家庭治疗:一种分析人类行为的新框架

家庭治疗是对个体心理治疗的一次革命,它挑战了"以个体为整个心理范畴中心"的基本信念,将所存在的问题或症状从个体转向了关系,从家庭环境的人际背景和家庭生命周期中寻找心理行为障碍的原因,认为家庭是解决与家庭相关联的个人问题的治疗所,通过家庭或更大的机构在内的系统的改变,来处理和消除个体所存在的问题或症状,提供了一种新的分析人类行为的框架,代表了心理治疗的一个新领域和新方向.     

清热化痰运脾消积法治疗小儿急性支气管炎痰热夹滞证30例

目的观察清热化痰、运脾消积法治疗小儿急性支气管炎痰热夹滞证的临床疗效。方法将60例急性支气管炎痰热夹滞证患儿随机分为治疗组与对照组,每组各30例。治疗组采用清金化痰汤加运脾之品临证化裁治疗,对照组予小儿消积止咳口服液治疗,连续治疗7d。结果治疗组临床疗效明显优于对照组(P0.05)。治疗组在改善咳嗽、咳痰、肺部啰音、不思乳食、腹胀腹痛、口干口渴、口臭、大便不调和脉象方面明显优于对照组(P0.05)。两组治疗后主症积分、次症积分、症状总积分均较治疗前明显降低(P0.05),治疗组治疗后主症积分、次症积分、症状总积分下降值显著大于对照组(P0.05)。结论清热化痰、运脾消积法治疗小儿急性支气管炎痰热夹滞证疗效确切。     

辅用刺血拔罐疗法对风火毒证蛇咬伤患者血小板及凝血功能的影响

目的 观察刺血拔罐疗法对风火毒证蛇咬伤患者血小板及凝血功能的影响。方法 将106例风火毒证蛇咬伤患者随机分为对照组和治疗组,每组53例。两组均给予蛇咬伤常规治疗,对照组予季德胜蛇药片治疗,治疗组在对照组基础上加用刺血拔罐疗法。两组患者治疗前后分别检测血常规、凝血功能,并观察两组临床疗效。结果 治疗组临床疗效明显优于对照组(P<0.05)。治疗组治疗前后血小板、凝血酶原时间改善程度优于对照组(P<0.05)。治疗组凝血功能异常转化率明显低于对照组（P＜0.05）。结论 辅用刺血拔罐疗法能改善风火毒证蛇咬伤患者血小板及凝血功能,提高临床疗效。     

联用通窍活血针法治疗脑卒中后吞咽困难26例

目的 观察联用通窍活血针法治疗脑卒中后吞咽困难的临床疗效。方法 将52例脑卒中后吞咽困难患者随机分为治疗组和对照组,每组26例。对照组给予西医基础治疗和常规针刺治疗,治疗组加用通窍活血针法治疗,即针刺“舌三针”穴位及深刺金津、玉液穴,点刺聚泉穴。治疗前后分别观察两组患者洼田饮水试验评分和中医症状评分,并观察临床疗效。结果 与治疗前比较,两组患者治疗后洼田饮水试验评分均显著升高（P＜0.05）,中医症状评分均显著降低（P＜0.05）;治疗组洼田饮水试验评分升高程度和中医症状评分降低程度明显大于对照组（P＜0.05）。两组临床疗效分布比较,差异有统计学意义（P＜0.05）,治疗组临床疗效明显优于对照组。结论 在常规针刺疗法基础上联用通窍活血针法可以提高脑卒中后吞咽困难的临床疗效。     

丹蛭降糖胶囊对糖尿病大鼠血清TNF-α和CXCL-5的影响

目的 观察丹蛭降糖胶囊对糖尿病大鼠血清肿瘤坏死因子-α（tumor necrosis factor alpha, TNF-α）和趋化因子（C-X-C基序）配基5（chemokine (C-X-C motif) ligand 5,CXCL-5）表达的影响,探究其降糖作用机制。方法 将健康雄性SD大鼠随机分为正常对照组,模型组,吡格列酮组,丹蛭降糖胶囊高、低剂量组。采用链尿佐菌素单次腹腔注射法复制糖尿病模型,采用双抗体夹心法测定大鼠血清TNF-α、CXCL-5水平。结果 与模型组比较,吡格列酮组和丹蛭降糖胶囊高、低剂量组TNF-α、CXCL-5水平显著降低（P＜0.01）,3个给药组TNF-α、CXCL-5比较,差异均无统计学意义（P>0.05）。与模型复制后0周末比较,2、4、8周末,吡格列酮组和丹蛭降糖胶囊高、低剂量组血糖水平均显著降低（P<0.01）。2、4、8周末,与模型组比较,吡格列酮组及丹蛭降糖胶囊高、低剂量组血糖水平均显著降低（P＜0.01）,但3个给药组之间血糖水平比较,差异均无统计学意义（P>0.05）。Pearson相关分析显示,8周末血糖水平与TNF-α、CXCL-5均呈正相关（P<0.01）。结论 丹蛭降糖胶囊降低糖尿病大鼠血糖的机制与其降低血清TNF-α、CXCL-5水平有关。     

电针结合激光治疗单纯性肥胖30例

目的 比较电针结合激光与单纯电针治疗单纯性肥胖的疗效差异。方法 将60例单纯性肥胖患者随机分为治疗组(电针结合激光治疗)、对照组(电针治疗)各30例,分别观察两组治疗前后体质量、腰围、臀围、股围、体质量指数（body mass index, BMI）的变化。结果 治疗后两组患者的体质量、腰围、臀围、股围、BMI均显著下降(P<0.01);治疗组体质量、腰围治疗前后差值显著大于对照组(P<0.05,或P<0.01),两组减肥疗效比较,差异无统计学意义（P>0.05）。结论 电针结合激光与单纯电针均对单纯性肥胖具有确切的临床疗效,电针结合激光在减少患者腰围上具有独特优势。     

中西医结合治疗重症蝮蛇咬伤26例

目的 回顾重症蝮蛇咬伤患者的病历资料,总结重症蝮蛇咬伤的治疗经验。 方法 对26例重症蝮蛇咬伤患者采用中西医结合疗法进行治疗。西医疗法以局部扩创排毒、注射抗蝮蛇毒血清及对症治疗为主,对危重症患者应用机械通气、血液净化、重症监护等治疗技术;中医疗法以内服院内协定方蛇伤冲剂及采用季德胜蛇药片内服外敷为主。结果 治愈22例,好转3例,无效1例,总有效率为96.1%。发生脏器功能损害26例,治疗后恢复25例。住院时间2～16 d,平均(7.72±1.35)d。结论 中西医结合治疗重症蝮蛇咬伤,治愈率高,脏器功能损害恢复好,住院时间短。     

Multidimensional Family Therapy in Theory and in Practice

This article reviews the family therapy case of an adolescent substance abuser through the lens of multidimensional family therapy (MDFT). Initially, the adolescent presented with suicidal ideation, depression, academic difficulties, and behavior problems. The family experienced chronically high levels of conflict, which related to the mother's depression, the father's harsh discipline, and the adolescent's sister's frequent suicidal threats and outbursts. Family therapeutic interventions helped to decrease family conflict and improve the adolescent's grades and behavior. In particular, conjoint work with the parents had a stabilizing effect on the family system. As predicted by MDFT, this stabilizing effect was shown to place the adolescent on a healthier developmental trajectory. Limitations of the case and implications for future research are also presented.     

Performing sinners: The Asobi and the Buddhist discourse of Tsumi

This essay addresses how Oprah's book choices are inevitably affective but not necessarily feminist. By reading Oprah's book choices as highly individualistic, I analyze how her choices might be more aggressive and more complex, thereby offering a sense of community rather than the power of individuality to her huge audiences. My argument is based on a belief in Oprah's communicative power, and especially if her book choices were invested with more complications than individual resolutions.     

Reconstructing the “Monsters” and the “Failures”

SUMMARY

“Monsters” and “Failures” are becoming the words of choice by many teachers, parents, administrators, and other adults when describing children and their behaviors. Ascribing the label can be constricting to the child and does very little to promote solutions to situations. Adults working with children can develop ways to look past the behavior and see the child and the child's needs, and acquire expectations of children that are in line with their development. This article explores the notion that family therapists, specializing in systems theory and parent education, are professionals, who are suited to help parents and school personnel interact with children in constructive and meaningful ways that promote development and minimize negative labeling. Family therapists can help the parent/teacher/administrator view the interactions among the components of the child's support system as dynamically interacting with one another and the child, and thus, strengthen the school-parent-community triad. Therapists, working col-laboratively with early childhood developmental education professionals, can assist adults in aligning their assessment and expectations of children with developmental understandings, thereby modifying the behaviors on the part of the adults, and ultimately eliciting more appropriate responses on the part of the children. A family systems approach to the rearing and teaching of children allows adults to reinforce the constructive behaviors of the child in a supportive and positive manner, leading to the social and cognitive growth of the child. The case material offered in this article presents ways in which family therapists can collaborate with education professionals and families in fostering the strength of the family-school-community relationship, and ensuring situations that are more child-friendly and developmentally appropriate.