密集型银质针松解术治疗慢性腰部软组织痛的临床评价

李信明1张逸1李定明1魏安宁2(1,629000;2,400010)目的:观察密集型银质针治疗慢性腰部软组织痛的疗效和安全性方法:135例慢性腰痛患者,给予密集型银质针松解术治疗,每7天1次,共3次在治疗前治疗后5天30天3个月及6个月对如下疗效与安全性指标进行评价疗效指标包括:疼痛视觉模拟评分(VisualAnalogueScale,VAS)局部压痛评分活动受限评分指地距离疗效评定等指标结果:经过3次治疗,第5天30天3个月及6个月患者各项指标均有明显改善(P0.05),第5天和30天时总有效率达100%,第3个月及6个月总有效率分别为98.5%及99.2%密集型银质针松解术治疗3例出现头痛,5例出现局部皮肤灼伤结论:密集型银质针松解术治疗慢性腰部软组织痛具有治痛确切疗效稳定安全性高不良反应轻等优点慢性腰部软组织痛;密集型银质针松解术;软组织损害CLINICALEVALUATIONOFDENSESILVERNEEDLEDECOMPRESSIONFORCHRONICLOWBACKPAINLIXinMing1,ZhangYi1,LIDingMing1,WEIAnNing2(1SuiningPeoples'Hospita,lSichuan629000;2ChongqingMedicalUniversityNO.2AffiliatedHospita,lChongqing400010)AbstractObjective:Toinvestigatetheefficacyandsafetyofdensesilverneedledecompressiononchroniclowbackpainfromsofttissuedamage.Methods:135patientswithchroniclowbackpainfromsofttissuedamageweretreatedwithdensesilverneedledecompression,onceeverysevendays,atotalof3times.Theefficacyandsafetywereevaluatedonthepretreatmentandonthe5days,30days,3monthsand6monthsaftertreatmen.tTheefficacyindicesincludedVisualanaloguescale(VAS),painreductiononmovementandtotalefficacyrate.Thesideeffectswerealsoobserved.Results:Allclinicalindiceswereimprovedsignificantlyonthe5thday,30thday,3month,6monthaftertreatment(P0.05).Thetotalefficacyratewere100%at5thand30thday,98.5%and99.2%at3monthand6month,respectively.Sideeffectssuchasmildheadachewereobservedin3patients,localskinburningwasobservedin5patients.Conclusion:Densesilverneedledecompressionhasareliableanalgesiceffectwithlesssideeffectsonthepatientswithchroniclowbackpainfromsofttissuedamage.KeywordsChroniclowerbackpain;Densesilverneedledecompression;Softtissuedamage,,[1,2],,,,[3],20074~200812,1.135,17~80,47.9;110,40.02;CTMRI;,;;;HLAB27ORF:;;;272ChineseJournalofPainMedicine2010,16,(5);;;;;;;2.(1):,,13171930cm,1.1mm(YZ,);,(2)![4]:,1/3,2,1.0~1.5cm,6~8,L3~S1,1.0~2.0cm2,1.0~1.5cm,5~6,L2~L42,(3):,,,,,,0.5%,,,,2cm∀1.5cm()1,,,,20min(4):3,73.53036(1)(VAS)[5]:0,10(2)4[3]:0:;1:(,,);2:,;3:(3):,,(cm)(4)[6]:0,1,2,3(5)::=()/()∀100%:,75%;,50~75%;,50%[7]4.SPSS17.0,#,2,t,P0.051.VAS53036,(P0.05,1)2.53036,530100%,3698.5%99.2%,6,(2)3.135,3,51(#,n=135)Table1Theclinicalindicesbeforeandaftertreatment(X#S,n=135)indexbaseline55daysaftertreatment3030daysaftertreatment33monthsaftertreatment66monthsaftertreatmentVAS6.75#1.132.23#0.94*1.45#0.42*1.37#0.73*1.56#0.61*scoreofpressingpain2.24#0.280.83#0.35*0.55#0.32*0.35#0.59*0.29#0.67*(cm)distancefromfingertoground45.89#5.1225.86#4.79*25.01#4.23*23.59#4.54*25.26#5.35*scoreofmovementlimitation0.40#0.292.43#0.34*2.29#0.33*2.46#0.43*2.51#0.37*,*P0.05,comparedwithpretreatment273ChineseJournalofPainMedicine2010,16,(5)2Table2Theclinicalefficacyaftertreatmenttime()excellent()good()poor(%)totalefficacyrate55daysaftertreatment1231201003030daysaftertreatment12510010033monthsaftertreatment12112298.566monthsaftertreatment11915199.2,(,,);()[5],;[3][8],,,,,,:,,[9],,VAS53036,VAS,,;36,121119,98.5%99.2%,,,,40∃(),,40∃50∃,,,[8],[10],150%[11],14,,,,45.89cm,25cm,,,2.24300.5530.3560.29,,,,,1cm2cm,0.5cm,3,,,365123121119,21,,,,,274ChineseJournalofPainMedicine2010,16,(5)1353,,35,,,,,,7,,,1ToughEA,WhiteAR,CummingsTM,eta.lAcupunctureanddryneedlinginthemanagementofmyofascialtriggerpointpain:asystematicreviewandmetaanalysisofrandomisedcontrolledtrials.EurJPain,2009,13:3~10.2ToughEA,WhiteAR,RichardsS,eta.lVariabilityofcriteriausedtodiagnosemyofascialtriggerpointpainsyndromeevidencefromareviewoftheliterature.ClinJPain,2007,23:278~286.3..:,2002.310:419~451.4..:,2004.200~201.5.,:,2007,139~142.6,,,..,2005,12:827~828.7..,2006,11:44~46.8DavidG,SimonsMD,JanetG,TravellMD,LoisS,SimonsMS..,.:,2007,11~94.9..,2009,31:42~43.10,,,..,2001,7:80~82.11,,..,2009,5:455~456.2010!!(ChineseJournalofPainMedicine),,::(),,(%&),,E-mail:,1664,:82-832,8.00,648.00:10019138!:01082801712;:01082801705:@[e-mail]275ChineseJournalofPainMedicine2010,16,(5)