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摘要: Objective: To evaluate the efficacy of acupuncture in treating chronic non-specific low back pain. Methods: Ten patients with chronic low back pain were selected to receive 9 acupuncture treatments over a three-week period with point selection based on syndrome differentiation in Chinese medicine. The BROM Instrument for assessment of back range of motion; subjective evaluation with Visual Analog Scale of Pain (VASP) ratings, Oswestry Disability ratings, objective measurements including Algometry, and Flexion and Extension ratings to investigate the range of motion were used for comparing the large, medium and small effect sizes of baseline, treatment and follow-up phases. Results: Clinical significance of pain relief was shown in all parameters assessed. A large effect size was detected in VASP, Oswestry and Algometry. A small effect size was demonstrated in Flexion/Extension. Needling over short period time (3 weeks) could relieve the pain, but the muscular-skeletal function measured by BROM persists. To treat patients exclusively by needling for statistical purposes can not be justified, because by merely relieving pain, permanent improvement in function may not be achieved. Conclusion: Acupuncture offers an effective alternative for the clinical management of chronic low back pain, significant improvement in most of the parameters evaluated, but the functional improvement was not as satisfactory as pain relieving. Further study with larger sample size focuses on long-term efficacy and functional improvement for chronic low back pain is recommended.

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  • Objective: To explore the patterns of Syndrome Differentiation (SD) of coronary heart disease (CHD) patients in peri-operative stage of coronary artery bypass graft (CABG). Methods: One week after operation, thirty-seven CHD patients, who received CABG of internal mammary artery or great saphena vein under conventional general anesthesia with low or middle temperature extracorporeal circulation were differentiated as various syndromes, with the pre- or post-operational EKG, color Doppler echocardiography were done during and after operation. The hemodynamic parameters were monitored. Results: In the CHD patients, 64.9% were differentiated as Qi-Yin deficiency, 67.6% were complicated with phlegm syndrome and 62.2% with blood stasis, suggesting that Qi-deficiency, phlegm and stasis are the basic pathogenetic factors in patients with CABG. Moreover, the peri-operative syndrome was correlated with the condition of coronary artery lesion, heart and lung functions before operation, and the extracorporeal circulation time during the operation. Conclusion: TCM SD conducting in peri-operative stage might be useful in exploring the patterns of syndrome alteration which provided a basis for preventing peri-operative complications and elevating success rate of operation.

  • 作者:程剑华;常纲;吴万垠;杨志钢;孟凡喆;徐凯;李柳宁;朱迪盈;陈春泳;罗海英

    To evaluate the effect, side-effect and prospect of hepatic arterial perfusion embolization (HAPE) with Zedoary turmeric oil (ZTO) in treating primary hepatic carcinoma (PHC).Methods: Clinical study was carried out by administration of 1-3 ml ZTO through arterial catheter to induce embolism in 32 patients of PHC, and compared with 32 patients treated by hepatic arterial perfusion embolization with chemical agents (HAPE-C) in the control group. The Chinese herbal medicine was given orally to both groups according to Syndrome Differentiation of TCM. In the experimental study, transplantation hepatic carcinoma model was established in 40 rats. They were randomly divided into the treated group and the control group, 20 in each group, and were perfused with 10 mg/kg ZTO and 0.2-0.3 ml normal saline respectively to observe the effect of treatment.Results: The effect of treatment in the ZTO group was CR in 1 case and PR in 13 cases, the total effective rate being 43.75%, with AFP negative reversed in 7 cases, titer decreased in 7; while in the control group it was PR in 10 cases, the total effective rate being 31.25%, AFP negative reversed in 5, titer decreased in 2, and the difference of therapeutic effect between the two groups was insignificant (P>0.05). The post-perfusion thrombotic syndrome occurrence, with the symptoms of fever, abdominal pain, vomiting, etc. in the two groups was similar, but no bone marrow inhibition occurred in the ZTO group, which was different from the control group (P<0.01, P<0.05). The mean survival time, median survival time, 1-, 2-, 3- and 4-year survival rate in the ZTO group was 13.84 months, 10 months, 37.5%, 18.87%, 9.70% and 6.4% respectively, and in the control group, 8.03 months, 6 months, 15.6%, 6.27%, 0% and 0% respectively, the mean survival time, median survival time and 1-year survival rate in the ZTO group were significantly superior to those in the control group (P<0.05). Experimental study showed that the effect in the treated group was better than that in the control group in tumor growth inhibition with the tumor growth rate as 10.8±4.5%% vs 20.6±12.7%, P<0.05, tumor necrosis degree (P<0.01) and survival time prolonged (14.8±3.4 days vs 11.7±1.9 days, P<0.05).Conclusion: HAPE-ZTO in treating PHC showed the therapeutic effect similar to that of HAPE-C, but superior to the latter in survival time prolongation and bone marrow inhibition.

  • Objective: To evaluate the efficacy of acupuncture in treating chronic non-specific low back pain. Methods: Ten patients with chronic low back pain were selected to receive 9 acupuncture treatments over a three-week period with point selection based on syndrome differentiation in Chinese medicine. The BROM Instrument for assessment of back range of motion; subjective evaluation with Visual Analog Scale of Pain (VASP) ratings, Oswestry Disability ratings, objective measurements including Algometry, and Flexion and Extension ratings to investigate the range of motion were used for comparing the large, medium and small effect sizes of baseline, treatment and follow-up phases. Results: Clinical significance of pain relief was shown in all parameters assessed. A large effect size was detected in VASP, Oswestry and Algometry. A small effect size was demonstrated in Flexion/Extension. Needling over short period time (3 weeks) could relieve the pain, but the muscular-skeletal function measured by BROM persists. To treat patients exclusively by needling for statistical purposes can not be justified, because by merely relieving pain, permanent improvement in function may not be achieved. Conclusion: Acupuncture offers an effective alternative for the clinical management of chronic low back pain, significant improvement in most of the parameters evaluated, but the functional improvement was not as satisfactory as pain relieving. Further study with larger sample size focuses on long-term efficacy and functional improvement for chronic low back pain is recommended.

  • Objective: To investigate the effect of Chinese drugs (CD) that invigorate Spleen to remove Dampness and activate the blood circulation to eliminate Turbid for retarding progression of chronic renal failure (CRF). Methods: Thirty-nine patients with CRF were divided into two groups at random: the 18 patients in group A (the control group) were treated with low protein diet and controlling blood pressure and 21 patients in group B (the treatment group) were treated similarly with that of the control group and additional CD. Levels of serous creatinine (SCr), blood urea nitrogen (BUN), blood albumin (Alb), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and hemoglobin (Hb) were checked every two months and the rate of progression of CRF was estimated by slope of the creatinine reciprocal (1/SCr) with time (months). Results: Levels of SCr and BUN in group B were lower and HDL higher than those in group A significantly, P<0.05. Mean slopes of the creatinine reciprocal with time in the two groups were markedly different, P<0.01. Conclusion: Additional CD treatment based upon the low protein diet and controlling blood pressure could retard the rate of progression of CRF evidently.

  • 作者:凌昌全;陈喆;朱德增;俞超芹;黄雪强;万旭英;李瑾;陈坚;沈峰;杨广顺;吴孟超

    To evaluate objectively the clinical effect and superiority of integrated traditional Chinese and western medicine (TCM-WM) in treating mid-late hepatocarcinoma.Methods: The 313 patients observed were divided randomly into 3 groups, Group Ⅰ, Ⅱ and Ⅲ, they were treated with protocol TACE, protocol PEI and comprehensive conservative therapy respectively. Each group was sub-divided into 2 sub-groups, sub-group A and B, and sub-group As was treated coordinately with different Chinese herbal medicine, Sisheng Decoction to sub-group ⅠA and ⅡA, and cinobufacin or norcantharidin to ⅢA respectively. And Chinese herbal medicine prescribed according to TCM Syndrome Differentiation was also given to all the sub-group As.Results: The integrated therapy showed significant effect in treating mid-late hepatocarcinoma, as it could improve significantly the clinical symptoms and signs, raise the quality of life and prolong the survival time in patients. When TCM-WM cooperated with TACE, it could alleviate the toxic effect and enhance the therapeutic effect of chemotherapy. There was statistical significant difference in clinical effect between the TCM-WM treated groups and the western medicine treated groups (P<0.05).Conclusion: TCM-WM therapy displays not only the action in enhancing the short-term therapeutic effect of treatment in treating mid-late hepatocarcinoma but also shows significant effect in enhancing long-term therapeutic effect and prolonging survival time in patients. It is worth further spreading.

  • 作者:刘嘉湘;施志明;李和根;徐振晔;朱晏伟;赵丽红;高虹;刘苓霜;朱惠蓉;张晖

    To observe the effects of Yifei Kangliu Yin(YFKLY) in treating non-small cell lung cancer (NSCLC). Methods:Two hundred and seventy-one patients with NSCLC were randomly divided into three groups, Group A treated only by YFKLY, Group B treated by the combination of YFKLY and chemotherapy, and Group C treated only by chemotherapy as the control group for control. Results: (1) Of the 127 cases in Group A, 1 case got complete remission (CR), 13 got partial remission (PR), 89 had no change (NC), and 24 had progression of disease (PD), thus CR+PR+NC accounting for 81.10%; of the 80 patients in Group B, 17 got PR , 53 got NC, 10 got PD, PR+NC accounting for 87.50%; of the 64 cases of chemotherapy group, 7 cases got PR, 39 cases got NC, 18 cases got PD, PR+NC accounting for 71.88% (P<0.01). (2) The metastasis rate was 23.52% in Group A, 20.00% in Group B and 35.71% in Group C respectively after treatment. (3) The 1-, 2-, 3- and 4-year survival rate were 73.09%, 32.01%, 13.18% and 13.18% in Group A, 71.85%, 46.35%, 29.19% and 23.35% in Group B and 37.61%, 13.67%, 9.7% and 0% in Group C. The symptoms were improved, and Karnofsky score was elevated in Group A and B. Conclusion: YFKLY could increase survival rate and quality of life, decrease metastasis rate, and enhance the immune function in NSCLC patients.

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