Acupuncture effects on the hippocampal cholinergic system in a rat model of neuropathic pain

The present study observed the effects of repeated electroacupuncture of Zusanli （ST36） and Yanglingquan （GB34） on expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA in chronic constrictive injury （neuropathic pain） and/or ovariotomy rats. Results demonstrated increased expression of hippocampal acetylcholinesterase, vesicular acetylcholine transporter, and muscarinic M1 receptor mRNA, as well as decreased pain threshold, in a rat model of chronic neuropathic pain after electroacupuncture. The effects of electroacupuncture increased with prolonged time, but the above-mentioned effects decreased in memory-deficient animals. Results indicated that repeated electroacupuncture has a cumulative analgesic effect, which is closely associated with upregulation of acetylcholinesterase and vesicular acetylcholine transporter activity, as well as M1 receptor mRNA expression and memory.

Effect of low-level laser therapy on tooth-related pain and somatosensory function evoked by orthodontic treatment

Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.

Effects of Pre-Operative Single Dose Gabapentin on Postoperative Pain Following Total Abdominal Hysterectomy: A Dose Finding Study

Background & Aims: The multimodal analgesia provides superior pain relief and reduces opioid consumption and its side effects. Gabapentin has been used successfully in multi-modal analgesia in different doses. We designed a double-blind randomized control trial to find the minimal effective dose of gabapentin in multimodal analgesia for postoperative pain following total abdominal hysterectomy. Material & Methods: After informed consent, total of 87 patients were randomly assigned to A, B & C groups to receive gabapentin orally 300 mg, 600 mg, and 900 mg respectively one to two hours before surgery. Postoperatively pain was managed by patient-controlled analgesia (PCA) using pethidine. Pain score, opioid consumption, and side effects of gabapentin were monitored. Rescue analgesia was given and monitored. Results: There was no statistically significant difference among the groups with respect to age, weight, height, pethidine consumption, and rescue analgesia. Mean pain scores were statistically insignificant at baseline, 8, 12, and 24 hours postoperatively. Only at 4 hours, the highest pain score (mean) was found in group A, which is statistically significant. The side effects of gabapentin like nausea, vomiting, somnolence, and dizziness were also statistically insignificant. Conclusion: A single preoperative oral gabapentin 300 mg was found to be minimal effective dose in multimodal analgesic regimen for reducing post-operative pain and analgesic requirement following total abdominal hysterectomy.

Efficacy and adverse effects of olanzapine in the treatment of moderate to severe refractory neuropathic pain

Objective The aim of the study was to investigate the efficacy and adverse effects of olanzapine in the treatment of moderate to severe refractory neuropathic pain.Methods Forty patients with digestive system cancer were enrolled,who had moderate to severe refractory neuropathic pain;the patients were treated with olanzapine for 2 weeks at a daily dosage of 5 mg to 10 mg per night according to patients’response and tolerability,combined with conventional analgesic therapy.Pain intensity was evaluated by using a Numeral Rating Scale(NRS)at baseline,3 days,and 2 weeks after therapy.The Pittsburg Sleep Quality Index(PSQI)was evaluated at baseline and 2 weeks after therapy.Data on adverse events were recorded.The dosage of conventional analgesics was adjusted over time based on the severity of pain.Results The mean pain score decreased by 2.575±1.318(P<0.000)at 3 days and by 3.400±1.614(P<0.000)at 2 weeks;30%of the patients experienced significant pain relief at 3 days and 50%at 2 weeks.The PSQI decreased by 4.725±2.828(P<0.000)at 2 weeks.The adverse events induced by olanzapine included sleepiness,weight gain,dizziness,fatigue,dry mouth,and constipation;all the side effects were mild.Conclusion When combined with conventional analgesic therapy,olanzapine was effective in relieving pain and sleep disturbance,and was well-tolerated among patients with refractory neuropathic pain.

Effect of percutaneous radiofrequency thermocoagulation on different neuropathic pains

BACKGROUND: The clinical treatment of neuropathic pain is very troublesome, and the physical method of radiofrequency thermocoagulation is a good choice for its treatment. OBJECTIVE: To observe the curative effect of percutaneous radiofrequency thermocoagulation on neuropathic neuralgia. DESIGN: A case follow-up analysis. SETTING: Minimally Invasive Surgery Room, Department of Neurosurgery, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA. PARTICIPANTS: Totally 131 patients were selected from the Department of Neurosurgery, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA from December 2000 to June 2006, including 73 males and 58 females, aging 37-72 years old, AND the disease course was 2-15 years. ① Drug treatment failed to alleviate the pain or induced obvious side effects; ② With the same pathological changes as pain and effective in the nerve block test; Had signed the informed consents before treatment. Distribution of the neuropathic pain: ① Trigeminal neuralgia, which were lighting attack, located at V2 in 28 cases, V3 in 46 cases, V1+V2 in 3 cases, V2+V3 in 28 cases, and V1+V2+V3 in 1 case; ② Migraine located at (except the frontal branch of trigeminal nerve) greater and lesser occipital nerves in 6 cases, auriculotemporal nerve in 3 cases, temporal and zygomatic nerves in 3 cases; ③ Unilateral neuralgia of C2 and C3 following herpes zoster in 1 case, and chest intercostals neuralgia in 2 cases; ④ Lasting burning pain in the operative area after thoracotomy was in 1 case of lung cancer. METHODS: ① All the enrolled patients were treated with percutaneous puncture at trigeminal ganglion or peripheral nerve, then nerve block was performed firstly for anesthesia, and the pain disappeared immediately at this moment, there was hypoesthesia or numbness in the area of innervation, which manifested the puncture apposition was correct, then electrostimulation of 50 Hz with the current of 0.1-0.5 V was given for further functional localization. ② The RFG-3C radiofrequency therapeutic instrument (Radionics, USA) was used, the tip of the radiofrequency electrode was exposed for 5 mm, the temperature was kept at 80-85 ℃, 30-60 for each time, and treated for 3 or 4 times. The neuralgia following herpes zoster could also be treated by thermocoagulation at several points. ③ Evaluation standards for the therapeutic efficacy: Excellent meant the pain disappeared completely without taking any anodyne. Good referred to the pain was alleviated as compared with the preoperative one, and it could be effectively controlled by anodyne at relapse, but radiofrequency therapy was unnecessary. MAIN OUTCOME MEASURES: Therapeutic efficacy of neuropathic neuralgia of different types after treatment of percutaneous radiofrequency thermocoagulation. RESULTS: All the 131 patients were involved in the final analysis of results, no one missed. ① Therapeutic efficacy: In the 24-month follow-up, the therapeutic efficacy was excellent in 106 cases (80.9%), good in 21 cases (16.0 %) and had no change in 4 cases (3.1%). For 13 of the patients with trigeminal neuralgia, the pain relapsed after the lesion of peripheral branches, and it disappeared after the second treatment. The treatment was invalid for 1 patient with lung cancer suffering from pain in the operative area after thoracotomy, and the pain was alleviated by spinal cord stimulation. The pain disappeared after treated for 3 times in the patients with cervical neuralgia following herpes zoster. ② The pain relapsed in 28 cases (21.4%) at 12 months of the follow-up. ③ Adverse events and side effects: Except the hypoesthesia of different severity at the site of pain, there was no other complication after treatment. CONCLUSION:The follow-up results showed that percutaneous radiofrequency thermocoagulation is one of the effective methods for treating neuropathic neuralgias of various types.

情绪释放疗法联合药物缓解混合痔手术病人术后疼痛的效果观察

目的:探讨对混合痔手术病人采取情绪释放疗法联合药物干预的临床应用价值及对缓解其术后疼痛的效果。方法:选取2021年1月—2022年12月我院收治的混合痔手术病人70例,随机分为对照组及研究组,各35例。对照组采取常规药物干预,研究组采取情绪释放疗法联合药物干预。比较两组术后不同时点的疼痛水平、疼痛缓解效果、凝血指标、并发症发生情况。结果:研究组术后24 h、36 h、72 h、7 d疼痛视觉模拟评分(VAS)均低于对照组(P<0.05);研究组疼痛缓解总有效率高于对照组(P<0.05);研究组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均长于对照组(P<0.05);研究组术后并发症发生率低于对照组(P<0.05)。结论:对混合痔手术病人采取情绪释放疗法联合药物干预,术后疼痛缓解效果显著,可改善凝血功能,减少并发症,促进术后康复。

冰康复新液湿敷治疗急性放射性皮炎的效果

目的分析冰康复新液湿敷治疗对于急性放射性皮炎的临床效果。方法选取江西省人民医院2021年1月至2023年6月收治的60例急性放射性皮炎患者作为研究对象,按照随机数字表法分为对照组及试验组,每组各30例。对照组采取生理盐水+庆大霉素+地塞米松+维生素B12治疗,试验组采取冰康复新液湿敷治疗。比较两组患者治疗有效率、疼痛评分、起效时间以及皮肤损伤的愈合时间。结果试验组患者临床疗效优于对照组,差异有统计学意义(P<0.05)。试验组患者治疗后视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。试验组患者治疗后起效时间、愈合时间短于对照组,换药次数少于对照组,差异有统计学意义(P<0.05)。结论对急性放射性皮炎患者采用冰康复新液湿敷治疗,临床效果佳,可以有效促进患者皮肤损伤的恢复,减轻患者疼痛感,值得研究推广。

苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床观察

目的观察苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床效果。方法将医院创伤骨科门急诊就诊的102例急性踝关节扭伤患者(2020年5月—2022年7月)纳入研究,以随机数字表法将患者分为两组,每组51例,对照组采取西医常规治疗,观察组采取西医常规治疗同时结合苏筋通络方及“行气活血”针刺法治疗。数据比较:临床治疗效果、中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分变化、踝关节跖屈活动度与背伸活动度变化、视觉模拟评分(Visual Analogue Scale,VAS)变化、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝-后足评分变化、血清疼痛物质(神经生长因子、神经肽、P物质)水平变化、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-1β(Interleukin-1β,IL-1β)、超敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)变化。结果观察组患者与对照组患者治疗总有效率相比[98.04%(50/51)vs86.27%(44/51)],P<0.05;治疗后各组患者中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分、踝关节跖屈活动度与背伸活动度、VAS评分、AOFAS踝-后足评分、神经生长因子、神经肽、P物质、IL-6、IL-1β、hs-CRP等指标均改善,观察组患者治疗后中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分、踝关节跖屈活动度与背伸活动度、VAS评分、AOFAS踝-后足评分、神经生长因子、神经肽、P物质、IL-6、IL-1β、hs-CRP等指标均明显优于对照组患者,P均<0.05。结论苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床效果显著,患者经治疗后临床症状显著改善,疼痛缓解,踝关节功能改善,值得应用。

Aromatic Essential Oil Acupressure Combined with Music Therapy in Cancer Pain Management

Objective: To explore the effect of aroma oil acupressure combined with music therapy in pain intervention for tumor patients. Methods: 60 patients with malignant tumors accompanied by cancer pain who were hospitalized in the oncology department of a tertiary-level hospital in Jingzhou City, Hubei Province, from January 2022 to December 2022 were selected as the study subjects, and were divided into 30 cases in the control group and 30 cases in the intervention group according to the stratified sampling method. The control group was divided into 30 cases of control group and 30 cases of intervention group according to the stratified sampling method. The control group was given medicine according to the conventional step analgesia, and the intervention group was given medicine according to the conventional step analgesia with the addition of aromatic oil acupressure combined with music therapy, and the effect of the intervention was valued by the NRS, the SAS and the SDS. Results: The NRS, SAS and SDS of patients in the intervention group were lower than those in the control group (p Conclusion: Aromatic oil acupressure combined with music therapy can effectively improve the pain symptoms of tumor patients, relieve anxiety and improve the quality of sleep of patients. Combined with pharmacological methods of pain relief, it can reduce the dose of pain medication and the frequency of administration of medication, and find a safe, low-cost, non-pharmacological pain complementary alternative therapy for tumor patients with cancer pain.

使用盐酸羟考酮缓释片治疗晚期癌痛的药学作用探讨

目的探讨使用盐酸羟考酮缓释片治疗晚期癌痛药学作用。方法选取2020年8月—2023年7月如皋博爱医院收治的156例晚期癌痛患者作为研究对象,通过随机数表法,将患者分为观察组和对照组,每组78例。观察组实行盐酸羟考酮缓释片治疗,对照组实行盐酸吗啡缓释片治疗,对比两组疼痛缓解情况、用药相关指标以及不良反应发生情况。结果观察组癌痛缓解有效率与对照组相比,差异无统计学意义(P>0.05)。观察组患者疼痛控制稳定时间,疼痛爆发次数与解救药物使用记录均低于对照组,差异有统计学意义(P均<0.05)。观察组的不良反应发生率(7.69%)低于对照组(19.23%),差异有统计学意义(χ^(2)=4.457,P<0.05)。结论给予晚期癌痛患者盐酸羟考酮缓释片作为镇痛措施,效果显著,且镇痛稳定、起效迅速,不良反应作用少。

不同浓度罗哌卡因用于超声引导下TAP阻滞在妇科手术中的镇痛效果及安全性

目的:探讨不同浓度罗哌卡因用于超声引导下腹横肌平面(TAP)阻滞在妇科手术中的临床效果。方法:将2021年4月-2023年4月于本院行全身麻醉下腹腔镜子宫全切术患者105例,依据双盲法分为3组,分别给予0.25%、0.30%、0.375%罗哌卡因。对比各组手术相关指标,不同时间点患者疼痛和舒适度评分变化,麻醉前后患者炎症因子水平,术后24h不良反应。结果:3组麻醉时间、术中出血量、手术时间均无差异(P>0.05);与术后1h对比,术后24h各组视觉模拟评分(VAS)均下降,Bruggrmann舒适度评分(BCS)均提升,但0.375%组VAS评分(1.56±0.51分)低于0.25%组(2.69±1.02分)、0.30%组(2.35±0.68分),BCS评分(3.24±0.54分)高于0.25%组(2.23±0.39分)、0.30%组(2.59±0.41分)(P<0.05);麻醉后各组C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)水平均提升,但0.375%组CRP(21.36±4.26 mg/L)、TNF-α(70.13±7.16 pg/ml)水平低于0.25%组(28.98±5.62 mg/L、96.54±8.97 pg/ml)、0.30%组(24.69±4.87 mg/L、84.33±7.62 pg/ml),不良反应发生率0.375%组(8.6%)低于0.25%组(40.0%)、0.30%组(31.4%)(均P<0.05)。结论:0.375%浓度罗哌卡因在超声引导下妇科TAP阻滞术中应用,改善患者疼痛效果显著,提升患者术后舒适度,有助于降低术后不良反应发生风险,提高用药安全性。

心理弹性在老年慢性疼痛患者疼痛管理自我效能与生活质量间的中介效应

目的 探讨心理弹性在老年慢性疼痛患者疼痛管理自我效能与生活质量间的中介效应。方法 2021年1月至12月采用方便抽样法选取在南京大学医学院附属鼓楼医院就诊的老年慢性疼痛患者96例为研究对象,应用心理弹性量表、疼痛管理自我效能量表及老年生活质量评定表对入组患者进行调查,采用Bootstrap法行中介效果验证。结果 老年慢性疼痛患者心理弹性与疼痛自我管理效能及生活质量呈正相关(r=0.456、0.478,P<0.05)。心理弹性在老年慢性疼痛患者疼痛自我管理效能及生活质量间存在部分中介效应,占总效应52.1%。结论 老年慢性疼痛患者心理弹性及疼痛自我管理水平处于中等偏低,生活质量还有待提高。心理弹性水平可影响老年慢性疼痛患者疼痛管理自我效能及生活质量,建议医院、社区及家庭可给予患者鼓励及支持,以增强患者心理弹性,提高患者疼痛管理自我效能,提高患者生活质量。

系统性功能训练结合护理干预对股骨头坏死行全髋关节置换术患者的康复效果及疼痛程度的影响

目的 探究在股骨头坏死行全髋关节置换术患者康复护理中应用系统性功能训练结合护理干预的效果。方法 随机选取2022年5月—2023年5月于聊城市人民医院接受全髋关节置换术治疗的100例股骨头坏死患者为研究对象,采用随机数表法分为两组,每组50例,参照组采用常规护理,研究组在常规护理基础上给予系统性功能训练,比较两组患者生活活动能力、疼痛程度、并发症发生率。结果 干预前,两组患者生活活动能力评分比较,差异无统计学意义(P>0.05);干预后,研究组生活活动能力评分高于参照组,差异有统计学意义(P<0.05)。干预前,两组患者疼痛评分比较,差异无统计学意义(P>0.05);干预后,研究组疼痛评分低于参照组,差异有统计学意义(P<0.05)。研究组并发症总发生率(2.00%)低于对照组(12.00%),差异有统计学意义(χ^(2)=5.118,P<0.05)。结论 将系统性功能训练与护理干预联合运用到股骨头坏死患者全髋关节置换术康复干预中,有助于髋关节功能恢复,减轻康复疼痛程度,可获得理想预后。

分期捐还是一次捐——个体捐赠的分期付款效应

支付技术的发展使分期付款的方式在个体捐赠领域得以普及:捐赠者可以在一段较长的时间内进行持续的定期捐赠,每次支付较少的金额。分期付款的捐赠形式在实践中应用广泛,但在文献中鲜有研究。本文将分期捐与一次捐进行对比,探讨分期捐的影响和适用情境。通过一个预实验和四个正式实验发现:相比一次捐,分期捐能够降低个体的感知支付痛苦,并提高个体对捐赠的感知有效性,从而提高其捐赠意愿;但是,当慈善项目的需求具有即时性或紧迫性时,分期捐对感知有效性的积极影响会被削弱甚至反转。此外,分期捐能够促使个体对慈善捐赠产生积极的态度。本研究丰富了对个体捐赠方式的认识,为慈善捐赠平台提升募捐效果、促进对慈善事业的长期资助提供有益借鉴。

基于神经调控的慢性疼痛治疗方法介绍

随着人口老龄化发展,慢性疼痛已成为严重的公共卫生问题。长期依赖药物治疗面临依赖性和毒副作用的困境。基于神经调控的非药物干预治疗为改善此情况提供了新思路。本文首先阐明慢性疼痛的现状及药物治疗的局限,指出拓展神经调控治疗的必要性。然后详细讨论神经调控治疗机制、主要方法及临床应用情况。同时,文章介绍了治疗效果评估的关键指标,并分析目前治疗方法的优劣势。最后,文章归纳相关治疗手段及当前面临的问题和挑战,展望未来研究方向,旨在系统梳理基于神经调控的慢性疼痛治疗策略,为改善慢性疼痛患者预后质量提供借鉴。

疼痛护理联合营养支持在鼻咽癌放疗患者中的应用

目的探讨疼痛护理联合营养支持在鼻咽癌放疗患者中的应用价值。方法简单随机选取2021年7月—2022年6月期间福建省泉州市第一医院收治的70例鼻咽癌放疗患者为研究对象,按随机数表法分为两组,各35例。对照组进行常规护理,观察组在此基础上应用疼痛护理与营养支持,比较两组患者口腔黏膜炎疼痛程度与溃疡愈合时间、营养状况、生活质量评分及护理满意度。结果观察组愈合时间短于对照组,疼痛评分低于对照组;观察组A级营养状况占比优于对照组;观察组生理状况评分、情感状况评分、社会/家庭状况评分、功能状况评分均高于对照组,差异有统计学意义(P均<0.05);观察组护理总满意度为94.29%,高于对照组的77.14%,差异有统计学意义(χ^(2)=4.200,P<0.05)。结论在鼻咽癌放疗期间,积极应用个体化营养支持与疼痛护理方案,能够有效改善口腔黏膜炎相关疼痛程度与患者机体营养状况,促进溃疡面愈合,提高生活质量和护理满意度。

鞘内输注盐酸氢吗啡酮对癌性疼痛患者的镇痛效果临床分析

[目的 ]观察鞘内输注盐酸氢吗啡酮对癌性疼痛患者的镇痛效果.[方法 ]选择口服给予吗啡缓释片治疗改为鞘内植入盐酸氢吗啡酮泵术治疗的50例癌性疼痛患者作为研究对象,观察改变镇痛方式前后的疼痛评分、生活质量、用药量、24 h内爆发痛次数及阿片类药物导致的恶心、呕吐、戒断反应等不良反应发生情况.[结果 ]鞘内植入盐酸氢吗啡酮泵的50例癌性疼痛患者术后24 h的NRS评分明显降低(P <0.05),生活质量明显改善,恶心、呕吐等不良反应症状明显缓解.3例发生戒断反应;癌症发生骨转移与否与药物无相关性(P> 0.05),癌症骨转移患者术后用药量明显降低(P <0.05);癌症发生骨转移与否与爆发痛次数无相关性(P> 0.05),但术前癌症骨转移患者爆发痛次数呈增多趋势,术后爆发痛次数明显减少(P <0.05).[结论 ]鞘内植入盐酸氢吗啡酮泵可降低癌性疼痛患者的疼痛评分,减少用药量及24 h内爆发痛次数,降低恶心、呕吐等不良反应的发生率,患者生活质量提高,戒断反应发生率亦降低.