Objective:To observe the clinical efficacy of tendon-regulating and bon e-setting manipulation combined with en dura nee resistance exercises in treating female with chronic neck pain,and explore the mechanism.Methods...Objective:To observe the clinical efficacy of tendon-regulating and bon e-setting manipulation combined with en dura nee resistance exercises in treating female with chronic neck pain,and explore the mechanism.Methods:A total of 57 female patients with chronic neck pain who met the inclusion criteria were randomly divided into a manipulation group(29 cases)and a medium-frequency electrotherapy group(28 cases).Patients in both groups received the same endura nee exercise therapy,while those in the man ipulation group received additi onalten don-regulating and bone-setting manipulation,and those in the medium-frequency electrotherapy group received additional medium-frequency electrotherapy.Both groups were treated for 5 weeks.Before and after treatment,the neck function of patients was evaluated by visual analog scale(VAS),Analgesy-Meter,Northwick Park questionnaire(NPQ),root mean square(RMS)and median frequency(MF)of surface electromyography of sternocleidomastoid muscle and posterior cervical extensor muscle,and the patients were followed up at a month after treatment.Results:All patients completed the treatment and were followed up.Compared with the same group before treatmerrt,the VAS scores of both groups decreased,the tenderness values increased,the RMS and MF values increased,and the NPQ scores decreased after treatment(all P<0.05).The improvement of manipulation group was more notable than that of medium-frequency electrotherapy group(all P<0.05).At one-month follow-up,the VAS and NPQ scores of the manipulation group were lower than those before and after treatment,and the VAS and NPQ scores of the mediumfreq ue ncy electrotherapy group were only lower than those before treatment;the two scores of the manipulation group were lower than those of the medium-frequency electrotherapy group(both P<0.05).Conclusion:Tendon-regulating and bone-setti ng man ipulati on combi ned with endurance resista nee exe rcises can relieve neck pain and cervical dysfunction in female patients with chronic neck pain.The efficacy of this method is more durable and better than that of medium-frequency electrotherapy combined with enduranee exercises.展开更多
Background Duloxetine, a selective serotonin and noradrenaline reuptake inhibitor, has been shown to be effective in treatment of diabetic peripheral neuropathic pain and approved for the management of patients with d...Background Duloxetine, a selective serotonin and noradrenaline reuptake inhibitor, has been shown to be effective in treatment of diabetic peripheral neuropathic pain and approved for the management of patients with diabetic peripheral neuropathic pain （DPNP） in the United States, European Union, and many other countries. This study assessed the efficacy and safety of duloxetine in Chinese patients with diabetic peripheral neuropathic pain. Methods This double-blind, randomized, placebo-controlled, flexible-dose study treated adult patients with diabetic peripheral neuropathic pain and baseline Brief Pain Inventory （BPI） 24-hour average pain severity ratings ≥4 with duloxetine 60 mg to 120 mg once daily or placebo for 12 weeks. Dose adjustments of duloxetine or matching placebo were based upon investigator＇s judgment of clinical response. Change from baseline to endpoint in BPI average pain was the primary efficacy outcome. Secondary outcome measures included BPI-severity and -Interference, Patient Global Impression of Improvement, Clinical Global Impressions of Severity, EuroQol： 5 Dimensions, Athens Insomnia Scale, and safety measures. Results Of 215 patients randomized, 88.4% and 82.1% of patients in placebo and duloxetine groups, respectively,completed the study. Mean change from baseline to endpoint in BPI average pain was not statistically different between the treatment groups （P=0.124）. Duloxetinetreated patients showed significantly greater pain reduction compared with those in placebo group at weeks 1,2, and 4 （P=0.004, P=0.009, and P=0.006, respectively） but not at weeks 8 （P=0.125） and 12 （P=0.107）. Duloxetine-treated patients experienced statistically significant improvement in Patient Global Impression of Improvement, Clinical Global Impression of Severity, area under the curve for pain relief, BPI-severity pain right now, and BPI-interference walking ability. Patients treated with duloxetine 120 mg once daily showed significantly greater pain reduction on the Brief Pain Inventory average pain score relative to placebo. Duloxetine-treated patients reported nausea, somnolence, anorexia, and dysuria significantly more than placebo. Conclusions Although the primary study endpoint was not achieved, the overall observed response pattern suggests the efficacy of duloxetine in the treatment of Chinese patients with diabetic peripheral neuropathic pain. The safety profile for duloxetine is similar to that reported in other global trials.展开更多
文摘Objective:To observe the clinical efficacy of tendon-regulating and bon e-setting manipulation combined with en dura nee resistance exercises in treating female with chronic neck pain,and explore the mechanism.Methods:A total of 57 female patients with chronic neck pain who met the inclusion criteria were randomly divided into a manipulation group(29 cases)and a medium-frequency electrotherapy group(28 cases).Patients in both groups received the same endura nee exercise therapy,while those in the man ipulation group received additi onalten don-regulating and bone-setting manipulation,and those in the medium-frequency electrotherapy group received additional medium-frequency electrotherapy.Both groups were treated for 5 weeks.Before and after treatment,the neck function of patients was evaluated by visual analog scale(VAS),Analgesy-Meter,Northwick Park questionnaire(NPQ),root mean square(RMS)and median frequency(MF)of surface electromyography of sternocleidomastoid muscle and posterior cervical extensor muscle,and the patients were followed up at a month after treatment.Results:All patients completed the treatment and were followed up.Compared with the same group before treatmerrt,the VAS scores of both groups decreased,the tenderness values increased,the RMS and MF values increased,and the NPQ scores decreased after treatment(all P<0.05).The improvement of manipulation group was more notable than that of medium-frequency electrotherapy group(all P<0.05).At one-month follow-up,the VAS and NPQ scores of the manipulation group were lower than those before and after treatment,and the VAS and NPQ scores of the mediumfreq ue ncy electrotherapy group were only lower than those before treatment;the two scores of the manipulation group were lower than those of the medium-frequency electrotherapy group(both P<0.05).Conclusion:Tendon-regulating and bone-setti ng man ipulati on combi ned with endurance resista nee exe rcises can relieve neck pain and cervical dysfunction in female patients with chronic neck pain.The efficacy of this method is more durable and better than that of medium-frequency electrotherapy combined with enduranee exercises.
文摘Background Duloxetine, a selective serotonin and noradrenaline reuptake inhibitor, has been shown to be effective in treatment of diabetic peripheral neuropathic pain and approved for the management of patients with diabetic peripheral neuropathic pain （DPNP） in the United States, European Union, and many other countries. This study assessed the efficacy and safety of duloxetine in Chinese patients with diabetic peripheral neuropathic pain. Methods This double-blind, randomized, placebo-controlled, flexible-dose study treated adult patients with diabetic peripheral neuropathic pain and baseline Brief Pain Inventory （BPI） 24-hour average pain severity ratings ≥4 with duloxetine 60 mg to 120 mg once daily or placebo for 12 weeks. Dose adjustments of duloxetine or matching placebo were based upon investigator＇s judgment of clinical response. Change from baseline to endpoint in BPI average pain was the primary efficacy outcome. Secondary outcome measures included BPI-severity and -Interference, Patient Global Impression of Improvement, Clinical Global Impressions of Severity, EuroQol： 5 Dimensions, Athens Insomnia Scale, and safety measures. Results Of 215 patients randomized, 88.4% and 82.1% of patients in placebo and duloxetine groups, respectively,completed the study. Mean change from baseline to endpoint in BPI average pain was not statistically different between the treatment groups （P=0.124）. Duloxetinetreated patients showed significantly greater pain reduction compared with those in placebo group at weeks 1,2, and 4 （P=0.004, P=0.009, and P=0.006, respectively） but not at weeks 8 （P=0.125） and 12 （P=0.107）. Duloxetine-treated patients experienced statistically significant improvement in Patient Global Impression of Improvement, Clinical Global Impression of Severity, area under the curve for pain relief, BPI-severity pain right now, and BPI-interference walking ability. Patients treated with duloxetine 120 mg once daily showed significantly greater pain reduction on the Brief Pain Inventory average pain score relative to placebo. Duloxetine-treated patients reported nausea, somnolence, anorexia, and dysuria significantly more than placebo. Conclusions Although the primary study endpoint was not achieved, the overall observed response pattern suggests the efficacy of duloxetine in the treatment of Chinese patients with diabetic peripheral neuropathic pain. The safety profile for duloxetine is similar to that reported in other global trials.
