目的探讨对乙酰氨基酚(扑热息痛)治疗脊椎疼痛和骨关节炎(髋关节、膝关节)的有效性和安全性。设计系统综述和荟萃分析。数据来源Medline、荷兰医学文摘数据库(EMBase)、AMED、CINAHL、Web of Science、LILACS、国际药学文摘、Cochrane...目的探讨对乙酰氨基酚(扑热息痛)治疗脊椎疼痛和骨关节炎(髋关节、膝关节)的有效性和安全性。设计系统综述和荟萃分析。数据来源Medline、荷兰医学文摘数据库(EMBase)、AMED、CINAHL、Web of Science、LILACS、国际药学文摘、Cochrane对照试验中心注册库,时间自建库至2014年12月。研究的纳入标准研究须为随机对照试验,比较扑热息痛和安慰剂治疗脊椎疼痛(颈痛或下腰痛)和骨关节炎(髋关节、膝关节)的疗效和安全性。数据的提取由2名独立的研究人员分别提取关于疼痛、失能和生活质量的数据。次要结果指标包括:不良反应、患者依从性和急救药物的使用。疼痛和失能评分转换为0(没有疼痛或失能)到100(疼痛加重和失能)的数值。采用随机效应模型计算加权均数差(WMD)或风险比(HR)以及95%可信区间(95%CI)。应用Cochrane协作工具对偏倚风险进行评估,采用GRADE方法对证据的质量进行评估,并对结论进行总结。结果共纳入12篇报道(13项随机试验)。对于下腰痛患者,扑热息痛在短期内减少疼痛强度〔WMD=-0.5,95%CI(-2.9,1.9)〕、失能〔WMD=0.4,95%CI(-1.7,2.5)〕或提高生活质量〔WMD=0.4,95%CI(-0.9,1.7)〕等方面均是无效的。对于髋关节炎或膝关节炎患者,扑热息痛在短期内减轻疼痛〔WMD=-3.7,95%CI(-5.5,1.9)〕、失能〔WMD=-2.9,95%CI(-4.9,0.9)﹞方面有显著作用,尽管在临床意义上不重要。报告任何不良反应〔HR=1.0,95%CI(0.9,1.1)〕、任何严重不良反应〔HR=1.2,95%CI(0.7,2.1)〕或因为不良事件退出研究〔HR=1.2,95%CI(0.9,1.5)〕的患者数量,在扑热息痛组和安慰剂组中类似。坚持治疗的患者数量〔HR=1.0,95%CI(0.9,1.1)〕和使用急救药物〔HR=0.7,95%CI(0.4,1.3)〕的患者数量,在两组之间也是相似的。扑热息痛组患者发生肝功能异常的概率是安慰剂组患者的4倍〔HR=3.8,95%CI(1.9,7.4)〕,但这种效应的临床意义是不确定的。结论扑热息痛在治疗腰痛方面是无效的,但可以对骨关节炎患者提供最小的短期利益。现有的临床实践指南推荐对下腰痛患者、髋关节或膝关节骨关节炎患者使用扑热息痛治疗,以上研究结果支持对这些推荐进行重新审议。展开更多
Objective To investigate the role of activated extracellular signal-regulated kinase 1/2 （ERK1/2） in spinal cord in the development of cystic pain in rabbit. Methods We observed the relationship between the activati...Objective To investigate the role of activated extracellular signal-regulated kinase 1/2 （ERK1/2） in spinal cord in the development of cystic pain in rabbit. Methods We observed the relationship between the activation of ERK1/2 in spinal cord and nociceptive behaviors, as well as the effect of U0126, a mitogen-activated protein kinase （MEK, upstream protein of ERK1/2） inhibitor, on cystic pain in rabbits by behavioral test, immunohistochemistry and western blot analysis. Results After injecting 0.5 ml formalin into gallbladder, the behaviors such as grasping of the cheek and licking of the abdomen increased in 30 min, with a significant increase in pERK1/2 expression in the spinal cord, as well as the pERK1/ 2 immunoreactive cells located in laminae Ⅴ-Ⅶ and X of the dorsal horn and ventral horn of T6 spinal cord. Administration of U0126 （100 -400 μg/kg body weight, i.v., 10 min before instillation of formalin） could attenuated nociceptive behaviors dose-dependently, but could not restrain the nociceptive behaviors completely even at the maximal efficient dose of 400 μg/kg body weight. Conclusion Activated ERK1/2 in the spinal cord at least partly participates in the development of acute inflammatory cystic pain induced by formalin in rabbits.展开更多
To evaluate the efficacy and safety of percutaneous balloon kyphoplasty as a new therapy for patients with painful osteoporotic vertebral compressive fractures of the lumbar and thoracic spine. Methods ： A retrospec...To evaluate the efficacy and safety of percutaneous balloon kyphoplasty as a new therapy for patients with painful osteoporotic vertebral compressive fractures of the lumbar and thoracic spine. Methods ： A retrospective analysis was conducted in 38 consecutive patients （28 females, 10 males）, whose ages ranged from 56 to 82 years （mean age 72 years）. The symptom- and sign-positive spinal segment was identified by MRI. The time between onset of symptoms and surgical intervention ranged from 2 days to 1 year. 62 segments （36 thoracic, 26 lumbar） were treated in this cohort. The pain score estimated by Visual Analog Scale and activity degree were assessed immediately after operation and at 1-, 6-, and 12-month postoperative follow-up. Preoperative and postoperative anterior, midline vertebral heights in fractured vertebrae were measured on lateral radiographs to evaluate the effect of the procedure. Results. The method achieved a swift pain relief associated with an evidently increased weight-bearing ability. The pain score was reduced from 8.2 to 2.4 points. The anterior and midline vertebral heights in 62 fractured vertebral bodies increased up to 82.76% ±26.84%, 88.82 % ± 21.75 % and the wedge decreased from 15 to 8 degrees. This effect persisted at least over a period of two years. The procedure did not induce narrowing of the spinal canal and no severe complications occurred. Conclusions： Balloon kyphoplasty can result in immediate clinical improvement of mobility and pain relief, increase vertebral body height, and quickly return patient＇s activity. The short-term results are approved excellent, and the long-term results need further judgment.展开更多
Objective： To observe the effect of electroacupuncture （EA） at Jiaji （EX-B 2） points plus hydro-acupuncture with sinomenine hydrochloride for low back pain caused by compression fractures in the elderly. Methods...Objective： To observe the effect of electroacupuncture （EA） at Jiaji （EX-B 2） points plus hydro-acupuncture with sinomenine hydrochloride for low back pain caused by compression fractures in the elderly. Methods： Ninety-five elderly in-patients with low back pain caused by compression fractures were randomly divided into an observation group and an EA group according to the visit sequence. Both groups received the same basic treatment. In the EA group, 48 cases were treated with EA at Jiaji （EX-B 2） points plus the basic therapy; 47 cases in the observation group received the basic treatment plus EA and hydro-acupuncture with sinomenine hydrochloride at Jiaji （EX-B 2） points. The levels of osteoprotegerin （OPG） and interleukin-1β（IL-1β） in peripheral blood were measured by enzyme-linked immunosorbent assay （ELISA） before and at the 21st day of treatment in both groups. Oswestry disability index （ODI） and visual analog scale （VAS） scores were used to analyze the clinical efficacy. Results： After treatment, the OPG content in the observation group was higher with statistical significance compared with that before treatment in the observation group and after the treatment in the EA group, respectively （both P〈0.05）; the content of IL-1β, ODI and VAS scores were lower than those before treatment in the observation group and after treatment in the EA group with statistical significances （all P〈0.05）. Conclusion： The combination of EA and hydro-acupuncture with sinomenine hydrochloride at Jiaji （EX-B 2） points is effective for low back pain caused by compression fractures in the elderly, and is superior to EA at Jiaji （EX-B 2） points alone.展开更多
文摘目的探讨对乙酰氨基酚(扑热息痛)治疗脊椎疼痛和骨关节炎(髋关节、膝关节)的有效性和安全性。设计系统综述和荟萃分析。数据来源Medline、荷兰医学文摘数据库(EMBase)、AMED、CINAHL、Web of Science、LILACS、国际药学文摘、Cochrane对照试验中心注册库,时间自建库至2014年12月。研究的纳入标准研究须为随机对照试验,比较扑热息痛和安慰剂治疗脊椎疼痛(颈痛或下腰痛)和骨关节炎(髋关节、膝关节)的疗效和安全性。数据的提取由2名独立的研究人员分别提取关于疼痛、失能和生活质量的数据。次要结果指标包括:不良反应、患者依从性和急救药物的使用。疼痛和失能评分转换为0(没有疼痛或失能)到100(疼痛加重和失能)的数值。采用随机效应模型计算加权均数差(WMD)或风险比(HR)以及95%可信区间(95%CI)。应用Cochrane协作工具对偏倚风险进行评估,采用GRADE方法对证据的质量进行评估,并对结论进行总结。结果共纳入12篇报道(13项随机试验)。对于下腰痛患者,扑热息痛在短期内减少疼痛强度〔WMD=-0.5,95%CI(-2.9,1.9)〕、失能〔WMD=0.4,95%CI(-1.7,2.5)〕或提高生活质量〔WMD=0.4,95%CI(-0.9,1.7)〕等方面均是无效的。对于髋关节炎或膝关节炎患者,扑热息痛在短期内减轻疼痛〔WMD=-3.7,95%CI(-5.5,1.9)〕、失能〔WMD=-2.9,95%CI(-4.9,0.9)﹞方面有显著作用,尽管在临床意义上不重要。报告任何不良反应〔HR=1.0,95%CI(0.9,1.1)〕、任何严重不良反应〔HR=1.2,95%CI(0.7,2.1)〕或因为不良事件退出研究〔HR=1.2,95%CI(0.9,1.5)〕的患者数量,在扑热息痛组和安慰剂组中类似。坚持治疗的患者数量〔HR=1.0,95%CI(0.9,1.1)〕和使用急救药物〔HR=0.7,95%CI(0.4,1.3)〕的患者数量,在两组之间也是相似的。扑热息痛组患者发生肝功能异常的概率是安慰剂组患者的4倍〔HR=3.8,95%CI(1.9,7.4)〕,但这种效应的临床意义是不确定的。结论扑热息痛在治疗腰痛方面是无效的,但可以对骨关节炎患者提供最小的短期利益。现有的临床实践指南推荐对下腰痛患者、髋关节或膝关节骨关节炎患者使用扑热息痛治疗,以上研究结果支持对这些推荐进行重新审议。
文摘Objective To investigate the role of activated extracellular signal-regulated kinase 1/2 （ERK1/2） in spinal cord in the development of cystic pain in rabbit. Methods We observed the relationship between the activation of ERK1/2 in spinal cord and nociceptive behaviors, as well as the effect of U0126, a mitogen-activated protein kinase （MEK, upstream protein of ERK1/2） inhibitor, on cystic pain in rabbits by behavioral test, immunohistochemistry and western blot analysis. Results After injecting 0.5 ml formalin into gallbladder, the behaviors such as grasping of the cheek and licking of the abdomen increased in 30 min, with a significant increase in pERK1/2 expression in the spinal cord, as well as the pERK1/ 2 immunoreactive cells located in laminae Ⅴ-Ⅶ and X of the dorsal horn and ventral horn of T6 spinal cord. Administration of U0126 （100 -400 μg/kg body weight, i.v., 10 min before instillation of formalin） could attenuated nociceptive behaviors dose-dependently, but could not restrain the nociceptive behaviors completely even at the maximal efficient dose of 400 μg/kg body weight. Conclusion Activated ERK1/2 in the spinal cord at least partly participates in the development of acute inflammatory cystic pain induced by formalin in rabbits.
文摘To evaluate the efficacy and safety of percutaneous balloon kyphoplasty as a new therapy for patients with painful osteoporotic vertebral compressive fractures of the lumbar and thoracic spine. Methods ： A retrospective analysis was conducted in 38 consecutive patients （28 females, 10 males）, whose ages ranged from 56 to 82 years （mean age 72 years）. The symptom- and sign-positive spinal segment was identified by MRI. The time between onset of symptoms and surgical intervention ranged from 2 days to 1 year. 62 segments （36 thoracic, 26 lumbar） were treated in this cohort. The pain score estimated by Visual Analog Scale and activity degree were assessed immediately after operation and at 1-, 6-, and 12-month postoperative follow-up. Preoperative and postoperative anterior, midline vertebral heights in fractured vertebrae were measured on lateral radiographs to evaluate the effect of the procedure. Results. The method achieved a swift pain relief associated with an evidently increased weight-bearing ability. The pain score was reduced from 8.2 to 2.4 points. The anterior and midline vertebral heights in 62 fractured vertebral bodies increased up to 82.76% ±26.84%, 88.82 % ± 21.75 % and the wedge decreased from 15 to 8 degrees. This effect persisted at least over a period of two years. The procedure did not induce narrowing of the spinal canal and no severe complications occurred. Conclusions： Balloon kyphoplasty can result in immediate clinical improvement of mobility and pain relief, increase vertebral body height, and quickly return patient＇s activity. The short-term results are approved excellent, and the long-term results need further judgment.
文摘Objective： To observe the effect of electroacupuncture （EA） at Jiaji （EX-B 2） points plus hydro-acupuncture with sinomenine hydrochloride for low back pain caused by compression fractures in the elderly. Methods： Ninety-five elderly in-patients with low back pain caused by compression fractures were randomly divided into an observation group and an EA group according to the visit sequence. Both groups received the same basic treatment. In the EA group, 48 cases were treated with EA at Jiaji （EX-B 2） points plus the basic therapy; 47 cases in the observation group received the basic treatment plus EA and hydro-acupuncture with sinomenine hydrochloride at Jiaji （EX-B 2） points. The levels of osteoprotegerin （OPG） and interleukin-1β（IL-1β） in peripheral blood were measured by enzyme-linked immunosorbent assay （ELISA） before and at the 21st day of treatment in both groups. Oswestry disability index （ODI） and visual analog scale （VAS） scores were used to analyze the clinical efficacy. Results： After treatment, the OPG content in the observation group was higher with statistical significance compared with that before treatment in the observation group and after the treatment in the EA group, respectively （both P〈0.05）; the content of IL-1β, ODI and VAS scores were lower than those before treatment in the observation group and after treatment in the EA group with statistical significances （all P〈0.05）. Conclusion： The combination of EA and hydro-acupuncture with sinomenine hydrochloride at Jiaji （EX-B 2） points is effective for low back pain caused by compression fractures in the elderly, and is superior to EA at Jiaji （EX-B 2） points alone.
