筋膜释放技术联合核心稳定训练治疗慢性非特异性腰痛的疗效观察

目的 探究筋膜释放技术（MFR）联合核心稳定训练（CSE）治疗慢性非特异性腰痛（CNLBP）的临床疗效。方法 选取2020年10月至2021年7月在山西医科大学第一医院治疗的40例CNLBP病人,采用随机数字表法分为观察组和对照组各20例。两组病人均接受核心稳定训练,观察组在此基础上进行筋膜释放技术治疗,治疗时间为2周。分别于治疗前、治疗1周及治疗2周后对两组病人进行疗效评估,评定方法包括Schober试验、视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）及恐惧-回避信念问卷（FABQ）。结果 治疗1周后,观察组与对照组Schober试验结果[（3.73±1.16）cm、（2.98±1.14） cm]与治疗前[（3.05±1.27）cm、（2.48±1.02） cm]比较均升高（P<0.001）,观察组与对照组的VAS评分[（2.90±1.28）分、（4.25±1.33）分]、ODI评分[（12.00±4.18）分、（16.45±3.95）分]及FABQ评分[（36.60±11.16）分、（43.80±12.66）分]与治疗前[（4.70±1.13）分、（4.90±...     

针刀筋膜松解技术治疗慢性劳损性腰痛的疗效分析

目的分析针刀筋膜松解技术治疗慢性劳损性腰痛的临床疗效。方法60例慢性劳损性腰痛患者,按照随机数字法分为对照组和试验组,每组30例。对照组患者给予塞来昔布联合乙哌立松治疗,试验组患者在对照组的基础上加用针刀筋膜松解技术治疗。对比两组患者的临床疗效、治疗前后视觉模拟评分法(VAS)评分,不良反应发生率。结果试验组患者的有效率为90.00%,高于对照组的66.67%,差异具有统计学意义(P<0.05)。治疗前,两组患者的VAS评分比较,差异无统计学意义(P>0.05);治疗后,两组患者的VAS评分均较本组治疗前降低,且试验组VAS评分(2.57±1.77)分低于对照组的(5.46±2.12)分,差异均具有统计学意义(P<0.05)。两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论对慢性劳损性腰痛患者行针刀筋膜松解技术治疗,疗效显著,可有效缓解患者疼痛,值得临床推广及使用。     

颊针治疗慢性非特异性下腰痛的临床疗效

目的 观察颊针治疗慢性非特异性下腰痛(NLBP)的临床疗效.方法 慢性NLBP患者100例,随机分为两组,每组50例.A组采用颊针治疗,根据痛点和肌肉挛缩或硬结处靶点位置在人体面颊部的相应穴位分布实施单侧或双侧颊针治疗,留针20～40 min,每3天1次,5次1个疗程;B组采用体外冲击波治疗作为对照.记录治疗前(T0)...     

动态神经肌肉稳定技术对老年慢性非特异性腰痛的康复效果

目的 观察动态神经肌肉稳定技术治疗老年慢性非特异性腰痛的效果。方法 2019年10月至2021年6月该院收治的老年慢性非特异性腰痛患者44例,根据治疗方法不同分为对照组与观察组各22例。两组均予康复科常规腰部稳定性训练,观察组在此基础上应用动态神经肌肉稳定技术进行配合治疗,包括膈肌呼吸训练和仰卧训练每周5次。两组均治疗4周后比较治疗前后VAS评分、腰部功能障碍指数（ODI）、日本骨科协会（JOA）评估治疗分数。结果 治疗后观察组VAS、ODI评分低于对照组,JOA评分高于对照组。结论 对老年慢性非特异性腰痛患者应用动态神经肌肉稳定技术治疗,可减轻疼痛程度、恢复腰背功能、改善运动能力、提高日常生活活动能力。     

电针联合西乐葆胶囊治疗慢性非特异性下腰痛的效果分析

目的:探讨电针联合西乐葆胶囊治疗慢性非特异性下腰痛的临床疗效。方法:选取2018年2月—2019年3月我院治疗的慢性非特异性下腰痛患者61例,按照随机数表法随机分为对照组(30例)和观察组(31例)。对照组口服西乐葆胶囊治疗,观察组在口服西乐葆胶囊的基础上加电针治疗。1周为1个疗程,两组连续治疗4个疗程。比较两组临床疗效、视觉模拟评分(VAS)、患者血清中p物质水平。结果:观察组治疗总有效率高于对照组(P<0.05)。观察组视觉模拟量表评分(VAS)明显低于对照组(P<0.05)。观察组与对照组血清中p物质水平具有明显差异(P<0.05)。结论:电针联合西乐葆胶囊治疗慢性非特异性下腰痛临床疗效明显优于单纯西乐葆胶囊治疗,是一种安全且疗效显著的治疗方法,值得在临床推广应用。     

应用深层肌肉刺激仪治疗非特异性下腰痛的临床疗效观察

目的观察深层肌肉刺激仪(deep muscle stimulator,DMS)治疗非特异性下腰痛的临床治疗效果。方法选取符合纳入标准的60例非特异性下腰痛患者按随机数字表法分为观察组和对照组,每组各30例。两组患者均给予干扰电及推拿治疗,观察组在此治疗基础上应用DMS进行治疗,分别于治疗前后采用JOA、VAS和ODI评分进行评定。结果治疗4个疗程后,两组患者JOA评分较治疗前明显提高,差异有统计学意义(P<0.05),且观察组评分高于对照组,差异有统计学意义(P<0.05);两组患者VAS、ODI评分较治疗前明显降低,差异有统计学意义(P<0.05),且观察组评分低于对照组,差异有统计学意义(P<0.05)。结论深层肌肉刺激仪治疗可以明显改善非特异性下腰痛患者的症状,提高患者的生活质量,在临床上治疗非特异性下腰痛上值得推广使用。     

核心肌群训练对慢性非特异性下腰痛的疗效观察

非特异性下腰痛定义为非已知的特定的病理造成的下腰痛（例如感染,肿瘤,骨质疏松症,骨折,结构畸形,炎症性疾病,神经根综合征或马尾综合征）。目前临床上治疗慢性非特异性下腰痛的方法很多,但效果都不是很理想,近年来研究提出核心稳定性训练（coremuscle training）方法,对慢性非特异性下腰痛有一定的疗效。我科近年来采用核心肌群训练下腰患者,取得较好的临床效果,现报告如下。     

针刺合并悬吊运动训练对慢性非特异性腰痛临床疗效观察

目的 观察针刺合并悬吊运动训练治疗慢性非特异性腰痛患者的临床疗效.方法 将54例慢性非特异性腰痛患者按照随机数字表法分为观察组和对照组,每组27例.对照组采用单纯针刺治疗,观察组在对照组治疗的基础上接受悬吊运动训练.记录开始治疗前、治疗结束后、以及3个月后患者Oswestry功能障碍指数评分法(ODI)、数字疼痛评分法(NPRS)变化,并比较其差异.结果 与治疗前相比,两组患者治疗后的ODI评分和NPRS评分均有改善(P＜0.05),且治疗组改善程度优于对照组(P＜0.05);3个月后随访所得数据中,对照组ODI评分和NPRS评分较治疗后无明显改善(P＞0.05),而观察组评分则较治疗后改善明显,差异有统计学意义(P＜0.05),说明观察组在维持疗效方面优于对照组.结论 针刺合并悬吊运动训练对慢性非特异性腰痛有较好的远期疗效.     

麦肯基疗法加电针治疗非特异性下腰痛疗效分析

目的观察麦肯基技术加电针治疗非特异性下腰痛的疗效。方法将80例患者随机分为治疗组和对照组各40例,治疗组采用麦肯基技术加电针治疗,对照组只用电针治疗,治疗前后依据VAS视觉模拟量尺进行评估。结果 2组经治疗10次均有明显改善,差异有统计学意义（均P〈0.05）,治疗组优于对照组。结论麦肯基技术加电针在非特异性下腰痛治疗中疗效显著。     

您的腰痛是慢性腰肌劳损吗？

慢性腰肌劳损多见于长期保持坐或立一种姿势工作的人，从临床症状和检查结果就可以确诊。     

A 12-week,randomized, placebo-controlled trial assessing the safety and efficacy of oxymorphone extended release for opioid-naive patients with chronic low back pain

ABSTRACT

Objective: Determine the efficacy and tolerability of oxymorphone extended release (OPANA ER) in opioid-naive patients with moderate to severe chronic low back pain (CLBP).

Design and methods: Patients ≥ 18 years of age were titrated with oxymorphone ER (5- to 10?mg increments every 12?h, every 3–7 days) to a well-tolerated, stabilized dose. Patients were then randomized to continue their oxymorphone ER dose or receive placebo every 12?h for 12 weeks. Oxymorphone immediate release was available every 4–6?h, as needed, for the first 4 days and twice daily thereafter.

Results: Sixty-three percent of patients (205/325) were titrated to a stabilized dose of oxymorphone ER, most (203/205) within 1 month. During titration, 18% discontinued from adverse events (AEs) and 1% from lack of efficacy. For patients completing titration, average pain intensity decreased from 69.4?mm at screening to 22.7?mm (?p < 0.0001). After random­ization, 68% of oxymorphone ER and 47% of placebo patients completed 12 weeks of double-blind treatment. Approximately 8% of patients in each group discontinued because of AEs. Placebo patients discontinued significantly sooner from lack of efficacy than those receiving oxymorphone ER (?p < 0.0001). Pain intensity increased significantly more in the placebo group (least squares [LS] mean change 26.9 ± 2.4 [median 28.0]) than in the oxymorphone ER group (LS mean change 10.0 ± 2.4 [median 2.0]; p < 0.0001). Oxymorphone ER was generally well tolerated without unexpected AEs. Although limitations of a randomized withdrawal study include the potential for unblinding and opioid withdrawal in placebo patients, opioid withdrawal was limited to two patients in the placebo group and one in the oxymorphone ER group.

Conclusions: Stabilized doses of oxymorphone ER were generally safe and effective over a 12?week double-blind treatment period in opioid-naive patients with CLBP.     

成人下腰痛与腰椎前凸的关系

目的探讨腰椎前凸角度与下腰痛的关系。方法测量58例患有下腰痛患者和35例无腰痛者的侧位X线片腰椎前凸角度,进行统计学分析。结果下腰痛患者的腰椎前凸角度小于无腰痛者,差异有统计学意义。结论下腰痛和腰椎前凸的丢失相关。     

经皮射频热凝治疗椎间盘源性下腰痛106例

目的：观察应用经皮射频热凝治疗椎间盘源性下腰痛的临床疗效。方法：应用北京北琪医疗科技有限公司R-2000B射频控温热凝器治疗仪对2009年10月～2011年11月收治的106例椎间盘源性下腰痛患者行经皮射频热凝治疗。结果：疗效评价采用Macneb腰腿痛手术评价标准进行,通过3～12个月的随访,很好70例;好21例;轻度好转10例;差5例。总有效率为95.28%,无效为4.72%。结论：经皮射频热凝是治疗椎间盘源性下腰痛的有效方法。     

肌内效贴联合深部肌肉刺激对战士非特异性下腰痛的疗效研究

目的 观察应用肌内效贴合并深部肌肉刺激(DMS)对战士非特异性下腰痛的临床治疗效果.方法 选取2017年7月至2018年12月在中国人民武装警察部队陕西省总队医院及第四军医大学第一附属医院就诊的非特异性下腰痛战士,共85例纳入本研究.应用随机数字表法,将纳入病人随机分到对照组(42例)和观察组(43例),对照组病人给予...     

Expert opinion on emerging drugs: chronic low back pain

Introduction: It is difficult to overestimate the personal and socioeconomic impact of chronic low back pain (CLBP). It is the leading cause of years lost to disability and poses the highest economic toll among chronic illnesses. Despite the strong need for extensive research efforts, few drugs have consistently demonstrated effectiveness for this condition.

Areas covered: In this review, the epidemiology, rationale for mechanism-based treatment, competitive environment and market trends, and the preclinical and clinical evidence supporting over 15 different classes of analgesic medications studied for CLBP or related pain conditions are discussed. Treatments are divided by drug category, type of CLBP they are likely to treat (e.g., neuropathic or mechanical), and whether they are new formulations of existing treatments, new indications for existing treatments or represent novel mechanisms of action. Databases searched included MEDLINE, Embase, Pharmaprojects and various clinical trial registries.

Expert opinion: Many barriers exist for the development of medications for CLBP including difficulties in identifying pathophysiological mechanisms, biologic resiliency secondary to multiple concurrent pain pathways and off-target and sometimes serious side effects. Nevertheless, the volume and diversity of novel molecular entities has continued to surge and includes possible disease-modifying therapies such as gene and stem cell therapy.     

早期运动疗法对坦克乘员腰痛的康复作用

目的探讨早期运动疗法对坦克乘员腰痛患者的疗效。方法407例坦克乘员腰痛患者随机分为治疗组和对照组,治疗组采用超短波、传统中医按摩和运动疗法,对照组仅采用超短波,传统中医按摩治疗。结果两组经治疗3月后,治疗组的Oswesty积分及疗效明显优于对照组,两组有显著性差异(P<0.01,P<0.05)。结论早期运动疗法对坦克乘员腰痛患者有明显疗效并能有效防止复发。     

针灸治疗腰痛的国内外研究评述

本研究回顾2005年至今国内外针灸治疗腰痛的研究,发现国内外研究的侧重点不同。国内研究侧重于某个穴位或某种针刺方法治疗腰痛效果,而国外学者研究的重点是针刺是否有效。通过对国内外研究的分析,提出增加样本量、明确纳入标准、采用适当和充足的针刺治疗方法、延长随访时间等建议,希望对今后的针灸治疗腰痛研究有所帮助。     

针刀治疗慢性下腰痛患者的临床疗效

目的：探讨针刀治疗慢性下腰痛的应用及疗效。方法：将147例慢性下腰痛患者分为两组。治疗组72例,依据关键性治疗点,采用针刀治疗,1次/7 d,3次为1个疗程,共2个疗程。对照组75例采用电针联合特定电磁波谱治疗,1次/2 d,10次为1个疗程,共2个疗程。对两组疗效进行比较。结果：治疗组治疗前与治疗近期和远期（4个月）的VAS差值分别为（4.14＆#177;0.98）分和（3.56＆#177;1.06）分,对照组则分别为（3.12＆#177;1.34）分和（2.47＆#177;1.28）分,组间差异有统计学意义（P〈0.01）。结论：针刀治疗慢性下腰痛有较好的临床疗效,明显优于电针联合特定电磁波谱治疗。     

Escitalopram 20 mg versus duloxetine 60 mg for the treatment of chronic low back pain

Background: Escitalopram has never been demonstrated to be useful in the treatment of chronic low back pain (CLBP), while duloxetine has demonstrated analgesic effect in chronic pain states. The aim of this trial was to examine the efficacy of escitalopram for the treatment of CLBP compared with duloxetine. Methods: A total of 85 adult patients with non-radicular CLBP entered a 13-week randomized study comparing escitalopram 20 mg with duloxetine 60 mg once daily. The primary measure was comparison of the two drugs on reduction in weekly mean 24-h average pain. Secondary measures included Clinical Global Impressions of Severity (CGI-S) and the 36-item Short-Form Health Survey (SF-36). Results: Eighty patients (n = 39 escitalopram, n = 41 duloxetine) completed the study. No significant differences existed between escitalopram and duloxetine on reduction in weekly mean 24-h average pain at end point. Both escitalopram and duloxetine demonstrated significant improvement on CGI-S and SF-36. Conclusions: Escitalopram and duloxetine demonstrated efficacy and safety in the management of CLBP, with no significant differences. Results of this study should be replicated in a larger sample of patients.