Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rat...Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.展开更多
Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP...Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association(ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity;therefore, it should be effective for CLBP in older adults.展开更多
Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain p...Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.展开更多
非特异性腰痛(nonspecific low back pain,NLBP)在中医归属“痹证”范畴,此疾病严重影响患者的日常生活。现代医学多采用改善患者局部组织血液循环、促进生物体新陈代谢和组织恢复,松解机体筋膜和软组织粘连等方法进行治疗。目前已有治...非特异性腰痛(nonspecific low back pain,NLBP)在中医归属“痹证”范畴,此疾病严重影响患者的日常生活。现代医学多采用改善患者局部组织血液循环、促进生物体新陈代谢和组织恢复,松解机体筋膜和软组织粘连等方法进行治疗。目前已有治疗方法的疗效并不显著。为治疗该疾病,作者基于前期动物实验结果,以“经筋-脾肾”理论展开叙述,认为寒凝筋脉、脾肾虚衰为非特异性腰痛的主要病因。故采用疏解经筋、固护脾肾的治疗方法,针对性地提出“针膏结合”的治疗手段,即皮内针针刺关元穴配以独活寄生汤膏药贴敷进行治疗。该手段为中医药在临床上治疗NLBP提供了新的思路及方法。展开更多
目的分析超声医生下背痛(low back pain,LBP)与相关缺勤发生影响因素,为防控LBP及其后果提供依据。方法采用分层整群抽样法抽取广东省内31家医院的超声医生作为研究对象,使用修订版北欧肌肉骨骼疾患问卷进行调查,并通过多因素logistic...目的分析超声医生下背痛(low back pain,LBP)与相关缺勤发生影响因素,为防控LBP及其后果提供依据。方法采用分层整群抽样法抽取广东省内31家医院的超声医生作为研究对象,使用修订版北欧肌肉骨骼疾患问卷进行调查,并通过多因素logistic回归分析LBP与相关缺勤发生的影响因素。结果共有512名超声医生的调查结果纳入分析,其LBP年发生率为55.5%,所致缺勤发生率为10.9%。妇幼保健院与综合医院的LBP发生率比较,差异无统计学意义(χ^(2)=0.477,P>0.05)。工龄>10~15年组的LBP发生率高于≤5年组(OR=3.34);月收入>10000元者LBP发生率高于月收入≤5000元者(OR=1.96);轮班引起LBP发生风险增加(OR=1.73)。工龄>10~15、>15~20、>20年组的LBP致缺勤发生率高于工龄≤5年组(OR=4.31、4.86、4.72);每天检查时间>8 h的LBP致缺勤发生率高于≤6 h者(OR=4.14)。结论超声医生的LBP发生率较高,其影响因素包括工龄、月收入和轮班情况,LBP致缺勤的影响因素包括工龄和每天超声检查时间,可考虑优先从工作组织管理措施减少LBP致缺勤发生。展开更多
目的观察不同地域腰痛患者临床特征的差异性及针灸综合治疗的疗效。方法回顾性分析2022年7月至2023年7月安徽中医药大学第二附属医院骨科、老年病科门诊与中国援柬埔寨中医医疗队在柬埔寨考斯玛医院中医科门诊接受针灸综合治疗的腰痛患...目的观察不同地域腰痛患者临床特征的差异性及针灸综合治疗的疗效。方法回顾性分析2022年7月至2023年7月安徽中医药大学第二附属医院骨科、老年病科门诊与中国援柬埔寨中医医疗队在柬埔寨考斯玛医院中医科门诊接受针灸综合治疗的腰痛患者454例,采用随机数字表法将符合纳入标准的患者按地域不同分为对照组(中国安徽地域)与观察组(柬埔寨金边地域);对两组患者中医证候分型的分布特点进行分析,评估针灸综合疗法对两组患者视觉模拟评分(visual analog scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)量表评分的影响。结果本研究中腰痛的中医分型分为寒湿证、瘀血证、湿热证、肝肾亏虚证4型;中国安徽地域患者以瘀血证居多(占57.89%),其他依次为肝肾亏虚证(占24.56%)、寒湿证(占10.96%)、湿热证(占6.58%);柬埔寨金边地域患者以湿热证居多(占40.27%),其他依次为肝肾亏虚证(占27.43%)、瘀血证(占23.89%)、寒湿证(占8.41%);两组患者中医证候分型分布比较,差异有统计学意义(P<0.05)。两组治疗后VAS评分、ODI量表评分均较治疗前显著减少(P<0.05);两组VAS评分、ODI量表评分比较,差异均无统计学意义(P>0.05)。结论不同地域、不同气候及不同饮食习惯会导致腰痛发病的中医证型存在差异,针灸综合疗法具有相似的临床疗效,具有普适性。展开更多
目的研究腰痛患者腰骶椎Modic改变(Modic changes,MCs)及其类型与骨质疏松的关系。方法选取2021年1月至2024年9月于南京中医药大学附属徐州市中医院就诊的女性腰痛患者204例为研究对象,根据磁共振成像结果将患者分为MCs组(139例)和无MCs...目的研究腰痛患者腰骶椎Modic改变(Modic changes,MCs)及其类型与骨质疏松的关系。方法选取2021年1月至2024年9月于南京中医药大学附属徐州市中医院就诊的女性腰痛患者204例为研究对象,根据磁共振成像结果将患者分为MCs组(139例)和无MCs组(65例),将MCs组按MCs分型分为Ⅰ型组(33例)、Ⅱ型组(90例)和Ⅲ型组(16例)。比较各组患者的年龄、髋部骨密度(bone mineral density,BMD)及其T值。结果MCs组和无MCs组患者的年龄、髋部BMD及相应T值比较差异均无统计学意义(P>0.05)。四组患者的髋部BMD及相应T值依次为Ⅲ型组>无MCs组>Ⅱ型组>Ⅰ型组。Ⅲ型组患者骨量多处于正常水平,其余三组患者多处于骨量减少或骨质疏松水平。Ⅱ型组与无MCs组患者的髋部BMD及相应T值比较差异均无统计学意义(P>0.05),Ⅲ型组患者的髋部BMD及相应T值均显著高于其余三组(P<0.05)。Ⅰ型组患者的髋部BMD及相应T值均显著低于其余三组(P<0.05)。结论腰痛患者不同的骨量水平有不同的MCs发病倾向:较高骨量(骨量正常)者多发生Ⅲ型MCs,骨量减少或骨质疏松者则易发Ⅰ型MCs,应重视Ⅰ型MCs患者的抗骨质疏松治疗。展开更多
基金supported by the 13th Five-Year Army Key Discipline Construction Project(No.2020SZ06-17).
文摘Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.
文摘Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association(ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity;therefore, it should be effective for CLBP in older adults.
基金funded by the Scientific Research Innovation Program regarding Traditional Chinese Medicine of Guangzhou University of Chinese Medicine (Central mechanism of balanced acupuncture for lumbar disc herniationusing functional MRI), No. 09CX068
文摘Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.
文摘非特异性腰痛(nonspecific low back pain,NLBP)在中医归属“痹证”范畴,此疾病严重影响患者的日常生活。现代医学多采用改善患者局部组织血液循环、促进生物体新陈代谢和组织恢复,松解机体筋膜和软组织粘连等方法进行治疗。目前已有治疗方法的疗效并不显著。为治疗该疾病,作者基于前期动物实验结果,以“经筋-脾肾”理论展开叙述,认为寒凝筋脉、脾肾虚衰为非特异性腰痛的主要病因。故采用疏解经筋、固护脾肾的治疗方法,针对性地提出“针膏结合”的治疗手段,即皮内针针刺关元穴配以独活寄生汤膏药贴敷进行治疗。该手段为中医药在临床上治疗NLBP提供了新的思路及方法。
文摘目的分析超声医生下背痛(low back pain,LBP)与相关缺勤发生影响因素,为防控LBP及其后果提供依据。方法采用分层整群抽样法抽取广东省内31家医院的超声医生作为研究对象,使用修订版北欧肌肉骨骼疾患问卷进行调查,并通过多因素logistic回归分析LBP与相关缺勤发生的影响因素。结果共有512名超声医生的调查结果纳入分析,其LBP年发生率为55.5%,所致缺勤发生率为10.9%。妇幼保健院与综合医院的LBP发生率比较,差异无统计学意义(χ^(2)=0.477,P>0.05)。工龄>10~15年组的LBP发生率高于≤5年组(OR=3.34);月收入>10000元者LBP发生率高于月收入≤5000元者(OR=1.96);轮班引起LBP发生风险增加(OR=1.73)。工龄>10~15、>15~20、>20年组的LBP致缺勤发生率高于工龄≤5年组(OR=4.31、4.86、4.72);每天检查时间>8 h的LBP致缺勤发生率高于≤6 h者(OR=4.14)。结论超声医生的LBP发生率较高,其影响因素包括工龄、月收入和轮班情况,LBP致缺勤的影响因素包括工龄和每天超声检查时间,可考虑优先从工作组织管理措施减少LBP致缺勤发生。
文摘目的观察不同地域腰痛患者临床特征的差异性及针灸综合治疗的疗效。方法回顾性分析2022年7月至2023年7月安徽中医药大学第二附属医院骨科、老年病科门诊与中国援柬埔寨中医医疗队在柬埔寨考斯玛医院中医科门诊接受针灸综合治疗的腰痛患者454例,采用随机数字表法将符合纳入标准的患者按地域不同分为对照组(中国安徽地域)与观察组(柬埔寨金边地域);对两组患者中医证候分型的分布特点进行分析,评估针灸综合疗法对两组患者视觉模拟评分(visual analog scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)量表评分的影响。结果本研究中腰痛的中医分型分为寒湿证、瘀血证、湿热证、肝肾亏虚证4型;中国安徽地域患者以瘀血证居多(占57.89%),其他依次为肝肾亏虚证(占24.56%)、寒湿证(占10.96%)、湿热证(占6.58%);柬埔寨金边地域患者以湿热证居多(占40.27%),其他依次为肝肾亏虚证(占27.43%)、瘀血证(占23.89%)、寒湿证(占8.41%);两组患者中医证候分型分布比较,差异有统计学意义(P<0.05)。两组治疗后VAS评分、ODI量表评分均较治疗前显著减少(P<0.05);两组VAS评分、ODI量表评分比较,差异均无统计学意义(P>0.05)。结论不同地域、不同气候及不同饮食习惯会导致腰痛发病的中医证型存在差异,针灸综合疗法具有相似的临床疗效,具有普适性。
文摘目的研究腰痛患者腰骶椎Modic改变(Modic changes,MCs)及其类型与骨质疏松的关系。方法选取2021年1月至2024年9月于南京中医药大学附属徐州市中医院就诊的女性腰痛患者204例为研究对象,根据磁共振成像结果将患者分为MCs组(139例)和无MCs组(65例),将MCs组按MCs分型分为Ⅰ型组(33例)、Ⅱ型组(90例)和Ⅲ型组(16例)。比较各组患者的年龄、髋部骨密度(bone mineral density,BMD)及其T值。结果MCs组和无MCs组患者的年龄、髋部BMD及相应T值比较差异均无统计学意义(P>0.05)。四组患者的髋部BMD及相应T值依次为Ⅲ型组>无MCs组>Ⅱ型组>Ⅰ型组。Ⅲ型组患者骨量多处于正常水平,其余三组患者多处于骨量减少或骨质疏松水平。Ⅱ型组与无MCs组患者的髋部BMD及相应T值比较差异均无统计学意义(P>0.05),Ⅲ型组患者的髋部BMD及相应T值均显著高于其余三组(P<0.05)。Ⅰ型组患者的髋部BMD及相应T值均显著低于其余三组(P<0.05)。结论腰痛患者不同的骨量水平有不同的MCs发病倾向:较高骨量(骨量正常)者多发生Ⅲ型MCs,骨量减少或骨质疏松者则易发Ⅰ型MCs,应重视Ⅰ型MCs患者的抗骨质疏松治疗。
