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2009 H1N1流感(猪流感)最新防治信息

哥伦布综合医疗中心    李柯娃  医师      陶炼晖  医师

秋冬时节，天气转凉。近几周内，今年的新型流感即A型2009 H1N1(猪流感)的发病案例在俄亥俄州乃至全美迅速增多，使得社区民众感到H1N1流感爆发流行的威胁就在眼前。

根据美国疾病控制中心(CDC), 也就是美国最具权威的疾病防治“最高司令部”截止10月20日的最新动态报告，这次H1N1流感具有以下几大新特点：（1）今年已发生的流感病例99% 系由今年新的A型H1N1病毒所致。 （2）2009 A型H1N1流感的常见临床症状与体征有：发热，体温多在100°F以上；上呼吸道症状如流涕、喉咙痒痛、干咳等；消化道症状如恶心、呕吐或腹泻等以及全身不适，肌肉酸痛。（3）由2009 A型H1N1病毒所致的死亡病例中88%的患者年龄小于65岁，其中约1/4是25岁以下的年轻病患；而普通的季节性流感重症死亡病例90%在65岁以上。（4）高危人群也就是指感染新的A型H1N1病毒后易发生严重病情的人群，包括：6个月至24岁的年轻人群，孕妇，患有慢性心、肺、肾、肝疾病，糖尿病，血液病或免疫功能低下如HIV（艾滋病）患者等。（5）目前能有效抑制2009 A型H1N1病毒有两种处方药物即Tamiflu (Oseltamivir) 和Ralenza (Zanamivir).  （6）美国疾病控制中心(CDC)预测，这次2009 A型H1N1流感大流行将可能累及全美一半以上的人口，估计死亡病例总数约在10万人或更高。八月底以来，已报道936病例死于2009 A型H1N1流感。以往每年全美死于重症普通流感的病例在3万6千人左右。

大疫当前，作为普通民众的我们能怎么做到尽可能地保护自己及周围人群呢？美国疾病控制中心及俄亥俄州/哥伦布市卫生局(Columbus Public Health, Ohio)建议如下：

1. 勤洗手。
2. 常使用含酒精60%以上的洁手剂 (Hand Sanitizer)。
3. 打喷嚏、咳嗽时应遮掩你的口鼻。
4. 如患流感请在家休息。
5. 及时注射流感预防针包括普通季节性流感和2009 H1N1流感(猪流感)疫苗。俄亥俄州/哥伦布市卫生局已于10月15日开始由政府控制的2009 H1N1流感(猪流感)疫苗注射，优先接种对象是一线医务工作者，孕妇，半岁以下婴儿的看护者，4岁以下儿童；随后是在校学生；然后为整个社区。
6. 若患有流感症状，请尽早（最好是发病的当天）咨询您的家庭医师，以免错过可以治疗的最佳时机。

另外，不少人对2009 H1N1流感(猪流感)疫苗的安全性存有疑问。根据权威机构美国疾病控制中心和FDA（美国食品药品管理局）的报道其安全性与以往普通季节性流感疫苗相似，如少数人有注射部位酸痛、低热等。再者就是一种极为罕见的累及神经系统的病症格林—巴利综合征(Guillain-Barre Syndrome，GBS)或称为急性感染性多发性神经根神经炎，其每年在全美发病率为十万分之一或二，而由疫苗接种引起的则更是微乎其微。

            总之，有关这波2009 A型H1N1流感(猪流感)的新闻动态随着疫情的急速发展每天都在更新，大家请随时注意从各新闻媒体获取即时信息。当然，我们诊所更愿能竭诚为社区提供全面、准确、及时的2009 A型H1N1流感(猪流感)防治的最新知识。欢迎读者随时登录我们的网站www.ohio-ccim.com 获取最新资讯，或与我们的诊所联系，电话614-760-0622。

伊利华报 2009年10月31日 144期 第11页

Acupuncture and Its Effect on Getting Pregnant

Acupuncture is a technique similar to acupressure, except that fine needles are inserted at specific points along the meridians just under the skin to stimulate, disperse and balance the flow or energy, relieve pain, and treat a variety of chronic, acute and degenerative conditions. Traditional Chinese Medicine (TCM) identifies more than 2,000 acupuncture points connected with pathways called meridians that conduct vital energy or qi (pronounced "chee") throughout the body. Illness or symptoms are associated with an imbalance of this vital energy.

Acupuncture uses hair-thin, disposable needles to penetrate and stimulate specific points in the body to restore normal energetic balance. This acupuncture technique stimulates specific areas associated with organ functions in order to restore balance and help the body maintain its own health. As more women seek drug-free treatment for the conditions of pregnancy, this ancient Chinese healing art has much to offer. Acupuncture may be able to help with many conditions relating to infertility for which more conventional treatments are not effective or long lasting. Acupuncture treatments are normally given once a month. An average session lasts 45 minutes, and women usually only feel a mild sensation such as a feeling of slight heaviness at the site of needle insertion.

Practitioners of Traditional Chinese Medicine (TCM) believe that a variety of energy patterns can interfere with becoming pregnant. Acupuncture can be used in combination with other Western Medicine treatments for infertility when trying to get pregnant. Acupuncture provides a noninvasive, holistic approach to reversing infertility and has a surprising success rate of sixty percent among infertile women; a very high number, considering that many women discover acupuncture late in their search for infertility solutions.

Acupuncture with IVF and ICSI

Many couples who have difficulty conceiving a child by traditional methods often employ various techniques to assist them in the reproductive process. The most common assisted reproduction therapy is in-vitro fertilization (IVF), in which a woman's eggs are harvested and fertilized with a man's sperm in a laboratory. In cases where a male's sperm count is extremely low, a different procedure known as intra-cytoplasmic sperm injection (ICSI) may be used.

Although assisted reproduction techniques like IVF and ICSI have been in use since the 1970s, they are still something of an inexact science. Success rates for each therapy range from as low as 1% to as high as 50%, and a successful pregnancy depends on a variety of factors, including the age of the woman, the cause of infertility, and the skill of the technician performing the procedure. Acupuncture is a useful tool for patients looking to increase their chances of becoming pregnant following assisted reproduction therapy.

Researchers in USA, UK, Germany, France, Australia and China have found that adding acupuncture to the treatment regimen of women using assisted reproductive techniques to have a child can dramatically improve the woman's chances of getting pregnant by up to 20%. In these women the chosen acupuncture points were those that relax the uterus according to the principles of TCM. This greatly increased the chances of getting pregnant because acupuncture has a great influence on the autonomic nervous system and needling specific points would optimized endometrial receptivity in these women.

Acupuncture and PCOS

Between 5 percent and 30 percent of women have characteristics of a condition called PCOS or polycystic ovarian syndrome. The extent is so large because PCOS often goes undiagnosed or misdiagnosed because of its variety of symptoms. Polycystic ovarian syndrome is a hormonal imbalance that leads to weight gain, excessive hair growth, irregular menstrual cycles and difficulty getting pregnant. Such patients are often prescribed hormonal drugs which may have side effects and interfere with getting pregnant. With the use acupuncture, doctors say that such patients may have an option of a drug free treatment.

Acupuncture has shown promising results in women with polycystic ovarian syndrome in regulating their periods. Almost all women suffering from polycystic ovarian syndrome who subscribed to acupuncture had their periods regulated in a study conducted. It has also helped women lose weight and relive headaches in the long run leading to a calmer and stable mind.