直线偏振光近红外线照射合用神经阻滞提高治痛效果的量化评估

Quantitative evaluation of the enhancement of therapeutic effect in pain therapy by combining nerve block and linear polarized near-infrared ray irradiation

目的:为提高治痛优秀率,对直线偏振光近红外线照射合用神经阻滞方法治疗疼痛性疾病,与单一神经阻滞进行比较。方法:选择2003-06/2004-11延边大学医学院附属医院麻醉疼痛科就诊的慢性疼痛患者130例。其中面肌痉挛21例、下肢感觉异常10例、带状疱疹后神经痛8例、膝痛18例、肩手综合征3例、椎间盘突出13例、颈椎病6例、网球肘10例、耳鸣1例、肩关节周围炎19例、腰痛症10例、腕、距小腿(踝)关节痛2例、肋间神经痛9例。随机分为2组,直线偏振光近红外线照射合用神经阻滞组和神经阻滞组,每组65例。直线偏振光近红外线照射合用神经阻滞组采用隔天1次作神经阻滞,并在不实施神经阻滞的时间隔天1次照射直线偏振光近红外线;根据不同的疾病选择相应的部位进行照射,其参数为输出80%～100%,照射周期2s/开、4s/关,照射时间为10～30min,次数介于3～12次。神经阻滞组采用单一神经阻滞疗法。全部病例用统一表格记录观察项目并以目测类比评分法测痛记分(优为0～2分,良为3～8分,差为9～10分)。主要比较两组的优、良及无效情况、优良率为优+良,采用t检验进行显著性分析。结果:130例患者全部完成治疗无退出,均进入结果分析。①直线偏振光近红外线合用神经阻滞组优占88%(57/65),良占11%(7/65),无效占1.5%(1/65),优良率99%。神经阻滞组优占72%(47/65),良占23%(16/65),无效占4.6%(3/65)。优良率97%。②两组的优秀率进行比较差异显著(88%,72%,P<0.05)。但对有效率(良)、优良率、无效率进行比较的结果,无显著差异(P>0.05)。结论:直线偏振光近红外线合用神经阻滞方法使直线偏振光近红外线作用更加强化,更好的发挥赋活机体刺激作用。疼痛病治疗采用神经阻滞并用超激光疼痛治疗仪照射疗法,可明显提高优秀率,能获得最佳效果。

AIM： To treat painful diseases by linear polarized near-infrared ray irradiation plus nerve block treatment versus nerve block alone in order to improve the excellent rate in pain therapy. METHODS： Totally 130 patients with chronic pain were selected from the Department of Anesthesiology and Pain Medicine,Affiliated Hospital of Yanbian University Medical College between June 2003 and December 2004,including 21 with facial spasm,10 with paresthesia in lower extremities,8 with postherpetic neuralgia,18 with knee pain,3 with shoulder-hand syndrome,13 with lumbar disc herniation,6 with cervical syndrome,10 with radiohumeral bursitis,1 with tinnitus,19 with shoulder periarthritis,10 with lumbag,2 with wrist and ankle joint pain and 9 with intercostal neuralgia. They were randomly and equally divided into two groups：linear polarized near-infrared ray irradiation plus nerve block group （combination treatment group） and nerve block group.In the combination treatment group,nerve block was performed once every other day,and linear polarized near-infrared ray irradiation was performed in the days when nerve block was not performed, i.e., once the other day.The irradation was performed according to the different affected position by the output of 80% to 100% with the irradiation cycle of 2 seconds every opening and 4 seconds per closing for 10 to 30 minutes,ranging from three times to twelve times.In the nerve block group, nerve block alone was performed.The observation items from all the cases were recorded into the uniform tables,and visual analogue scale （VAS） was used （0 to 2 points were regarded as be excellent,3 to 8 points as be good,and 9 to 10 as be poor）.The excellent,good and ineffective results,and excellent and good rates were compared between the two groups with significant analysis by t test. RESULTS：All the 130 patients completed the therapy and were involved in the result analysis. ①In the combination group,the excellent effect accounted for 88%（57/65）,good effect for 11%（7/65）,and ineffectiveness for 1.5%（1/65） with the excellent and good rate of 99%,and those in the nerve block group were 72%（47/65）,23%（16/65）,4.6%（3/65） correspondingly with the excellent and good rate of 97%. ②The excellent rate was significantly different between the two groups（88% vs 72%, P 〈 0.05）,but the good rate,excellent and good rate and ineffective rate were insignificantly different between the two groups（P 〉 0.05）. CONCLUSION：The therapy of linear polarized near-infrared ray irradiation plus nerve block enhances the effect of simplex linear polarized nearinfrared ray irradiation,and stimulates the activity of bodies.The combination therapy of nerve and Super Lizer apparatus can increase the excellent rate remarkably to achieve a satisfactory outcome.