目的 探讨针刺治疗在防治术后恶心呕吐（PONV）中的作用与疗效。 方法 通过对2012年6月收治的1例全身麻醉下行小脑血肿清除术后出现持续性恶心呕吐症状，后辅以针刺治疗好转的病例报道，就针刺治疗对PONV的穴位选择，刺激方式，介入时间等相关研究进行复习和总结。 结果 患者恶心呕吐症状在选取中脘、足三里（双）、内关（双）穴针刺治疗3次后（30 min/次）明显减少，自诉恶心程度较前缓解，连续针灸6次后呕吐现象得到有效控制。 结论 目前有关针刺治疗PONV的研究越来越多，但尚无统一的治疗标准。
Objective To assess the effect of problem-based learning (PBL) to improve clinical practice skills for clinical students after graduation. Methods Computer retrieval was conducted to search for controlled studies comparing PBL with non-PBL. The quality of the included studies was critically evaluated and data were analyzed. Results A total of 16 articles were included. The results showed that in integrated capabilities, PBL teaching was superior to traditional teaching methods. Whether in self-evaluation or objective evaluation, in terms of legal and ethical aspects of health care, research and presentation skills and ability to solve problem, PBL teaching was superior to non-PBL-learning methods. But in other aspects, it was yet controversial whether PBL-learning was better than non-PBL-learning. Conclusion Problem-based learning could improve clinical practice skills for clinical students after graduation. However, most trials included are of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
ObjectiveTo observe the clinical efficacy of acupuncture treatment on primary mild and moderate pruritus ani. MethodsAccording to the diagnostic and inclusion criteria, 50 outpatients between March 2013 and March 2014 were randomly divided into acupuncture group and drug control group, with 25 cases in each. The acupuncture treatment group were treated by perianal local surrounding needling mostly with body acupuncture treatment for 14 times in 4 weeks. Drug control group were given oral antihistamine drugs and traditional Chinese medicine, pevisone cream rub for 4 weeks. Itching index scores, dermatology life quality index scores and treatment satisfaction were observed before and after treatment, and referral number and average number of pruritus of the two groups were observed in six months after the end of treatment. ResultsAfter 4 weeks of treatment, itching index score of patients in the acupuncture treatment group was significantly lower than the drug control group; the dermatology life quality index scores and treatment satisfaction were significantly better than the drug control group, and in the six months after the end of treatment, referral number and the average number of pruritus were lower than the drug control group. The differences were statistically significant (P<0.05). ConclusionClinical efficacy of acupuncture treatment on primary mild and moderate pruritus ani is significant, and the long term effect is stable.