The effect of massage therapy on pain after surgery: A comprehensive meta-analysis

BackgroundFindings on the usefulness of massage therapy (MT) in postoperative pain management are often inconsistent among studies.ObjectivesThis study’s aim is to conduct a meta-analysis of randomized controlled trials (RCT) to clarify the effects of massage therapy in the treatment of postoperative pain.MethodsThree databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for RCTs published from database inception through January 26, 2021. The primary outcome was pain relief. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The random-effect model was used to calculate the effect sizes and standardized mean difference (SMD) with 95 % confidential intervals (CIs) as a summary effect. The heterogeneity test was conducted through I². Subgroup and sensitivity analyses were used to explore the source of heterogeneity. Possible publication bias was assessed using visual inspection of funnel plot asymmetry.ResultsThe analysis included 33 RCTs and showed that MT is effective in reducing postoperative pain (SMD, −1.32; 95 % CI, −2.01 to −0.63; p = 0.0002; I² = 98.67 %). A similar significant effect was found for both short (immediate assessment) and long terms (assessment performed 4–6 weeks after the MT). Remarkably, we found neither the duration per session nor the dose had an impact on the effect of MT and there seemed to be no difference in the effects of different MT types. In addition, MT seemed to be more effective for adults. Furthermore, MT had better analgesic effects on cesarean section and heart surgery than orthopedic surgery.LimitationsPublication bias is possible due to the inclusion of studies in English only. Additionally, the included studies were extremely heterogeneous. Double-blind research on MT is difficult to implement, and none of the included studies is double-blind. There was some heterogeneity and publication bias in the included studies. In addition, there is no uniform evaluation standard for the operation level of massage practitioners, which may lead to research implementation bias.ConclusionsMT is effective in reducing postoperative pain in both short and long terms.     

推拿手法安全性的研究进展

中医推拿疗法是一种传统的、有效的理疗方法。在临床实践中具有独特的优势。它可以弥补许多疾病和损伤的药物治疗的不足,具有不可替代的疗效。推拿是部位和手法的综合作用,意外事件的发生主要是因为有的医者求效心切,不关注治疗部位和手法,疗效不明显,而且增加了患者的痛苦并危及患者的健康。本文试从施术部位和手法的不同,分析推拿操作中的意外事件,总结产生损伤的原因,并厘清操作要点,以期指导临床推拿操作的安全实施。     

王友仁呼吸按动法治疗寒邪客胃型胃脘痛经验

目的:探讨王友仁主任医师推拿手法治疗寒邪客胃型胃脘痛的临床经验。方法:从病因病机和治则治法方面论述王老以"呼吸按动法"为主治疗寒邪客胃型胃脘痛的学术观点和临床经验,对其基本手法及配伍予以总结。结果:王老以"呼吸按动法"为主,配合温中散寒的手法治疗寒邪客胃型胃脘痛,临床疗效佳。结论:王老认为胃脘痛多因胃腑外感寒邪或脾胃阳虚所致,呼吸按动法疗效显著。     

按法对大鼠脑卒中后肌痉挛的影响及其机理研究

目的:观察按法干预后脑卒中后肌痉挛大鼠血浆及脊髓L1-L3节段灰质前角组织中γ-氨基丁酸(GABA)和甘氛酸(Gly)含量的变化,探讨按法缓解脑卒中后肌痉挛的作用机制。方法:健康成年雄性Sprague-DawIey(SD)大鼠80只,随机抽取10只为空白组,其余70只造模。采用左颈外动脉插入线栓法建立大鼠大脑中动脉局灶性脑缺血(MCAO)模型。Longa神经功能评定为2-3分,且改良Ashworth肌张力评分评定为;1+、1+及2级的30只大鼠纳入实验。用随机数字表法将30只造模成功的大鼠随机分为模型组、按肌腱组和按肌腹组。造模成功2 d后,按肌腱组及按肌腹组大鼠分别接受大鼠按法橾作治疗仪按股四头肌肌腱和按股四头肌肌腹治疗,压力控制在(350±50)g,按压频率为5s/次,每次15 min,每日1次,连续治疗5d。各组于治疗第5次后,采用改良Ashworth#挛评定标准对大鼠股四头肌的张力进行评定。采用酶联免疫吸附试验(ELISA)法观察大鼠血浆及脊髓L1-L3节段中Gly的含量变化,采用高效液相色谱法(HPLC)观察大鼠血浆及脊髓L1-L3节段中GABA的含量变化。结果:各组改良Ashworth量表肌张力评定中,按肌腱组大鼠肌张力下降较按肌腹组更为明显(P<0.01);按肌腱组血浆及香髓L1-L3节段组织中Gly及GABA的含量增加较按肌腹组更为明显(均P<0.01)。结论:基于腱器官“反牵张反射”理论,采用按法刺激腱器官诱发“反牵张反射”对大鼠肌痉挛状态的改善效果优于按压肌腹。大鼠血浆和脊髓L1-L3节段中Gly和GABA含量的增加,可能是按法刺激腱器官改善大鼠肌痉挛状态的作用机制之一。     

Massage and reflexology for post-operative cancer cystectomy patients: Evaluation of a pilot service

Backgroundand purpose: Radical cystectomy is a gold standard treatment for invasive bladder cancer. However the length of the operation is long and recovery is usually slow and painful. There is growing recognition of the importance of health related quality of life among patients undergoing invasive surgical procedures. In response, a massage and reflexology service was piloted and evaluated.Materials and methodsOne hour of massage, reflexology or a combination of both was provided twice to 38 cystectomy patients by a trained therapist in their acute post-operative phase (day one and day three). Self-reported concerns, well-being and pain were measured before and immediately after the therapy. Pain was measured once more in the early evening of each therapy day.ResultsSelf-reported concerns and pain were significantly reduced following the intervention on both days treatments were given. Pain was measured again on the evening of each of the intervention days, and this reduction was maintained on day one but not day three. Well-being scores were also significantly improved pre to post intervention on both day one and day three. Qualitative comments highlighted that this complementary therapy service was viewed both beneficial and relaxing. There were no significant differences between the different therapies used (massage, reflexology, or a combination of the two).ConclusionThe findings of this pilot evaluation very tentatively support the benefits of cancer cystectomy patients receiving massage and/or reflexology in their acute postoperative recovery period. There are many limitations to this evaluation. Further research utilising a randomised control methodology alongside medical, independent markers is warranted, and currently in development.     

The side effects and mother or child related physical harm from massage during pregnancy and the postpartum period: An observational study

IntroductionWomen commonly use massage therapy during pregnancy for pregnancy-related health conditions such as lower back and neck pain; however, there is little to no research related evidence on the side effects or mother or child physical harm of massage during pregnancy and the postnatal period.ObjectivesThis study aims to report on the side effects and mother or child physical harm of massage during pregnancy and the postnatal period.DesignAn observational study methodology.Setting and time frameTwo massage clinics, one in Sydney and one in Melbourne recruited participants from December 2016 to December 2017.InterventionMassage.Main outcome measureSide effects and mother or child physical harm from massage.ResultsOne hundred and one participants were recruited to the study. Two fifths of the participants (n = 32, 40%) experienced one of more post-massage side effects. There were no mother or child physical harm events. Low back pain was the most common condition women sought massage treatment for 34 (33.7.%). A significant benefit (p < 0.001) was seen pre-massage to post-massage and pre-massage to 1-week post massage in decreasing stress, decreasing pain, increasing range of motion and improving sleepDiscussionSimilar to previous research, low back pain was the most common condition that women sought massage treatment for followed by hip pain, shoulder pain, neck pain and to improve mental health. Ninety-seven percent of the cohort received a full body massage including the feet leading credence that ‘massage on the feet during pregnancy is harmful’ is mythic in nature.ConclusionWhile our findings lead credence that massage on the feet during pregnancy is a myth the study was not powered to determine the safety of pregnancy massage and further research is needed. Massage was commonly sought for low back pain with promising benefits in decreased pain and improved range of movement and further research on the effectiveness of massage for low back pain in pregnancy.     

中药补气活血方离子导入配合穴位按摩治疗糖尿病周围神经病变效果观察

目的:探讨中药离子导入联合穴位按摩应用在糖尿病周围神经病变的临床疗效及应用价值。方法:选取2016年1月至2018年10月西宁市城北区中医院收治的糖尿病周围神经病变210例作为研究对象,按照治疗方案不同分为对照组和观察组,每组105例,对照组给予西医基础治疗,观察组在对照组基础上联合中药离子导入与穴位按摩治疗,比较2组治疗效果。结果:观察组患者治疗总有效率为97.14%显著高于对照组的86.67%,组间比较差异有统计学意义(P<0.05)。观察组治疗后肢体麻木评分(1.53±0.11)分,肢体疼痛评分(1.34±0.12)分,倦怠乏力评分(1.23±0.14)分,手足畏寒评分(1.33±0.14)分;对照组疗后肢体麻木评分(2.06±0.38)分,肢体疼痛评分(1.96±0.34)分,倦怠乏力评分(1.84±0.37)分,手足畏寒评分(1.85±0.32)分,组间比较差异有统计学意义(P<0.05)。观察组治疗后尺神经传导速度(51.68±3.75)m/s,胫神经传导速度(39.96±2.98)m/s,腓总神经传导速度(38.43±2.88)m/s;对照组治疗后尺神经传导速度(45.32±2.86)m/s,胫神经传导速度(37.04±2.41)m/s,腓总神经传导速度(35.06±2.19)m/s,组间比较差异有统计学意义(P<0.05)。结论:中药离子导入联合穴位按摩应用在糖尿病周围神经病变可以提升临床疗效,改善神经传导素,减轻临床症状评分,值得在临床推广应用。     

中药熏蒸联合针灸推拿治疗中风的临床效果

目的：观察中药熏蒸联合推拿和针灸治疗中风的临床疗效。方法：选取2018年11月至2020年7月南通大学第二附属医院收治的中风患者100例作为研究对象，按照入院顺序进行编号，按编号单双数不同分为对照组和观察组，每组50例。对照组给予推拿+针灸治疗，观察组则在对照组基础上给予中药熏蒸治疗。比较2组患者临床疗效、红细胞压积（HCT）、纤维蛋白原（FBG）、血浆黏度（CP）、免疫学（lgA，lgG，lgM）、神经缺损（NDF）、运动功能（FMA）、临床痉挛指数（CSI）及不良反应。结果：治疗后，观察组临床有效率为96.00%，对照组为84.00%，差异有统计学意义（P<0.05）；2组FBG、CP、HCT、IgA、IgM、IgG水平均显著降低，且观察组显著低于对照组（P<0.05）；2组NDF、CSI评分均明显降低，且观察组明显低于对照组（P<0.05）；2组FMA评分上升，且观察组显著高于对照组（P<0.05）；对照组与观察组的不良反应发生率分别为10.00%和12.00%，差异无统计学意义（P>0.05）。结论：改良中药熏蒸法联合推拿、针灸可改善中风患者血循环状态和免疫调节，促进神经及运动功能恢复，疗效确切。