This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs:chronic proctalgia, coccygodynia, pudendal neuralgia, and chroni...This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs:chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing:A recently published large randomized,controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.展开更多
Background： Trigeminal neuralgia （TN） is a neuropathic pain syndrome. It is the most frequent cranial neuralgia and defined as sudden, usually unilateral and lightning-like, knife-like or burning-like recurrent epi...Background： Trigeminal neuralgia （TN） is a neuropathic pain syndrome. It is the most frequent cranial neuralgia and defined as sudden, usually unilateral and lightning-like, knife-like or burning-like recurrent episodes of pain within the distribution area of one or more divisions of the trigeminal nerve. Here we reported that an 81-year-old woman with TN who complained of severe pain on her right face showed a complete clinical relief after comprehensive therapy containing fire needle, filiform needle and blood-letting therapy. Methods： The patient was applied fire needle combined with filiform needle therapy （3 times / week for 4 months） and three consecutive fire needle combined with blood-letting therapy （3 times / week for one week）. Fire needle was inserted into the back points of Du meridian, the first lateral line of bladder meridian, the right spreading area of the trigeminal nerve and the points around the pain radiation site. The filiform needle acupuncture was applied to the points on the right face including Yuyao （EX-HN4）, Yangbai （GB14）, Toulinqi （GB15）, et al; points on the abdomen including Xiawan （RN10）, Qihai （RN16）, Guanyuan （RN14） and the bilateral points including Tianshu （ST25）, Daheng （SP15）, Zusanli （ST36）, et al. Finally, the three-edged fire needle punctured the points of Yangbai （GB41）, Shangguan （GB3）, Jiache （ST6） on the right face accompanied by the cupping method on the bleeding points. Results： The patient reported the complete disappearance of pain and could open mouth and eat normally. The face was normal and no triggering pain recurred after one-month follow-up. Conclusions： The fire needle combined with blood-letting therapy can cure the TN and might provide an alternative non-drug therapy for those patients who still suffered from TN after other medical treatments or whom that refused surgical treatment.展开更多
基金Supported by In part by Grant R01 DK031369 from the NI-DDK
文摘This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs:chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing:A recently published large randomized,controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.
文摘Background： Trigeminal neuralgia （TN） is a neuropathic pain syndrome. It is the most frequent cranial neuralgia and defined as sudden, usually unilateral and lightning-like, knife-like or burning-like recurrent episodes of pain within the distribution area of one or more divisions of the trigeminal nerve. Here we reported that an 81-year-old woman with TN who complained of severe pain on her right face showed a complete clinical relief after comprehensive therapy containing fire needle, filiform needle and blood-letting therapy. Methods： The patient was applied fire needle combined with filiform needle therapy （3 times / week for 4 months） and three consecutive fire needle combined with blood-letting therapy （3 times / week for one week）. Fire needle was inserted into the back points of Du meridian, the first lateral line of bladder meridian, the right spreading area of the trigeminal nerve and the points around the pain radiation site. The filiform needle acupuncture was applied to the points on the right face including Yuyao （EX-HN4）, Yangbai （GB14）, Toulinqi （GB15）, et al; points on the abdomen including Xiawan （RN10）, Qihai （RN16）, Guanyuan （RN14） and the bilateral points including Tianshu （ST25）, Daheng （SP15）, Zusanli （ST36）, et al. Finally, the three-edged fire needle punctured the points of Yangbai （GB41）, Shangguan （GB3）, Jiache （ST6） on the right face accompanied by the cupping method on the bleeding points. Results： The patient reported the complete disappearance of pain and could open mouth and eat normally. The face was normal and no triggering pain recurred after one-month follow-up. Conclusions： The fire needle combined with blood-letting therapy can cure the TN and might provide an alternative non-drug therapy for those patients who still suffered from TN after other medical treatments or whom that refused surgical treatment.
