我的病案

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我的医案

A pilot study of acupuncture plus moxibustion in treating major depressive disorder

WANG Xuefeng

Abstract: [Objectives] To observe the response rate and the remission rate of acupuncture plus moxibustion in treating major depressive disorder(MDD), and to compare them with the SSRI antidepressant citalopram in STAR*D. [Method] This is a real world study. The study was carried out in a private practice located in a small city of Switzerland from Nov 2016 to Mar 2018. Any patient who met the criteria of inclusion was observed.   Altogether 13 patients, 11 women and 2 men, are included according to the diagnosis of MDD. The age is between 23 and 69, 46.31±SD14.53. They may have anxiety and different general medical conditions. Acupuncture was used on the points SI19,HT5,HT4,ST25,KI4,ST41,GB35,KI9, and moxibustion was used on the points BL15,BL19,BL20. Every patient had maximal 10 sessions of treatments. The PHQ9 was recorded before and after treatments. GAD7 was recorded to measure the severity of anxiety before and after treatments when patients report anxious symptoms. The response rate and the remission rate were compared with antidepressants citalopram in the first level of STAR*D research. [Results] Before the treatment, all patients’ scores of PHQ9 are between 10 and 25. After treatment, the scores of ten patients are below 5, one is 50% above the initial score, and two patients dropped out. So both the response rate and remission rate are 76.9%. Comparing with the response rate and remission rate of Citalopram in the first level of STAR*D, 47% and 33% individually, this pilot study shows that acupuncture and moxibustion treatment could approach much higher response rate and remission rate in treating MDD and further researches is strongly advised to confirm this result.

Key words: Major depressive disorder; anxiety; Citalopram; Acupuncture; Moxibustion; STAR*D

Wednesday, 16 November 2016 20:06

高血压头痛治疗一例

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高血压头痛治疗一例

作者:汪雪峰

 

患者,S.E,女性,71岁。初诊日期05.04.2016。因发现高血压一年,头痛及右面颊近耳侧疼痛2周就诊。患者就诊时测血压228/122毫米汞柱,心率90次/分有头晕。之前测也经常上压超200。睡眠因疼痛不佳,劳动时出汗多,无盗汗,口干明显,容易激动。无心悸,行走无气急,无疲劳,食欲好,大便正常。曾在家庭医生处降压药治疗,或者因为副作用,或者无效,经家庭医生推荐来我处中医治疗,就诊时未服用任何降压药。

Wednesday, 19 October 2016 10:19

柴胡加龙骨牡蛎汤治疗全身毛发脱落两例

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全秃两例

 
两年前,曾有一位抑郁证患者伴有全身毛发脱落患者,女性,五十多岁,吸烟,头发,眉毛,腋下,阴部毛发全部脱落,伴有疲劳。
Tuesday, 12 April 2016 18:29

偏头痛更年期妇女伴颈肩疼痛

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患者,M.Y,女性,56岁,较壮。07.01.2015首诊。偏头痛30年,近4年加重,每月可发作6到7次。疼痛部位或左或右或头后,可伴呕吐头晕畏光,舌淡红,胖大有齿印,白腻苔,双脉弦略大。有潮热盗汗,用雌激素贴剂。
患者,G.K,女,29岁。形体中等。23.11.2015初诊。有腹痛腹泻10年,5月前腹泻加重,行肠镜确诊为克隆病。服用强的松20毫克,和Imurek免疫抑制剂。眼和关节无症状。同时伴有肛瘘,两月前因肛瘘脓肿刚做过手术,但未恢复,仍然需要去医院每周换药。体力尚好,有容易怕冷,手足冷,有盗汗。平时易腹胀,以脐周为中心,不易饥饿,大便三次每日。无口腔溃疡,但口唇易生疱疹。舌淡红,双脉无殊。腹诊腹力中等,肋下无压痛。考虑克隆病也是肠道内溃疡性改变,肛瘘类似狐惑病,所以给予甘草泻心汤原方。针刺足三里,上巨墟,太冲,天枢,门金,肠门,制污穴,气海,关元。加艾灸。之后复诊诉盗汗减轻,腹胀减轻,医院每次换药都发现肛瘘渗出也好转。但为了肛瘘完全好,必须再次手术。12月中旬停强的松。18.01再次手术,之后未用中医针灸治疗。到了25.02再来复诊时大便又5-6次每天,稀便伴腹胀,右肩胛上疼痛,疲劳。发现双肋下有硬满感,给予柴胡桂枝干姜汤。此后腹胀明显减轻,最后一次复诊24.03诉腹胀已轻微,每周仅一两次。大便三到四次每天,成型。疲劳改善,右肩胛上疼痛也消失。嘱每月一次随访。柴胡桂枝干姜汤续服。
Saturday, 12 March 2016 07:06

偏头痛女孩伴伸舌轻微颤抖,腰背部怕痒

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女,L.V,23岁。初诊日期16.11.2015。头痛多年,每周两次,发作时伴视物异常,有时恶心呕吐。

Saturday, 21 November 2015 15:21

人参在经方中的运用

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人参在经方中的运用

汪雪峰

近日,在治疗一位老年耳鸣患者,给予益气聪明汤后,耳鸣没有改善,但患者却非常满意,因为他的腹胀消失了。我也非常意外,仔细查看益气聪明汤组成,发现此方最有可能消除腹胀的药物是人参。联想到伤寒论中厚朴生姜半夏甘草人参汤时,此方也是治疗发汗后,腹胀满。还有理中汤,此方还有一个名字为人参汤,用来治疗太阴病脾胃虚寒痞满。继续发现非常多的脾胃升降失调的经方都含有人参,比如半夏泻心汤,旋覆代诸汤都有心下痞满。吴茱萸汤,还有麦门冬汤,竹叶石膏汤等都有气逆呕吐的症状,所以人参在这里也是治疗消化道症状。