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《广州医药》编辑部
目的 探讨放血疗法对小儿发热的疗效。方法 检索包括中国生物医学文献数据库(CBM)、CNKI、万方、维普、PubMed、Embase、Web of Science、Cochrane Library等8个中、英文数据库自建库至2025年5月所发表的放血疗法治疗小儿发热的随机对照试验研究(RCT),2名研究人员根据Cochrane系统评价手册(5.1.0版)推荐的偏倚风险评估表对所纳入文献进行质量评估,采用RevMan 5.4软件对纳入文献质量进行系统分析。结果 纳入19项RCT,共2 224例患儿,其中观察组1 118例、对照组1 106例。放血疗法能够提高小儿发热的临床疗效[OR=4.18,95% CI(3.00,5.38),P<0.001];降低患儿24 h内高热复发率[OR=0.12,95% CI(0.05,0.34),P<0.001];缩短平均退热时间[MD=-1.78,95% CI(-2.56,-1.00),P<0.001]。结论 放血疗法能够提高小儿发热的临床疗效,降低复发率,缩短退热时间,可作为小儿发热的辅助治疗方法。
Objective To explore the efficacy of bloodletting therapy treatment on pediatric fever by meta-analysis.Methods The randomised controlled trials(RCTs)examining bloodletting therapy for paediatric fever were retrieved from eight Chinese and English databases—China Biomedical Literature Database(CBM),CNKI,Wanfang,VIP,PubMed,Embase,Web of Science,and Cochrane Library—covering publications from the establishment of each database up to May 2025.Two researchers assessed study quality using the risk of bias assessment tool recommended in the Cochrane Handbook for Systematic Reviews(version 5.1.0).RevMan 5.4 software was employed for systematic analysis of included studies.Results Nineteen RCTs involving 2 224 patients were ultimately included,comprising 1 118 patients in the observation group and 1 106 in the control group.Results indicated that bloodletting therapy significantly improved clinical efficacy in paediatric fever(OR=4.18,95% CI[3.00,5.38],P<0.001),reduced the recurrence rate of high fever within 24 hours(OR=0.12,95% CI[0.05,0.34],P<0.001),and shortened the average time to fever resolution(MD=-1.78,95% CI[-2.56,-1.00],P<0.001).Conclusions Bloodletting therapy can improve the clinical efficacy of pediatric fever,reduce the recurrence rate and shorten the time of fever reduction,and can be used as an adjunctive treatment for pediatric fever.
文章围绕康复治疗学专业创新创业人才培养模式展开研究,讨论了国内外高校创新创业人才培养现状。从教育理念、课程体系、师资力量、资源配套等方面探讨了人才培养所面临的问题。结合广东药科大学康复治疗学专业培养现状,从管理、教学、平台、服务四大体系明确了具体要求,有望为其他高校康复治疗学专业培养模式改革提供思路。
The article focuses on innovative and entrepreneurial talent-cultivation models in the Rehabilitation Therapy specialty,discussing the current status of such cultivation in domestic and international universities.It explores challenges in talent development from perspectives including educational philosophy,curriculum system,faculty resources,and resource allocation.Based on the current training status of Guangdong Pharmaceutical University’s Rehabilitation Therapy Program,the study specifies detailed requirements through four major systems:management,teaching,platform,and service.This research is expected to provide valuable insights for the reform of talent cultivation models in rehabilitation therapy programs at other higher educationinstitutions.
目的 观察超声引导下针刺蝶腭神经节治疗过敏性鼻炎的临床疗效。方法 将80例过敏性鼻炎患者随机分成干预组(40例)和对照组(40例),干预组采用超声引导针刺蝶腭神经节,对照组采用常规方法针刺蝶腭穴,每周2次,持续4周。结果 治疗4周后,干预组和对照组均显示出良好疗效。干预组的总有效率为92.50%,对照组的总有效率为82.50%,差异有统计学意义(P<0.05);干预组在鼻症状总分(TNSS)、非鼻症状总分(TNNSS)、视觉模拟量表(VAS)和鼻结膜炎生活质量问卷(RQLQ)等指标上的改善均优于对照组(P<0.05)。结论 超声引导下针刺蝶腭神经节治疗过敏性鼻炎能有效改善患者的临床症状。
Objective To investigate the main clinical effect of acupuncture of pterygopalatine ganglion on patients with allergic rhinitis under the guidance of ultrasound.Methods A total of 80 patients with allergic rhinitis were randomly divided into intervention group and control group.The intervention group was treated with ultrasound guided acupuncture of the sphenopalatineganglion,the control group was treated with conventional acupuncture at sphenopalatine point.The clinical efficacy was determined after the course of treatment.Results The total effective rate was 92.50% in the intervention group and 82.50% in the control group.The improvement of total nasal symptom score,total non-nasal symptom score,VAS and Arhinoconjunctivitis Quality of Life Questionnaire scores in the treatment group was significantly better the control group Conclusions Ultrasound-guided acupuncture of the sphenopalatine ganglion can improves clinical symptoms of patients with allergic rhinitis.
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.
目的 识别经皮冠状动脉介入治疗(PCI)后恐动症患者抑郁、焦虑和压力的影响因素。方法 采用横断面研究,纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能,并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素,应用中介分析探索潜在的中介机制。结果 271例(34.7%)、304例(39.0%)和153例(19.6%)恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明,较高的家庭月收入与较高的抑郁水平相关(线性回归:β为0.908和1.937;Logistic:OR为2.05和5.47),社会支持程度与抑郁水平呈负相关(线性回归:β=-0.079;Logistic:OR=0.93)。单身/离异/寡居患者的焦虑水平显著高于已婚患者(线性回归:β=1.613;Logistic:OR=2.28)。与家庭月收入低于5 000元者相比,家庭月收入为5 000~10 000元之间的患者的压力水平较高(线性回归:β=1.065;Logistic:OR=3.14)。此外,自我感受负担较重的患者具有更高的压力水平(线性回归:β=0.077;Logistic:OR=1.05)。中介分析结果表明,焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论 PCI术后恐动症患者广泛存在心理健康问题,其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素,制定综合管理策略以改善其预后。
Objective To identify the risk factors associated with depression,anxiety and stress in patients with kinesiophobia after percutaneous coronary intervention(PCI).Methods In this cross-sectional study,780 patients who developed kinesiophobia after undergoing PCI were enrolled.A series of scales were used to assess the psychological health status,quality of life,self-perceived burden,social support,and exercise self-efficacy of patients with kinesiophobia,and socio-demographic data of the patients were collected through a questionnaire.Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes,including depression,anxiety,and stress.Furthermore,mediation analysis was employed to explore the potential mediating mechanisms.Results Among the 780 patients with kinesiophobia,271(34.7%),304(39.0%)and 153(19.6%)were found to have varying degrees of depression,anxiety,and stress,respectively.The levels of depression,anxiety and stress in patients with kinesiophobia were positively correlated with each other.The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression(linear:β=0.908 and 1.937;Logistic:OR=2.05 and 5.47),while the degree of social support was negatively correlated with depression levels(linear:β=-0.079;Logistic:OR=0.93).For patients who were single,divorced or widowed,their levels of anxiety were significantly higher than those of married patients(linear:β=1.613;Logistic:OR=2.28).Compared to patients with a monthly household income of less than 5 000 yuan,those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress(linear:β=1.065;Logistic:OR=3.14).Additionally,patients who perceived a higher personal burden also experienced greater stress(linear:β=0.077;Logistic:OR=1.05).Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression.Conclusions This study reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues.Factors such as monthly household income,age,marital status,lifestyle and medical history were found to be significantly associated with these negative psychological outcomes.Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis.
目的 通过对急性深静脉血栓形成(DVT)患者经导管接触性溶栓治疗(CDT)中,影响血管导管相关感染(VCAI)危险因素及病原菌分析,为VCAI的预防提供合理、有效的措施。方法 收集2019年1月—2022年12月徐州市肿瘤医院介入科行CDT治疗的急性DVT患者的临床资料,回顾性调查患者诊疗相关资料及血培养结果,并对发生VCAI和病原菌情况进行分析。结果 本研究共调查急性DVT行CDT治疗的患者437例,发生VCAI的患者共21例,千日感染率为0.543‰。多因素Logistic回归分析结果显示:溶栓频率>3次/天[OR=3.49(95%CI:1.86~6.45)]、导管留置时间>7 d[OR=3.86(95%CI:1.26~10.18)]和有导管回送[OR=8.67(95%CI:4.83~12.65)]是患者发生VCAI的危险因素(P<0.05)。发生VCAI的21例患者,血培养共培养出24株病原菌,有3例患者出现复合病原菌感染情况。其中以革兰阳性球菌最为常见,共培养出13株,占比54.17%,革兰阴性菌9株,占比37.5 %。结论 导管留置时间>7 d、溶栓频率>3次/天和有导管回送是急性DVT患者CDT治疗中发生VCAI的危险因素。VCAI的病原菌以单一病原菌为主,可合并其他病原菌感染,其中以革兰阳性球菌为主。
Objective By analyzing the risk factors and pathogens of vessel catheter associated infection(VCAI)in patients with acute deep vein thrombosis(DVT)undergoing catheter directed thrombolysis(CDT),to provide reasonable and effective measures for the prevention and treatment of VCAI .Methods Clinical data of patients undergoing CDT treatment for acute DVT in the interventional department of the hospital from January 2019 to December 2022 was collected,patient diagnosis and treatment related data and blood culture results were retrospectively investigated and organized,and the occurrence of VCAI and pathogenic bacteria was statistically analyzed.Results This study investigated 437 patients undergoing CDT treatment for acute DVT,and a total of 21 patients developed VCAI,with an infection rate of 0.543‰.The results of multiple Logistic regression analysis show that thrombolysis frequency>3 times/day(OR=3.49[95%CI:1.86-6.45]),catheter retention days>7 days(OR=3.86[95%CI:1.26-10.18]),and the presence of catheter return(OR=8.67[95%CI:4.83-12.65]) were risk factors for the occurrence of VCAI in patients.Among the 21 patients with VCAI,a total of 24 strains of pathogenic bacteria were discoveredin blood culture,and 3 patients developed composite pathogen infections.Among them,Gram positive cocci were the most common,with a total of 13 strains cultured,accounting for 54.17%,9 strains of Gram negative bacteria,accounting for 37.5%.Conclusions The duration of catheter retention>7 days,thrombolysis frequency>3 times/day,and the presence of catheter return are risk factors for VCAI in acute DVT patients undergoing CDT treatment.The pathogen of VCAI is mainly single pathogen,which can be combined with other pathogens,among which Gram positive cocci are the main pathogen.
目的 探讨基于思维导图的绿色通道急救干预对急性心肌梗死患者介入治疗的效果。方法 对天津市人民医院2022年1月—2024年12月收治的80例AMI患者进行研究,依照收治时间进行分组,将2022年1月—2023年6月采取常规急救流程干预的40例患者分为常规组,将2023年7月—2024年12月的采取基于思维导图的绿色通道急救干预的40例患者分为思维导图组。比较两组患者急救效率、急救前后生命体征(心率、舒张压、收缩压)、心肌损伤指标[磷酸肌酸激酶(CK-MB)及肌钙蛋白Ⅰ(cTnI)],最后比较两组患者干预满意度。结果 对比急救效率发现,思维导图组的预检时间、会诊时间、导管室激活时间、急诊送至PCI手术时间均短于常规组(P<0.05);对比急救前后生命体征发现,与急救前对比,急救后两组的心率、舒张压、收缩压均降低(P<0.05),急救前后两组心率、舒张压、收缩压比较差异无统计学意义(P>0.05);对比急救前后心肌损伤指标发现,急救前两组CK-MB、cTnI比较差异无统计学意义(P>0.05),急救后,思维导图组CK-MB、cTnI低于常规组与急救前(P<0.05);对比干预满意度发现,思维导图组干预满意度为100.00%,高于常规组的85.00%(P<0.05)。结论 基于思维导图的绿色通道急救干预可提升AMI患者的急救效率,稳定患者生命体征,减轻心肌损伤的同时,提升患者干预满意度。
Objective To explore the effect of green channel emergency nursing based on mind mapping on percutaneous coronary intervention(PCI) of patients with acute myocardial infarction(AMI).Methods A study was conducted on 80 AMI patients admitted to Tianjin People’s Hospital from January 2022 to December 2024.The patients were divided into two groups based on their admission time.The 40 patients who received routine emergency nursing interventions from January 2021 to June 2023 were assigned to the conventional group,while the 40 patients who received green channel emergency nursing based on mind mapping from July 2023 to November 2024 were assigned to the mind mapping group.The emergency treatment efficacy,vital signs(heart rate,diastolic blood pressure,systolic bloodpressure),myocardial injury indicators(phosphocreatine kinase[CK-MB],and troponin I[cTn1])between two groups of patients before and after emergency treatment were compared.Results The pre-examination time,consultation time,catheterization room activation time and emergency room to PCI operation time of mind mapping group were all shorter than those of conventional group(P<0.05).Compared with the vital signs before and after emergency treatment,we found that the heart rate,diastolic pressure and systolic blood pressure of the two groups decreased after emergency treatment(P<0.05),and there was no significant difference between the heart rate,diastolic pressure and systolic blood pressure of the two groups before and after emergency treatment(P>0.05).Comparing the myocardial injury indicators before and after emergency treatment,there was no significant difference in CK-MB and cTn1 between the two groups before emergency treatment(P>0.05).After emergency treatment,CK-MB and cTn1 in the mind map group were lower than those in the conventional group and before emergency treatment(P<0.05).Comparing the intervention satisfaction,it was found that the mind mapping group of 100.00% was higher than the conventional group of 85.00%(P<0.05).Conclusions Green channel emergency nursing based on mind mapping can improve the efficiency of emergency treatment for AMI patients,stabilize their vital signs,reduce myocardial injury,improve patient intervention satisfaction.
目的 评价新型穿戴式气压治疗仪预防深静脉血栓的临床疗效及安全性。方法 将156例脑梗死患者随机分为对照组和试验组,各78例。试验组使用新型穿戴式气压治疗仪(邦普医疗/VW100)进行气压治疗。对照组使用韩国元金压力治疗仪进行气压治疗。两组疗程均为10 d,观察临床疗效及安全性,比较两组深静脉血栓形成率、医护人员和患者的使用满意度。结果 治疗10 d后,试验组与对照组深静脉血栓未发生率差值为1.2%,相应的95%置信区间为–5.3%~7.9%,下限高于–10%,医护人员和患者对试验组的评价优于对照组(P<0.001)。结论 新型穿戴式气压治疗仪预防深静脉血栓形成的临床疗效不劣于市面上已有的气压治疗仪,治疗过程中未见明显不良反应,临床使用安全有效。
Objective To evaluate the effectiveness and safety of new wearable pneumatic compression pump in preventing deep vein thrombosis.Methods One hundred and fifty-six patients with cerebral infarction were randomly divided into control and study group with 78 cases in each group.Study group was treated with the new wearable pneumatic compression pump(Bangpu Medical / VW100).Control group was treated with pneumatic compression pump(Wonjin-POWER).The course of both groups was 10 days,comparing the deep vein thrombosis rate and useage satisfaction of patients and staffs between the two groups.Results After 10 days of treatment,the difference between the incidence of deep venous thrombosis in the study and control group was 1.2%.The corresponding 95% confidence interval was(-5.3%,7.9%),and the lower limit was greater than -10%.The appraisal from medical staffs and the patients of study group was better than that of the control group(P<0.001).Conclusions The clinical effect of the new wearable pneumatic compression pump to prevent deep vein thrombosis is not inferior to the existing pneumatic compression pump,which clinical practice experience is better.There is no obvious adverse reactions in the treatment process,and the clinical practice is also safe and effective.