穴位按压合松弛疗法治疗脑卒中睡眠障碍31例

目的 观察穴位按压加松弛疗法对脑卒中睡眠障碍患者的疗效。方法 将62例脑卒中睡眠障碍患者随机分为治疗组和对照组各31例,治疗组采用穴位按压加松弛疗法,对照组每晚睡前30 min口服艾司唑仑,3周后,采用匹兹堡睡眠质量指数（Pittsburgh sleep quality index,PSQI）评价睡眠质量。结果 与本组治疗前比较,两组患者治疗后PSQI总分及各因子评分均显著减低（P<0.01）,且治疗组PSQI总分及各因子评分显著低于对照组（P<0.05,或P<0.01）。结论 穴位按压加松弛疗法对脑卒中睡眠障碍具有较好的疗效。     

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.     

调神益肾针法对更年期大鼠下丘脑阿片促黑素皮质素原mRNA表达的影响

目的：研究调神益肾针法对更年期雌性大鼠下丘脑阿片促黑素皮质素原mRNA表达的影响。方法：采用逆转录－聚合酶链反应技术。结果：更年期大鼠下丘脑阿片促黑素皮质素原mRNA表达明显降低；经针刺干预后，调神益肾组该基因的表达明显上调，补肾健脾组则无明显变化。结论：增强下丘脑阿片促黑素皮质素原mRNA的表达可能是调神益肾针法治疗更年期综合征的机制之一。     

火针为主综合治疗非哺乳期乳腺炎30例

目的 观察以火针为主的综合疗法对非哺乳期乳腺炎的临床疗效。方法 选取非哺乳期乳腺炎脓肿期或溃后期患者60例,将其随机分为治疗组30例和对照组30例。其中治疗组采用火针排脓祛腐法治疗,对照组采用切开排脓法治疗,两组均口服浆乳2号方,疗程2个月。比较两组患者的治疗效果。结果 两组患者临床疗效比较,差异无统计学意义（P＞0.05）;与对照组比较,治疗组患者伤口愈合时间明显降低（P＜0.05）,瘢痕直径与脓肿长轴直径比值显著缩小（P＜0.05）,治疗组患者治疗后乳房外观评分和满意度评分均显著增加（P<0.05）;与治疗前比较,两组患者治疗后肿块面积和溃口面积显著缩小（P<0.05）,但治疗组溃口面积缩小程度优于对照组（P<0.05）。结论 火针为主综合治疗非哺乳期乳腺炎不仅有良好的临床疗效,而且治疗周期短,能维持乳房外形的美观,患者满意度较高,是临床有效可行的方法。     

分部针刺法治疗急性期肩关节周围炎的临床研究

目的:观察分部针刺法治疗急性期肩关节周围炎的疗效和作用规律。方法:60例急性期肩关节周围炎患者按临床就诊顺序随机分为治疗组和对照组,每组30例。治疗组选取阿是穴、第4~6颈夹脊、合谷、足三里,对照组选取肩髃、肩前、肩贞、阿是穴、阳陵泉、中平穴。电针刺激,每次30 m in,每周2~3次,共2周。比较观察两种疗法治疗急性期肩关节周围炎的疗效。结果:首次治疗后,治疗组有效率为86.67%,对照组有效率为63.33%,治疗组首次治疗疗效与对照组比较,差异有显著性(P<0.05);疗程治疗后,治疗组有效率为96.67%,对照组有效率为93.33%,治疗组疗程治疗疗效与对照组比较,差异无显著性(P>0.05)。进一步用两组数字疼痛量表(NRS)和描述疼痛量表(VRS)分析可知,两组首次治疗前后NRS和VRS比较,差异均有显著性(P<0.01或P<0.05);治疗组首次治疗前及疗程治疗前NRS和VRS与对照组比较,差异无显著性(P>0.05),治疗组首次治疗后NRS和VRS与对照组比较,差异有显著性(P<0.05),而治疗组疗程治疗后NRS和VRS与对照组比较,差异无显著性(P>0.05)。结论:分部针刺法治疗急性期肩关节周围炎疗效确切,收效快捷,值得推广应用。     

银翘散联合三仁汤加减治疗新型冠状病毒肺炎普通型湿毒郁肺证20例

目的 回顾性观察银翘散联合三仁汤加减治疗新型冠状病毒肺炎普通型湿毒郁肺证患者的临床疗效。方法 采用回顾性临床研究方法,收集36例新型冠状病毒肺炎普通型湿毒郁肺证患者的临床资料,将其分为治疗组和对照组。治疗组20例采用常规治疗联合银翘散和三仁汤加减,对照组16例采用常规治疗。以中医证候积分、中医证候疗效、体温复常时间、病毒核酸转阴率、肺部病灶吸收情况作为结局指标评价治疗效果。结果 两组患者治疗后中医证候评分均较治疗前显著下降(P＜0.05),治疗组中医证候积分下降程度明显大于对照组(P＜0.05)。治疗组中医证候疗效明显优于对照组（P<0.05）。与对照组比较,治疗组患者体温复常时间明显缩短(P＜0.05),治疗10 d后病毒核酸转阴率明显升高(P＜0.05)。两组患者肺部病灶吸收情况比较,差异无统计学意义(P＞0.05)。结论 在西医常规治疗基础上,采用银翘散联合三仁汤加减治疗能够改善新型冠状病毒肺炎普通型湿毒郁肺证患者临床症状,缩短体温复常时间,提高病毒核酸转阴率。     

针药结合治疗绝经过渡期绝经相关症状临床研究

目的 比较针药结合、电针、中药3种不同疗法治疗绝经过渡期绝经相关症状的临床疗效。方法 将符合纳入标准的患者随机分为针药结合组、电针组和中药组各20例,治疗8周后观察并比较3组临床疗效、绝经症状评价量表（menopause rating scale, MRS）评分、围绝经期生存质量量表(menopause-specific quality of life questionnaire, MENQOL）评分。结果 治疗8周后,3组临床疗效的分布比较,差异无统计学意义（P>0.05）。在降低MRS、MENQOL评分方面,针药结合组与电针组、中药组比较,差异具有统计学意义(P<0.05)。针药结合组在改善心脏不适方面优于电针组和中药组（P<0.05）;电针组在治疗膀胱问题方面优于针药结合组和中药组（P<0.05）;中药组在治疗性问题方面优于电针组和针药结合组（P<0.05）;在治疗潮热汗出、失眠、情绪失控、易感疲劳方面,3组疗效差异无统计学意义（P>0.05）。结论 在改善绝经过渡期患者绝经症状方面,针药结合组疗效优于电针组和中药组。     

中医综合治疗早中期慢性肾功能衰竭脾肾气虚证疗效观察

目的 观察中医综合治疗早中期慢性肾功能衰竭（chronic renal failure,CRF）脾肾气虚证临床疗效。方法 将60例CRF患者随机分为对照组和治疗组,每组30例。两组均给予西医常规治疗,治疗组患者在此基础上口服补肾健脾方配合擦背辅助治疗,对照组患者口服百令胶囊,两组疗程均为8周。比较两组患者治疗前后估算的肾小球滤过率（estimated glomerular filtration rate,eGFR）、血尿素氮（blood urea nitrogen,BUN）、血清肌酐（serum creatinine,SCr）、血红蛋白（hemoglobin,Hb）、白蛋白（albumin,ALB）的变化,评价两组临床疗效及症状改善情况。结果 与治疗前比较,两组患者治疗后SCr、BUN水平均显著下降（P<0.05）,eGFR、ALB、Hb水平均显著升高（P<0.05）。治疗组患者治疗后SCr、BUN水平下降程度以及eGFR、ALB、Hb水平上升程度较对照组更为显著（P<0.05）。两组中医证候疗效分布、临床疗效分布比较,差异均有统计学意义（P<0.05）。结论 西医常规疗法联合中医综合治疗可以显著改善CRF患者的肾功能,提高患者生存质量。