Treating acute low back pain with acupuncture:A randomized controlled study protocol to compare the effectiveness between distal and local acupoints

Objective To compare the efficacy of using“distal acupoints only”vs.“local acupoints mainly combined with distal acupoints”in cases of acute low back pain(ALBP).Methods A total of 102 eligible patients aged 18–65 years with ALBP lasting less than 6 weeks will be randomized in a 1:1 ratio to the distal acupoints only group(DPOG)and the local acupoints mainly combined with the distal acupoints group(LPMG).During a 4-week treatment period,patients in the DPOG will receive acupuncture at distal acupoints only(Houxi[SI 3]and Yaotongxue[EX-UE 7])twice a week,while those in the LPMG group will receive acupuncture at local acupoints(mainly Shenshu[BL 23]and Dachangshu[BL 25])combined with distal points(Weizhong[BL 40]).The patients in both groups will be evaluated at every session of treatment,and the follow-up will be performed for 3 months.The primary outcome measure will be the change in ALBP intensity,assessed using visual analogue scale scores before and after treatment.The secondary outcome measure will be the evaluation of functional disability using the Oswestry Disability Index.Discussion This study compares the DPOG and LPMG to explore the feasibility of the DPOG in the treatment of ALBP.

Analysis of acupoint massage combined with touch on relieving anxiety and pain in patients with oral implant surgery

BACKGROUND Oral implant surgery is an effective procedure for artificial implants in missing tooth areas under local anesthesia.Because patients under local anesthesia are conscious during this procedure,compared with general anesthesia-related operations,they are more likely to experience negative emotions,such as anxiety and tension.These emotional reactions result in shivering and chills in the limbs,leading to poor doctor-patient cooperation and even avoidance of treatment.In traditional Chinese medicine,it is believed that acupoint massage regulates blood and Qi,dredge menstruation,and relieve pain,which is beneficial for patients’emotional adjustment;however,there are few related clinical studies.AIM To observe the changes in anxiety and pain in patients with oral implant after acupoint massage combined with touch therapy.METHODS One hundred patients undergoing oral implantation in our hospital between May 2020 and May 2023 were randomly divided into control and study groups,according to a random number table,with 50 patients in each group.The control group received routine intervention,and the study group received acupoint massage combined with touch on the basis of the control group.Anxiety[assessed using the Modified Dental Anxiety Scale(MDAS)],pain severity,blood pressure,heart rate,and satisfaction were compared between the two groups.RESULTS Before intervention,the difference in MDAS score between the two groups was not significant(P>0.05),while after the intervention,the MDAS scores decreased in both groups compared with those before the intervention(P<0.05);the MDAS score of the study group was lower than that of the control group,with a statistically significant difference(P<0.05).The degree of pain in the intervention group was significantly lower than that in the control group(P<0.05).Before the intervention,there were no significant differences in systolic and diastolic blood pressures or heart rate between the two groups(P>0.05).The systolic and diastolic blood pressures and heart rate in the intervention group,during and after the intervention,were significantly lower than those in the control group(P<0.05).The total degree of satisfaction in the study group was significantly higher than that in the control group(P<0.05).CONCLUSION Acupoint massage combined with touch better relieves anxiety and pain in patients undergoing dental implant surgery,improving the perioperative comfort of these patients and ensuring safety and a smooth operation.

Research on the Different Frequencies of Transcutaneous Electrical Acupoint Stimulation for Postpartum Pelvic Girdle Pain

Objective:To observe the clinical effect of different frequencies of transcutaneous electrical acupoint stimulation in treating postpartum pelvic girdle pain and promoting postpartum rehabilitation.Methods:From January to September 2022,300 patients with pelvic girdle pain after spontaneous delivery in a hospital in Shaanxi Province were selected and randomly divided into three groups,low frequency,high frequency,and alternating frequency,with 100 cases in each group.In addition to routine postpartum care and psychological counseling,the three groups received transcutaneous electrical acupoint stimulation at low-frequency(2 Hz,)high-frequency(100 Hz),and alternating frequency(2/100 Hz),respectively.The differences in initial pain,pain scores before and after treatment,satisfaction with analgesic effect,and postpartum rehabilitation effect were evaluated among the three groups of patients.Results:There was a significant correlation between maternal age and postpartum pelvic girdle pain(P<0.001),but no correlation was observed between newborn birth weight and postpartum pelvic girdle pain(P>0.05).After 1d/2d of treatment,the pain scores and rehabilitation effect of patients in the alternating-frequency group and low-frequency group were significantly better than those in the high-frequency group,and the postpartum curative effect of patients in the alternating-frequency group was the best,followed by the low-frequency group,and the high-frequency group;the differences were statistically significant(P<0.001).Among the three groups,the alternating-frequency group had the highest satisfaction with the analgesic effect and the highest rate of selecting the same analgesic regimen the next time;the differences were statistically significant(P<0.001).Conclusion:Transcutaneous electrical acupoint stimulation at different frequencies is safe and effective in treating postpartum pelvic girdle pain and beneficial to postpartum rehabilitation.Sparse-dense wave stimulation is effective in treating postpartum pelvic girdle pain.It has the best effect in promoting postpartum rehabilitation and the highest patient satisfaction.Therefore,its application in clinical practice is highly recommended.

Application of buried auricular point combined with Wenjing Sanhan prescription in arteriosclerosis obliterans patients with resting pain

BACKGROUND Research on the combined use of ear acupoint embedding beans and warming meridians with cold-dispersing formulas for alleviating resting pain in patients with arteriosclerosis obliterans(ASO)remains limited.AIM To explore the therapeutic efficacy of auricular point embedding beans combined with Wenjing Sanhan prescription in alleviating resting pain in patients with lower-limb ASO.METHODS A total of 100 patients with ASO experiencing resting pain who were treated at our hospital from January 2022 to January 2023 were enrolled.They were randomly allocated into two groups using a double-blind approach.The control group was treated using a warming meridian with a cold-dispersing formula,while the study group received additional treatment with ear acupoint embedding beans.The clinical efficacy,ankle-brachial artery pressure ratio,hemorheological indicators,and traditional Chinese medicine symptom scores were compared between the two groups.RESULTS The clinical efficacy rate in the study group was significantly higher(94.00%)than that in the control group(72.00%,P<0.05).Moreover,the ankle-brachial artery pressure ratio was significantly higher in the study group after treatment(P<0.05).Hemorheological parameters,including whole blood viscosity,plasma viscosity(1.83±0.11)mPa/s,fibrinogen levels(3.30±0.21)g/L,platelet adhesion rate(49.87%±10.51%),and erythrocyte aggregation index(1.79±0)were improved in the study group compared to the control group.In addition,the scores for decreased skin temperature(1.41±0.26),intermittent claudication(1.30±0.20),and resting pain(1.23±0.31)were significantly lower in the study group than those in the control group(all P<0.05).The level of oxidative stress in the study group also exhibited significant improvement(P<0.05),and the levels of inflammatory factors were considerably lower than those in the control group.CONCLUSION The combination of ear point embedding beans and Wenjing Sanhan prescription demonstrates promising clinical efficacy in alleviating resting pain associated with ASO.

CLINICAL OBSERVATIONS ON THE SELECTION OF ABDOMINAL ACUPOINTS TO RELIEVE LOWER LUMBAR PAIN

This paper discusses the selection of abdominal area kidney and meridian acupoints120 patients suffering from lower lumbar pain using the fingers to press the acupoints. Althoughthe types of ailments, mildness or severity of the patients’ conditions f and duration of illness var-ied, in all cases satisfactory treatment results were achieved. The average effective rate was 97.5%. The average rate of cure (complete recovery rate) was 73.3%. Patients who had sufferedfrom symptoms for a period of less than one year and patients afflicted with mild or moderate con-ditions enjoyed the most outstanding treatment results. The advantages of this treatment method or technique are as follows: 1. This method ortechnique brings the distinctive dynamics of traditional Chinese medicine theory and meridian the-ory into full play. 2. This method of treatment uses neither acupuncture needles nor moxibus-tion. It merely utilizes the fingers to press certain acupoints. It is simple, convenient and easy toimplement.It is

Pain management using Han’s acupoint nerve stimulator combined with patient-controlled analgesia following neurosurgery A randomized case control study

BACKGROUND： Han＇s acupoint nerve stimulator （HANS） has been frequently used to relieve pain by promoting the central nerve system＇s release of endogenous opioid peptides through electric stimulation to the body surface. OBJECTIVE： To investigate the pain-relieving effects of HANS, combined with patient-controlled analgesia, following neurosurgery, and to observe adverse reactions and effects. DESIGN, TIME AND SETTING： A randomized control observation was performed at the Department of Neurology in the First Affiliated Hospital of Gannan Medical College （Ganzhou, Jiangxi Province, China） from January 2005 to February 2006. PARTICIPANTS： Forty patients, who were selected for craniotomy and required pain relief following surgery at the Department of Neurology in the First Affiliated Hospital of Gannan Medical College （China）, were included in this study. METHODS： Forty patients underwent neurosurgery and were randomly divided into two groups： patient-controlled analgesia plus HANS （＋HANS, n = 20） and patient-controlled analgesia （-HANS, n = 20）. Both groups were well matched in baseline data. Automatic syringe infusion pump ZZB-150 was the product of Nantong Aipeng Medical Instruments Co., Ltd. （China）. Patient-controlled analgesia consisted of 100 mL 0.02% lappaconitine/0.02% metoclopramide. LH-402 HANS instrument was produced in Beijing （China）, with a serial number of 402183. The HANS instrumentation was used to stimulate the Hegu-Laogong acupoint on one side and Jiaogan, Shenmen penetrating Shen, Waifei, Naogan penetrating Pizhixia ear acupoints on the affected side for one hour, with 2-hour intervals. The disperse-dense wave was alternating, with a 2/100 Hz frequency of electrical stimulation. MAIN OUTCOME MEASURE： The scores of visual analogue scale and incidence of adverse reaction were observed in two groups following surgery. RESULTS： Compared with the HANS group, the visual analogue scale scores were remarkably lower in the ＋HANS group six hours after surgery （P 〈 0.01）, and the incidence rate of adverse reactions, such as nausea and vomiting, was also decreased （P 〈 0.05）.CONCLUSION： The application of HANS to induce body surface stimulation can enhance the effect of pain relief and reduce adverse reactions when used in combination with patient-controlled analgesia following neurosurgery. The effect of combined therapy is superior to patient-controlled analgesia alone.

Clinical Study of Vitamin K_3 Acupoint Injection In Treating Pelvic Pain

Pelvic pain is one of the most common symptoms in gynecologic outpatients. Primary dysmenorrhea, acute or chronic pelvic inflammatory disease, endometriosis, post-operational pelvic adhesion, blood stagnation of pelvic vein, etc. , are mentioned as the often encountered causes of pelvic pain. It has been reported in the recent ten or more years that intramuscular injection of vitamin K3 (Vit K3) could relieve pain induced by smooth muscle spasm. In order to evaluate the effect of Vit K3 administered by acupoint injection in relieving pelvic pain, 180 patients were treated and observed from April 1997 to April 1999 in our hospital, and good therapeutic effect was obtained. It was reported as follows.

Advances in the treatment of peptic ulcer by acupoint application therapy

Acupoint application therapy is a convenient,effective and with few side effects traditional Chinese medicine external treatment method.It’s dual effects of drug absorption and acupoint stimulation show unique advantages in the clinical treatment of peptic ulcer(PU).This paper summarized its research progress in terms of its medication,acupoint selection and the synergistic application.It’s clear that acupoint application has a positive effect in the treatment of PU and it can better improve the clinical symptoms of epigastric pain in patients with PU,so as to provide new ideas for further exploration of its research direction and demonstration of its efficacy.

Study on the therapeutic effect of external application of Shounian powder combined with acupuncture at Zhitong acupoint on intercostobrachial nerve syndrome after breast cancer operation

Background:To explore the clinical effect of external application of ShouNian Powder combined with acupuncture at Zhitong acupoint in the treatment of intercostobrachial nerve syndrome(ICBNs)after breast cancer operation.Methods:A total of 80 patients with ICBNs who underwent modified radical mastectomy in our hospital from July 2014 to July 2016 were collected and divided into control group and study group according to the different treatment methods of ICBNs.40 patients in the control group were treated with symptomatic analgesia and 40 patients in the study group were treated with external application of ShouNian Powder combined with acupuncture at Zhitong acupoint to compare and analyze the pain relief,quality of life and analgesic recurrence rate of ICBNs between the two groups.Results:Compared with the control group,the pain relief rate of ICBNs in the study group was higher.The patient satisfaction and long-term quality of life in the study group were better than those in the control group.However,there was no significant difference in postoperative pain recurrence rate.Conclusion:External application of ShouNian Powder combined with acupuncture at Zhitong acupoint can effectively relieve pain and improve quality of life for patients with ICBNs after breast cancer operation,which has a certain popularizing significance in clinical practice.

Treatment of Painful Diabetic Neuropathy With Catgut-Embedding in Acupoints

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Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection:A randomized controlled trial

BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.METHODS Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive:(1)TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery,plus two 30-min daily sessions for 3 consecutive days after surgery(perioperative TEAS group);(2)Preoperative and intraoperative TEAS only;(3)Preoperative and postoperative TEAS only;or(4)Sham stimulation.The primary outcome was the time from the end of surgery to the first bowel sound.RESULTS In total,441 patients were randomized;405 patients(58.4±10.2 years of age;247 males)received the planned surgery.The time to the first bowel sounds did not differ among the four groups(P=0.90;log-rank test).On postoperative day 1,the rest pain scores differed significantly among the four groups(P=0.04;Kruskal–Wallis test).Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group(1.4±1.2)than in the sham sti-mulation group(1.7±1.1;P=0.04).Surgical complications did not differ among the four groups.CONCLUSION TEAS provided analgesic effects in adult patients undergoing major abdominal surgery,and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

次髎穴埋线治疗对混合痔病人术后疼痛和营养状况的影响

目的:探讨次髎穴埋线用于混合痔术后镇痛治疗的效果以及对病人营养状况的影响。方法:2019年9月至2021年7月本院收治的混合痔手术病人90例,随机分为3组:埋线组、针刺组和药物组,每组30例。术后不同时间对病人进行疼痛评分,检测病人血清总蛋白、白蛋白和球蛋白水平,记录住院时间、住院费用和镇痛治疗费用。结果:术后12 h、24 h、3 d、5 d及7 d,次髎穴埋线组病人疼痛评分均明显低于针刺组和药物组(P<0.05)。术后7 d,埋线组病人血清总蛋白水平明显高于针刺组(P<0.05)。埋线组病人住院时间和住院费用均低于针刺组和药物组(P<0.01)。结论:次髎穴埋线具有良好的镇痛作用,有助于改善病人营养状况,缩短住院日,降低医疗费用,加快病人术后康复,具有较好的临床应用前景。

Observation on the Therapeutic Effect of Shangjinbitong Powder(伤筋痹痛散)on Improving Acupoint Plaster

Objective:To study the therapeutic effect of Shangjinbitong Powder(伤筋痹痛散)on improving acupoint plaster,in order to provide some scientific basis for clinical use.Methods:This project was carried out from June 2020 to January 2021,30 patients with low back pain in the outpatient department of orthopedics and traumatology in our hospital and 30 patients with low back pain in the rehabilitation department of Fuping County Hospital of Traditional Chinese Medicine were selected as the research objects.Patients with low back pain in our hospital were treated with Shangjinbitong Powder as the control group,and patients in rehabilitation department of Fuping County Hospital of Traditional Chinese Medicine as the research group were treated with acupoint plaster improved by Shangjinbitong Powder.After one week of treatment,the effective rates of the two groups were compared.Results:The effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05).There were no adverse reactions such as infection,scald and bleeding in the study group and the control group during the treatment.Conclusion:Shangjinbitong Powder improved acupoint plaster has good curative effect,convenient use,certain safety and clinical popularization value.

枳实消痞丸化裁方联合穴位贴敷治疗脾虚气滞型阿片类药物相关性便秘的临床效果

目的 探讨枳实消痞丸化裁方联合穴位贴敷治疗脾虚气滞型阿片类药物相关性便秘(OIC)的临床效果。方法 选取2022年2月至2023年2月石家庄市中医院住院的70例脾虚气滞型OIC患者,按照随机数字表法分为治疗组和对照组,各35例。治疗组予枳实消痞丸化裁方联合穴位贴敷治疗,对照组予乳果糖治疗。连续治疗2周。比较两组治疗前后便秘主要症状积分、中文版便秘患者生存质量自评量表(PAC-QOL)评分及血清胃肠激素[P物质(SP)、胃动素(MTL)、血管活性肠肽(VIP)]水平,评价其临床疗效。结果 治疗前,两组排便频率,排便费力,排便时间,腹胀,下坠、不尽及胀感,粪便性状积分比较,差异无统计学意义(P>0.05);治疗后,两组排便频率,排便费力,排便时间,腹胀,下坠、不尽及胀感,粪便性状积分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组PAC-QOL量表中的生理、社会心理、担忧焦虑及满意度各项评分比较,差异无统计学意义(P>0.05);治疗后,两组PAC-QOL量表中的生理、社会心理、担忧焦虑及满意度各项评分均低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组VIP、MTL、SP水平比较,差异无统计学意义(P>0.05);治疗后,两组VIP水平低于治疗前,MTL、SP水平高于治疗前,且治疗组VIP水平低于对照组,MTL、SP水平高于对照组,差异有统计学意义(P<0.05)。治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。结论 枳实消痞丸化裁方联合穴位贴敷能降低脾虚气滞型癌痛患者OIC的严重程度,提高生活质量,具有良好的临床疗效,考虑与其能调整胃肠激素水平具有相关性。

枳实消痞方联合大黄神阙穴贴敷治疗阿片类药物相关性便秘临床观察

目的探讨枳实消痞方联合大黄神阙穴贴敷治疗阿片类药物相关性便秘(OIC)的临床疗效。方法选取医院中西医结合科2021年1月至2022年1月收治的口服盐酸羟考酮缓释片治疗癌性疼痛的OIC患者70例,按随机数字表法分为观察组和对照组,各35例。观察组患者予枳实消痞方联合大黄粉神阙穴贴敷治疗,对照组患者予乳果糖口服溶液治疗,均连续用药2周。结果观察组患者的便秘治疗总有效率为85.71%,显著高于对照组的57.14%(P<0.05)。观察组患者治疗后的慢性便秘严重程度评分量表及便秘患者生活质量量表各项评分和总分均显著低于对照组(P<0.05);观察组患者的卡氏体力状况量表(KPS)评分有效率为82.86%,显著高于对照组的60.00%(P<0.05)。结论枳实消痞方联合大黄神阙穴贴敷能缓解OIC症状,改善患者的生活质量,增强其体力。

中医耳穴压豆在下肢动脉硬化闭塞症患者中的护理效果及对疼痛的影响

目的:探讨中医耳穴压豆在下肢动脉硬化闭塞症患者中的护理效果及对疼痛的影响。方法:选取2019年1月至2022年3月本院接受治疗的130例下肢动脉硬化闭塞症患者为研究对象,采用随机数字表法将患者分为实验组(n=65)以及参考组(n=65);参考组给予常规疼痛护理干预,实验组给予中医耳穴压豆干预;比较两组患者临床疗效、临床症状消失时间及护理前后疼痛(VAS)评分。结果:实验组治疗有效率明显高于参考组(P<0.05);实验组溃疡、斑块以及坏疽消失时间低于参考组(P<0.01);护理后,两组VAS评分较护理前明显降低,且实验组显著低于参考组(P<0.01);两组ADL评分明显提高,且实验组大于参考组(P<0.01);两组不良反应发生率比较无显著差异(P>0.05)。结论:耳穴压豆在下肢动脉硬化闭塞症护理中的应用效果良好,能有效改善患者临床症状,降低疼痛,提高其日常生活能力,推广价值高。

温针灸四关穴对中晚期宫颈癌癌性疼痛患者T淋巴细胞亚群调节作用研究

目的 探讨温针灸四关穴治疗气滞血瘀证中晚期宫颈癌癌性疼痛的疗效及对T淋巴细胞亚群的调节作用。方法 选定沧州市中心医院2021年10月至2023年10月就诊的84例气滞血瘀证中晚期宫颈癌癌性疼痛患者,按随机数字表法分为温针灸组、西药组,各42例。西药组给予三级止痛治疗,温针灸组在西药组基础上给予温针灸四关穴治疗,比较两组患者临床疗效、卡氏评分量表(Karnofsky,KPS)评分、视觉模拟评分量表(visual analogue scale,VAS)评分、一般自我效能感量表(general self-efficacy scale-schwarzer,GSES)评分、疼痛应激指标[5-羟色胺(5-hydroxytryptamine,5-HT)、β内啡肽(β-endorphin,β-EP)、P物质(substance P,SP)]、T淋巴细胞亚群指标、生活质量综合评定问卷量表(generic quality of life inventory-74,GQOLI-74)评分。结果 温针灸组总有效率(95.24%)高于西药组(76.19%)(P<0.05)。两组治疗后KPS评分、GSES评分、GQOLI-74评分、血清β-EP水平、CD3+、CD4+、CD4+/CD8+均较治疗前更高(P<0.05),两组治疗后VAS评分、血清5-HT水平、SP水平、CD8+均较治疗前更低(P<0.05)。温针灸组治疗后KPS评分、GSES评分、GQOLI-74评分、血清β-EP水平、CD3+、CD4+、CD4+/CD8+均较西药组更高(P<0.05,P<0.01),VAS评分、血清5-HT水平、SP水平、CD8+均较西药组更低(P<0.01)。结论 在三级止痛的基础上联合温针灸四关穴可有效缓解气滞血瘀证中晚期宫颈癌癌性疼痛患者疼痛症状,改善身体状况、免疫功能,调节疼痛应激物质释放,提高生存质量,效果显著。

特定电磁波治疗仪联合穴位敷贴改善腹腔镜肝切除术后肩痛的临床研究

目的观察特定电磁波(TDP)照射联合穴位敷贴在腹腔镜肝切除术后肩痛患者中的应用效果。方法选择2020年1月至2023年12月在我院进行腹腔镜肝切除术后肩痛患者160例作为研究对象,按随机数字表法分为观察组和对照组,每组80例。对照组给予常规护理,观察组在对照组的基础上给予TDP联合穴位敷贴干预,比较两组患者干预前及干预后1、3 d时的疼痛程度[视觉模拟评分法(VAS)]评分、疼痛介质[P物质(SP)、前列腺素E2(PGE2)]、临床疗效及护理满意度结果观察组干预后各个时间点的VAS评分均低于对照组,差异有统计学意义(均P<0.05)。观察组干预后1、3 d时的血清SP、PGE2水平均低于对照组,差异均有统计学意义(均P<0.05)。两组的治疗效果比较,观察组的治疗总有效率为93.8%,对照组为73.8%,两组比较差异具有统计学意义(P<0.05)。观察组的护理满意度评分高于对照组,差异具有统计学意义(P<0.05)。结论TDP联合穴位敷贴可有效减轻腹腔镜肝切除术后肩痛程度,降低疼痛介质水平,提高临床疗效和护理满意度。

穴位按摩联合艾灸治疗乳腺癌术后上肢淋巴水肿临床研究

目的:观察穴位按摩联合艾灸治疗乳腺癌术后上肢淋巴水肿的临床疗效。方法:采用随机数字表法将80例乳腺癌术后上肢淋巴水肿患者分为对照组、治疗组各40例。2组均给予地奥司明片治疗,对照组加用按摩与上肢功能锻炼治疗,治疗组加用穴位按摩联合艾灸治疗,2组连续治疗8周。比较2组临床疗效及治疗前后腺癌淋巴水肿症状体验指数(BCLE-SEI)、淋巴水肿纤维化分级、视觉模拟评分法(VAS)肿胀、VAS疼痛、乳腺癌患者生命质量测定量表(FACT-B)评分及上肢活动度。结果:治疗后,治疗组总有效率95.00%,高于对照组80.00%(P<0.05)。治疗后,2组中医证候积分、BCLE-SEI评分、淋巴水肿纤维化分级评分、VAS肿胀评分、VAS疼痛评分、FACT-B维度(生理、社会/家庭、情感、功能及其他状况)评分均较治疗前降低(P<0.05),且治疗组治疗后上述指标均低于对照组(P<0.05)。治疗后,2组上肢上举、内旋、外旋、水平屈曲及水平伸展活动度均较治疗前增大(P<0.05),且治疗组治疗后上述5项活动度高于对照组(P<0.05)。结论:穴位按摩联合艾灸治疗乳腺癌术后上肢淋巴水肿疗效确切,能够减轻患者患肢水肿和疼痛程度,促进上肢功能恢复,提高生活质量。

桃红四物汤加味联合穴位贴敷治疗带状疱疹后遗神经痛患者的临床疗效及作用机制

目的探讨桃红四物汤加味联合穴位贴敷治疗带状疱疹后遗神经痛(Postherpetic nerualgia,PHN)患者的临床疗效及作用机制。方法选取2021年2月—2023年2月期间成都中医药大学附属医院疼痛科收治的93例PHN患者,按入院顺序分为对照组46例和观察组47例。其中对照组脱落3例,观察组脱落2例,最终88例完成试验,每组各44例。对照组采用常规西药治疗,观察组在对照组基础上加用桃红四物汤加味和穴位贴敷治疗。治疗4周后,观察比较两组患者治疗前后疼痛情况[视觉模拟评分(Visual analogue scales,VAS)、疼痛持续时间积分、疼痛间隔时间积分]、炎症因子[环氧化酶-2(Cyclooxygenase-2,COX-2)、肿瘤坏死因子-α(Tumor necrosis factor,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-10(Interleukin-10,IL-10)]、疼痛介质[P物质(Substance P,SP)、神经肽Y(Neuropeptide Y,NPY)、β-内啡肽(β-endorphin,β-EP)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化情况,评估临床疗效及安全性。结果治疗后两组患者VAS、疼痛持续时间积分、疼痛间隔时间积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组各疼痛积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者COX-2、TNF-α、IL-6、IL-1β水平均较治疗前降低,IL-10水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组COX-2、TNF-α、IL-6、IL-1β水平均明显低于对照组,IL-10水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清SP、NPY水平均较治疗前降低,β-EP水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组血清SP、NPY水平均明显低于对照组,β-EP水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)均较治疗前降低,差异有统计学意义(P<0.05);且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均明显高于对照组,CD8^(+)明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率90.91%(40/44)明显高于对照组79.55%(35/44),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应率比较,差异无统计学意义(P>0.05)。结论桃红四物汤加味联合穴位贴敷治疗PHN能减轻疼痛症状,临床疗效确切,其机制推测与降低炎性因子表达,抑制疼痛介质释放,调节免疫功能相关。