骨质疏松症(OP)是一种以骨量减少、骨组织退化为特征的代谢性疾病,骨质疏松性疼痛(OPP)是其最常见的临床症状,极大程度影响患者生活质量,且现代医学治疗存在局限,随着老龄化加剧,挖掘更经济有效的OPP干预措施势在必行。该文基于中国知网、维普、万方、BioMed、Web of Science等数据库,挖掘OPP中医病机与现代医学机制的联系,并回顾性总结了中医方药治疗OP及相关疼痛疾病的基础、临床研究方法及证据。研究表明,中医方药围绕补肾、健脾、活血化瘀等治则,能够显著改善疼痛症状,提高骨密度(BMD),调整Ⅰ型胶原交联C-末端肽(CTX)、血清骨钙素(S-BGP)、碱性磷酸酶(ALP)等骨代谢指标。中医方药治疗OP并改善OPP症状的作用机制与Wnt/β-连环蛋白(β-catenin)、核因子(NF)-κB受体激活因子、丝裂原活化蛋白激酶(MAPK)、磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)、骨保护素(OPG)/NF-κB受体激活因子(RANK)/RANK配体(RANKL)等信号通路有关。进一步加强临床数据积累与分析,严谨设计并开展大样本量下中医方药治疗OPP的随机对照研究,采用制定核心指标集(COS)等方法规范化基础与临床研究的结局指标,联合质谱学、组学等方法挖掘更多潜在活性成分与机制,或可有助于进一步深入探索中医方药治疗OPP的优势与内涵。
Objective To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate.Methods The patients confirmed to the enrolled criteria were randomly divided into an observation group（n=31） and a control group（n=30）.In the observation group,electroacupuncture was applied to Sìbái（四白 ST 2）,Xiàguān（下关 ST 7）,Hégǔ（合谷 LI 4） and Zhīgōu（支沟 TE 6） on the left side for the anesthesia and the routine local anesthesia was done on the right side.In the control group,the routine local anesthesia was adopted on both sides.The feelings of pain,circulatory index and operation effect were observed and compared between the two groups.Results During radiofrequency ablation,the pain grades of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group（all P〈0.05）.In the observation group,the pain grade on the left side was lower than that on the right side（P〈0.05）,and the systolic blood pressure and the heart rate were lower than those in the control group when undergoing the 2nd radiofrequency ablation on the right side and on the left side,respectively（all P〈0.05）.There was no significant difference in operation effect between the two groups.Conclusion Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for hypertrophic inferior turbinate,and would be helpful to prevent cyclic fluctuation during the operation at the same time.
目的:观察电针干预对气管插管全麻胃肠术后咽喉痛(POST)及术后恶心呕吐(PONV)的防治作用。方法:60例气管插管全麻下胃肠手术患者按随机数字表法分为电针组30例和对照组30例。电针组患者全身麻醉前30 min给予点刺少商,电针尺泽、合谷并持续至术毕,对照组患者仅接受常规静脉全身麻醉。分别统计两组患者术后12、24、48 h POST的发生率及严重程度、术后咽喉痛视觉模拟量尺(VAS)评分和术后12、24 h PONV的发生率及严重程度。结果:电针组患者术后12、24 h时POST和PONV的发生率及严重程度、VAS评分均明显低于对照组(P<0.05)。与术后12 h比较,两组术后24、48 h的VAS评分明显降低(P<0.05)。结论:电针可改善患者POST的转归,减少PONV的发生。
