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Objective: To evaluate the efficacy of acupuncture in treating chronic non-specific low back pain. Methods: Ten patients with chronic low back pain were selected to receive 9 acupuncture treatments over a three-week period with point selection based on syndrome differentiation in Chinese medicine. The BROM Instrument for assessment of back range of motion; subjective evaluation with Visual Analog Scale of Pain (VASP) ratings, Oswestry Disability ratings, objective measurements including Algometry, and Flexion and Extension ratings to investigate the range of motion were used for comparing the large, medium and small effect sizes of baseline, treatment and follow-up phases. Results: Clinical significance of pain relief was shown in all parameters assessed. A large effect size was detected in VASP, Oswestry and Algometry. A small effect size was demonstrated in Flexion/Extension. Needling over short period time (3 weeks) could relieve the pain, but the muscular-skeletal function measured by BROM persists. To treat patients exclusively by needling for statistical purposes can not be justified, because by merely relieving pain, permanent improvement in function may not be achieved. Conclusion: Acupuncture offers an effective alternative for the clinical management of chronic low back pain, significant improvement in most of the parameters evaluated, but the functional improvement was not as satisfactory as pain relieving. Further study with larger sample size focuses on long-term efficacy and functional improvement for chronic low back pain is recommended.
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中国肘关节置换术的历史与发展
肘关节置换术是治疗肘关节终末期疾病的有效方法,其主要应用于因创伤、类风湿、骨肿瘤等原因破坏的肘关节,并以人工假体替代,终达到缓解疼痛并挽救部分肘关节功能的目的。我国自20世纪60年代开展了肘关节置换术,并在20世纪70年代开始自主研发设计人工肘关节。进入21世纪,随着手术技术的提高和人工关节的设计成熟,我国肘关节置换术的发展也得到了长足的进步。本文拟对我国人工肘关节置换术的发展及现状作一论述。
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癌症三阶梯止痛治疗的临床体会
疼痛是癌症病人常见的症状,而药物止痛是缓解疼痛的主要方法.本组50例晚期癌症患者经参照世界卫生组织(WHO)有关文件,进行分级和疗效评定后,仍采用WHO所规定的"三阶梯治疗"方法进行治疗,疼痛全部缓解,其中明显缓解38%,完全缓解59%,取得了满意效果,不良反应轻.现将具体做法介绍如下:
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病人静脉自控镇痛术用于主动脉夹层瘤急性疼痛治疗
目前临床对患者实施手术引起的急性疼痛已有完善的处理方法,而对于非手术类病人包括内科保守治疗、介入前、手术前存在的急性疼痛,尚未引起足够的重视.我院自2003年2月~2007年1月对18例以急诊主动脉夹层瘤(AD)入院病人实施以阿片类镇痛药芬太尼30~50μg/kg为主的静脉自控镇痛术(Intravenous PCA,PCIA)与其他对症处理相结合,使病人平稳渡过疼痛关,降低了急症期死亡率,为介入或手术创造了前提条件.