胶七散对消化性溃疡愈合质量及其复发的影响

目的评价胶七散对消化性溃疡愈合质量及其复发的影响。方法将168例活动期消化性溃疡合并幽门螺杆菌(Helicobacter pylori,Hp)感染患者随机分为对照组和胶七散组,对照组患者接受阿莫西林(或克拉霉素)、呋喃唑酮、埃索美拉唑治疗,胶七散组患者加用胶七散。治疗后1个月进行胃镜、超声胃镜、病理检查和Hp检测,治疗后12个月进行胃镜检查和Hp检测。结果治疗后1个月,两组Sa、Sb、Sc期的分布及组织学成熟度比较,差异具有统计学意义(P0.05);两组愈合溃疡黏膜下低回声团总面积比较,差异具有统计学意义(P0.05),胶七散组无低回声团百分率显著高于对照组(P0.05)。治疗后12个月,胶七散组复发率显著低于对照组(P0.05);两组Hp根除率比较,差异无统计学意义(P0.05)。结论在抑制胃酸分泌、抗Hp感染的基础上,联用胶七散能提高溃疡的愈合质量,减少溃疡复发。     

万花油外用结合物理疗法治疗慢性肾衰竭血液透析患者动静脉内瘘血肿48例

目的观察万花油外用结合物理疗法对慢性肾衰竭血液透析患者动静脉内瘘血肿的临床疗效。方法将96例慢性肾衰竭血液透析动静脉内瘘血肿患者随机分为对照组和治疗组,每组各48例。对照组给予冰敷、热敷及红外照射的物理治疗,治疗组在对照组疗法基础上加用万花油,两组均治疗至血肿消失。比较两组患者治疗3d后血肿消退情况、血肿局部疼痛评分情况及治疗结束后随访6个月时的并发症发生情况。结果治疗组血肿消退情况明显优于对照组(P0.05)。两组治疗后内瘘局部血肿疼痛均明显减轻(P0.05),但治疗组治疗后疼痛评分下降程度显著大于对照组(P0.05)。随访6个月后,治疗组患者内瘘血流不足、静脉炎、内瘘狭窄、血栓形成的发生率均明显低于对照组(P0.05)。结论万花油外用结合物理疗法可促进透析患者动静脉内瘘血肿的消退,减轻局部疼痛,减少并发症的发生。     

复方黄柏液涂剂溻渍治疗Wagner 2－3级糖尿病足的疗效观察及其对血清炎症因子的影响

目的 观察复方黄柏液涂剂溻渍治疗Wagner 2-3级糖尿病足的临床疗效及其对炎症因子的影响。方法 将符合纳入标准的52例糖尿病足Wagner 2-3级患者随机分为观察组和对照组,每组26例。观察组给予复方黄柏液涂剂溻渍治疗,对照组给予乳酸依沙吖啶溶液湿敷治疗,比较两组临床疗效、创面面积及血清炎症因子[白细胞介素-1(interleukin-1, IL-1)、白细胞介素-6(interleukin-6, IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)]变化。结果 观察组临床疗效明显优于对照组(P<0.05);治疗后观察组创面面积明显小于对照组(P<0.05);治疗后观察组IL-1、IL-6、TNF-α水平均较治疗前显著降低(P<0.05),且明显低于对照组(P<0.05)。结论 复方黄柏液涂剂溻渍治疗Wagner 2-3级糖尿病足,可以促进创面愈合,降低炎症因子水平,临床疗效确切。     

Working with People Who Are Violent to Their Partners: A Safety Building Approach

This article offers a new perspective on the assessment, treatment and management of adults who are violent to their partners. Using a worked case example, it describes how a solution-focused approach is used to develop, and evidence, safety for all family members.

On-treatment predictions of success in peg-interferon/ribavirin treatment using a novel formula

AIM:To predict treatment success using only simple clinical data from peg-interferon plus ribavirin therapy for chronic hepatitis C. METHODS:We analyzed the clinical data of 176 patients with chronic hepatitis and hepatitis C virus genotype 1 who received 48 wk standard therapy, derived a predictive formula to assess a sustained virological response of the individual patient using a logistic regression model and confirmed the validity of this formula.The formula was constructed using data from the first 100...     

刺血拔罐联合蛇伤冲剂治疗蝮蛇咬伤临床观察

目的 观察刺血拔罐联合蛇伤冲剂治疗蛇咬伤患者的临床疗效。方法 采用随机数字表法将60例蛇咬伤患者分为对照组和观察组各30例,对照组给予西医基础治疗,观察组在对照组基础上加用刺血拔罐和内服蛇伤冲剂,评估患肢肿胀、疼痛消失时间并检测治疗前后血清超敏C反应蛋白（high-sensitive C-reactive protein,hs-CRP）、白细胞介素-6（interleukin-6,IL-6）水平。结果 观察组患者治疗后肿胀、疼痛症状的改善程度优于对照组（P<0.05）;与治疗前比较,两组治疗后hs-CRP、IL-6均显著降低（P<0.05）。两组治疗后hs-CRP降低值比较,差异无统计学意义（P>0.05）,观察组IL-6降低值显著大于对照组（P<0.05）。结论 刺血拔罐联合蛇伤冲剂内服可以改善蛇咬伤后肿胀、疼痛的症状,降低血清hs-CRP、IL-6水平。     

温肾宣肺汤合针灸治疗过敏性支气管哮喘30例

目的：探讨温肾宣肺汤结合针灸对过敏性支气管哮喘的治疗作用,并了解其对体内致哮喘因子的调节作用。方法：将５５例患者随机分为２组。治疗组３０例,用温肾宣肺汤结合针灸治疗;对照组２５例,采用必可酮气雾剂吸入加口服博利康尼治疗,观察两种治疗方法的临床疗效、治疗前后肺功能及血中ＩＬ－４（白细胞介素－４）和ＩｇＥ变化情况。结果：治疗组与对照组均有较好的近期临床疗效和改善肺功能作用,两者之间无明显差异（Ｐ〉０．０５）。远期疗效方面,治疗组优于对照组（Ｐ〈０．０５）,治疗组治疗后血中ＩＬ－４和ＩｇＥ比对照组显著降低（Ｐ〈０．０５,Ｐ〈０．０１）。结论：温肾肺汤结合针灸治疗过敏性支气管哮喘疗效确切,且有降低血中ＩＬ－４和ＩｇＥ的作用。     

刮痧联合和乳汤治疗肝郁气滞型乳腺增生症临床观察

目的 观察刮痧联合疏肝行气中药治疗肝郁气滞型乳腺增生症的临床疗效。方法 将60例肝郁气滞型乳腺增生症患者随机分为对照组及观察组,每组30例,对照组患者口服和乳汤3个月,观察组患者口服和乳汤并接受刮痧治疗3个月。治疗前后分别采用超声观察乳腺的增生腺体厚度和增生肿块最大径,采用视觉模拟量表(visual analogue scale, VAS)评价乳房疼痛程度,采用焦虑自评量表(self-rating anxiety scale, SAS)和抑郁自评量表(self-rating depression scale, SDS)评价患者的焦虑、抑郁情绪。结果 与治疗前比较,治疗后两组患者乳房增生肿块最大径、增生腺体厚度显著缩小(P<0.05),乳房疼痛VAS评分和SAS、SDS评分显著降低(P<0.05),且观察组上述指标改善程度显著大于对照组(P<0.05)。观察组临床疗效明显优于对照组(P<0.05)。结论 刮痧联合和乳汤内服对肝郁气滞型乳腺增生症具有较好的疗效,并优于单纯和乳汤内服的疗效。     

Verbal Aggression Among Male Alcoholic Patients and Their Wives in the Year Before and Two Years After Alcoholism Treatment

Our earlier reports on 88 male alcoholics and their wives showed that domestic violence decreased significantly in the first and second year following a behavioral marital therapy (BMT) alcoholism treatment program. The present study examined verbal aggression in this same sample. In the year before BMT, verbal aggression was significantly greater—being five to seven times more prevalent for clinically elevated aggression and substantially more frequent—for the alcoholic husbands and their wives than for a demographically matched, nonalcoholic comparison sample. In the two years after BMT, both alcoholic men and their wives showed significant and substantial reductions in verbal aggression as compared with the year before BMT. Despite these significant reductions from the year before BMT, verbal aggression in the two years after BMT remained significantly elevated relative to demographically similar nonalcoholic controls. As predicted, relapsed alcoholics and their wives showed more verbal aggression in the 2 years after BMT than both couples with a remitted alcoholic husband and demographically similar nonalcoholic controls, whereas remitted alcoholics and their wives had similar levels of verbal aggression to the nonalcoholic controls. Further, frequency of drinking was positively correlated with verbal aggression in the 2 years after BMT; verbal aggression was greater when the alcoholic husband drank more frequently.     

Judges as therapists and therapists as judges: the collision of judicial and therapeutic roles in drug treatment courts

This paper explores the implications of the expansion of judicial and therapeutic roles in a drug treatment court (DTC) in Canada. Issues that are raised are: how the courtroom is framed as a therapeutic space where public appearances by participants are part of the therapeutic process; how judges have taken on therapeutic practices, effectively compromising their traditional role as neutral arbiter; how certain women resisted therapeutic interventions by judges and felt they received harsher punishments than men; and how treatment counselors in DTCs are given powers of enforcement over their clients. The collision of judicial and therapeutic roles in the DTC results in negative consequences for individuals in the specialized courts. Specifically, DTC participants are expected to engage in a therapeutic relationship with their treatment counselors and the court; however, their right to confidentiality is withheld, and their treatment counselors act as agents for the court.