AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conduct...AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption.展开更多
Objective： To explore the tenderness response at the acupoints on the medial crus in the patients of pelvic inflammatory disease.Methods： A total of 30 patients of pelvic inflammation and 30 healthy people were incl...Objective： To explore the tenderness response at the acupoints on the medial crus in the patients of pelvic inflammatory disease.Methods： A total of 30 patients of pelvic inflammation and 30 healthy people were included. WAGNER FDX body mechanics algometer was used to determine the score of the visual analogue scale（VAS） and tenderness threshold value at Yīnlíngquán（阴陵泉 SP 9）, Sānyīnjiāo（三阴交SP 6） and Lígōu（蠡沟 LR 5）.The changes in the tenderness on the body surface at the relevant acupoints were compared and analyzed in the patients of pelvic inflammation.Results： The occurrence rate of tenderness at LR 5 at the pelvic inflammation group was higher significantly than the health group（86% Vs 42%, P0.01）. In SP 9, SP 6 and LR 5,the VAS scores at the acupoints in the pelvic inflammation group were higher significantly than the health group（test 1：55.00± 15.12 vs 27.25 ± 10.31,47.07 ± 18.38 vs 29.75 ± 14.30, 47.16 ± 19.4 vs 20.16 ±10.76; test2：53.40± 17.23 vs 33.42± 13.07, 45.95 ± 15.74 vs 29.15± 11.97, 42.50± 21.67 vs 21.05 ± 11.97; test 3：48.50± 14.97 vs 40.08 ± 13.20, 38.24± 15.29 vs 29.29± 12.37, 37.93± 19.17 vs 23.09± 12.26）, P〈0.01,P〈0.05.In SP 9, SP 6 and LR 5,the tenderness threshold values at the acupoints in the pelvic inflammation group were higher significantly than the health group（test 1：0.86 ± 0.95 vs 0.53 ± 0.39, 0.86 士 0.95 vs 0.53 ±0.39, 0.85 ± 0.77 vs 0.47 ± 0.47; test 2：0.88 ± 0.81 vs 0.44 ± 0.32, 0.98 ± 0.83 vs 0. 44 ± 0. 32,0.85±0.77 vs 0.47±0.47; test 3：0.98±0.80 vs 0.36±0.26, 1.11 ±0.92 vs 0. 36±0. 26,0.85±0.77 vs0.47 ± 0.47）, P〈0.01,P〈0.05（P〈0.05）.Conclusion： The VAS scores and tenderness threshold values at SP 9, SP 6 and LR 5 in the patients of pelvic inflammation are higher significantly than those in the healthy people. The occurrence rate of tenderness at LR 5 is higher significantly as compared with the healthy people.展开更多
Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation com...Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty （Group A, n=12） or posterior shortening osteotomy （Group B, n=16） for osteoporotic thoracolumbar Kummell＇s disease were analyzed retrospectively. Japanese orthopedic association （JOA） and visual analogue scale （VAS） scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered. Results： The follow-up period was 12-54 months （average 29 months）. Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation （t=-5.306, P〈0.001）. There was no significant difference between Groups A and B （t=0.618,P〉0.05）. The kyphosis were corrected from preoperative 33.9°（A）/ 37.3°（B） to postoperative 10.3°（A）/6.5°（B）, and 15.3° （A）/13.7°（B） at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions： The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kummell＇s disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.展开更多
OBJECTIVE:To explore factors influencing the curative effect of scraping therapies (at acupoints or along channels) and to determine the relationship of scraping site and strength to curative effect. METHODS: Two hund...OBJECTIVE:To explore factors influencing the curative effect of scraping therapies (at acupoints or along channels) and to determine the relationship of scraping site and strength to curative effect. METHODS: Two hundred and ten patients with lumbar muscle strain were divided into five groups with 42 patients each.The "scraping therapy at acupoint until appearance of skin eruptions" and "scraping therapy along channel until appearance of skin eruptions" groups were treated with a 4-daycourse. The "scraping therapy at acupoint without appearance of skin eruptions", "scraping therapy along channel without appearance of skin eruptions", and acupuncture groups were treated with a 2-day course.The five groups were treated with seven courses. The visual analog scale (VAS), oswestry disability index (ODI), and lumbago scores were recorded in the five groups before treatment, after each treatment, and in follow-up visits one month and three months after treatment. RESULTS: VAS, ODI, and lumbago scores after treatment improved in the five groups (P<0.01). There was a statistical difference (P<0.01) in the change of VAS scores by appearance of skin eruptions and scraping site. CONCLUSION: Scraping therapy can effectively alleviate lumbago symptoms. The appearance of skin eruptions and scraping therapy along channels can enhance the curative effect of scraping therapy.展开更多
Objective:To observe the clinical efficacy of filiform fire-needling plus continuous passive motion(CPM)therapy for frozen shoulder.Methods:A total of 72 patients were randomized into an observation group and a contro...Objective:To observe the clinical efficacy of filiform fire-needling plus continuous passive motion(CPM)therapy for frozen shoulder.Methods:A total of 72 patients were randomized into an observation group and a control group by the random number table method,with 36 cases in each group.Patients in the control group received celecoxib capsule plus CPM,while those in the observation group received filiform fire-needling plus CPM.The whole course of treatment lasted for 2 weeks in both groups.The visual analog scale(VAS),Constant-Murley score(CMS)and range of motion of shoulder joint were measured for therapeutic efficacy evaluation.Results:The total effective rate was 91.7%in the observation group,higher than 72.2%in the control group,and the between-group comparison showed statistical significance(P<0.05).After treatment,the VAS scores in the two groups dropped significantly,the CMS as well as the range of motion including abduction,forward flexion and extension were all increased significantly,and the intra-group comparisons showed statistical significance(all P<0.05).The betweengroup comparisons showed the improvements in these items in the observation group were more significant than those in the control group(all P<0.05).Conclusion:Filiform fire-needling plus CPM can produce more significant efficacy than celecoxib capsule plus CPM for frozen shoulder;it can alleviate pain,improve shoulder function and restore joint range of motion in such patients.展开更多
基金Supported by Faculty of Medicine Siriraj Hospital Research Project Grant
文摘AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption.
文摘Objective： To explore the tenderness response at the acupoints on the medial crus in the patients of pelvic inflammatory disease.Methods： A total of 30 patients of pelvic inflammation and 30 healthy people were included. WAGNER FDX body mechanics algometer was used to determine the score of the visual analogue scale（VAS） and tenderness threshold value at Yīnlíngquán（阴陵泉 SP 9）, Sānyīnjiāo（三阴交SP 6） and Lígōu（蠡沟 LR 5）.The changes in the tenderness on the body surface at the relevant acupoints were compared and analyzed in the patients of pelvic inflammation.Results： The occurrence rate of tenderness at LR 5 at the pelvic inflammation group was higher significantly than the health group（86% Vs 42%, P0.01）. In SP 9, SP 6 and LR 5,the VAS scores at the acupoints in the pelvic inflammation group were higher significantly than the health group（test 1：55.00± 15.12 vs 27.25 ± 10.31,47.07 ± 18.38 vs 29.75 ± 14.30, 47.16 ± 19.4 vs 20.16 ±10.76; test2：53.40± 17.23 vs 33.42± 13.07, 45.95 ± 15.74 vs 29.15± 11.97, 42.50± 21.67 vs 21.05 ± 11.97; test 3：48.50± 14.97 vs 40.08 ± 13.20, 38.24± 15.29 vs 29.29± 12.37, 37.93± 19.17 vs 23.09± 12.26）, P〈0.01,P〈0.05.In SP 9, SP 6 and LR 5,the tenderness threshold values at the acupoints in the pelvic inflammation group were higher significantly than the health group（test 1：0.86 ± 0.95 vs 0.53 ± 0.39, 0.86 士 0.95 vs 0.53 ±0.39, 0.85 ± 0.77 vs 0.47 ± 0.47; test 2：0.88 ± 0.81 vs 0.44 ± 0.32, 0.98 ± 0.83 vs 0. 44 ± 0. 32,0.85±0.77 vs 0.47±0.47; test 3：0.98±0.80 vs 0.36±0.26, 1.11 ±0.92 vs 0. 36±0. 26,0.85±0.77 vs0.47 ± 0.47）, P〈0.01,P〈0.05（P〈0.05）.Conclusion： The VAS scores and tenderness threshold values at SP 9, SP 6 and LR 5 in the patients of pelvic inflammation are higher significantly than those in the healthy people. The occurrence rate of tenderness at LR 5 is higher significantly as compared with the healthy people.
文摘Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty （Group A, n=12） or posterior shortening osteotomy （Group B, n=16） for osteoporotic thoracolumbar Kummell＇s disease were analyzed retrospectively. Japanese orthopedic association （JOA） and visual analogue scale （VAS） scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered. Results： The follow-up period was 12-54 months （average 29 months）. Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation （t=-5.306, P〈0.001）. There was no significant difference between Groups A and B （t=0.618,P〉0.05）. The kyphosis were corrected from preoperative 33.9°（A）/ 37.3°（B） to postoperative 10.3°（A）/6.5°（B）, and 15.3° （A）/13.7°（B） at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions： The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kummell＇s disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.
基金Supported by National Sci-tech Project in "the 11th Five-year Plan": Standardized Research into Treatment of Lumbago with Reinforcing and Reducing Methods of Scraping Therapy(2008 BAI53B063)National Natural Science Foundation Project: Research into Biological Effect and Mechanism of Scraping Manipulations(81173346)
文摘OBJECTIVE:To explore factors influencing the curative effect of scraping therapies (at acupoints or along channels) and to determine the relationship of scraping site and strength to curative effect. METHODS: Two hundred and ten patients with lumbar muscle strain were divided into five groups with 42 patients each.The "scraping therapy at acupoint until appearance of skin eruptions" and "scraping therapy along channel until appearance of skin eruptions" groups were treated with a 4-daycourse. The "scraping therapy at acupoint without appearance of skin eruptions", "scraping therapy along channel without appearance of skin eruptions", and acupuncture groups were treated with a 2-day course.The five groups were treated with seven courses. The visual analog scale (VAS), oswestry disability index (ODI), and lumbago scores were recorded in the five groups before treatment, after each treatment, and in follow-up visits one month and three months after treatment. RESULTS: VAS, ODI, and lumbago scores after treatment improved in the five groups (P<0.01). There was a statistical difference (P<0.01) in the change of VAS scores by appearance of skin eruptions and scraping site. CONCLUSION: Scraping therapy can effectively alleviate lumbago symptoms. The appearance of skin eruptions and scraping therapy along channels can enhance the curative effect of scraping therapy.
文摘Objective:To observe the clinical efficacy of filiform fire-needling plus continuous passive motion(CPM)therapy for frozen shoulder.Methods:A total of 72 patients were randomized into an observation group and a control group by the random number table method,with 36 cases in each group.Patients in the control group received celecoxib capsule plus CPM,while those in the observation group received filiform fire-needling plus CPM.The whole course of treatment lasted for 2 weeks in both groups.The visual analog scale(VAS),Constant-Murley score(CMS)and range of motion of shoulder joint were measured for therapeutic efficacy evaluation.Results:The total effective rate was 91.7%in the observation group,higher than 72.2%in the control group,and the between-group comparison showed statistical significance(P<0.05).After treatment,the VAS scores in the two groups dropped significantly,the CMS as well as the range of motion including abduction,forward flexion and extension were all increased significantly,and the intra-group comparisons showed statistical significance(all P<0.05).The betweengroup comparisons showed the improvements in these items in the observation group were more significant than those in the control group(all P<0.05).Conclusion:Filiform fire-needling plus CPM can produce more significant efficacy than celecoxib capsule plus CPM for frozen shoulder;it can alleviate pain,improve shoulder function and restore joint range of motion in such patients.
