OBJECTIVE: To assess both regional (vulvar) and overall (generalized) pain sensitivity in women with vulvodynia to determine whether both are increased, suggestive of altered central pain processing. METHODS: Seventee...OBJECTIVE: To assess both regional (vulvar) and overall (generalized) pain sensitivity in women with vulvodynia to determine whether both are increased, suggestive of altered central pain processing. METHODS: Seventeen patients (aged 18-60 years) with vulvodynia and 23 age-matched control subjects were included in this cross-sectional study. Pressure pain thresholds in the vulvar area were evaluated in 23 defined locations using a newly developed vulvodolorimeter. Peripheral pressure pain sensitivity was assessed by applying 1) continuously ascending pressures to 3 bilateral locations (thumb , deltoid , and shin), and 2) discrete pressure stimuli to the thumb using both an ascending and random sequence of varying pressures. RESULTS: Pain thresholds at all vulvar locations were lower in the women with vulvodynia than in pain-free control subjects. Similarly, peripheral pain thresholds were lower at the thumb in women with vulvodynia when obtained by discrete ascending or random staircase paradigms, as well as at the thumb, deltoid, and shin when tested by dolorimeter (P < .05). Findings were similar in both those with generalized vulvar dysesthesia and those with localized vestibulodynia. The quantitative results obtained with the vulvodolorimeter and with the more subjective cotton-tipped swab testing routinely used in diagnosis were strongly correlated. CONCLUSION: Women with vulvodynia displayed significantly increased pressure pain sensitivity in both the vulvar region and in peripheral body regions, suggesting a “central”component to the mechanisms mediating this disorder. Both the novel vulvodolorimeter and the thumb pressure stimulator may assist in future experimental tests of this and related hypotheses.展开更多
Objective: To explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the re leva nt studies published betwee n 1985 and 2017. Methods: Based on the Chinese Medicine Acupunct...Objective: To explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the re leva nt studies published betwee n 1985 and 2017. Methods: Based on the Chinese Medicine Acupuncture-moxibustion Information Database, quantitative analysis, correlation an alysis and Chi-square test were applied to an a lyze the comm only used acupoi nts, meridia n affiliatio ns and body regi on distributi ons, comm only used methods and acupoi nt correlati ons, treatme nt method correlati ons, the efficacy of acupuncture- moxibusti on plus the three-step an algesic ladder for can cer pain, and in dicators. Results: Zusanli (ST 36), Ashi point and Sanyinjiao (SP 6) ranked the top on the list of frequency;points from Bladder Meridian of Foot Taiyang and Stomach Meridian of Foot Yangming were often used;points from the lower limbs and back had high frequencies. The most commonly used treatment method was acupuncture-moxibustion plus medication. Acupuncture-moxibusti on plus the three-step an algesic ladder showed certai n adva ntage compared with the two methods used separately, and among the integrated methods, acupoint application plus the three-step analgesic ladder produced the most significant efficacy. It took (44.77±55.54) min for the analgesic effect to act and the effect lasted for (12.81±14.59) h. Numerical rati ng scale (NRS), visual an alog scale (VAS) and Kar nofsky performa nee status (KPS) scores all showed sign ifica nt changes after interventions (all P<0.01);there was no significant change in the score of quality of life (QOL) after interventions (P>0.05). Conclusion: Zusa nli (ST 36), Ashi point and Sanyin jiao (SP 6) are comm only selected in acup un cture-moxibusti on treatment of cancer pain;acupuncture and acupoint application are often used;acupuncture-moxibustion plus the three-step an algesic ladder can boost the treatme nt efficacy.展开更多
文摘OBJECTIVE: To assess both regional (vulvar) and overall (generalized) pain sensitivity in women with vulvodynia to determine whether both are increased, suggestive of altered central pain processing. METHODS: Seventeen patients (aged 18-60 years) with vulvodynia and 23 age-matched control subjects were included in this cross-sectional study. Pressure pain thresholds in the vulvar area were evaluated in 23 defined locations using a newly developed vulvodolorimeter. Peripheral pressure pain sensitivity was assessed by applying 1) continuously ascending pressures to 3 bilateral locations (thumb , deltoid , and shin), and 2) discrete pressure stimuli to the thumb using both an ascending and random sequence of varying pressures. RESULTS: Pain thresholds at all vulvar locations were lower in the women with vulvodynia than in pain-free control subjects. Similarly, peripheral pain thresholds were lower at the thumb in women with vulvodynia when obtained by discrete ascending or random staircase paradigms, as well as at the thumb, deltoid, and shin when tested by dolorimeter (P < .05). Findings were similar in both those with generalized vulvar dysesthesia and those with localized vestibulodynia. The quantitative results obtained with the vulvodolorimeter and with the more subjective cotton-tipped swab testing routinely used in diagnosis were strongly correlated. CONCLUSION: Women with vulvodynia displayed significantly increased pressure pain sensitivity in both the vulvar region and in peripheral body regions, suggesting a “central”component to the mechanisms mediating this disorder. Both the novel vulvodolorimeter and the thumb pressure stimulator may assist in future experimental tests of this and related hypotheses.
文摘Objective: To explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the re leva nt studies published betwee n 1985 and 2017. Methods: Based on the Chinese Medicine Acupuncture-moxibustion Information Database, quantitative analysis, correlation an alysis and Chi-square test were applied to an a lyze the comm only used acupoi nts, meridia n affiliatio ns and body regi on distributi ons, comm only used methods and acupoi nt correlati ons, treatme nt method correlati ons, the efficacy of acupuncture- moxibusti on plus the three-step an algesic ladder for can cer pain, and in dicators. Results: Zusanli (ST 36), Ashi point and Sanyinjiao (SP 6) ranked the top on the list of frequency;points from Bladder Meridian of Foot Taiyang and Stomach Meridian of Foot Yangming were often used;points from the lower limbs and back had high frequencies. The most commonly used treatment method was acupuncture-moxibustion plus medication. Acupuncture-moxibusti on plus the three-step an algesic ladder showed certai n adva ntage compared with the two methods used separately, and among the integrated methods, acupoint application plus the three-step analgesic ladder produced the most significant efficacy. It took (44.77±55.54) min for the analgesic effect to act and the effect lasted for (12.81±14.59) h. Numerical rati ng scale (NRS), visual an alog scale (VAS) and Kar nofsky performa nee status (KPS) scores all showed sign ifica nt changes after interventions (all P<0.01);there was no significant change in the score of quality of life (QOL) after interventions (P>0.05). Conclusion: Zusa nli (ST 36), Ashi point and Sanyin jiao (SP 6) are comm only selected in acup un cture-moxibusti on treatment of cancer pain;acupuncture and acupoint application are often used;acupuncture-moxibustion plus the three-step an algesic ladder can boost the treatme nt efficacy.
