水针疗法结合频谱照射缓解慢性软组织损伤疼痛的疗效评估(英文)

Effect of fluid acupuncture therapy combined with spectrum therapy for relieving pain due to chronic soft tissue injury

背景:单纯针刺疗法治疗慢性软组织损伤所致疼痛效果不够显著,水针由于作用穴位时间长且有药物的协同作用,理论上疗效较佳。目的:观察复方丹参注射液水针结合频谱照射对慢性软组织损伤疼痛的干预效果,并与单纯针刺治疗进行比较。设计:病例对比观察。单位:南京农业大学工学院卫生所。对象:选择2001-05/2004-11在南京农业大学工学院卫生所门诊就诊的慢性软组织损伤患者94例,均自愿参加观察。将94例患者分为2组,结合治疗组和针刺对照组各47例。方法:①结合治疗组:穴位注射选取风池穴、天宗穴、秉风穴、曲垣穴、阿是穴、背俞穴、夹脊穴。抽取复方丹参注射液,每个穴位注射二三厘米。每个患病部位取穴2个/次,隔日1次。30d为1个疗程。频谱照射在穴位注射后,用频谱仪对注射部位进行照射。30min/次,隔日1次。30d为1个疗程。穴位注射及频谱照射均治疗1个疗程。②针刺对照组选取上述穴位进行单纯针刺治疗,30min/次,30d为1个疗程,治疗1个疗程。治疗前及治疗1个疗程后分别对两组患者进行疼痛视觉模拟评分,并根据评分进行疗效比较。显效:治疗后疼痛视觉模拟评分下降率>80%;有效:疼痛视觉模拟评分下降率在20%～80%;无效:疼痛视觉模拟评分下降率<20%。主要观察指标:①两组患者治疗前及治疗1个疗程后疼痛视觉模拟评分。②两组患者治疗1个疗程后的疗效。结果:①两组患者治疗前及治疗1个疗程后疼痛视觉模拟评分比较:针刺对照组和结合治疗组患者治疗1个疗程后评分均较治疗前显著下降[1.30±0.90,0.50±0.40;6.57±1.21,6.64±1.13(t=23.958,35.116,P<0.01)],结合治疗组患者评分下降率显著高于针刺对照组[(93.14±10.12)%,(80.13±11.08)%(t=8.764,P<0.01)]。②两组患者治疗1个疗程后的疗效比较:结合治疗组的总有效率(显效率+有效率)显著高于针刺对照组[93.6%,78.7%(χ2=4.644,P<0.05)]。结论:穴位注射复方丹参注射液结合频谱照射能显著缓解慢性软组织损伤患者的疼痛,而且干预效果优于单纯针刺治疗。

BACKGROUND： Simple acupuncture therapy often fails to produce significant relief of pain induced by chronic soft tissue injury, but liquid acupuncture therapy, with its longer action on the acupoint and the synergistic effect of the drugs, may, at least theoretically, have better effect. OBJECTIVE： To observe the effect of fluid acupuncture therapy with compound Danshen injection solution combined with spectrum therapy for relieving pain caused by chronic soft tissue injury. DESIGN： A ease-control observation SETTING： Health Clinic, College of Engineering of Nanjing Agricultural University. PARTICIPANTS： Ninety-four outpatients with chronic soft tissue injury treated in the Health Clinic of College of Engineering, Nanjing Agricultural University between May 2001 and November 2004 participated in this experiment on a voluntary basis. The patients were divided into liquid acupuncture therapy combined with spectrum therapy group （Combined treatment group） and acupuncture control group, with 47 patients in each group. METHODS： In combined treatment group, the acupuncture was administered on the acupoints offengchi （GB 20）, tianzong （Sill）, quyuan （SI13）, ashixue, beishuxue, and jiajixue. Compound Danshen injection solution was injected into each acupoint 2 to 3 cm. Two acupoints were chosen from each region of pain for injection every other day, for 30 days for a treatment course. After the injection, the sites of injection were subjected to spectrum therapy for 30 minutes every other day, for 30 days for a treatment course. One course of acupuncture and spectrum therapy was administered separately. In the acupuncture control group, the above aeupeints were chosen for simple acupuncture therapy in identical treatment course. Visual anologue score （VAS） was used for evaluation of the therapeutic effects before and 1 course after the therapy. Remarkable effect was defined by reduction rate of VAS 〉80% after therapy, improvement by VAS reduction by 20% and 80%, and no effect by VAS reduction by 〈 20%. MAIN OUTCOME MEASURES： VAS score of the patients in the two groups before and 1 course after therapy, and curative effect 1 treatment course after therapy. RESULTS： VAS of the patients in the acupuncture control group and combined therapy group was significantly decreased after 1 course of therapy in comparisofi with that before therapy （1.30±0.90 vs 6.57±1.21 for the former and 0.50±0.40 vs 6.64±1.13 for the latter, t=23.958 and 35.116, P 〈 0.01）. Reduction rate of the score was significantly higher in combined therapy group than in the control group [（93.14±10.12）% vs （80.13±11.08）%, t=8.764, P 〈 0.01], and so was the total effective rate （remarkable effect rate and improvement rate, 93.6% vs 78.7%, X^2=4.644, P 〈 0.05 ）]. CONCLUSION： Fluid acupuncture with compound Danshen injection solution in combination with spectrum therapy can significantly relieve the pain caused by chronic soft tissue injury, with better effect than simple acupuncture therapy.