灯盏花素注射液对肢端感觉异常症循证治疗.docVIP

灯盏花素注射液对肢端感觉异常症循证治疗【摘要】 目的 从循证医学的角度，介绍灯盏花素注射液对肢端感觉异常症循证治疗方案的确立方法。方法 以一位难治性肢端感觉异常症患者为例，介绍如何提出临床问题，怎样检索文献，如何对文献进行评价，怎样结合病例的具体情况和临床医生的个人经验，应用得到的证据拟定治疗方案。结果 按照循证医学方法确立的以灯盏花素注射液为主治疗肢端感觉异常症患者22次后，患者症状得到明显改善。结论 通过临床提出问题、寻找证据、分析证据、循证决策、循证实践过程，不但患者对疗效满意，医生也提高了理论水平和临床能力。 【关键词】 灯盏花素注射液；肢端感觉异常症；治疗；循证医学 Evidence-based treatment of breviscapine injection for limb perceive abnormality XIE Shun-qing，ZHOU Xian-gang.Department of Neurology,the Longchang People′s Hospital, Sichuan Province, Longchang 642150,China 【Abstract】 Objective To introduce the establishment method of breviscapine injection treatment program for limb perceive abnormality from the view of evidence-based medicine.Methods One patient of limb perceive abnormality was used as an example，and it was introduced how to raise clinical questions，to retrieval relative literature，to evaluate the retrieval literature，how to use the retrieval evidences to stipulate treatment program in combination with concrete condition of this case and the doctor′s experience.Results The breviscapine injection treatment program for limb perceive abnormality established by evidence-based medicine was adopted to treat the patient for 22 times，all symptoms of the patient have been improved obviously.Conclusion Through clinical raising questions，searching for evidences，analyzing evidences，making a strategic decision，practising evidence-based course，the patient can attain satisfactory therapeutic effect，and the physician can raise theoretical level and clinical ability. 【Key words】 Breviscapine injection;Limb perceive abnormality;Treatment；Evidence-based medicine 循证医学目前广泛应用于临床，通过提出问题、寻找证据、分析证据、循证决策这一过程，对疾病治疗提供最为科学的诊治依据。现将循证治疗分析结果报告如下。 1 病例 患者，女，46岁，教师，2006年12月6日就诊。主诉：双侧手指及前臂夜间疼痛和麻木2个月。现病史：2个月前患者无明显诱因在夜间睡眠中出现双侧手指及前臂疼痛、麻木，多见于后半夜，醒后感到双手刺痛难忍，并有麻木和僵硬感，去区级医院内科就诊，诊断为周围神经炎。给予复方丹参注射液静脉滴注，VitB?1、B?12肌内注射，谷维素、地巴唑等口服，治疗10余天后效果不明显，改服中药5剂(1剂/2 d，药物不详)，症状仍无缓解，再改用物理治疗等，1次/d，断续治疗近1个月，症状仍无明显好转，遂在家休息1周后前来我科就诊。 现症：患者自诉在夜间后半夜睡眠中出现双侧手指及前臂疼痛、