目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料，根据随机数字表法将患者分为两组：对照组40例，术前5 min予5 mL生理盐水；观察组40例，术前5 min予以0.25 mg/kg艾司氯胺酮（以生理盐水配置成5 mL）。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为（213.54±64.22）min、（240.67±81.26）min、（141.31±45.03）mL，与对照组的（210.43±65.71）min、（244.25±81.33）min、（137.64±42.75）mL比较，差异均无统计学意义（t=0.214、0.197、0.374，P均＞0.05），而观察组丙泊酚、瑞芬太尼用量分别为（1 075.52±134.37）mg、（1 267.18±242.26）μg，虽然低于对照组的（1?126.64±150.21）mg、（1 352.50±295.14）μg，但差异也无统计学意义（t=1.604、1.413，P均＞0.05）；观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为（54.52±9.64）pg/mL、（40.08±7.75）pg/mL、（30.38±6.93）mg/L，均低于对照组的（77.31±10.86）pg/mL、（56.35±9.47）pg/mL、（43.73±7.61）mg/L（t=9.926、8.409、8.203，P均＜0.05）；术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为（51.92±4.41）分、（53.96±4.47）分、（3.59±1.14）分、（3.06±1.01）分、（2.89±0.91）分、（2.57±0.76）分，均低于对照组的（55.06±5.12）分、（57.21±5.19）分、（4.27±1.36）分、（3.68±1.18）分、（3.41±1.06）分、（2.96±0.92）分（t=2.939、3.001、2.423、2.525、2.329、2.067，P均＜0.05），但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义（P＞0.05）；两组术后不良反应发生率也无显著差异（P＜0.05）。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平，减轻术后疼痛，缓解术后负性情绪，且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer．Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed．The patients were divided into two groups according to the random number table method：40 cases in the control group were given 5 mL saline，five minutes before operation，40 cases in the observation group were treated with 0.25 mg / kg esketamine（in 5 mL saline）five minutes before operation．The perioperative indicators，inflammatory factors，negative emotions，pain and adverse reactions were compared between two groups．Results The operation time，anesthesia time and intraoperative blood loss of the observation group were（213.54±64.22）min，（240.67±81.26）min and（141.31±45.03）mL，respectively，which were not significantly different from those of the control group（210.43±65.71）min，（244.25±81.33）min and（137.64±42.75）mL（t=0.214，0.197，0.374，all P＞0.05）．The dosage of propofol and remifentanil in the observation group were（1 075.52±134.37）mg and（1 267.18±242.26）μg，respectively，which were lower than those in the control group of （1126.64±150.21）mg and（1352.50±295.14）μg，but the difference was not statistically significant（t=1.604，1.413，P＞0.05）．The levels of tumor necrosis factor-α，interleukin-6 and C-reactive protein in the observation group at 24 h after operation were（54.52±9.64）pg / mL，（40.08±7.75）pg / mL and（30.38±6.93）mg / L，respectively，which were lower than those in the control group of （77.31±10.86）pg / ml，（56.35±9.47）pg / mL and 43.73±7.61）mg / L（t=9.926，8.409，8.203，all P＜0.05）．The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h，6 h，12 h and 24 h after operation were（51.92±4.41），（53.96±4.47），（3.59±1.14），（3.06±1.01），（2.89±0.91） and（2.57±0.76），respectively，which were lower than those of the control group（55.06±5.12），（57.21±5.19），（4.27±1.36），（3.68±1.18），（3.41±1.06） and（2.96±0.92）（t=2.939，3.001，2.423，2.525，2.329，2.067，P＜0.05）．However，no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively（P＞0.05）．Adverse event rates showed no significance in two groups（P＞0.05）．Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation，decrease pain，mitigate negative emotions，without increasing the incidence of postoperative adverse reactions．

      目的 观察慢性阻塞性肺疾病急性加重期（AECOPD）患者应用基于Caprini量表评估的干预模式联合充气加压泵（IPC）预防静脉血栓（VTE）的效果。方法 选取河南省人民医院在2023年11月—2024年11月收入的82例AECOPD患者作为研究对象，经随机数表法分为对照组41例予以VTE常规干预，观察组41例在对照组的基础上接受基于Caprini量表评估的干预模式联合IPC预防。比较两组AECOPD患者肢体情况及深静脉血栓（VTE）发生情况、凝血指标及股静脉血流速度。结果 观察组肢体肿胀率、肢体疼痛率及VTE发生率均低于对照组（P＜0.05）。干预前，两组AECOPD患者凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、D-二聚体水平比较差异无统计学意义（P＞0.05）；干预后，两组患者TT、PT、APTT、D-二聚体水平均降低，观察组较低（P＜0.05）。干预前，两组AECOPD患者平均流速、血流峰速及阻力指数比较差异无统计学意义（P＞0.05）；干预后，两组患者平均流速、血流峰速均升高，观察组高于对照组（P＜0.05）；阻力指数均降低，观察组低于对照组（P＜0.05）。结论 AECOPD患者应用基于Caprini量表评估的干预模式联合IPC能有效降低肢体肿胀率、肢体疼痛率及VTE发生率，改善凝血指标与股静脉血流速。

   Objective To observe the effect of a Caprini score?based intervention model combined with intermittent pneumatic compression（IPC）in preventing venous thromboembolism（VTE）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods A total of 82 AECOPD patients admitted to Henan Provincial People’s Hospital from November 2023 to November 2024 were selected as subjects and randomly divided into a control group（41 cases）and an observation group（41 cases）using a random number table．The control group received routine VTE prevention，while the observation group received the Caprini score?based intervention combined with IPC in addition to the routine care．The extremity conditions，occurrence of VTE，coagulation parameters，and femoral venous blood flow velocity were compared between the two groups．Results The rates of extremity swelling，extremity pain，and VTE incidence in the observation group were lower than those in the control group（P＜0.05）．Before the intervention，there were no statistically significant differences in thrombin time（TT），prothrombin time（PT），activated partial thromboplastin time（APTT），or D?dimer levels between the two groups（P＞0.05）．After the intervention，TT，PT，APTT，and D?dimer levels decreased in both groups，with lower values in the observation group（P＜0.05）．Before the intervention，there were no statistically significant differences in mean flow velocity，peak flow velocity，or resistance index between the two groups（P＞0.05）．After the intervention，mean flow velocity and peak flow velocity increased in both groups，with higher values in the observation group（P＜0.05），while the resistance index decreased，with a lower value in the observation group（P＜0.05）．Conclusions The application of a Caprini score?based intervention model combined with IPC in AECOPD patients can effectively reduce the rates of extremity swelling，extremity pain，and VTE incidence，and improve  coagulation parameters and femoral venous blood flow velocity．

      目的 合并肺纤维化的慢性阻塞性肺疾病（COPD）是COPD的特殊亚型，患者兼具气流受限与肺组织纤维化病理特征，临床症状更严重、肺功能下降更快，且现有单一治疗方案难以同时改善气流受限与纤维化进展，预后较差。基于此，本研究旨在分析尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD患者的效果及对肺功能的影响，为优化临床治疗方案提供依据。方法 选取2022年3月—2024年12月收治的96例合并肺纤维化的COPD患者，采用前瞻性随机对照研究设计，应用随机数字表法分为试验组与对照组。所有患者均采取常规治疗，对照组48例采取尼达尼布治疗，试验组采取尼达尼布联合格隆溴铵治疗。两组均治疗24周后，比较治疗前后症状评分、肺功能、纤维化指标、炎症指标，并分析两组治疗安全性。结果 治疗后，两组CAT评分、mMRC评分及VAS降低（P＜0.05）；且与对照组比较，试验组CAT评分、mMRC评分及咳嗽VAS评分较低（P＜0.05）。治疗后，两组FVC、FEV₁、DLCO及FEV₁/FVC比值均较治疗前改善（P＜0.05）；且与对照组比较，试验组FVC、FEV₁、DLCO及FEV₁/FVC比值较优（P＜0.05）。治疗后，两组血清KL-6、SP-D水平及CT纤维化评分均降低（P＜0.05）；且与对照组比较，试验组血清KL-6、SP-D水平及CT纤维化评分较低（P＜0.05）。治疗后，两组血清IL-6、TNF-α及TGF-β1水平降低（P＜0.05）；且与对照组比较，试验组血清IL-6、TNF-α及TGF-β1水平较低（P＜0.05）。试验组总不良反应发生率为8.33%（4/48），对照组为10.42%（5/48），两组比较差异无统计学意义（P＞0.05）。结论 尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD效果良好，可减轻患者临床症状，改善肺功能与肺纤维化，降低机体炎症反应，安全性较高。

   Objective To analyze the effects of the combination of nintedanib and glycopyrrolate in treating chronic obstructive pulmonary disease（COPD）patients with associated pulmonary fibrosis and its impact on lung function，providing a basis for optimizing clinical treatment strategies．Methods Ninety-six COPD patients with pulmonary fibrosis admitted from March 2022 to December 2024 were selected，and divided into experimental group and control group using a random number table method．Using a prospective randomized controlled study design，all patients received conventional treatment，with 48 cases in the control group receiving treatment with nintedanib and the experimental group receiving treatment with nintedanib combined with glycopyrrolate bromide．After 24 weeks of treatment in both groups，the symptom scores，lung function，fibrosis indicators，and inflammation indicators were compared before and post-treatment，and the drug safety of the two groups was analyzed．Results Post-treatment，CAT score，mMRC score and VAS decreased in both groups（P＜0.05）．Compared with the control group，CAT score，mMRC score and cough VAS score were lower in the experimental group（P＜0.05）．Post-treatment，FVC，FEV₁，DLCO and FEV₁/FVC ratio of both groups improved compared with that before treatment（P＜0.05）．Compared with the control group，FVC，FEV₁，DLCO and FEV₁/FVC ratio of the experimental group were better（P＜0.05）．Post-treatment，serum KL-6，SP-D levels and CT fibrosis scores of both groups decreased（P＜0.05）．Compared with the control group，serum KL-6，SP-D levels and CT fibrosis scores of the experimental group were lower（P＜0.05）．Post-treatment，serum IL-6，TNF-α and TGF-β1 levels in both groups decreased（P＜0.05）．Compared with the control group，serum IL-6，TNF-α and TGF-β1 levels in the experimental group were lower（P＜0.05）．The incidence of total adverse reactions in the experimental group was 8.33%（4/48），and that in the control group was 10.42%（5/48）．There was no difference between the two groups（P＞0.05）．Conclusions The combination of nintedanib and glycopyrrolate has a significant effect on the treatment of COPD complicated with pulmonary fibrosis，which can alleviate its clinical symptoms，improve lung function and pulmonary fibrosis，reduce the body’s inflammatory response，which is relatively safe．

       目的 探讨自回归求和时间序列模型（ARIMA）在耐碳青霉烯类肺炎克雷伯菌（CRKP）医院感染预测中的应用，为CRKP感染的科学防控提供策略。方法 选取贾汪区人民医院住院患者2018年1月—2024年12月共7年每月CRKP医院感染率，应用SPSS 19.0建立ARIMA模型，利用该模型对2024年1—12月每月CRKP医院感染数据进行验证，以评价模型的预测性能。结果 用2018—2024年住院患者每月CRKP医院感染率建模、拟合，建立最优模型ARIMA（1，1，1），模型拟合值与实际值较吻合，模型对CRKP医院感染率实际值与预测值吻合度较高，平均相对误差为5.40%。结论 用ARIMA模型可有效拟合、预测CRKP医院感染情况，为CRKP防控提供科学指导。

     Objective To explore the value of auto regressive integrated moving average（ARIMA）model in predicting theinfection rate of carbapenem-resistant Klebsiella pneumoniae（CRKP）．Methods The monthly incidence of nosocomial infection of CRKP in Jiawang District People’s Hospital from 2018 to 2024 was selected，and the ARIMA model was established by19.0 SPSS to analyze the fitting and prediction value of the model．Results The ARIMA was established based on the monthly CRKP infection rate from January 2018 to December 2024．The fitted value of the ARIMA（1，1，1）model was in good agreement with the actual value．The incidence of CRKP infection were in good agreement with the predicted value．The average relative errors were 5.40%．Conclusions The ARIMA model can effectively fit and predict the CRKP infection rate，providing scientific guidance for the prevention and control of CRKP infection．

       目的 探究单髁膝关节置换（UKA）联合注射布比卡因脂质体治疗老年孤立性内侧间室骨关节炎（OA）的效果，并分析其对患者术后长效镇痛的作用。方法 前瞻性选取2023年11月—2025年11月期间收治的80例老年孤立性内侧间室OA患者，分为对照组与研究组，各40例。两组患者均接受UKA手术治疗，研究组在术中于相同部位注射布比卡因脂质体，对照组于术中关节周围注射等体积的生理盐水混合物。比较两组术后疼痛强度，镇痛药物消耗与需求，早期膝关节功能恢复情况、早期膝关节功能，以及两组不良反应发生率。结果 研究组术后6 h、12 h、24 h及48 h VAS评分均低于对照组，术后48 h内，研究组中重度疼痛发生率较对照组低（P＜0.05）；研究组术后首次请求镇痛的时间晚于对照组，48 h内曲马多总消耗量及补救镇痛需求率均较对照组低（P＜0.05）；研究组在术后24 h、48 h、72 h的膝关节主动活动度较对照组大，研究组首次直腿抬高时间、术后下地行走时间及住院时间均较对照组短（P＜0.05）；术前两组膝关节协会评分（KSS）和牛津膝关节评分（OKS）评分无差异（P＞0.05）。术后1周，两组评分均改善，且研究组优于对照组（P＜0.05）；两组不良反应发生率无差异（P＞0.05）。结论 UKA术中联合应用布比卡因脂质体，能安全、有效地为老年孤立性内侧间室OA患者提供长效术后镇痛。且该方案不仅能显著减轻患者早期疼痛、减少阿片类药物依赖，更能有效促进膝关节早期功能恢复、缩短住院时间，并为患者获得更优的早膝关节功能奠定基础。

    Objective To investigate the efficacy of unicompartmental knee arthroplasty（UKA） combined with injection of bupivacaine liposomes in the treatment of elderly isolated medial compartment osteoarthritis（OA），and analyze its long-term analgesic effect on patients after surgery．Methods A prospective study was conducted on 80 elderly patients with isolated medial compartment OA admitted between November 2023 and November 2025．They were divided into a control group and a study group，with 40 patients in each group．Both groups of patients received UKA treatment．The study group received injection of bupivacaine liposomes at the same site during surgery，while the control group received injection of an equal volume of physiological saline mixture around the joints during surgery．Postoperative pain intensity，analgesic drug consumption and demand，early knee joint function recovery，early knee joint function were compared between two groups，and the incidence of adverse reactions was compared between the two groups．Results The study group had lower VAS scores at 6 h，12 h，24 h，and 48 h postoperatively compared to the control group．Within 48 hours after surgery，the incidence of moderate to severe pain in the study group was lower than that in the control group（P＜0.05）．The time to first postoperative analgesic request in the study group was later than that in the control group，and the total tramadol consumption and the need for analgesia within 48 hours were lower（P＜0.05）．The active range of motion of the knee at 24 h，48 h，and 72 h postoperatively was greater in the study group compared to the control group．Additionally，the time to first straight leg raise，time to ambulation，and length of hospital stay were all shorter in the study group（P＜0.05）．Preoperatively，there were no differences between the two groups in the Knee Society Score（KSS） and the Oxford Knee Score（OKS）（P＞0.05）．One week postoperatively，both groups showed improved scores，with the study group showing greater improvement than the control group（P＜0.05）．There was no significant difference in the incidence of adverse reactions between the two groups（P＞0.05）．Conclusions The combined use of bupivacaine liposomes during UKA can provide safe and effective long-term postoperative analgesia for elderly patients with isolated medial compartment OA．And this plan not only reduces early pain and opioid dependence in patients，but also effectively promotes early knee joint function recovery，shortens hospitalization time，and lays a solid foundation for patients to achieve better early knee joint function．

       目的 研究数字化口内扫描印模技术（DIOS）对重度牙周炎（SP）患者口腔种植修复效果及龈沟液炎症因子水平的影响并进行分析。方法 选取医院2022年1月—2025年1月收治的100例SP患者进行研究。以密封信封抽签法分为数字化组（n=50）及常规组（n=50）。两组均开展口腔种植修复，常规组采用常规硅橡胶印模技术，数字化组则采用DIOS。对比两组印模制取时间、印模过程中疼痛程度及种植成功率、修复体满意度、龈沟液炎症因子水平、并发症发生情况。结果 数字化组印模制取时间短于常规组，VAS评分低于常规组，而种植成功率高于常规组（均P＜0.05）。数字化组边缘密合度、咬合关系、邻接关系满意度均高于常规组（均P＜0.05）。修复3个月后两组龈沟液各项炎症因子水平均低于修复前，且数字化组低于常规组（均P＜0.05）。数字化组并发症总发生率低于常规组（P＜0.05）。结论 DIOS可显著提高SP患者口腔种植修复效果，降低龈沟液炎症因子水平，减少并发症的发生。

      Objective To investigate the effects of digital intraoral scanner（DIOS）on the oral implant restoration effect and the levels of inflammatory factors in gingival crevicular fluid in patients with severe periodontitis（SP）．Methods A total of 100 SP patients admitted to the hospital from January 2022 to January 2025 were selected for the study．They were divided into the digital group（n=50）and the conventional group（n=50）by the sealed envelope lottery method．Both groups underwent oral implant restoration．The conventional group used the conventional silicone rubber impression technology，while the digital group underwent DIOS．The time of impression preparation，the degree of pain during the impression process，the success rate of implantation，the satisfaction of restorations，the levels of inflammatory factors in gingival crevicular fluid，and the occurrence of complications were compared between the two groups．Results The impression acquisition time of the digital group was shorter than that of the conventional group，the VAS score was lower than that of the conventional group，while the implantation success rate was higher than that of the conventional group（all P＜0.05）．The marginal fit，occlusal relationship and adjacent relationship in the digital group were all higher than those of the conventional group（all P＜0.05）．Three months after repair，the levels of various inflammatory factors in gingival crevicular fluid in both groups were lower than those at admission，and the digital group was lower than the conventional group（all P＜0.05）．The total incidence of complications in the digital group was lower than that in the conventional group（P＜0.05）．Conclusions DIOS can significantly improve the oral implant restoration effect of SP patients，reduce the levels of inflammatory factors in gingival crevicular fluid，and reduce the occurrence of complications．

       目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭（CHF）并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低（P<0.05）。与对照组相比,观察组干预后左室射血分数（LVEF）水平明显更高,超敏心肌肌钙蛋白T（hs-cTnT）、N末端B型利钠肽前体（NT-proBNP）、左室舒张末期内径（LVEDD）水平更低（P<0.05）。与对照组相比, 观察组干预后主观整体营养状况评价表（PG-SGA）评分明显更低,血红蛋白（Hb）、前白蛋白（PA）、白蛋白（ALB）水平更高（P<0.05）。与对照组相比,观察组干预后症状、身体、情感及总分更低（P<0.05）。观察组不良事件发生率（1.96%）低于对照组（15.69%）（P<0.05）。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。

       Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure（CHF）and frailty．Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included． According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention．The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups．Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention（P<0.05）．Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention（P<0.05）．Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention（P<0.05）．Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention（P<0.05）．The incidence of adverse events in the observation group（1.96%）was lower than that in the control group（15.69%）（P<0.05）．Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events．

        目的   观察桂枝加芍药汤个体化干预治疗儿童功能性腹痛的临床疗效。方法   选取2023年100名在广东省妇幼保健院门急诊就诊确诊为儿童功能性腹痛患儿。100名儿童随机分为两组，益生菌组50名、益生菌+中药个体化干预组50名。连续治疗1周。记录两组患儿卧立位心率、卧立位血压、Rutter 儿童行为量表和中医临床症状的改善情况。结果   益生菌+中药个体化干预组患儿治疗后卧立位心率和Rutter儿童行为量表中N行为评分比益生菌组下降，中医临床症状评分的有效率优于益生菌组。结论   桂枝加芍药汤个性化干预治疗儿童功能性腹痛疗效显著。

    Objective  To observe the clinical efficacy of individualized intervention with Guizhi plus Shaoyao Decoction in children with functional abdominal pain disorders（FAPDs）．Methods  A total  of  100  children  diagnosed with  FAPDs at the outpatient and emergency departments of Guangdong Women and Children Hospital were selected．These children were randomly divided into two groups：the probiotics group（50 cases）and the probiotics+traditional Chinese medicine individualized intervention group（50 cases）．Both groups received continuous treatment for 1 week．Parameters including  supine/upright heart rates，supine/upright blood pressure，Rutter Children’s Behavior Questionnaire，and improvements in traditional Chinese clinical symptom scores were recorded．Results  The probiotics+traditional Chinese medicine individualized intervention group exhibited significantly greater reductions in supine/upright heart rates and N-behavior scores compared to the probiotics group．The effective rate of Chinese clinical symptom scores was also significantly higher in the individualized intervention group．Conclusions  Individualized intervention of Guizhi plus Shaoyao Decoction has a remarkable efficacy in treating FAPDs in children．

       目的   研究非酒精性脂肪肝老年人体质辨识及中医治未病服务对其治疗效果。方法   选择2023年1月—2024年1月贵州中医药大学第一附属医院就诊的非酒精性脂肪性肝病老年患者70例作为研究对象，根据患者就诊顺序分配为两组。对照组35例，接受常规干预；观察组35例，其在对照组基础上予中医“治未病”理念下体质辨识干预模式。比较两组干预效果，以及干预前后血脂水平、肝功能、生存质量的变化。结果   观察组的治疗总有效率91.43%，高于对照组的68.57%，差异有统计学意义（P＜0.05）。治疗前，两组各项血脂水平、肝功能、慢性肝病问卷（CLDQ）评分比较，差异无统计学意义（P＞0.05）；治疗后，两组各项血脂水平优于治疗前，各项肝功能低于治疗前，CLDQ评分高于治疗前，差异有统计学意义（P＜0.05）；治疗后，观察组的各项血脂水平优于对照组，各项肝功能低于对照组，CLDQ评分高于对照组，差异有统计学意义（P＜0.05）。结论   对非酒精性脂肪性肝病老年患者而言，中医“治未病”理念下体质辨识干预服务能够提高其治疗效果，调节血脂水平的异常，改善肝功能及生存质量，值得应用。

       Objective  To study the physical identification of nonalcoholic fatty liver in the elderly and the therapeutic effect of traditional Chinese medicine on preventing disease before arising．Methods  A total of 70 elderly patients with nonalcoholic fatty liver disease treated in the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to January 2024 were selected as the study objects．Patients were assigned to two groups，control group（35 cases）received  routine intervention，observation group（35 cases）received physical identification intervention based on preventing disease before arising of traditional Chinese medicine additionally．The effect of intervention and the changes of blood lipid levels，liver function and quality of life before and after intervention were compared between the two groups．Results  The total effective rate of the observation group was 91.43%，higher than that of the control group（68.57%），the difference was statistically significant（P＜0.05）．Before treatment，there were no significant differences in blood lipid levels，liver function and CLDQ scores between the two groups（P＞0.05）．After treatment，the levels of blood lipids were better than those before treatment，liver function was lower than that before treatment，CLDQ score was higher than that before treatment，the difference was statistically significant（P＜0.05）．After treatment，the blood lipid levels of the observation group was better than that of the control group，the liver function was lower than that of the control group，and the CLDQ score was higher than that of the control group，with statistical significance（P＜0.05）．Conclusions  For elderly patients with nonalcoholic fatty liver disease，the intervention service of body constitution identification under the concept of preventing disease before arising of traditional Chinese medicine can improve the therapeutic effect，regulate the abnormal blood lipid levels，improve liver function and quality of life，which is worthy of application．

       目的   探究认知行为疗法联合治疗性沟通在对内镜黏膜下剥离（ESD）术患者心理及治疗依从性的效果。方法   前瞻性选取2023年3月至2025年3月鹰潭市一八四医院收治的122例行ESD术的患者作为研究对象，采用随机数字表法将患者分为A、B组，B组56例患者采取治疗性沟通干预，A组66例患者采用认知行为疗法联合治疗性沟通干预，两组均连续干预2个月。比较两组患者干预前后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分、心理弹性量表（CD-RISC）评分、Herth希望指数量表（HHI）评分差异，对比两组干预依从性。结果   干预后，两组SAS、SDS评分均下降且A组低于B组（t分别为12.096、10.326，P＜0.05）；干预后，两组CD-RISC量表各项评分均提高且A组高于B组（t分别为18.483、12.060、13.622，P＜0.05）；干预后，两组HHI量表各项评分均上升且A组高于B组（t分别为1.289、11.568、12.527、13.794，P＜0.05）；A组患者总依从率96.97%（64/66）高于B组80.36%（45/56）（χ ² =8.782，P＜0.05）。结论   认知行为疗法联合治疗性沟通在ESD术患者中干预效果理想，能够明显改善患者负性情绪，提高心理弹性及对疾病康复的希望水平，有效提升依从性。

       Objective  To explore the effect of cognitive behavioral therapy combined with therapeutic communication on psychological  health and therapy compliance of patients undergoing endoscopic submucosal dissection（ESD）．Methods  Prospectively，122 patients who underwent ESD at Yingtan 184 Hospital from March 2023 to March 2025 were selected as the research subjects．These patients were randomly divided into Group A and Group B using the random number table method，and 56 patients in group B were treated with therapeutic communication，66 patients in group A were treated with cognitive behavioral therapy combined with therapeutic communication，and both groups were continuously intervened for 2 months．The  scores of Self-Rating Anxiety Scale（SAS），Self-Rating Depression Scale（SDS），Connor-Davidson Resilience Scale（CD-RISC）and Herth Hope Index（HHI）were compared between the two groups before and after treatment．Therapy compliance between the two groups was compared．Results  After treatment，the SAS and SDS scores of the two groups were decreased，and the scores of group A was lower than that of group B（t=12.096，10.326，P＜0.05）after the intervention，the scores of the CD-RISC scale of the two groups were improved，and the score of group A was higher than that of group B（t=18.483，12.060，13.622，P＜0.05）．After intervention，the scores of HHI scale in both groups increased and score of group A was higher than that ofgroup B（t=11.289，11.568，12.527，13.794，P＜0.05）．The total compliance rate of patients in group A was 96.97%（64/66），which was significantly higher than 80.36%（45/56）in group B（χ ² =8.782，P＜0.05）．Conclusions  Cognitive-behavioral therapy combined with therapeutic communication has an ideal effect in ESD patients，which can significantly improve patients’ negative emotions，psychological resilience and hope for disease recovery，and also therapy compliance．