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Objective:To observe the clinical efficacy of combining repeated transcranial magnetic stimulation (rTMS) with radiofrequency ablation (RF) of dorsal root ganglia in treating herpes zoster infection and neuralgia.Methods:Eighty-four individuals with a herpes zoster infection who had suffered from neuralgia for no more than 7 days were divided randomly into a control group, an rTMS group, an RF group, and an observation group, each of 21. All were treated with gabapentin, valciclovir and mecobalamin. The rTMS group received rTMS treatment, 5 days per week, for 2 consecutive weeks. The RF group received RF treatment of the dorsal root ganglia on the 15th day after enrollment, while the observation group received only the medication. Before the experiment as well as after 3, 7, 16, 30 and 60 days, all of the subjects self-assessed their discomfort using a pain visual analog scale (VAS). The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Quality of Life Assessment Scale (QOL-SF36), and Pittsburgh Sleep Quality Index (PSQI) were also administered.Results:The average VAS, HAMA, HAMD, QOL-SF36, and PSQI scores of the observation group improved continuously and significantly during and after the treatment. Beyond 16 days all of those results were significantly better than the control group′s averages, and the observation group′s average VAS, HAMA and HAMD results were also significantly better than those of the rTMS group. The observation group′s average VAS, HAMA, HAMD and PSQI scores had improved significantly more than the RF group′s averages beyond 30 days.Conclusion:Combining rTMS and dorsal root ganglion RF can effectively alleviate the early pain symptoms of herpes zoster infection and neuralgia, relieve anxiety and depression, and significantly improve sleep and life quality. Such therapy is worthy of clinical promotion and application.
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Objective:To observe any effect of combining ultrasound-guided stellate ganglion pulsed radiofrequency irradiation with electroacupuncture in treating migraine.Methods:Seventy-two migraine patients were randomly divided into a combined group, an electroacupuncture group and a control group, each of 24. All three groups were treated with etocoxib and zolmitriptan dispersible tablets, while the electroacupuncture group and the combined group were additionally provided with electroacupuncture or ultrasound-guided stellate ganglion pulsed radiofrequency irradiation combined with electroacupuncture. The therapeutic interventions were administered once daily for 7 days. A visual analogue scale (VAS), a migraine-specific quality of life questionnaire (MSQOL), the Hamilton anxiety scale (HAMA), the Hamilton depression scale (HAMD) and a migraine disability scale (MIDAS) were used to evaluate each patient before the experiment and on the 3rd, 7th, 30th and 90th days after completion of the treatment.Results:The average VAS, MSQOL, HAMA and HAMD scores of the combined and acupuncture groups had improved significantly at all time points. Moreover, the average MIDAS scores of the combined and acupuncture groups had improved significantly 30 and 90 days after the treatment. On the 3rd day after the treatment, the average VAS, MSQoL, HAMA and HAMD scores of the combined group were significantly higher than the acupuncture group′s averages, while the average MIDAS score of the former group was significantly lower on the 30th and 90th days after the treatment. The average VAS, HAMA and HAMD scores of the combined group were significantly lower than the control group′s averages 3, 7, 30 and 90 days after the treatment, while their average MSQOL score was significantly higher. The average MIDAS score of the combined group was significantly lower than the control group′s average 30 and 90 days after the treatment.Conclusion:Ultrasound-guided stellate ganglion pulsed radiofrequency irradiation combined with electroacupuncture can significantly relieve the symptoms of migraine and improve the life quality of migraine patients for at least 3 months.
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Objective To observe the clinical effect of combining extracorporeal shock waves with pulsed radiofrequency irradiation of the dorsal root ganglia in the treatment of spinal cord-derived abdominal pain. Methods A total of 88 patients were randomly divided into a control group, a shock wave group, a pulsed irradiation group and a combination group, each of 22. All of the patients were given etocoxib and pregabalin medication for 3 weeks. In ad-dition to the drugs, the shock wave group received extracorporeal shock wave therapy, and the irradiation group re-ceived pulsed radio frequency irradiation of the dorsal root ganglia. The combination group received both. A visual an-alogue scale was used to assess perceived pain. The quality of life short form 36 ( QOL-SF36) , Hamilton anxiety scale and Hamilton depression scale were administered to all 4 groups before the treatments and after 1, 4 and 12 weeks of the treatments. The development of diseases, gastrointestinal function, medical treatment and medical expenses of the 4 groups were observed for two years after the treatments. Results After 4 weeks of treatment, the average scores of all four groups in all of the evaluations had improved significantly compared with before the treatment. In combination group′s average results were significantly better than those of the other 3 groups from 4 weeks until 12 weeks after the treatment. During the subsequent two years that group′s gastrointestinal symptoms, hospital visits and medical expen-ses were all significantly lower, on average, than those of the other groups. Conclusion Extracorporeal shock waves combined with pulsed radio frequency irradiation of the dorsal root ganglia has significant clinical efficacy for alleviating spinal cord-derived abdominal pain. It can significantly reduce medical costs and is worthy of clinical pro-motion.
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Objective To observe the clinical efficacy and safety of non-surgical spinal decompression com-bined with intervertebral foramen injection in the treatment of lumbar intervertebral disc herniation. Methods Nine-ty-six patients were randomly divided into a control group, a decompression group, an injection group and a combined group. All of the subjects were given loxoprofen sodium and chestnut seed extract. The decompression group was trea-ted with non-operative spinal decompression. The injection group received intervertebral foramen injections. The com-bined group received both treatments. Pain perceptions, quality of life perceptions and lumbar dysfunction were ob-served before the treatment, and 2 days, 1 month, 6 months and 12 months afterward. Results There were no sig-nificant differences among the groups in average pain perceptions quantified using a visual analogue scale ( VAS) be-fore the treatment. The average scores on a 36-item short-form health survey, the Oswestry disability index and a Jap-anese Orthopedic Association instrument also were not significantly different. All of those indicators had improved sig-nificantly in the decompression, injection and combined groups at 1, 6 and 12 months after the treatment, but the combined group′s average indicators were all significantly better than the other groups′ averages at the same time points. All of the significant improvements in the combined group′s averages occurred in the first month after the com-bined treatment. Conclusion Non-operative spinal decompression has a synergistic effect with intervertebral fora-men injection in treating patients with lumbar disc herniation. Their combined effect is better than either treatment a-lone. Their combined effect is lasting, safe and has few complication risks. It is worthy of clinical application.
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Objective To observe the clinical effect of pulsed radiofrequency electrotherapy combined with acupuncture or electroacupuncture in treating neuralgia after herpes zoster infection.Methods Eighty-eight patients were divided into a control group,an electroacupuncture group,a pulsed electrotherapy group and a combined group using a random number table.The 4 groups were routinely given gabapentin and tramadol,while the electroacupuncture group was additionally treated with electroacupuncture,the pulsed electrotherapy group received radiofrequency irradiation of the dorsal root ganglion,and the combined group was given CT-guided pulsed radiofrequency electrotherapy combined with electroacupuncture or acupuncture.Before the treatment and 15 days and 1 month afterward,everyone was evaluated using a visual analogue scale (VAS) for pain intensity,the Hamilton anxiety (HAMA) and depression (HAMD) scales and the short form 36 (QOL-SF36) quality of life assessment.The area of painful skin was also measured.Results There were no significant differences among the 4 groups at the outset in any of the measurements.Significant improvement was observed in all of the measurements 15 and 30 days after the treatment except in the control group.The combined group was by then significantly better than the other 3 groups.Their dosage of gabapentin and tramadol had decreased significantly compared with the other groups after 3 months of treatment.Conclusion CT-guided pulsed radiofrequency electrotherapy combined with acupuncture or electroacupuncture is safe and effective for treating post-herpes neuralgia.It is worthy of clinical application and promotion.
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Objective To evaluate the clinical efficacy of compound matrine injection combined with fentanyl transdermal patch in the treatment of elderly patients with advanced gastric cancer.Methods A total of 100 elderly patients with advanced gastric cancer were enrolled in this study.All patients were randomly divided into the observation group (n =50) given compound matrine injection plus Fentanyl transdermal patch and the control group given fentanyl transdermal patch alone(n=50).The analgesic efficacy,quality of life and adverse reaction were evaluated and compared between the two groups.Results The analgesic efficacy was significantly higher in the observation group[76％(38/50)]than in the control group[(44％),(x2=4.46,P＜0.05)].Before treatment,the life quality scores were similar between two groups.After treatment,the life quality score of the two groups was significantly improved as compared with pre-treatment.In addition,life quality score was significantly higher in the observation group than in control group(t=8.61,P＜0.05).After treatment,only mild adverse events were observed in two groups,with no significant difference in adverse events between the two groups(x2 =0.00,P＞0.05).Conclusions Compound matrine injection plus Fentanyl transdermal patch are safe and effective in the treatment of carcinoma pain in elderly patients with advanced gastric cancer.
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Objective To investigate the relation of autophagy and postherpetic neuralgia in elderly patients,and provide new methods for prevention and treatment of postherpetic neuralgia.Methods One hundred thirty-five specimens were obtained from elderly patients with herpes zoster,containing 83 patients with herpes zoster plus neuralgia and 52 cases with non-neuralgia herpes zoster.The level of autophagy was determined by acridine orange-stain.The protein expressions of autophagy marker protein LC3 and autophagy related protein Beclinl were detected by Western blot.Results Flow cytometer detection after acridine orange-stain showed that mean fluorescence intensity (MFI) of herpes zoster plus neuralgia patients was 0.775±0.068 and non-neuralgia herpes zoster patients was 0.342±0.025.The level of autophagy of non-neuralgia herpes zoster patients was significant lower than herpes zoster plus neuralgia patients (P＜0.05).The expressions of autophagy marker protein LC3 and autophagy related protein Beclin1 detected by Western blot also showed the level of autophagy of non-neuralgia herpes zoster patients was decreased compared with herpes zoster plus neuralgia patients.Conclusions High level autophagy is risk factor for postherpetic neuralgia in elderly patients.
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Objective To observe the clinical efficacy of combining buprenorphine with joint mobilization in the treatmeut of periarthritis of the shoulder.Methods A total of 103 patients were randomly divided into groups A,B and C.Group A received buprenorphine and joint mobilization;group B was treated with the non-steroidal antiinflammatory drug loxoprofen sodium and joint mobilization;group C received only joint mobilization.One week,3 weeks and three months after the treatment,the subjects used a visual analogue scale (VAS) to rate their level of discomfort,and Constant-Murley scores (CMS) and the degree of shoulder activity were quantified in all 3 groups.Any differences in the intensity of joint mobilization were also observed.Results The VAS ratings,CMS and the degree of activity of the shoulder joint improved significantly in all three groups after the treatment.One week after the treatment,the average VAS score of group A (2.8±1) was significantly lower than that of groups B (3.8±1) and C (4.5± 1.3),but group A's average CMS (60.1±10.7) had increased to significantly more than those of groups B (48.8± 11.0) and C (44.9±9.7).At the same time,the average shoulder joint rear protraction,90° extorsion abduction,internal rotation and external rotation angles of group A were all significantly bigger than those of groups B and C.The differences were maintained until at least three months after the treatment.One week after the treatment,the intensity of the joint mnobilization of group A was significantly higher than in groups B and C,with that discrepancy also continuing until at least 3 months after the treatment.Conclusions Buprenorphine combined with joint mobilization is very effective in the treatment of periarthritis of the shoulder.It is simple,safe and elicits good patient compliance.It is worthy of pronotion among shoulder periarthritis patients.
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Objective To observe the effect of extracorporeal shock wave (ESW) combined with intervertebral foramen injection on the lumbar facet joint syndrome.Methods Ninety-three patients presenting the syndrome were randomly divided into acombined group,ashock wave group and acontrol group,each of 31,according to a random number tab.All three groups were given a nonsteroidal anti-inflammatory drug,the shock wave group was additionally treated with a course of ESW,while the combined group received the shock wave treatment and lumbar intervertebral foramen injection.The three groups were assessed using theOswestry disability index (ODI),theRoland Morris Disability Questionnaire (RMDQ)and a life quality scale (QOL-SF36) beforetreatment and after 1,4 and 8 weeks of treatment.Pain was reported using a visual analogue scale (VAS).Results Theaverage VAS,ODI,RMDQ and QOL-SF36 scores of the three groups had all improved after the treatment.After one week the average scores of VAS (2.6±1.4),ODI (15.9±8.3),RMDQ (9.9±5.4) and QOL-SF36 (74.6±17.1) of the combined group had improved significantly more than those of the control group [VAS (4.3± 1.3),ODI(22.8± 6.9),RMDQ (14.9±7.7) and QOL-SF36 (61.6±17.7)].Fourweeks after the treatment,the averageVAS,ODl,RMDQ andQOL-SF36 scores [(2.5±1.3),(15.1±7.3),(9.8±5.1) and (76.8±16.8)] of the shock wave group had improved significantly more than those of the control group [(3.9 ± 1.4),(20.3 ± 8.2),(13.9 ± 8.1) and (67.2±20.6)].Such significant improvements lasted until 8 weeks after the treatment.ConclusionsESW combined with intervertebral foramen injection can relieve the pain oflumbar facet joint syndrome,improve lumbar vertebral function and patients' quality of life.It is worthy of clinical application.
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OBJECTIVE:To observe therapeutic efficacy of zoledronic acid in the treatment of acute pain of vertebral compres-sion fractures during different courses. METHODS:207 patients with acute thoracic or (and) lumbar vertebral compression frac-tures were selected and randomly divided into trial group(107 cases)and control group(100 cases). Control group was given calci-um carbonate(1 200 mg/d)diclofenac sodium sustained-released tablet(75 mg/d).Trial group was additionally given zoledronic ac-id 5 mg added into 5%Glucose solution 100 ml,intravenous dripping for 15-30 min,on the basis of control group. RESULTS:Af-ter treatment,VAS score of two group decreased significantly,and trial group the decrease was more significant than control group,with statistical significance (P0.05);after 4d treatment,there was statistical significance in VAS score between course≤one month and one month 0.05);after one week,there was statistical significance in VAS score between one month 2 months (P<0.05).CONCLUSIONS:Zoledronic acid may partly alleviate the pain of acute vertebral fractures,the analgesic effect is more clear in early stage.
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Objective To compare the effects of epidural administration of different combinations of lidocaine, corticosteroids (dexamethasone, prednisolone) and vitamins(B 1,B 6,B 12 ) on epidural space adhesion and nerve root inflammation in rabbits Methods Forty eight adult Japannese white rabbits of either sex weighing (2 38?0 31)kg were anesthetized with intramuscular ketamine 15 mg?kg -1 and midazolam 0 2 0 3 mg?kg -1 A catheter was inserted into epidural space at L 2 when the ligamentum flavum was exposed by surgery and advanced caudally for 2 3cm Correct placement of the catheter in epidural space was confirmed by injecting 0 5% lidocaine 0 2 ml through the cathter when the animal was awake 24h after epidural cathter placement 0 2ml?kg -1 of normal saline containing talcum power 1mg?ml -1 was injected into epidural space 3 days later the animal were randomly divided into 8 groups: group Ⅰ received no treatment, group Ⅱ epidural normal saline 0 2ml?kg -1 , group Ⅲ epidural 0 5% lidocaine 0 2ml?kg -1 , group Ⅳ epidural compound lidocaine solution 1 (lidocaine 100mg +dexamethasone 10 mg in 20 ml normal saline) 0 2ml?kg -1 , group V epidural compound lidocaine solution 2 (lidocaine 100mg+prednisolone 50 mg in 20 ml normal saline)0 2 ml?kg -1 , group Ⅳ epidural compound lidocaine solution 3 (lidocaine 100mg+dexamethasone 10 mg+vitamin B 1 200mg in 20 ml normal saline) 0 2 ml/kg, group Ⅵ epidural compound lidocaine solution 4 ( lidocaine 100mg+dexamethasone 10 mg+vitamin B 6 200mg in 20 ml normal saline) 0 2 ml/kg, and group Ⅷ epidural compound lidocaine solution 5 (lidocaine 100mg+dexamethasone 10 mg+vitamin B 12 200mg in 20 ml normal saline) 0 2 ml/kg One week later animals were killed by intravenous injection of air Spinal column below L 1 was removed Epidural space and nerve root adhesion was checked first with naked eye then examined under microscope Epidural space adhesion was divided into 4 grades according to Rydell Results 1 Macroscopic examination of epidural space for adhesion: there was no significant different between group Ⅰ and group Ⅱ,Ⅲ, also between group Ⅱ,Ⅲ and group Ⅳ,Ⅴ,Ⅵ,Ⅶ,Ⅷ; there was significant different between group Ⅰ and groupⅣ,Ⅴ,Ⅵ,Ⅵ,Ⅷ (P