Résumé
Objective: To observe the clinical efficacy of acupuncture plus subtle adjustment manipulation of the cervical spine for peripheral facial paralysis.Methods: A total of 60 patients with peripheral facial paralysis who met the screening criteria were selected and divided into two groups according to the method of random number table, with 30 cases in each group. The patients in the acupuncture plus tuina group received routine treatment of acupuncture and subtle adjustment manipulation of the cervical spine, while the patients in the acupuncture group only received the same acupuncture treatment. Assessment of peripheral facial paralysis with integrated traditional Chinese and Western medicine was adopted for rehabilitation assessment. Results: The total effective rate of the acupuncture plus tuina group was 93.3％, while that of the acupuncture group was 70.0％, and there was a significant between-group difference (P<0.05). After treatment, the total scores of rehabilitation assessment in both groups were significantly higher than those before treatment (both P<0.05), and the score of the acupuncture plus tuina group was significantly higher than that of the acupuncture group (P<0.05). Conclusion: The treatment of acupuncture plus subtle adjustment manipulation of the cervical spine can improve the function of facial muscles in patients with peripheral facial paralysis, and its clinical efficacy is better than that of the acupuncture treatment alone.
Résumé
Objective: To analyze the prognostic factors of transfusion-dependent non-severe aplastic anemia (TD-NSAA) patients treated with cyclosporine A (CsA) and androgen. Methods: Clinical data of 77 consecutive TD-NSAA patients treated with CsA and androgen were retrospectively analyzed between 2010 and 2013. We obtained clinical manifestations and baseline parameters of routine blood test from responders, and compared those with non-responders. All data were analyzed by univariate analysis and multivariate analysis. Results: In 77 patients, there were 43 (55.8%) patients achieved hematological response after 6 months'treatment, and 53 (68.8%) patients got response after 12 months. Univariate analysis showed that platelets baseline was the only factor related to hematological response [19 (6-61) ×10(9)/L vs 13.5 (5-45) ×10(9)/L, P=0.001] after 6 months therapy. After 12 months, the statistical differences were maintained, which were platelets baseline [18 (6-61) ×10(9)/L vs 10.5 (5-45) ×10(9)/L, P<0.001], absolute reticulocytes [0.03 (0.01-0.06) ×10(12)/L vs 0.029 (0.02-0.06) ×10(12)/L, P=0.043], transfusion-dependent of platelet (P=0.007) , transfusion-dependent of platelet and erythrocyte (P=0.012) . Multivariate analysis showed that platelets baseline could be an independent prognostic factor of hematological response (P=0.010 or 0.009) . Cutoff value of platelets by receiver operating characteristic curve was 15.5×10(9)/L. Conclusion: Baseline of higher platelets, higher reticulocyte, and no transfusion dependence of platelet are favorable prognostic factors. When platelets baseline is higher than 15.5×10(9)/L, CsA and androgen regimen is rational.