经皮椎体成形术治疗鼻咽癌脊椎转移瘤疼痛的观察及护理

目的:探讨经皮穿刺椎体成形术治疗鼻咽癌脊椎转移瘤疼痛的疗效及护理方法。方法:通过视觉模拟评分法对20例鼻咽癌脊椎转移瘤患者的疼痛情况进行术前、术后评分来判断、分析经皮穿刺椎体成形术的镇痛效果,并对疼痛及出现的并发症给予针对性的配合护理。结果:20例患者术后疼痛评分低于术前(P<0.01),无临床并发症发生。结论:细心观察、及时护理干预,能够为评估经皮椎体成形手术效果提供可靠的依据、预防并发症,减轻患者痛苦,提高患者的生存质量。

挑罐法治疗脊椎退变性腰腿痛临床报告

目的观察挑罐疗法治疗脊椎退变性腰腿痛临床疗效 ;方法 采用随机单盲对照观察 ,治疗组用挑罐治疗 ,对照组用超短波理疗配服消炎痛 ;结果 治疗组有效率 91.3% ,治愈率 76 .1%高于对照组有效率70 .7%、治愈率 53.7% ,其统计学差异显著 ;结论 :挑罐法治疗脊椎退变性腰腿痛疗程短 ,镇痛迅速完全 ,不良反应少 ,临床疗效肯定。

甲钴胺注射局部痛区+脊椎旁治疗带状疱疹后神经痛临床观察

目的:观察甲钴胺注射局部痛区+脊椎旁治疗带状疱疹后神经痛临床疗效。方法:40例患者按就诊顺序随机分为观察组和对照组,每组20例。观察组采用甲钴胺注射局部痛区+脊椎旁治疗;对照组应用甲钴胺肌肉注射。两组均1周治疗3次,共3周,主要观察疼痛情况。结果:观察组较对照组可迅速缓解疼痛,两组在疼痛量化评级方面均有明显改善,观察组显著优于对照组,差异具有统计学意义(P<0.05)。结论:甲钴胺注射局部痛区+脊椎旁治疗带状疱疹后遗神经痛具有较好的临床疗效,可明显减轻患者疼痛,较对照组疗效有明显优势。

Activation of ERK1/2 in spinal cord contributes to the development of acute cystic pain in rabbits

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.

中西医结合联合脉冲射频治疗脊椎术后腰腿痛的效果观察

目的:观察中西医结合联合脉冲射频治疗脊椎术后腰腿痛的临床效果及影响。方法:随机选取本院2018年1~2020年2月期间收治脊椎术后腰腿痛患者共100例设为研究对象开展对比性治疗研究,患者入院后根据其治疗方案选择将其分为对照组、观察组,各组样本量均为50例。对照组选择传统中西医治疗,观察组选择中西医结合联合脉冲射频治疗。对比患者不同治疗阶段疼痛症状评分、腰椎功能、生活质量评分变化差异及治疗效果。结果:治疗前,患者疼痛症状评分、腰椎功能、生活质量评分组间对比结果无统计学差异,P>0.05;自治疗第4周起,观察组患者疼痛症状评分较对照组呈明显下降趋势,观察组腰椎功能评分、生活质量评分均呈明显上升趋势,且均高于对照组,P<0.05;观察组临床治疗有效率明显较高,P<0.05。结论:中西医结合联合脉冲射频治疗脊椎术后腰腿痛,疗效确切,可使患者疼痛症状有效减轻,改善腰椎功能及生活质量,临床价值显著。

围绝经期骨痛症单元组合辨证分类法分期整体治疗策略

围绝经期骨痛症是在围绝经期产生的骨骼肌肉系统的疾病,可发生在绝经前期和绝经后期。根据围绝经期骨痛症的特点,首先应分期治疗,分为绝经前骨痛症和绝经后骨痛症,不同时期的骨痛症治疗策略和用药原则不一样;其次,每个时期的骨痛症沈绍功教授提出应采用单元组合辨证分类法,综合治疗可以提高临床疗效,将每个时期的骨痛症分为不同的证类单元,再组合成常见的证类,据此来选药处方;同时还要重视患者的运动、饮食等配合治疗。由此,采用单元组合辨证分类法分期整体治疗围绝经期骨痛症,便于医生临床用药,促进患者身体康复。

Clinical Study on Tuina Therapy for Degenerative Spondylolisthesis of the Lumbar Spine

Objective： There is definite therapeutic effect in tuina treating low back pain. The comparative observation was performed on the two types of tuina manipulation for degenerative lumbar spondylolisthesis, in order to explore the best tuina manipulation for lumbar spondylolisthesis. Methods： All of 121 cases with degenerative lumbar spondylolisthesis were divided into the experimental group and control group randomly by the visit orders and pathological gradations, 61 cases in the experimental group, including 34 cases of grade Ⅰ and 27 cases of grade Ⅱ, and 60 in the control group, including 34 cases of grade Ⅰ and 26 cases of grade Ⅱ. There was no significant difference in the general materials of the two groups. Based upon the similar tuina therapy applied on the soft tissues in the two groups, micro-regulating manual technique of the spine was applied in the experimental group, and the hip and knee-flexed and pillow method was applied in the control group. The treatment was given 3 sessions a week, with 10 sessions as one course of the treatments. The therapeutic effects were assessed after one course of the treatments. Results： There was significant difference （P〈0.01） in the total effective rate and in the remarkable effective rate and curative rate of the patients with grade Ⅰ between the experimental group and control group, also there was significant difference （P〈0.05） in the total effective rate of the patients with grade Ⅱ. Conclusions： The therapeutic effects by the micro-regulatory manual technique are comparatively better for degenerative lumbar spondylolisthesis, and the milder the pathological condition is, the better the therapeutic effects would be.

Balloon kyphoplasty: an experience of 38 patients with painful osteoporotic vertebral compressive fractures

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.

Clinical observation of warm needling moxibustion plus lumbar traction for lumbar disc herniation

Objective To observe the clinical efficacy of warm needling moxibustion plus lumbar traction for lumbar disc herniation(LDH)and its effect on Oswestry disability index(ODI)score,present pain intensity(PPI)score,and the degree of straight leg raising.Methods A total of 146 patients with LDH were randomized into a combination group and a control group by the random number table method,with 73 cases in each group.The control group was treated with lumbar traction,and the combination group was treated with lumbar traction plus warm needling moxibustion.The curative efficacy of the two groups was compared.Also,the lumbar function,pain,straight leg raising degree,and inflammatory factor levels before and after treatment were compared.Results The total effective rate of the combination group was 93.2%,which was higher than 78.1%of the control group(P<0.05).After treatment,the lumbar ODI score,the PPI scores of lumbar pain and lower-limb pain,tumor necrosis factor(TNF)-αand interleukin(IL)-6 levels,and straight leg raising test score in both groups were significantly decreased(P<0.05).The Japanese Orthopaedic Association(JOA)score significantly increased(P<0.05).The improvements of the above items in the combination group were all superior to those in the control group(P<0.05).Conclusion Warm needling moxibustion plus lumbar traction in the treatment of LDH can improve lumbar function,relieve pain,and reduce inflammatory response of the body.

Clinical observation on electroacupuncture plus hydro-acupuncture for low back pain caused by compression fractures

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.

Subtle adjustment of the cervical spine combined with Shu Jing Ding Xuan Decoction for cervical vertigo

Objective：To observe the effect of subtle adjustment of the cervical spine combined with Shu Jing Ding Xuan （Neck-relaxing and Dizziness-alleviating） Decoction for cervical vertigo. 〈br〉 Methods：An open-label, randomized and parallel controlled clinical study was designed. Subtle adjustment of the cervical spine combined with Shu Jing Ding Xuan （Neck-relaxing and Dizziness-alleviating） Decoction was used for patients in the treatment group, whereas subtle adjustment alone was used for patients in the control group. The results in the two groups were statistically analyzed after two courses of treatment. 〈br〉 Results：The recovery rate and total effective rate in the treatment group were 20.6%and 88.2%respectively, versus 14.7%and 73.5%in the control group. The inter-group differences were statistically significant （both P＆lt;0.01）. 〈br〉 Conclusion： Subtle adjustment of the cervical spine combined with Shu Jing Ding Xuan （Neck-relaxing and Dizziness-alleviating） Decoction is better than subtle adjustment alone for cervical vertigo.