Quantification of the Pain and Physical Burden Experienced during Positioning for Craniocaudal Imaging in Mammography, Evaluated by Measurement of Muscle Activity

Mammography is carried out in a special position, i.e. “an image is taken while the breast is compressed, stretched and kept in a fixed position”. The purpose of this study was to demonstrate quantitatively and qualitatively the physical and psychological burden due to positioning and breast compression during mammography. Muscle activity of each part of the body during positioning for the standard imaging method, to obtain craniocaudal (CC) view images, was measured in 15 adult females using surface EMG. The associated pain was analyzed using visual analogue scale (VAS) scores. During positioning for the CC view, muscle activity was highest in the biceps (24.44 iEMG/s) followed by the trapezius (17.78 iEMG/s) on the imaging side. Muscle activity of the biceps and the sternocleidomastoid on the imaging side showed significant differences compared with pre-imaging activity (biceps P < 0.031, sternocleidomastoid P < 0.005). The pain during mammography was rated as moderate to severe pain (VAS = 3.3 - 6.7) for CC views. As a result, the activities of not only the muscles directly involved in mammography positioning but also those indirectly involved were high as compared with the normal state. Measurement of muscle activity during mammography is expected to be used effectively, such as in the care to reduce pain for the subjects.

Effects of Chiropractic and Traditional Chinese Medicine in Treating Patients with Acute Postpartum Pubis Symphysis Pelvic Girdle Pain

[Objectives]To analyze and study the effects of chiropractic and traditional Chinese medicine on pain score and functional ambyiation category scale rating in patients with cervical spondylosis.[Methods]41 postpartum patients with acute pubic symphysis pelvic girdle pain were treated by Xiao Huoluodan Granules(orally taking one bag of Xiao Huoluodan Granules 20 g three times daily with 120-150 mL warm water after each meal),and combined with sacroiliac joint manipulation,muscle posture relaxation and muscle energy technique.[Results]After treatment,the pain score(VAS)was decreased and Holden walking function rating was improved(all P<0.001).[Conclusions]Chiropractic and traditional Chinese medicine therapy has a significant effect on the treatment of postpartum acute pubic symphysis pelvic girdle pain,and it can effectively relieve pain,improve postpartum quality of life and prevent postpartum complications.Due to its benefits,it is worthy of clinical promotion and application.

Clinical therapeutic effect of self-prescribed Sanhanchushi Tongbi on lumbar disc herniation

BACKGROUND Lumbar disc herniation(LDH)commonly occurs during spinal surgery;LDH is on the increase in younger patients and is classified as"paralysis"and"back pain."Sanhanchushi Tongbi(SPST)is a customized prescription.It disperses cold,relieves pain,removes cold from the meridians and viscera,and treats neuropathic pain.However,few studies have investigated its mechanism of pain relief.AIM To observe the clinical therapeutic effects on LDH treated with self-prescribed SPST.METHODS A total of 211 patients with LDH syndrome were divided into two groups:107 patients in the control group were treated with conventional massage combined with traction,and 104 patients in the observation group were treated with a combination of the control regimen and self-prescribed oral SPST.The patients were treated for 4 wk.Indices of traditional Chinese medicine(TCM)syndrome score and serum inflammatory factor levels were measured.RESULTS After therapy,the TCM syndrome score in the observation group was significantly lower than that in the control group(P<0.05).The main symptoms,clinical signs,daily activities,and Japanese Orthopedic Association scores in the observation group were significantly higher than those in the control group after therapy(P<0.05).The levels of tumor necrosis factor-α,interleukin-6,and C-reactive protein were lower in the observation group than in the control group(P<0.05).In the observation group,superoxide dismutase levels were significantly higher,whereas malondialdehyde levels were significantly lower,compared with the control group(P<0.05).The overall efficacy rate in the observation group was 96.15%,which was substantially higher than that in the control group(88.79%;P<0.05).CONCLUSION Self-prescribed SPST can reduce the levels of inflammatory and pain-causing factors as well as lumbar pain in patients with LDH.

Efficacy of gabapentin for low back pain at a tertiary hospital: A prospective observational study

Objective:To assess the efficacy of gabapentin in the treatment of low back pain patients.Methods:This prospective observational study was conducted over 6 months to assess the efficacy of gabapentin in patients suffering from low back pain.Past medical history,pain severity by Visual Analogue scale(VAS)and sleep quality by Pittsburgh Sleep Quality Index(PQSI)were collected.VAS scores and PQSI scores before and after gabapentin treatment were compared,and gabapentin satisfaction post treatment were recorded.Results:This study included 100 low back pain patients with 65 males and 35 females,and the mean age was(39.0±10.5)years.The commonest presentation was non-radiating low back pain(40%).The mean VAS score and the mean PQSI score in the study before treatment were 7.70±1.91 and 10.95±5.02,respectively.After treatment with gabapentin,the mean VAS score and the mean PQSI score decreased to 2.75±1.79 and 4.90±2.20,respectively,and the differences before and after the treatment were significantly different(both P=0.001).Overall,62%of the patients were extremely satisfied with gabapentin because they reported no adverse drug reaction.Besides,31%of the patients were satisfied and 7%were strongly dissatisfied with the therapy.Conclusion:Gabapentin can improve sleep quality and reduce lower back pain as measured by the VAS and PQSI.The efficacy of this drug is relatively good,but further improvement is required.

Comparing the Effectiveness of Motor Control Exercises versus Mckenzie Exercises for Work Related Back Pain

Background: Work related low back pain has been identified as a one of the most costly disorders among the worldwide working population. This condition was highly prevalent that approximately 85% patients having back pain were brought on by prolonged sitting. With the rapid development of modern technology, sitting has now become the most common posture in today’s work- place. Idea of using motor control learning approach provides the optimal control and coordination of the spine. The McKenzie evaluation was received using repeated movements and sustained positions. Therefore high quality randomized clinical trial was required to compare the effectiveness of these treatments for work related low back pain. Objectives: To compare the effectiveness of motor control exercises and McKenzie exercises in reducing pain and disability in work related low back pain. Method: The study included 40 subjects with work related low back pain due to prolonged sitting. They were randomly allocated into two groups (Group A and Group B). Group A was treated with motor control exercises and group B was treated with McKenzie exercises for 4 weeks. Results: Both the groups have shown statically significant improvement in vas with p < 0.0001 and ODI with p < 0.0001. When the comparison was done after the 4 weeks, the percentage of improvement in group A was much higher than Group B. Conclusion: The study concluded that motor control exercises have shown statically and clinically significant improvement in reducing pain and disability when compared to McKenzie exercises among work related low back pain subjects.

Therapeutic efficacy of acupuncture combined with neuromuscular joint facilitation in treatment of hemiplegic shoulder pain

BACKGROUND Stroke is a type of cerebrovascular disease with high prevalence,mortality,and onset of disability.As a neurodevelopmental therapy,neuromuscular joint facilitation(NJF)is widely used in the treatment of orthopedic and neurological disorders in the clinical practice.It is mainly used for central nervous system diseases or orthopedic diseases,movement disorders,and pain rehabilitation.According to related studies,NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain(HSP).AIM To investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.METHODS Forty patients with HSP were randomly divided into a treatment group and a control group.The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone.All patients were assessed by using the visual analogue scale(VAS),Fugl-Meyer assessment(FMA),Barthel index(BI),and passive range of motion(PROM)before and after the training.All the clinical data were analyzed using SPSS 20.0 statistical software.RESULTS There was no statistical difference in the general characteristics between the two groups.In the terms of duration of treatment,age,and pre-treatment indicators,the two groups were comparable(P>0.05).After the treatment,VAS,PROM,BI,and FMA scores were significantly improved in the two groups of patients(P<0.05).The VAS,PROM and FMA scores were significantly higher in the treatment group than in the control group(P<0.05).However,there was no significant difference in BI scores between the two groups(P>0.05).CONCLUSION Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective,and can improve the clinical symptoms of patients.Acupuncture combined with NJF can improve the upper limb motor function,relieve pain,and increase joint mobility in patients with HSP.The combination therapy is better than acupuncture alone.However,there is no significant difference in improving the score of patients’self-care ability.

Development of Unilateral Piriformis Syndrome in a Female with Congenital Leg Length Discrepancy

Background: This is a rare case of piriformis syndrome. We discuss the patient’s symptoms, imaging study results, laboratory examination findings, and prescribed treatment in an attempt to determine the possible mechanisms or reasons for this patient’s development of piriformis syndrome. Methods: The patient is a 22-year-old female soldier who was admitted for lower back pain with soreness radiating to her right buttock and right lower extremity. We found that she had leg length discrepancy under X-ray finding. She was diagnosed piriformis syndrome by physical examination and Magenetic Resonance Image. Results: We performed scanography for lower extremities revealed a left femur length of 42.7 cm, a right femur length of 43.3 cm, a left tibia length of 33.2 cm, and a right tibia length of 33.6 cm;her left lower extremity was 1 cm shorter than her right. The MRI of sacrum also reveals hypertrophy of right piriformis muscle. Conclusions: Piriformis syndrome might be caused by short-term compensation in congenital leg length discrepancy. The patient with leg length discrepancy changed posture when standing, walking, and running. These compensation postures could lead to abnormality position of bones where there is insertion of the muscle.

The Effect of Humorous Stimuli on Alleviating Pain during Mammography: A Preliminary Study

Mammography is widely performed as a standardized procedure for breast cancer screening;however, women often feel some degree of pain during this procedure. Currently, there are limited options available for alleviating pain related to mammography. A non-medicinal approach to the alleviation of pain involves the effects of laughter on physical and psychological wellbeing. We therefore examined the possibility that humorous stimuli would alleviate the physical burden on women undergoing mammography. We assessed 29 women, 15 women received only conventional mammography (neutral group), while 14 women (humor group) watched a funny video during the same examination. The intensity of pain experienced during mammography was assessed by visual analogue scale (VAS) and the VAS results showed a statistically significant difference (P = 0.007) between the two groups, with the humor group experiencing less pain. In an additional experiment, 14 women in the humor group also underwent conventional mammography without exposure to the funny video and pain was assessed by VAS. We found that the pain experienced during conventional mammography without the funny video was significantly greater than the pain experienced during the same mammography but with the funny video (P = 0.047). These findings suggested the possibility of alleviating pain during mammography by humorous stimuli.

Efficacy of 2 Drops versus 3 Drops Proparacaine 0.5% Ophthalmic Solution for Phacoemulsification Surgery: A Comparative Study

Background and Aim: Phacoemulsification surgery with intraocular lens implantation is routinely done under topical anaesthesia in many centres. No comparative study on the efficacy of number of drops of topical anaesthetics effective for phacoemulsification surgery has been done. This study was conducted to compare the efficacy of 2 drops versus 3 drops proparacaine 0.5% ophthalmic solution for phacoemulsification surgery. Methods: Patients with uncomplicated cataract undergoing phacoemulsification surgery were randomised into two groups. Group 1 (n = 53) received 3 drops of proparacaine 0.5% whereas group 2 (n = 47) received 2 drops of the same solution before the start of surgery. All the patients underwent phacoemulsification with foldable intraocular lens implantation. Each patient’s subjective experience of pain was measured using a 10 point Visual Analogue Pain Scale (VAS). Patient’s cooperation during the surgery was assessed using a 3 point score. Both the evaluating resident doctor and patients were blinded. Results: In group 1, 73.6% patients scored 0, 20.8% scored 1 and 5.7% scored 2 of VAS respectively and in group 2, 89.4%, 6.4%, 4.3% patients scored 0, 1 and 2 of VAS respectively. In patient cooperation, 90.1% and 9.4% patients in group 1 scored 1 and 2 respectively whereas 87.2% and 12.8% patients scored 1 and 2 respectively in group 2. No statistically significant difference in the mean VAS (P = 0.0.55) and patient cooperation score (P = 0.597) was found between the two groups. The mean VAS score was 1.24 ± 0.534 and the mean patient cooperation score was 1.11 ± 0.314. The mean total surgical time was 25.11 ± 2.68 minutes. No additional drops were required for either group. Conclusions: Topical anaesthesia with both 2 drops and 3 drops proparacaine 0.5% ophthalmic solution is effective for phacoemulsification with intraocular lens implantation. Additional anaesthesia may be unnecessary in these cases.

选择性功能动作评估在颈、腰痛患者中的应用及对治疗效果的评价

目的通过选择性功能动作评估(SFMA)方法精准评估颈、腰痛患者造成疼痛的主要功能障碍情况,为进一步个性化精准康复治疗提供指导和建议,并评价治疗效果。方法选择2022年6月至12月就诊于西安交通大学第一附属医院康复医学科门诊的30例颈、腰痛患者为研究对象,均进行SFMA精准评估,并实施相同频次和治疗周期的针对性治疗,评价患者的治疗效果;比较患者治疗前、后的视觉模拟评分法(VAS)评分及主动呼吸模式。结果治疗后,显效11例(36.67%),有效18例(60.00%),无效1例(3.33%),治疗总有效率为96.67%(29/30)。治疗前的VAS评分为(4.47±1.04)分,治疗2周后的VAS评分为(2.03±1.29)分。治疗前、后的VAS评分比较,差异具有统计学意义(t=9.371,P<0.001);随访1个月后的VAS评分为(1.50±1.30)分,与治疗2周后的VAS评分比较,差异无统计学意义(t=1.585,P=0.118)。治疗前,15例为胸腹联动呼吸模式,15例为胸式呼吸模式;治疗后,30例为胸腹联动呼吸模式,0例为胸式呼吸模式。治疗前、后的呼吸模式比较,差异具有统计学意义(χ^(2)=17.422,P<0.001)。结论应用SFMA对颈、腰痛患者的治疗有指导意义,可有效减轻颈、腰痛,且治疗效果维持时间长,值得临床应用与推广。

穴位埋线治疗中重度乳腺增生病临床研究

目的:观察穴位埋线治疗中重度乳腺增生病(MGH)的疗效。方法:选取72例中重度MGH患者,按随机数字表法分为对照组及观察组各36例。对照组采用小金丸口服,观察组采用聚对二氧环己酮(PPDO)对折旋转穴位埋线治疗。2组均连续治疗8周,随访3个月。比较2组临床疗效,比较2组治疗前后乳房疼痛评分、乳房肿块大小、情绪评分[汉密尔顿焦虑量表-14项(HAMA)、汉密尔顿抑郁量表-17项(HAMD)]的变化。结果:观察组总有效率为90.63%,对照组为63.64%,2组比较,差异有统计学意义(P<0.05)。2组不同时间点乳房疼痛评分在时间因素、时点交互因素方面比较,差异有统计学意义(P<0.05)。治疗后及随访期,2组乳房疼痛评分均较治疗前下降(P<0.05),观察组治疗后及随访期的乳房疼痛评分均低于同一时间段的对照组(P<0.05)。2组不同时间点乳房肿块大小在时间因素、组间因素、时点交互因素方面比较,差异有统计学意义(P<0.05)。治疗后及随访期,2组乳房肿块大小均较治疗前缩小(P<0.05),观察组治疗后及随访期乳房肿块均小于同一时间段的对照组(P<0.05)。2组不同时间点HAMA评分、HAMD评分在时间因素、组间因素、时点交互因素方面比较,差异有统计学意义(P<0.05)。治疗后及随访期,2组HAMA、HAMD评分均较治疗前下降(P<0.05);观察组治疗后及随访期HAMA评分、HAMD评分均低于同一时间段的对照组(P<0.05)。结论:穴位埋线治疗中重度MGH疗效较好,可减轻乳房疼痛程度,缩小肿块大小,改善患者情绪。

神经根沉降征四分法分型与腰椎管狭窄症严重程度、疼痛、最小硬膜囊横截面积的相关性

目的:分析神经根沉降征(NRS)四分法分型与腰椎管狭窄症(LSS)严重程度、视觉模拟疼痛量表(VAS)评分、最小硬膜囊横截面积(CSA)的相关性,探讨其对LSS的临床价值。方法:回顾性选择180例LSS患者作为研究对象,均行MRI横断面扫描;采用NRS四分法分型分为阳a型58例,阳b型55例,阳c型31型及阴型36例4组,比较4组最小硬膜囊CSA、VAS评分、Oswestry功能障碍指数(ODI)及腰椎管狭窄相关指标,分析NRS四分法分型与最小硬膜囊CSA、VAS评分、ODI的相关性。结果:4组最小硬膜囊CSA、VAS评分、ODI比较,差异均有统计学意义(均P<0.05)。最小硬膜囊CSA组间两两比较:阳a型、阳b型、阳c型均小于阴型,阳b型、阳c型均小于阳a型,阳c型小于阳b型,差异均有统计学意义(均P<0.05)。VAS评分、ODI组间两两比较:阳a型、阳b型、阳c型均大于阴型,阳b型、阳c型均大于阳a型,阳c型大于阳b型,差异均有统计学意义(均P<0.05)。各型椎管正中矢状径、侧隐窝矢状径差异均无统计学意义(均P>0.05)。NRS分型与VAS评分、ODI呈正相关(r=0.894,0.929;均P<0.001),与最小硬膜囊CSA呈负相关(r=-0.870,P<0.001)。结论:NRS四分法分型越高,LSS症状和狭窄程度越重,这对LSS的诊断和病情评估均有重要价值。

颈项功治疗颈型颈椎病60例的疗效观察

目的:通过对颈型颈椎病患者进行锻炼干预,比较颈项功和常规米字操治疗颈型颈椎病的临床疗效及对颈痛、压痛阈(Pressure Pain Threshold,PPT)的影响。方法:选择2020年11―12月浙江中医药大学纳入的60例颈型颈椎病患者,应用随机数字表法将60例颈型颈椎病患者分为功法组和常规米字操组,每组各30例。功法组患者采用功法“仙鹤点水”锻炼,常规米字操组患者采用常规米字操锻炼,两组患者每天早晚各锻炼1次,以锻炼4周为一个疗程。锻炼前对两组患者进行压痛点筛查,结果得到两组患者压痛点多在肩井穴和C3夹脊穴,并以此作为PPT值的采集点。观察各组患者在锻炼前后的视觉模拟评分法(Visual Analogue Scale,VAS)评分、Northwick Park颈痛量表(Northwick Park Neck-pain Questionnaire,NPQ)评分及肩井穴和C3夹脊穴的PPT值,并综合评定各组的临床疗效。结果:锻炼4周后两组患者的VAS评分和NPQ评分均较锻炼前降低(P<0.05),两组患者肩井穴的PPT值均较锻炼前升高(P <0.05),功法组C3夹脊穴的PPT值较锻炼前升高(P <0.05),常规米字操组C3夹脊穴的PPT值与锻炼前差异无统计学意义(P> 0.05)。功法组的总有效率为86.67%(26/30),优于常规米字操组的63.33%(19/30)(P <0.05)。结论:功法和常规米字操均能改善颈型颈椎病患者的颈部疼痛和压痛,但功法的疗效更加显著。

揿针联合硬膜外分娩镇痛对产后抑郁症的影响研究

目的:观察揿针联合硬膜外分娩镇痛对产后抑郁症(PPD)的影响。方法:选取110例初产妇为研究对象,按随机数字表法分为观察组和对照组各55例。对照组给予硬膜外分娩镇痛,观察组给予揿针联合硬膜外分娩镇痛。比较2组产妇治疗前后疼痛视觉模拟评分法(VAS)评分、爱丁堡产后抑郁量表(EPDS)评分及血清β-内啡肽(β-EP)、谷氨酸(Glu)水平,并比较2组产妇分娩方式、新生儿1 min Apgar评分及产妇PPD发生率。结果:宫口开4、6、8、10 cm时,2组VAS评分降低(P<0.05),且各时间点观察组均低于对照组(P<0.05)。宫口开10 cm时,2组血清β-EP水平升高(P<0.05),且观察组高于对照组(P<0.05);观察组血清Glu水平降低(P<0.05),对照组血清Glu水平升高(P<0.05),且观察组低于对照组(P<0.05)。2组分娩方式、新生儿1minApgar评分比较,差异均无统计学意义(P>0.05)。产后42d,2组EPDS评分升高(P<0.05),但观察组低于对照组(P<0.05)。产后42 d,观察组PPD发生率低于对照组(P<0.05)。结论:揿针联合硬膜外分娩镇痛可降低产妇PPD发生率,其机制可能与缓解分娩疼痛、调节神经递质释放有关。

四位一体多功能疼痛评估工具的研制和临床应用效果评价

目的设计一种新型四位一体多功能整合式疼痛评估工具并探讨其临床应用效果。方法选取我院2021-04-01/2021-06-01期间接收外科手术的患者300例,采用随机数字表法分为对照组(n=160)和观察组(n=140),对照组采用常规疼痛评估工具数字评分工具(NRS)、视觉模拟评估工具(VAS)、语言评分工具(VRS)或修订版面部表情疼痛评估工具(FPS-R))进行疼痛评估,观察组采用研制的四位一体多功能疼痛评估工具进行疼痛评估。评价2组患者首次疼痛评估所需要的时间和疼痛评估工具使用时的解释次数以及护士对疼痛评估工具的使用的满意度。结果NRS、VAS、VRS、FPS-R和多功能疼痛评估工具的应用正确评估时间分别为34.65±1.42,31.28±1.65,21.26±1.85,22.32±1.53,13.21±1.32,解释次数分别为1.90±0.10,1.45±0.08,1.13±0.06,1.16±0.05,1.03±0.02,采用Fisher精确概率法,P<0.05。护士对疼痛评估工具使用的总体评价比较,多功能疼痛评估工具的使用满意度优于常规疼痛评估工具的使用(P<0.05)。结论四位一体多功能疼痛评估工具可以提高护士的疼痛评估效率,提升工作满意度,值得临床推广应用。

超声多参数成像评价腰部多裂肌损伤的前瞻性临床研究

目的:应用超声多参数成像评估慢性腰痛病人与无症状者腰部多裂肌超声影像特征。方法:2022年3月至2023年8月前瞻性纳入慢性腰痛病人(腰痛组)与无症状志愿者(无症状组)各60人,由2位超声医师分别测量受试者多裂肌厚度、面积,L3筋膜厚度以及多裂肌弹性模量。分析上述参数的一致性、随腰椎节段的变化趋势,以及两组之间的差异。结果:上述超声参数具有良好的一致性。随着腰椎节段的增加,多裂肌的厚度和面积均不断增加。腰痛组与无症状组相比,L3~4、L4~5多裂肌厚度显著减低,L2~3、L3~4、L4~5多裂肌面积显著减低;L3筋膜厚度及多裂肌弹性显著增加。结论:腰痛病人腰部多裂肌超声影像特征可发生明显变化,提示腰部多裂肌损伤可能是导致腰痛的重要原因。

针刺联合悬吊运动治疗非特异性下腰痛的临床观察

目的研究针刺联合悬吊运动治疗非特异性下腰痛(nonspecific low back pain,NLBP)的临床效果。方法采用随机数字表法,将2020年3月至2023年1月在湖南中医药大学第一附属医院针灸推拿康复科进行治疗的60例NLBP患者分为观察组、对照组,各30例。两组患者在常规处理的基础上,对照组采用针刺治疗,观察组采用针刺联合悬吊运动治疗,均治疗4周。观察两组患者疼痛视觉模拟评分(visual analogue scale,VAS)、功能障碍问卷(roland morris disability questionnaire,RMDQ)、中医症候积分、肌肉紧张度、生物力学特征、生活质量综合评定问卷(generic quality of life inventory 74,GQOL-74)、生活活动能力(Barthel指数)及疗效。结果治疗后,两组患者VAS、RMDQ评分、中医症候积分、两侧竖脊肌、多裂肌紧张度及腰背屈/伸比值(flexion/extension,F/E)均较治疗前下降(P<0.05),且观察组上述指标均低于对照组(P<0.05);治疗后,两组患者腰背伸状态下峰力矩(peak torque,PT)、平均功率(average power,AP)、GQOL-74及Barthel评分较治疗前升高(P<0.05),且观察组上述指标均高于对照组(P<0.05);经过治疗后,观察组总有效率(93.33%)高于对照组的(73.33%)(P<0.05)。结论单纯针刺和针刺联合悬吊运动在治疗NLBP上均有一定的疗效,可有效缓解患者疼痛,改善竖脊肌、多裂肌主动活动功能,提高生活质量,且针刺结合悬吊运动疗效优于单纯针刺治疗,值得临床推广应用。

颊针联合椎旁神经阻滞治疗胸背部带状疱疹后神经痛的疗效观察

目的:观察颊针联合椎旁神经阻滞治疗胸背部带状疱疹后神经痛(PHN)的临床疗效。方法:选取2021年1月至2021年12月无锡市中医医院收治的PHN患者100例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组50例。对照组采用基础药物配合椎旁神经阻滞治疗,观察组在对照组基础上联合颊针治疗。观察并记录2组患者治疗前及治疗1、2、3、4周后视觉模拟评分(VAS),治疗前后的健康调查简表(SF-36)评分、血清中神经元特异性烯醇化酶(NSE)水平、辅助T细胞1/2(Th1/Th2)水平、不良反应发生情况及总有效率。结果:治疗后2组患者VAS均低于治疗前,且观察组优于对照组(P<0.05)。2组患者的SF-36除生理功能外均较治疗前升高,且观察组优于对照组(P<0.05)。2组患者NSE水平明显低于治疗前,且观察组优于对照组(P<0.05)。2组患者γ干扰素(IFN-γ)水平明显高于治疗前,且观察组优于对照组(P<0.05),2组患者白细胞介素4(IL-4)、白细胞介素10(IL-10)水平明显低于治疗前,且观察组优于对照组(P<0.05)。2组均未发生明显不良反应(P>0.05),观察组总有效率优于对照组(P<0.05)。结论:颊针联合椎旁神经阻滞治疗胸背部PHN效果显著,能有效缓解疼痛,提升患者治疗期间的生命质量,降低神经细胞损伤,提高免疫力。

4种疼痛评估量表在房颤射频消融术患者中的应用比较

目的比较4种疼痛评估量表在房颤患者射频消融术中的应用效果。方法选取160例接受射频消融术的房颤患者为研究对象,术中分别采用数字评定量表、视觉模拟评分、Wong-Baker面部表情疼痛量表、词语描述量表评估疼痛,比较不同疼痛评估量表在患者首选率、作答时间及效标效度方面的差异。结果4种疼痛评估量表在患者首选率、作答时间方面差异具有统计学意义(均P<0.05),Wong-Baker面部表情疼痛量表及词语描述量表患者首选率较高,而作答时间最短。不同性别、年龄及文化程度患者对4种疼痛量表首选率比较,差异无统计学意义(均P>0.05)。消融术中不同时间点词语描述量表、Wong-Baker面部表情疼痛量表、视觉模拟评分分别与数字评定量表(作为效标)评分存在高度相关(r=0.774~0.886,均P<0.05)。结论4种疼痛评估量表在房颤射频消融术中具有较好的疼痛评估作用,且Wong-Baker面部表情疼痛量表、词语描述量表的临床应用效果最佳。

砭石艾灸治疗原发性痛经的效果

目的探讨砭石艾灸治疗原发性痛经的临床效果。方法选取2022年1月至2023年1月在北京按摩医院门诊治疗的120例原发性痛经患者作为研究对象,通过随机信封法分为砭石艾灸组(60例,砭石艾灸)和药物组(60例,布洛芬缓释胶囊)。比较两组治疗前后视觉模拟评分法(VAS)和COX痛经症状量表评分及临床疗效。结果砭石艾灸组治疗有效率高于药物组(P<0.05);两组治疗后即刻、治疗1个月后和治疗2个月后VAS评分均降低,且砭石艾灸组低于药物组(P<0.05);治疗后,两组总发作时间和平均严重程度评分均降低,且砭石艾灸组低于药物组(P<0.05)。结论砭石艾灸治疗原发性痛经的临床效果较好,能减轻疼痛,缓解临床症状。