肺心病伴脑梗死偏瘫的早期康复护理特点

脑梗死是老年人常见的多发病之一,3/4的存活者有不同程度的残疾[1]。我院呼吸科从1997年2月～2001年6月,收治了肺心病并发脑梗死患者28例,均经CT确诊为不同部位的脑梗死且有不同程度的偏瘫。我们对这类患者实施了早期康复护理,对病人的瘫侧肢体恢复起到了促进作用,现将护理体会报道如下。

中药配合甲氨喋呤分期治疗对类风湿性关节炎患者远期疗效观察

类风湿性关节炎(RA)发病率高,危害性大,约有1/3患者可致残。由于病因迄今不明,临床表现复杂,目前国内外尚无特殊治疗方法。近年来我科运用中药辨证施治配合西药治疗143例,疗效满意,现报道如下。

针药并用辨证治疗脑卒中偏瘫200例疗效观察

自从1995年以来我们采用针药并用治疗200例脑卒中病人,收到较好的效果,现将临床治疗观察介绍如下。

按时针刺尺泽穴治疗脑梗死30例报告

我们采用按时针刺尺泽穴治疗脑梗死30例,收到满意效果。现报道如下。1对象与方法30例中,男22例,女8例;年龄42～68岁;病程短3d,长30d;所有病例均以上肢瘫痪为主要指征。

运动性疲劳产生的中枢机制和心理学因素对其的影响

疲劳机制的研究一直是运动医学界工作热点，研究者已在此方面做了大量的工作，尽管提出不少假说，但运动疲劳机制理论至今并没有得到完整的阐述。按发生的部位，习惯上把运动疲劳分为中枢疲劳和外周疲劳两部分，尤其是中枢神经系统在疲劳过程中的作用越来越受到人们的重视，中枢神经系统功能紊乱是运动疲劳产生的重要原因之一。本文欲总结前人工作的基础上，结合部分心理学知识对运动疲劳时中枢神经系统的表现进行综述。

运动防治高血压、冠心病和心力衰竭的作用及其机制的研究进展

运动是对机体刺激的一种形式,是调节机体心血管功能的物理应激。现就近年来运动对高血压、冠心病的预测和对心力衰竭的检查以及对其康复治疗机制的研究进展作一综述,以促进此领域内研究的进一步深入。

儿童少年生长发育趋势研究

目的研究10～15岁儿少的生长发育趋势。方法检测骨龄、月经初潮、形态、机能、身体素质等。结果儿童少年3种发育类型的构成比是,男生早熟占27.6%,平行发育占65.7%,晚熟占6.7%;女生早熟占37.3%,平行发育占57.7%,晚熟占5.0%。结论早熟者比平行发育及晚熟者高。为少年儿童的生长发育提供实证依据。

脑卒中失语病人言语功能恢复的分析与对策

目的分析首次发病失语症病人近期结局的影响因素,为制定有效的康复治疗和功能训练方案提高理论依据。方法采用回顾性问卷法对32例脑卒中失语病人进行评价,所得资料进行单因素分析和多元逐步回归分析。结果发现失语症的预后与发病的严重程度、病灶范围大小、年龄、失语症的种类及康复治疗开始的时间、方法等因素有关。结论针对病人失语症的特点进行康复治疗和功能训练且尽早介入对提高脑卒中失语病人的言语功能恢复率有重要意义。

引导式教育辅以神经生理学疗法对脑性瘫痪儿童运动功能的改善与评价

目的观察 Bobath与 Vojta的神经生理学疗法和引导式教育辅以 Bobath与 Vojta相结合对脑性瘫痪 (脑瘫 )患儿的作用效果。方法选择年龄 1～ 3岁的脑瘫患儿 ,观察组 1为 23例 , 采用引导式教育辅以 Bobath和 Vojta法 ; 观察组 2为 25例 , 采用 Bobath和 Vojta法。结果表明两观察组脑瘫儿治疗前后运动功能得分 , 不但治疗前后均有非常显著性差异 (P《 0.01), 而且引导式教育辅以 Bobath和 Vojta疗法组与 Bobath和 Vojta组有显著差异(P《 0.05) 。结论引导式教育辅以 Bobath和 Vojta疗法优于单纯采用 Bobath和 Vojta疗法。

脑卒中后抑郁症药物治疗与心理康复的疗效比较

目的探讨脑卒中后抑郁症(PSD)的发生情况及心理康复的作用。方法通过Hamilton抑郁量表调查PSD的发生情况,同时给予抗抑郁药物和心理康复治疗。结果PSD的发生率为62.75%。抗抑郁药物和心理康复治疗PSD均有效,药物治疗显效快,但有一定的副作用;心理康复治疗显效相对缓慢,但无副作用,可进行长期治疗。结论脑卒中的康复特别是PSD的康复,心理康复是一种安全有效的方法。

扎鲁司特对哮喘患者肺功能和心理情绪的作用

目的探讨白三烯受体拮抗剂扎鲁司特对成人哮喘患者心理情绪的作用。方法40例哮喘患者随机分为治疗组和对照组各20例。治疗组口服扎鲁司特20mg,2次/d,疗程4周。对照组不用扎鲁司特。试验期间两组按需使用β2-激动剂,停用口服或吸入糖皮质激素。服药前及4周后测血常规、尿常规、肝肾功能和肺功能,采用医院内焦虑、抑郁评分表(HAD)进行心理情绪评估。结果治疗组口服扎鲁司特4周后日间及夜间症状计分、夜间憋醒次数、无症状天数和吸入β2-激动剂用量及肺功能肺活量、第1秒用力呼气量、呼气流量峰值率以及焦虑抑郁评分有显著改善。结论扎鲁司特能有效控制哮喘症状,改善肺功能和心理情绪。

社区脑卒中患者家庭康复现状调查分析

目的了解社区脑卒中患者家庭康复现状,分析其中存在的问题。方法对62例脑卒中患者及其主要照顾者进行家庭入户问卷调查。结果居家康复的脑卒中患者遗留有多种功能障碍,缺乏家庭康复训练,家庭设施未行相应改造,患者的综合自理能力及主要照顾者的照顾能力均较差。结论社区脑卒中患者的家庭康复存在问题较多,应加强家庭康复护理指导工作。

有氧运动对老年心力衰竭患者运动耐力及左心功能的影响

目的探讨有氧运动疗法对慢性心力衰竭(chroniccongestiveheartfailure,CHF)患者运动耐力及心功能的影响。方法对48例慢性心力衰竭患者进行心率控制下的有氧运动6个月,并与无运动锻炼的对照组比较其运动耐力及心功能的变化。结果疗程结束后病人的血压、心率有不同程度的下降(P《0.05),运动耐力明显提高(P《0.01),左心功能指数明显改善(P《0.01)。结论有氧运动作为一种中等强度的有氧运动可提高慢性心力衰竭病人的心功能。

抑郁症患者睡眠障碍与康复的关系研究

目的探讨抑郁症患者睡眠障碍与疾病康复的关系。方法采用自编调查表及汉密顿抑郁量表 (HAMD)对入组患者进行检测并分组 , 经同样治疗后比较存在严重睡眠障碍患者和睡眠障 碍不明显患者的康复情况。结果存在严重睡眠障碍患者的康复明显滞后于睡眠障碍不明显患者 , 睡眠障碍和患者的病情轻重及发病有密切的关系。结论抑郁症的睡眠障碍直接影响其康复和预后 , 在抑郁症的治疗过程中应加强对睡眠障碍的原因分析和治疗。

高压氧综合治疗持续性植物状态17例

为探讨提高持续性植物状态(PVS)患者的生存率,改善其预后可能性,本院自1989年起用高压氧(HBO)综合治疗PVS17例,现报道如下。

高压氧治疗以面神经麻痹为首发症状的系统性红斑狼疮1例

1病历摘要患者,女,33岁,1个月前出现面部麻痹,口角歪斜,眼睑不能闭合。继之逐渐精神抑郁,反应迟钝。10d前开始发热,高达40.1℃,伴双下肢肌肉酸痛。查体:体温40.2℃,脉搏124次/min,呼吸30次/min,血压112/68mmHg(1mmHg=0.133kPa),神清,反应迟钝。颈、面部呈现弥漫性水肿性红斑,表面有鳞屑。左眼裂增宽,眼睑不能闭合,左侧鼻唇沟变浅,口角向右歪斜。

高压氧综合治疗X-刀术后晚发放射性脑病

目的观察高压氧综合治疗X-刀术后晚发放射性脑病的疗效。方法30例X-刀术后晚发放射性脑病患者应用高压氧加药物治疗,对照组25例患者应用单纯药物治疗,比较两组疗效及平均住院床日。结果高压氧综合治疗组痊愈6例,总有效率86.7%,对照组总有效率60%,P<0.05,差异有显著性。平均住院天数高压氧综合治疗组为(26.0±3.0)d,对照组为(25.0±3.4)d,P<0.01,差异有显著性。结论X-刀术后晚发放射性脑病在常规药物治疗的同时加用高压氧治疗有更好的疗效,同时可缩短平均住院天数。

用高压氧舱治疗气栓症

由于医护质量的提高,医源性气栓症已不多见,用高压氧治疗医源性气栓症就更少了。我院于1999年遇到1例,经高压氧治疗转危为安。现报道如下。

高压氧治疗糖尿病微血管病变的临床价值

目的为探讨高压氧治疗糖尿病微血管病变(DMA)的临床价值。方法将30例确诊为2型糖尿病合并DMA患者随机分为两组,治疗组16例,在药物常规治疗的基础上进行高压氧治疗;对照组14例,单纯以药物常规治疗。通过对治疗前后眼底和尿蛋白改变的比较及血糖、血脂及血液流变学等各项指标变化的观察。对两组疗效进行对比。结果治疗组症状改善,眼底及尿蛋白检查均有好转,空腹血糖、餐后2h血糖、血清胆固醇、甘油三酯、全血高切黏度、血浆高切黏度、全血低切黏度、红细胞聚集指数、红细胞刚性指数、纤维蛋白原均低于对照组,差异有显著性(P<0.05)。结论糖尿病患者经高压氧治疗能控制糖代谢紊乱,使血糖、血脂降低,改善血液流变学,延缓了因缺氧、微循环障碍所致的DMA的发生及发展。

氨肽碘直流电导入治疗玻璃体混浊50例

近来我们将直流电导入技术应用于氨肽碘治疗玻璃体混浊的治疗过程,效果较好,现报道如下。

微波改良悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征10例报告

悬雍垂腭咽成形术(UPPP)治疗阻塞性睡眠呼吸暂停综合征(OSAS)以被广泛应用,常规的UPPP术中出血较多、切缘的缝合较为繁琐、悬雍垂切除有一定的鼻咽关闭不全等缺憾,为减少和避免上述不足,我们在常规UPPP基础上,利用微波改良UPPP治疗不同程度OSAS共10例,取得满意结果,报道如下。

局灶性脑缺血再灌注后白细胞介素-6、肿瘤坏死因子-α的表达及川芎嗪对其表达的影响

目的探讨大鼠局灶性脑缺血再灌注后各时相的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的表达及中药川芎嗪对其表达的影响。方法采用放免法测定IL-6、TNF-α的动态变化。结果对照组IL-6表达在12h时显著增高(P《0.05);实验组在再灌注6h时表达显著增高(P《0.05),12h时仍显著增高(P《0.05)。对照组TNF-α缺血早期表达即增高,再灌注12h时显著,而实验组明显降低(P《0.05)。结论TNF-α加重脑缺血再灌注损伤;IL-6可能作为一种脑缺血后神经细胞死亡的内生拮抗剂,起到神经保护作用;川芎嗪可抑制脑缺血再灌注后TNF-α的表达,使IL-6的表达提前,可能是川芎嗪对抗脑缺血再灌注损伤的机制之一。

多动行为问题儿童血5－羟色胺浓度变化相关性探讨

目的探讨多动行为问题儿童与正常儿童外周血5-羟色胺浓度差别;进一步了解心理卫生偏异儿童、不同年龄阶段行为问题儿童外周血5-羟色胺浓度差别,并分析各种行为问题儿童外周血5-羟色胺浓度的变化及其意义。方法应用《Achenbach儿童行为量表》筛查并根据其因子分分类,对30例行为问题儿童进行外周血5-羟色胺含量测定,与30例正常儿童对照比较。结果多动行为问题儿童与正常儿童外周血5-羟色胺浓度比较明显降低 , 差异显著(P《 0.05);内向型因子组与外向型因子组比较明显升高,差异显著(P《0.05);不同年龄阶段行为问题儿童外周血5-羟色胺浓度随着年龄的增长与正常儿童差异增大。结论外周血5-羟色胺浓度与行为问题有关,可能是儿童行为问题发生的物质基础之一。

冷负荷对人体体表循经红外辐射轨迹影响的初步观察

目的观察冷负荷对人体体表循经红外辐射轨迹的影响。方法应用日本三荣公司生产的 Thermo Tracer 6T67型红外热像仪系统 , 对 45名健康成年志愿者的背部、上肢内侧面的经与非经部位同时进行致冷 , 观察其恢复过程。结果经线上的皮温恢复要比非经部位快 , 与致冷前比较 , 经线上的轨迹表现得更加清晰。结论经脉循行线下相应的组织中的微循环可能更丰富 , 能量代谢也更旺盛。

川芎嗪拮抗庆大霉素耳毒性扫描电镜观察

目的研究川芎嗪注射液(四甲基吡嗪TMP)对庆大霉素(GM)耳中毒豚鼠耳蜗毛细胞的影响,探讨TMP对GM耳毒性损伤的保护作用。方法选用健康白色红目豚鼠40只,体重200～250g,随机分为4组:GM组、TMP+GM组、TMP组、生理盐水组。应用听脑干反应(ABR)测试及扫描电镜技术。结果TMP+GM组耳蜗ABR阈值明显低于GM组(P《0.01),而且毛细胞倒伏、缺失或残缺不全等现象明显少于GM组。结论TMP可拮抗GM的耳毒性,从而改善听功能。

调神方对老年性痴呆大鼠学习记忆和细胞因子调节的实验研究

目的探讨调神方对老年性痴呆(AD)大鼠学习记忆和细胞因子调节的作用机制。方法建立AD鼠模型,分为正常组、衰老组、假损伤组、模型组、调神方组、他克林组,观察Y-电迷宫和血清细胞因子。结果调神方能明显提高Y-电迷宫正确次数,明显下调血清白介素1β(IL1β)、白介素6(IL6)的水平。结论调神方可能通过调整AD大鼠的免疫状态而提高学习记忆能力。

抑郁症状与睡眠脑电图参数的相关分析

目的调查抑郁症状与睡眠脑电图参数的相关性。方法对停用精神药物3d的18例病人估价其汉密顿抑郁量表(HAMD)总分/诸因子分与14项睡眠脑电图参数的相关性。结果(1)焦虑/躯体化因子与快波睡眠百分率呈显著负相关性(r=-0.5097,df=16,P《0.05);(2)绝望感因子与慢波睡眠2相百分率呈显著正相关性(r=0.4874,df=16,P《0.05);(3)绝望感因子与快波睡眠活动量及强度分别呈显著负相关性(r分别为-0.5067和-0.5657,df=16,P均《0.05)。结论慢波睡眠2相百分率、快波睡眠活动量及强度可作为绝望感因子的生物学标记。

儿童情绪障碍过氧化脂质及谷胱甘肽过氧化物酶的研究

目的了解儿童情绪障碍过氧化脂质 (LPO)及谷胱甘肽过氧化物酶 (GPX)水平 , 探讨其病 因。方法测定 30例儿童情绪障碍 LPO及 GPX水平与正常儿童(30例 ) 比较研究。结果儿童情绪 障碍 LPO明显高于对照组 (P《 0.05)。结论 LPO的改变可能是儿童情绪障碍的生物学原因之一。

儿童侧脑室周围白质软化症 36例临床与磁共振成像特征

目的探讨儿童侧脑室周围白质软化症 (PVL)的临床和核磁共振 (MRI)特征。方法对 36例 PVL的临床资料进行回顾性分析。结果胎龄 : 30～ 37周 22例 , 38～ 42周 14例。临床表现 : 肢体 瘫痪 36例 , 皮质盲 2例 , 智力低下 9例 , 癫痫 10例。 MRI表现 : 病灶形态 : 斑片状 16例 , 斑点状 13例 , 条纹状 7例。部位 : 半卵圆中心及侧脑室周围白质。病灶信号 : 呈长 T1或等 T1, 长 T2变 化。其他 : 两侧侧脑室体部扩张 8例 , 三角区扩大 5例。结论 PVL是脑性瘫痪的一个主要原因 , MRI是早期诊断 PVL的一个主要方法。

针灸治疗慢性失眠的疗效研究

Objective To evaluate therapeutic effect of acupuncture on chronic insomnia.Methods Head-acupuncture, galvano-acupuncture, and body acupuncture were used to treat the chronic insomnia. Statistical analysis was conducted therapeutic effect by using self-made Sleep Index Form(FormⅠ ) and the self-made clinical symptoms Form(FormⅡ ). Results P< 0.01. Therapeutic effect after treatment compared with that before treatment. Conclusion Acupuncture is effective in treating insomnia without obvious adverse effects.

弱视儿童视觉诱发电位改变

Amblyopia is common among children.Visual evoked potential(VEP) is a new approach for diagnosis and evaluation of amblyopia. VEP was examined using tessellation stimulation in our hospital since 1999.20 healthy children were selected as controls.Here is the report.

心理治疗反应性精神病128例疗效分析

反应性精神病是由剧烈持久的精神紧张或精神创伤直接引起的,在精神科临床上比较常见。

应用磁性固位体修复无牙颌上颌骨、颧骨、眼眶联合缺损恢复口腔功能的探讨

Objective The magnetic retainer was used to respair combined defects including edentous jaw,zygoma and orbit defects to recover patients mastication,language and swallow functions.Method Impression models of jaw,zygoma and orbit were taken.Two prosthesis were connected by magnetic retainer.Result Fixation,and recovery of language and face shape were favorable for patients with magnetic retainer.Mastitating function was completely recovered in health side and partially in affected side.Conclusion The magnetic retainer provide sufficient retention and reliable connection.It can recover mastication with convenient wearing and taking. ``

康复科艺术行为治疗方法探讨

艺术行为治疗，是指应用各种艺术手段，结合心理治疗等技术，以矫正不良行为、促进康 复为目的的治疗方法，简称艺术治疗。由于国内艺术行为治疗是在原来的工娱疗基础上发展 而来的，故又称特殊工娱疗。据报道住院精神病患者的生存质量低于社区中的患者 [1]，艺术 行为治疗可以很好地提高患者治疗的依从性及生存质量。目前，各家医院都把艺术行为治疗 作为精神康复工作的重要内容。本文重点对康复科艺术行为治疗的治疗程序及实施原则进行 了总结。

帕罗西汀与氯丙米嗪治疗强迫症远期疗效观察

目的比较帕罗西汀与氯丙米嗪治疗强迫症的远期疗效及不良反应。方法66例病人随机分两组,帕罗西汀组34例,给帕罗西汀20～60mg,1次/d,追踪观察48周。氯丙米嗪组32例,给氯丙米嗪100mg,2次/d,追踪观察48周。采用Yale-Brown强迫量表(Y-BOCS),汉密顿抑郁量表(HAMD),汉密顿焦虑量表(HAMA),药物副反应量表(TESS)分别评定。结果帕罗西汀组有效率70.59%,氯丙米嗪组有效率68.75%,两组疗效差异无显著性。氯丙米嗪组不良反应较多。结论帕罗西汀可用于强迫症的治疗。

奎的平与氯氮平对精神分裂症患者临床康复的对照研究

Background:Bilateral thalamus infarction near median line is uncommon in clinic.Reports concerned with this conditions were more less.It is characterized by conscious disorder and Korsakoff syndrome.The main caused may be the injury of intralaminar nuclei,dorsomedial nuclei,and injury of cortical matter,mammalillary bodies,fasciculus thalamicus around cerebral chamer III.Comprehensing the disability characteristics in pateints with bilateral thalamus infarction near median line is important for direction of rehabilitation.While study of survival time will improve evaluation of prognosis. Design:Patients recruited from June 1997～ October 2000 were analyzed. Unit:Intraneural Department of First People's Hospital of Yunnan Province. Subjects:55 subjects with MRI proved bilateral thalamus infarction near median line entered study.These patients included 3 women,2 men(age ranging from 50 to 77 years old,mean age:68.6 years).The period from onset to admission ranged from 5 hours to 2 days.All subejcts experienced acute bilateral thalamus infarction near median line.All had hypertension previously,1 had diabetes,2 had auricular fibrillation. Intervention:All patients received management which was conducted according to protocol for treatment of ischemic cerebrovascular diseases. Patients clinical characteristics were summari-zed and analyzed.Follow up was conducted to determine the survival period. Main evaluation indexes:Survival time and conscious disorder were evaluated. Result:All patients showed different level of conscious disorder.3 cases developed thalamic dementia,2 developed vision numb,In 1 case,condition progressively deteriorated manifesting as moderate coma progressed to deep coma,and bilateral mydriasis.Finally,this patients died of central respiratory and circulatory failure after 8 days.4 cases with favorable prognosis discharged,3 out of them died within 1 year after discharge.Survival subject suffered from reduced memory was followed up till now. Conclusion:Concious or cognitive disorder ,vision bumb are common among patients with bilateral thalamus infarction near median line.Their prognosis are poor.In the current study,the number of case was samll,so further study is needed.

重症肝病患者自杀心理障碍分析及疏导方法探讨

Background:Suicide is an much severe public hygiene problem. It was reported that suicidal rate in our country was 22.2 per hundred thousand each year(1993).One third of which was caused by their own diseases.Patients of severe hepatitis B suffer severe conditions of the disease with protracted course. It is easy for the patients to have severe psychonosema and suicide occurs.If the abnormal mood of the patients could be found early, the suicide might be avoided,and the patient might get rehabilitation earlier. Objective:To analyze the suicidal causes of the patients of hepatitis B and to study the method of treatment or persuation. Unit:Dept.of Hepatitis,the Sixth People's Hospital of Hangzhou Subjects:9 suicidal cases by falling from high place at the Dept. of Hepatitis B of the Sixth People's Hospital from 1991 to 2000 include 6 men and 3 women, with mean age of (36.7± 10.27) years(23～ 56 years) who were all diagnosed as chronic severe hepatitis with mean protracting course of (5.6± 4.2) years(2～ 11 years).The shortest inpatient time was 1 day,the longest was 228 days.7 of them were married.Their included 4 workers ,4 peasantsand individual trader.Their educational levels included 5 graduates from high school,4 from junior middle school.They all fell from the ward building for suicide. Intervention:The psychonosema were analysed by analyzing the patients'words,letters and their behavior before their suicides.Psychological therapy against these psychonosema were studied in order to avoid more suicide happen. Results:(1)Causes of suicides:One patient had symptoms of psychosis such as hallucination and delusional thinking disturbance.8 patients felt hopeless in curing the disease.4 cases had stress in family relationship. 3 cases could not endure body pain. 6 cases could not endure the heavy economic burden.Love relationship stopped because of the disease in 1 case.(2) Manifestations before their suicides 6 patients had insomnia, emotional lability,anxiety,pessimism and worldweariness in their words.They used to cry secretly.2 cases showed excessive care about their family with special exceted emotion.3 cases used to refered to psychological persuation.(3)Methods of psychological persuation:Physicians should have strong responsibility for their patients.They should understand patients' psychological state besides manage the primary diseases.Once psychological disorder occurred,psychological intervention should be administered immediately.If necessary,family members should participated the intervention.To let patients realize the impact of diseases.Physicians should help patients to clear anxiety and courage them to overcome the condition.Physicians should discuss the management project with patients.For patients with depression,monitoring should be focused.Consultation should be performed on severe patients.Environment surrounding patients should be improved.24-hour care should be carried out by family members. Conclusion:Delayed recovery of somatic diseases and drastic affliction will make patients loss the confidence,and hence exaggerate economical condition.Paradox within family will result severely psychological disorder and suicide.So,necessary psychological intervention is feasible.

心理治疗对分裂样精神病人的效果分析

目的了解心理治疗在分裂样精神病康复过程中的治疗效果。方法将30例分裂样精神病随机分成两组,A组15例为精神病药物合并心理治疗的观察组,B组15例为单一药物治疗的对照组。结果治疗前、后及出院1年后随访,经简明精神病评定量表、抑郁量表、阴性阳性症状评定量表评分比较,有显著差异(P《0.01),观察组缓解14例(93.3%),1例1年随访后复发(6.7%),平均住院日43d。对照组缓解9例(60%),1年内随访复发6例(40%),平均住院日50d。结论分裂样精神病患者在使用药物治疗的同时,开展与之相适应的心理治疗,促进患者康复,并提高对负性因素的应对能力,干预并减轻精神病的阳性症状,服药的依从性好,复发率低,住院天数相对较短。

CT增强检查患者300例的心理分析

1 General data 300 subjects underwent enhanced CT examination consisted of 182 males and 118 females.143 underwent head enhanced CT,93 underwent abdomen enhanced CT,46 thorax enhanced CT and 18 enhanced CT of other parts.Patients and their family were surveyed using questionnaire.Investigator fill the table if patients were illiterate.Percent constitution was used to analyze data. 2 Result Deficiency in understanding enhanced CT examination:261 patients(87％ ) hardly hear or want to receive the enhanced CT examination.Misunderstanding and distrust:112 subjects(37.3％ ) assumed effect of horizontal scanning of CT was poor and examiner's ability or responsibility were unsatisfying.13 subjects underwent CT in other hospital were advised to receive enhanced CT.But they rejected enhanced CT due to risk of enhanced drugs and came to our hospital for consultation.265(88.3％ ) subjects showed anxiety and horror due to its risk.Among these patients,16 chosed other examinations such as MRI.14 subjects underwent enhanced CT showed stronger psychological tolerance when they know risk of reexamination of enhanced CT compared with those first received the examination.4 subjects gave up the enhanced CT due to poor economical condition. 3 Discussion and countermeasure Psychological response characteristics:Psychological response is characterized by anxiety,horror,depression,unhappiness,agitation,helplessness.The following facts were the causes:patients were eager to understand conditions and examination results,worried impact of condition himself and family； They did not understand examination procedure and approach； They felt helpless due to disease.Economic conditon was poor； Inhospitality shown by family and unit to patients. Countermeasure: (1)To establish good relationship between doctors and patients.Amiable attitude could relive patient's anxiety and make patients actively cooperate with examiners.Examiners should evaluate pateints' response intensity to enhanced eaxmination.To understand their mind changes through communication with pateints and family.Patients should be permitted to express their feelings and receive examiner's instrucions and explains.Physician should care and help patients psychosomatically.Not noly social and physiological help but psychological help should also be given. (2)To introduce necessity and knowledge associated with enhanced CT examination,provide information to relieve anxiety and distrusting feeling and establish safety feeling.(3)5 mg fumeisong was injected to enhance patients' confidence 20 minutes before enhanced CT.(4) Normal response such as fever and nausea to patients should be introduced to make patients have sufficient psychological preparation.If problems occurred,active contermeasures should be employed.If nausea occured,patients should endure until examination is end.Anti-allergy measures should be employed after examination.(5)To tell family care patients and observe abnormal responses during examination process.These measures can enhance patients' safety feeling.At the same time,to instuct patients to relax and ask some unexcessary problems which can relieve anxiety.These measures will make patients fell be cared and helped.

电针足三里对应激大鼠血浆表皮生长因子和降钙素基因相关肽的影响

Objective To study the effect of electroacupuncture (EA) on epidermal growth factor( EGF),calcitonin gene-related peptide(CGRP) and gastric mucosa in stress rats. Methods 72 SD rats were randomized into 3 groups:control group,stress group and EA group.Each group were divided into 3 small groups by 1,3,5 d test time.By radioactive-immunon-assay and Guth methods, ;the changes of EGF.CGRP in plasma and ulcer index (UI) were analyzed. Results Stress group compared with control group, the level of EGF decreased (P< 0.05);but UI increased (P< 0.01).In the EA group compared with stress group, plasma EGF increased (P< 0.05);but UI decreased (P< 0.01).The changes of CGRP in test 5d was more obvious than in 1d in EA group (P< 0.01).Conclusion EA can protect gastric mucosa in stress rats, EGF, CGRP take part in this function.CGRP in EA group can be effected by test time.

离休干部心理健康状况调查

为了解杭州市离休干部的心理健康状况 , 我院于 2001年 10月对来我院疗养的 150例离休干部进 行了心理健康状况调研。 1 对象与方法 1.1 对象 2001年 10月来我院疗养的杭州市离休干部随机抽取 150名 , 其中男 100名 , 女 50名 , 年龄 73～ 81岁 , 文化程度初中～大学。

新医学模式中的心理社会因素探讨

近年来随着社会的迅速改革发展，生活节奏、竞争压力、医疗费用负担、性观念及婚姻家庭状况等与过去相比都发生了很大变化。生物心理社会医学模式中心理和社会因素益现重要。医务工作者面对的不再是人的某些个疾病，而是患有某些个疾病的人。心理社会因素不但关系到疾病的发生发展，而且影响到病史采集、诊断、治疗等医疗行为的成败 [1]。要与身心整体的社会的人打交道，其社会心理因素不容忽视。为此，本文想就这方面的问题和临床同道做些探讨。

利培酮治疗慢性精神分裂症及对社会功能康复的影响

目的评价利培酮治疗慢性精神分裂症的疗效及对社会功能康复的影响。方法采用氟奋乃静随机对照。将72例慢性精神分裂症患者随机分为两组治疗8周,用简明精神病评定量表、社会功能缺陷量表(SDSS)、药物副反应量表(TESS)评价两组疗效及功能。结果利培酮组的治愈率26.71%明显高于氟奋乃静组的4.65%。两药的显效率及总有效率无显著差异;利培酮组疗后的SDSS评分明显低于氟奋乃静组TESS总分也明显低于氟奋乃静组。结论利培酮治疗慢性精神分裂症疗效好于氟奋乃静,副反应小于氟奋乃静,促进社会功能康复的作用明显优于氟奋乃静。

综合性医院躯体疾病伴心理障碍患者120例会诊分析

1 Clinical data Consultation was conducted for 120 patients at all departments during January 2000～ June 2001.These 120 patients consisted of 76 men,44 women aged from 14～ 68 years old with mean age of (48± 14.2)years.

生物反馈对精神障碍患者的康复作用

生物反馈技术作为一种行为疗法，已广泛应用于高血压等慢性心身疾病的康复治疗[1]。作者在精神障碍患者的康复治疗中应用该技术取得了一定疗效，现总结报道如下。

森田疗法治疗强迫症的随访对照研究

目的研究森田疗法在强迫症治疗中的作用及长期疗效。方法将 60例门诊强迫症患者随机分成两组 , 分别用药物合并森田疗法(研究组 30例 ) 和单一药物(对照组 30例 ) 治疗 ; 疗程 10～ 12周 , 均与疗前、疗后及治疗结束后半年做耶鲁布郎强迫症状量表 (Y-BOCS)、汉密顿焦虑量表 (HAMA)评定病人 ,并于半年后用社会功能缺陷筛选量表 (SDSS)评定病人。结果治疗后及半年随访时研究组强迫症状评分及焦虑症状评分均显著低于单一用药组 , 半年后研究组 SDSS评分低于单一用药组。结论森田疗法不仅能减轻强迫症状 , 而且能改善焦虑症状 , 增强社会功能 , 提高生存质量 , 是全面改善强迫症的治疗方法 , 且长期应用疗效显著 , 适用于门诊病人。

运动对30例2型糖尿病患者血糖、氧分压、二氧化碳分压的影响

运动是糖尿病患者长期综合治疗方法之一,30例2型糖尿病患者进行运动疗法,观察其血糖、氧分压(PaO2)、二氧化碳分压(PaCO2)的变化,现报告如下。

干预高血压、高血脂、高黏滞血症对心脑血管疾患发生率的影响

Background:According to American Heart Association's report,death composition of cerebrovascular and cerebrovascular disease was increased to 29％ in 1996,and now 33％ from 25％ in 1992.Now,atherosclerosis seriously endanger human's health.Hypertension,hyperlipemia and hyperviscosity syndrome are main risk factors of cardiovascular and cerebrovascular diseases.There conditions often existed simultaneously in elders.Intervention to these diseases can prevent cardiovascular and cerebrovascular events,which is feasible. Objective:To investigate impact of hypertension,hyperlipemia and hyperviscosity syndrome on incidence of cardiovascular and cereborvascular events. Design:Random,controlled study. Unit:Department of Senile Diseases, Qianfoshan Hospital of Shandong. Subjects:In study group, 52 senile subjects with complete hospitalizing data were recruited from 1995～ 2000.Patients with hypertension,hyperlipemia ,hyperviscosity syndrome were included in the current study.13 subjects asked medical help due to hypertension,25 due to hyperlipemia and 14 due to hyperviscosity syndrome.Sometimes blood pressure of hypertension patients was 140～ 160/90～ 100 mmHg.Patients' mean age was 65.21.Ratio of male to female was 13:1.In control group,50 outpatients were included who had similar diseases those in study group.Mean age was 62.34 and ratio of male to female was 17.33:1. Intervention:In study group,calcium antagonist such as adalatcc, nitrendipine, plendil and/or ASCE inhibitor such as perindopril and captopril were given o.s.Blood pressure was con trolled to normal level.Blood lipid regulating drugs such as pravastatin, ticlopidine,and lipanthy were given for hyperlipemia patients.For patients with hyperviscosity syndrome,enteral aspirin or persantine was given,50～ 75 mg/day.Interval of drugs was 1 day to 2 months.Detailed data was unavailable.Red sage root or its compound form injecto was given i.v.,70 mg/day,pueraria root was given i.v.300～ 500 mg/day;astraglaus root was given 20～ 214 g/day,ginkgo leaf,70 mg/day.10～ 15 days was a disease course.Drugs were given for once in 17 subjects and twice 35 subjects.No subjects received 3 times of therapy.In control group,patients received no described treatment during 5 years.Outpatients' medical records as well as discharge record for inpatients were read to study conditions during five 5 years retrospectively. Main prognosis indexes:Collection point for statistical analysis was determined as begging phase of obervation and end point after 5 years.Cardiovascular events such as heart infarction,cerebrovascular disease such as cerebral infarction,cerebral hemorrhage and TIA were evaluated. Result: Incidence of cardiovascular and cerebrovascular events was markedly lower in study group compared with that in control group.In study group,2 subjects developed acute heart infarction(3.84％ ),11 subejcts developed heart infarction in control group(22.00％ )(P< 0.01).Ischemic cerebrovascular disease occurred in 1 subject(1.92％ ) in study group and 7 in control group(14.00％ ).Amount of cerebral hemorrhage showed no significant decrease in 1 subject (1.92％ )in study group and 3 subjects in control group(6.00％ )(P >0.05). Conclusion:Risk factors of cardiovascular and cerebrovascular disease in elders should be actively intervened to reduce development of cardiovascular and cerebrovascular disease.

玻璃酸钠黏弹性补充治疗缓解膝骨关节炎患者关节疼痛观察

骨关节炎(OA)是一种常见的风湿性疾病,临床特征为进行性软骨丧失和骨性过度增生。膝骨关节炎在骨关节炎中为常见。应用玻璃酸钠膝关节腔内注射治疗膝骨关节炎,取得了良好的治疗效果,报道如下。

老年先天房间隔缺损31例介入治疗与术后康复措施探讨

Objective To evaluate the efficiency of intervention therapy of congenital auricular septal defect among elders and rehabilitation approaches after the operation.Methods To summarize and analyze efficacy of intervention and rehabilitation approaches for patients with congenital auricular septal defect in elders among 215 cases.Results Succesful rate of operation was 100% .6-month follow up showed pulmonary artery systolic pressure,tricuspid reflux,right ventricle volume and blood flow of pulmonary artery were reduced compared with pre-and postoperational phase.Difference was significant(P< 0.01).No complications developed.Conclusion Success rate of intervention therapy in elders is high with favorable effect and less complications.It is the first choice for elders underwent rehabilitative therpay after operation. ``

九五期间我国老年病防治研究进展

For the first time,prevention and treatment of senile disease was listed in National Key Projects after repeated provement among specialists during “ Nine Five ” phase,which promotes development of senile health work. Diabetes,osteoporosis,Parkinson's disease and senile dementia are frequently encountered diseases among elders.There conditions are not leading causes of death,but they consumed a lot of medical resource.Complications and higher disbility rate seriously endanger elders' quality of life and increase family and social load.There senile diseases will affect continued development of our economy without appropriate prevention and treatment. Using same project and standard,multicenter study on diabetes mellitus,essential osteoporosis,senile dementia,Parkinson disease was conducted through multiple layer and phase chester sampling method. Pvevalence,risk factors associated with these disease were investigated.Sex,age,education level and prevalence in town and country were compared.Based on previous job,IGT was used to decrease community intervention.Test communities for prevention and treatment of senile disease such as diabetes mellitus,essential osteoporosis,senile dementia,Parkinson disease were established.

医疗体操加中药治疗对充血性心力衰竭患者康复的影响

充血性心力衰竭(congestiveheartfailure,CHF)是由于心脏收缩力减弱,心输出量相对或绝对减少,静脉回流受阻,以致心脏搏出的血量不能满足组织细胞物质代谢需要的综合征。该病病因诱因多而复杂,难根治而易复发。我们自1995年以来采用综合治疗,能较好地控制病情,减少复发,提高生存质量,现报告如下。

施行糖尿病患者康复教育的临床意义

Background:Diabetes is a kind of chronically permanent disease.Management during hospitalization was insufficient.Now,health education is the important project in diabetes study.Patients' lifestyle ,attitude to condition and previous treatment showed obvious impact on diabetes control.Some investigators indicated patients had less knowledge about diabetes-related matters,and their self-health idea was unobvious.They rarely abided by physicians' demands.So,rehabilitative education is important for diabetes patients. Objective:To observe the therapeutic effect of rehabilitative education on diabetes patients. Unit:Department of Leader Health,Laiwu People's Hospital. Subjects:80 diabetes were recruited during July 1997 to July 2001.Among these patients,46 were males,34 were females aged 12～ 72(mean age:56.5).42 had high school education and others had middle school education. Intervention:Based on education project for diabetes developed by Endocrine Institute of Hunan Medical University,health education was conducted during hospitalization.After admission,《 Elementary knowledge about diabetes prevention and treatment》 was given to patients.Extensive education ways were used for diabetes patients and their family members.Patients can seek tele-medical directions with telephone or letters according to their demands. Patients were evaluated before and after education. Main prognosis indexes:Comprehensive condition for elementary knowledge about diabetes,fasting blood glucose and accordance behavior were evaluated. Result: (1)Elementary knowledge about diabetes was mastered by 26% patients before education and 80% after education.(2)Fasting blood glucose was (8.22± 0.80)mmol/L before education and (6.10± 0.50)mmol/L after education(P< 0.05).Follow-up showed no changes in fasting blood glucose after discharge.(3) Accordance rate of drugs uptake,diet control,activity intensity,detection of blood glucose and urinary glucose was 50% before education and 85% after education. Conclusion:Rehabilitative education can enhance patients' self regulation and self detection ability,delay development of complications.

脑卒中患者使用背带预防肩痛的疗效观察

电刺激预防和治疗脑卒中后肩痛

脑卒中患者上肢运动疗法疗效分析

脑卒中和脑外伤患者轻瘫上肢功能训练

脑卒中后的上肢问题——脑卒中后肩手综合征的预防方法

脑卒中后肩关节半脱位、肩峰静息位置、肩内旋外展的相关性分析

脑卒中后轻瘫上肢协同运动与痉挛的关系

脑卒中后上肢协同运动与挛缩的相关性研究

脑卒中后伴有失语或半侧空间忽略患者肩痛评估的可靠性

帕金森病情绪障碍的认知治疗

该文介绍了帕金森病情绪障碍发生的原因和临床表现,并就情绪障碍的认知治疗理论做一介绍.通过对典型病例的治疗过程介绍加以详细解释.

脑卒中后吞咽困难的评价

介绍了正常吞咽过程,各期吞咽困难的临床表现,吞咽困难的主要检查方法,吞咽困难的评价方法.通过评价发现和确定造成吞咽困难的原因,为吞咽困难的治疗提供可靠的依据.

类风湿性关节炎的康复用药

针对类风湿性关节炎的康复用药进行循证,评价了多种药物对改善功能障碍的疗效.

单纯性肥胖的运动处方

肥胖不仅在一定程度上影响人们的正常生活和心理健康,还与多种疾病有重要的发病学关系.本文以运动处方形式推荐一些有氧运动及力量锻炼方法,旨在为不同程度的肥胖者在减肥过程中提供较健康、科学的降脂减肥方法,以期达到强身健体的目的.

SF36量表在糖尿病患者生存质量测量中的应用

糖尿病患者生存质量(qualityoflife,QOL)测量常用SF36量表,就其性能使用、构造、内容、使用方法作了介绍,并分析了影响糖尿病患者QOL的影响因素.

中国脑血管病后三级康复治疗的研究

脑血管病后三级康复治疗是指脑血管病后的持续康复治疗.我国脑血管病发病率高,病后患者存在明显功能障碍,因此,建立起符合我国国情的完整的三级康复网络,已是势在必行.目前,我国的脑血管病后三级康复治疗已有了一个良好的开端,随着国家科委"十五"攻关课题的完成,真正意义上达到全面开展脑血管病后三级康复治疗已经成为可能.

慢性阻塞性肺疾病患者呼吸障碍症状的康复治疗

慢性阻塞性肺疾病(chronicobstructivepulmonarydisease,COPD)是不可逆转的慢性肺疾病,病人的主要症状是呼吸困难,康复治疗是在药物治疗的基础上通过运动训练(包括上肢运动训练、下肢运动训练、呼吸肌的运动训练)进一步改善病人的呼吸困难症状,增加生活活动能力.通过康复评价综合评价病人的心、肺和运动功能,制定适当的康复计划.

抗痉挛治疗对脑卒中偏瘫患者肢体功能恢复的疗效分析

目的探讨抗痉挛治疗对偏瘫肢体运动功能的影响。方法40例脑卒中偏瘫患者均采用以促通技术为主的神经肌肉再训练方法进行训练,并对治疗前后状态进行比较。结果瘫侧上下肢运动功能均有不同程度的改善,显效率上肢达47.5%,下肢达60%;有效率上肢达95%,下肢达97.5%。训练前后存在显著性差异(P《0.01)。结论抗痉挛治疗是促进肢体运动功能恢复的有效途径。

舒脑宁促进康复期脑梗死患者记忆功能的疗效分析

目的探讨舒脑宁对康复期脑梗死患者记忆功能改善的疗效分析。方法将46例病人随机分为治疗组和对照组(每组23例)两组均采用常规治疗。治疗组加舒脑宁。结果治疗组效果高于对照组(P<0.05)。结论舒脑宁可促进脑梗死记忆障碍功能的恢复,提高生存质量。

壳聚糖胶原生物敷料的安全性研究

目的研究壳聚糖胶原生物敷料(chitosancollagenbiologicaldressing,CCBD)的生物安全性。方法通过CCBDA、B原液兔皮肤刺激实验、角结膜刺激实验、肌肉刺激实验和细胞毒性实验研究CCBDA、B的生物安全性。结果CCBDA、B原液无皮肤、角结膜和肌肉刺激性,对角质形成细胞和成纤维细胞无毒性。结论CCBDA、B具良好生物安全性。

水杨酸庆大霉素减轻耳毒性的机制研究

目的探讨庆大霉素新剂型-水杨酸庆大霉素的耳毒性。方法将实验动物随机分为五组,即庆大霉素(GM)组;水杨酸庆大霉素(SAGM)组;庆大霉素+水杨酸钠(GM+NaSA)组;水杨酸钠(NaSA)组和对照(C)组。实验前后检测动物ABR反应阈;耳蜗铺片观察毛细胞缺失程度;电镜观察毛细胞超微结构;并检测血清和外淋巴铁及肾功能。结果SAGM组ABR阈移较GM组小(P<0.05),各频率和时间点与GM+NaSA组无明显差异(P>0.05)。耳蜗铺片和电镜观察显示,SAGM组毛细胞损失程度和超微结构变化较GM组明显减轻。各组间血清铁和外淋巴铁无显著差异,SAGM对肾功能无明显影响。结论新剂型水杨酸庆大霉素的耳毒性较硫酸庆大霉素明显减轻。

弥可保治疗糖尿病周围神经病56例疗效观察

糖尿病神经病变是糖尿病常见的慢性并发症和主要致残因素之一,其发病机制目前认为主要与微血管病变及山梨醇旁路代谢增强以至山梨醇增多有关。病变部位以周围神经为常见。常见的自觉症状为麻木感、疼痛。以往治疗方法和药物很有限,疗效也不十分理想,近年来我们在临床上应用弥可保治疗收到良好效果。

认知疗法和自血回输疗法强化西比灵治疗偏头痛的疗效观察

目的观察认知疗法心理干预和自血回输疗法对西比灵偏头痛的疗效。方法将98例偏头痛病人随机分为实验A组(33例),实验B组(33例)和对照组(32例)。3组病人均服用西比灵治疗,实验A组实施认知疗法心理干预,实验B组采用自血回输治疗,2个月后对3组疗效进行评价。结果治疗前3组病人年龄、性别、伴随症状、头痛程度、发作频度无明显差异,治疗后实验A组和实验B组疗效都明显高于对照组(P<0.05)。实验A、B两组之间疗效无差异。结论认知疗法心理干预和自血回输疗法都能明显提高西比灵治疗偏头痛的疗效。

脑卒中后抑郁症与社会支持的调查分析

目的对脑卒中后患者抑郁发生与社会支持影响因素进行分析。方法100例神经内科住院脑卒中患者,采用抑郁自评量表(SDS)与社会支持量表进行评测,所得资料进行统计学处理。结果100例脑卒中患者发生抑郁症44例占44%;脑卒中患者发生抑郁症与社会支持有显著性差异,P<0.01;脑卒中患者各年龄段比较,30～50岁患者非抑郁症与抑郁症社会支持,主观支持65岁以上及支持利用51岁以上二者等均未发现明显差异,P>0.1;而51岁以上社会支持各项二者等均有显著性差异,P<0.01。结论社会支持的研究,不仅具有它的理论价值,同时有助于在对患者进行整体护理中,有针对性的进行护理,对提高护理质量和水平有较大的帮助。

康复医学的发展是历史之必然

去年是已故美国著名的康复医学前辈--腊斯克教授的100周年诞辰纪念年,回顾现代康复医学发展近百年的历史,我们可以清楚看到康复医学这个新兴学科,从无到有,从小到大,已有了蓬勃的发展.康复医学作为医学科学的一个分支的出现与发展是医学发展到现代的一个必然产物,再次印证了新生事物必然发展的客观规律.

临床康复:从认识到实践道路还将有多长

《现代康复》杂志创刊5年后,从2002年起改名为《中国临床康复》杂志,这是杂志在新世纪的一个大跨越,也是中国康复医学信息界的一件大喜事,对此表示衷心的祝贺.

金施尔康在胃肠术后恢复期的应用方法探讨

本文主要研究了金施尔康在胃肠术后恢复期的作用及其临床意义,指导应用金施尔康方法。1对象与方法本组60例病人,均为胃肠道术后2周,可进正常软食,无呕吐、腹泻,排气、排便正常。

多维元素在恶性肿瘤防治中的作用

多维元素包括多种维生素及微量元素,是人体维持正常生理功能不可缺少的物质。近年来,恶性肿瘤的发病率越来越高。随着对维生素、微量元素研究的不断深入,人们发现人体内维生素、微量元素的缺乏,可导致生理功能紊乱,免疫功能低下,终发生恶性肿瘤。现就几种维生素、微量元素与肿瘤关系研究作一简要的综述。

老年人骨质疏松症的病因及防治

老年性骨质疏松症是随着年龄的增长必然发生的一种生理性退行性病变。研究中国人骨矿含量随年龄增长而变化的规律,骨质疏松症的发病规律等对骨质疏松的研究及防治具有重要意义。

金施尔康在慢性阻塞性肺疾病营养疗法中的作用

慢性阻塞性肺疾病(COPD)是一组慢性阻塞性疾病的统称,发病率高,若不积极治疗,常极快发展为慢性肺源性心脏病,以至多脏器功能衰竭而死亡,故COPD的治疗非常重要。COPD的治疗是个综合治疗,除了氧疗、抗炎、平喘外,营养治疗越来越受到人们重视。营养治疗是用增加营养素作为治疗手段,针对疾病具体情况,恰如其分地调整和提出临床需要的营养方案。通过各种途径,如合理的膳食安排,食品的调配,科学的烹调方法,正确的饮食制度等供给患者所需的营养素,或去除患者应避免的营养素,改善代谢功能,增强机体抵抗力,达到促使疾病好转或痊愈的目的。早在19世纪初人们已经注意到严重的肺气肿多为瘦体形者,COPD患者有明显的体重减轻,体重减轻的COPD患者呼吸衰竭的发生率和病死率都显著增高。

维生素与无机盐复合制剂改善糖尿病患者末梢神经炎、植物神经功能紊乱的疗效分析

目的研究维生素与无机盐复合制剂(复合营养素)对糖尿病病情控制的作用。方法分别观察了使用复合营养素组和非使用组在治疗前后临床自觉症状、血糖和血中3种无机盐的变化。结果服用复合营养素组2个月后植物神经功能紊乱明显改善,餐后血糖明显低于非使用组,血清中3种无机盐水平明显提高。结论对于已确诊为糖尿病或糖耐量异常的患者,在进行药物治疗和饮食疗法的同时,补充适量的复合营养素有利于病情的控制和症状的改善。

糖尿病发病与微量元素铬、锌、硒的相关性

糖尿病的患病率与日俱增,微量元素在糖尿病的发生、发展、预防、治疗等方面处于不可忽略的地位,人们对微量元素的研究不断在深入。本文主要介绍了微量元素铬、锌、硒在这方面的作用。

卵巢早衰与自然绝经妇女骨密度比较及替勃隆疗效观察

目的比较卵巢早衰(POF)与自然绝经妇女的骨密度(BMD),并观察替勃隆的疗效。方法63例经DEXA确诊为骨质疏松的病人分为3组:29例POF为A组,年龄48～76(62.1±7.0)岁;34例自然绝经妇女为B组,年龄52～77(63.4±6.0)岁;63例中的32例应用替勃隆治疗(1.25mg/d,疗程6个月)为C组。应用美国Hologic公司QDR4500-W型双能X线骨密度仪测定A组和B组腰椎及股骨颈BMD,测定C组治疗前后的BMD。结果A、B两组L2～4、股骨颈BMD相比,有显著性差异(P《0.05);C组治疗前后L2～4、股骨颈BMD相比有非常显著性差异(P《0.01),平均增长率分别为2.7%、2.2%。结论POF比自然绝经妇女骨量丢失的早并且丢失的多,绝经后骨质疏松应用激素替代疗法效果明显。

骨折愈合刺激素(金葡液)对体外培养成骨细胞的影响

目的观察骨折愈合刺激素(金葡液)对体外培养成骨细胞的作用。方法在新生SD大鼠头颅骨第二继代成骨细胞(OB2)培养液中分别加入不同浓度(20000～200U/L)骨折愈合刺激素(金葡液),分别观察OB2的增殖功能(用波长570nm处OD值表示)、分化功能[用碱性磷酸酶(ALP)活性表示]和矿化功能(用矿化结节数量/视野表示)。结果OD值实验组为(0.336±0.073)～(0.359±0.051),对照组为0.347±0.035;ALP(U/g蛋白质)活性实验组为83±9,对照组为81±4;矿化结节数量/视野(个)实验组为6.000±1.826,对照组为1.5±1.0。结论骨折愈合刺激素(金葡液)各浓度对OB2的增殖和分化功能均无明显作用(P》0.05),而对其矿化功能具有明显的刺激作用(P《0.01)。

老年性骨质疏松患者松质骨中骨形成蛋白-2及骨形成蛋白-7基因表达

目的通过观察老年性骨质疏松患者与正常人松质骨中骨形成蛋白(BMP)2、7mRNA含量的变化,探讨BMP基因表达在老年性骨质疏松症发病机制中的作用。方法共选8例临床病例,根据患者X线表现、桡骨远端骨密度值以及生化指标检测确定为老年性骨质疏松患者。对照组取8例年龄在20～30岁之间的骤然死亡的健康男性股骨头,取各自的股骨头提取RNA,以BMP2、7cDNA为探针进行RNA斑点杂交,根据图像分析结果进行统计处理,比较两组差异。结果临床患病组BMP2、BMP7mRNA含量明显低于对照组。结论老年性骨质疏松症患者松质骨中BMP2及BMP7mRNA表达明显降低,这可能是老年性骨质疏松症发病原因之一。

三仙汤对成骨细胞增殖的影响

目的通过对三仙汤促进成骨细胞株增殖的研究,判断三仙汤能否应用于绝经后骨质疏松症的防治。方法应用UMR-106成骨细胞株,采用体外细胞培养技术,以氟化钠为阳性对照药,用MTT法测定三仙汤对成骨细胞增殖的影响。结果氟化钠1.25μmol/L、5μmol/L组与空白组相比有显著性差异(前者P<0.01,后者P<0.001);10μmol/L组与空白组无明显差别。三仙液在5、10、100、500、1000mg/L5个不同浓度均使MTT法检测的光吸收值显著升高(P<0.001或P<0.01)。结论三仙汤能促进体外培养成骨细胞增殖。

雌激素对去卵巢大鼠骨形态的影响

目的观察大鼠去卵巢后椎体骨丢失的组织学改变、椎体骨密度和生物力学性能变化,了解激素复合药物对椎体骨丢失的影响。方法选用40只6月龄雌性SD大鼠,随机分为4组,每组10只,包括非手术组、假手术组、去卵巢组和去卵巢后药物治疗组。治疗组为去卵巢后3周给予盖福润(gevrine)0.8mg/kg,羟乙膦酸钠35mg/kg,1次/d。术后12周处死各组大鼠,进行骨形态计量学、骨密度及生物力学检测。结果与假手术组相比,去卵巢组的骨小梁体积占海绵骨体积百分比明显降低(P<0.01),椎体骨密度显著降低(P<0.01),骨的力学强度降低(P<0.05)。与去卵巢组相比,治疗组骨小梁体积占骨体积百分比明显增加(P<0.05),椎体骨密度明显增加(P<0.05),骨的力学强度增加(P<0.05)。结论雌激素复合药物盖福润和羟乙膦酸钠能抑制骨丢失,促进骨形成,对大鼠脊柱骨质疏松有明显的防治作用。