方法：选取我院2018年1月到2020年1月共收治的80例脑卒中患者,所有患者均出现不同部位痉挛现象,将患者随机分为观察组与对照组,每组40例。给予对照组患者常规治疗与康复训练,观察组患者在常规治疗基础上应用低频重复经颅刺激联合肌电生物反馈模式下的康复训练。对比两组患者的治疗效果与上肢功能改善情况。结果：观察组治疗总有效率95.00 %,高于对照组72.50 %（P＜0.05）;治疗前两组患者的NIHSS评分应用神经功能缺损量表（Neurological deficit scale,NIHSS）、MMSE评分应用认知功能量表（Cognitive function scale,MMSE）、ADL评分应用日常生活能力量表（Activities of daily living scale,ADL）评分对比无显著差异（P＞0.05）,治疗后,观察组的NIHSS评分低于对照组,ADL评分高于对照组（P＜0.05）;治疗前两组患者的肱二头肌和肱三头肌均方根值（Root mean square,RMS）对比无显著差异（P＞0.05）,治疗后,观察组患者的肱二头肌RMS低于对照组,肱三头肌RMS高于对照组（P＜0.05）;治疗前两组患者的运动功能评估表中的上肢功能部分（Upper limb function in motor function assessment table,FMA-UE）、手部精细化动作及上肢功能测量表（Measurement table of hand fine movement and upper limb function,Carroll）评分对比无显著差异（P＞0.05）,治疗后,观察组患者的FMA-UE、Carroll评分高于对照组（P＜0.05）。结论：对脑卒中上肢痉挛患者在常规治疗与康复训练的基础上应用低频重复经颅刺激联合肌电生物反馈模式下的康复训练,虽然对患者的认知功能无明显影响,但是能提升患者上肢痉挛的治疗效果,促进患者上肢功能恢复,提高生活能力,值得临床应用推广。     

全面质量管理对老年心血管疾病患者的效果分析*

摘要目的：探讨全面质量管理模式对老年心血管疾病患者的生活质量的改善情况所起的积极作用,为临床护理提供参考。方法： 选择2011 年2 月至2012 年12 月在我院心血管内科接受住院治疗的老年患者60 例,随机分为常规组和全面管理组。常规组采 取基础护理模式,全面管理组在常规护理的基础上对患者进行心理干预、健康教育及饮食管理等。对比两组患者干预前后生活质 量改善情况,并对护理服务的满意度进行问卷调查。结果：全面管理组患者的生活质量较干预前明显改善,且患者的心理功能、生 活能力及社交功能评分均显著优于常规组,差异具有统计学意义(P<0.05)。全面管理组患者对心理护理、饮食管理、健康教育及护 患沟通的满意度均高于常规护理组,差异具有统计学意义(P<0.05)。结论：采取全面质量管理的模式对老年心血管疾病患者进行 康复指导具有显著的效果,可明显改善患者的生活质量,并且能够提高患者对护理服务的满意度,值得临床推广。     

止颤汤联合重复经颅磁刺激治疗帕金森病合并睡眠障碍、抑郁的临床疗效观察

摘要 目的：评价止颤汤联合重复经颅磁刺激（rTMS）治疗帕金森（PD）合并睡眠障碍、抑郁的临床疗效。方法：选入我院2022年9月~2023年1月收治的PD合并睡眠障碍、抑郁患者80例，随机分为对照组和观察组，各40例。对照组予以常规西药+rTMS治疗，观察组在对照组基础上加服中药止颤汤。评价两组的临床疗效、睡眠及抑郁状况等，并进行统计比较。结果：两组治疗后中医证候积分较治疗前下降（P＜0.05），而观察组下降幅度显著高于对照组（P＜0.05）；两组总有效率无明显差异（P＞0.05），但观察组愈显率较对照组高（P＜0.05）；与治疗前比较，两组治疗后UPDRS-Ⅰ、UPDRS-Ⅱ、UPDRS-Ⅲ，NMSE和HAMD量表得分明显下降，PDSS得分明显上升（P＜0.05），而观察组下降幅度更大（P＜0.05）；两组不良反应发生率无差异（P＞0.05）。结论：止颤汤联合rTMS治疗PD合并睡眠障碍、抑郁疗效肯定，可有效改善患者的临床症状，提高睡眠质量，缓解抑郁状态，且安全性良好。