脉冲电磁场对卵巢切除大鼠骨质疏松的预防作用

目的：观察脉冲电磁场(PEMFs)对去势后大鼠骨质疏松症的预防作用。方法：40只雌性SD大鼠随机分为5组：去势组、对照组和3个PEMFs治疗组。治疗组磁场强度分别为2、4和8G，每天治疗6h，共12周。术后12周处死动物，测定血清骨钙素、骨密度、生物力学参数、骨形态计量学分析。结果：PEMFs治疗可以提高骨密度、骨小梁面积百分比、骨小梁宽度、骨小梁数目和股骨生物力学性能。PEMFs还可以降低去势后升高的血清骨钙素。结论：PEMFs治疗可以预防大鼠卵巢切除引起的骨质疏松。     

云克联合低频脉冲电磁场治疗骨质疏松症的临床观察

目的探讨云克联合低频脉冲电磁场(pulsed electromagnetic fields,PEMFs)在骨质疏松症(OP)治疗中对缓解患者疼痛症状及提高骨密度的作用。方法入选的124例原发性骨质疏松患者,采用前瞻对照配对分组,分为4组:A组(n=31),给予云克注射液静推;B组(n=31),给予PEMFs治疗;C组(n=31),给予云克+PEMFs治疗;对照组D组(n=31),给予阿仑膦酸钠(70mg/片),晨起空腹每周一片口服。A、B、C三组均20d一疗程,行3个疗程治疗。于治疗前、治疗后3个月及6个月观察患者疼痛症状的改变情况;测定第四腰椎(L4)及股骨颈骨密度(BMD),行统计学分析。结果①A、B、C、D四组治疗3月后疼痛改善效果的有效率分别为67.7%、74.2%、93.5%、35.5%;治疗6月后疼痛症状缓解的有效率分别为80.6%、77.4%、96.8%、61.3%。②C组治疗3月、6月后,L4及股骨颈的BMD增加明显,与A组、B组、D相比显著性显著(P<0.05)。结论云克联合PEMFs能在短期内迅速有效的缓解骨质疏松症患者的疼痛症状,提高患者的骨密度。     

脉冲电磁场对卵巢切除大鼠骨质疏松的预防作用

目的:观察脉冲电磁场(PEMFs)对去势后大鼠骨质疏松症的预防作用.方法:40只雌性SD大鼠随机分为5组:去势组、对照组和3个PEMFs治疗组.治疗组磁场强度分别为2、4和8G,每天治疗6h,共12周.术后12周处死动物,测定血清骨钙素、骨密度、生物力学参数、骨形态计量学分析.结果:PEMFs治疗可以提高骨密度、骨小梁面积百分比、骨小梁宽度、骨小梁数目和股骨生物力学性能.PEMFs还可以降低去势后升高的血清骨钙素.结论:PEMFs治疗可以预防大鼠卵巢切除引起的骨质疏松.     

利塞膦酸钠联合脉冲电磁场治疗去势大鼠骨质疏松的 实验研究

目的观察利塞膦酸钠联合脉冲电磁场对去势大鼠骨质疏松的疗效。方法将32只雌性SD大鼠(250±20)g随机分成4组:正常生长组(Sham)、去卵巢模型组(OVX)、利塞膦酸钠治疗组(RIS)和利塞膦酸钠联合骨质疏松治疗仪治疗组(RIS+PEMFs),每组8只。后三组大鼠行双侧卵巢切除术。去势后12 w RIS组给予0.1 mg·kg-1·d-1利塞膦酸钠灌胃治疗,RIS+PEMFs组给予0.1 mg·kg-1·d-1利塞膦酸钠灌胃和1h·d-1脉冲电磁场治疗,Sham、OVX组每天给予等量生理盐水灌胃。去势后12 w、灌胃治疗4 w、8 w、12 w后四组大鼠均用双能X线吸收法骨密度仪测量全身骨密度(BMD),治疗12 w后进行血生化检测、骨CT值测量和骨组织形态学观察。结果去势后12w后三组BMD与Sham组比较均显著降低(P0.01),大鼠骨质疏松模型确立;灌胃治疗12 w后,RIS、RIS+PEMFs两组较OVX组BMD(P0.01)、骨CT值(P0.01)均较高,且RIS+PEMFs组BMD、骨CT值均比RIS组高(P0.01);RIS组血清Ca、ALP浓度均较RIS+PEMFs、Sham组高(P0.05),且RIS+PEMFs组血清ALP浓度较Sham组相比差异无统计学意义(P0.05);股骨颈病理形态学观察中RIS+PEMFs组的骨小梁形态较完整,较接近Sham组水平。结论去势后12 w可建立大鼠骨质疏松模型;利塞膦酸钠对去势所致骨质疏松大鼠有治疗作用,其与脉冲电磁场联合的治疗效果更为显著。     

低频脉冲电磁场治疗骨质疏松症的短期疗效观察

目的观察低频脉冲电磁场(PEMFs)治疗骨质疏松的临床疗效。方法将100例病人随机分为治疗组、对照1组和对照2组,对照1组单纯采用药物治疗,对照2组单纯采用XT-2000B骨质疏松治疗仪(天津市希统电子设备有限公司生产)治疗,治疗组采用对照1组和对照2组相结合的方法治疗。比较三组治疗前后的疼痛视觉模拟评分(VAS)、骨密度(BMD)变化和临床疗效。结果三组治疗后VAS评分及骨密度(BMD)变化较治疗前明显改善,有统计学差异,P0.01,且治疗组疗效更优于对照1、2组单纯治疗,P0.05。结论低频脉冲电磁场联合药物治疗骨质疏松症效果显著,值得推广。     

脉冲电磁场辅助治疗原发性骨质疏松症疗效分析

目的观察脉冲电磁场对原发性骨质疏松症患者骨痛,日常生活活动及骨密度的影响。方法收集原发性骨质疏松症患者120例,其中男性50例,女性70例。年龄50~88岁,平均68±15岁。随机分为2组,治疗组60例,对照组60例,治疗组采用HX2010型脉冲电磁场骨质疏松治疗系统联合钙剂,维生素D及双膦酸盐治疗,对照组采用钙剂,维生素D及双膦酸盐治疗,连续治疗24周。治疗前后分别测定患者VAS疼痛评分,ADL日常生活活动评分及骨密度,并进行统计学分析。结果治疗前两组VAS疼痛评分无统计学差异,治疗后4周治疗组VAS评分下降,与对照组相比有显著性差异;治疗前两组ADL评分无差异,治疗后4周ADL评分升高,与对照组相比有显著性差异;治疗前两组骨密度无差异,治疗后24周骨密度明显升高,与对照组相比有显著性差异。结论脉冲电磁场可缓解原发性骨质疏松症的骨痛,效果较为显著,能够明显改善患者的日常生活活动能力,可提高骨密度。     

应用原子力显微镜观察脉冲电磁场对大鼠骨质疏松的治疗后骨组织表面超微结构的变化

目的观察实验性大鼠骨质疏松模型股骨颈超微结构的变化特点,并探讨利用原子力显微镜观察的可行性。方法清洁级雌性SD大鼠(鼠龄3个月)60只,体重(200±20)g。随机将其分成对照组(Sham组)、去卵巢组(OVX组)、阿伦膦酸钠治疗组(ALN组)、PEMFs治疗组(PEMFs组),每组大鼠15只。除Sham组外,对其他各组行双侧卵巢切除术,造模后第30天开始分组干预。ALN组给予阿伦膦酸钠灌胃,PEMFs组给予脉冲电磁场治疗。Sham组和OVX组手术后正常喂养,不予任何处理。治疗后30d取大鼠股骨头切片,通过AFM观察大鼠股骨颈的表面超微结构。结果 Sham组原子力显微镜扫描可显示骨组织的骨陷窝、骨小管及其表面的钙磷晶体沉积,骨组织表面粗糙度为(2.59±0.645)μm。OVX组可见骨陷窝的大小变化及其钙磷晶体的排列紊乱,模型组骨组织表面粗糙度明显高于对照组(P0.01),提示造模成功;ALN组表面粗糙度明显低于OVX组(P0.05),PEMFs组的表面粗糙度与OVX组相比,有明显降低,差异具有统计学意义(P0.05);而PEMFs组与ALN组比较,其表面粗糙度无明显差异(P0.05)。结论通过原子力显微镜能清晰观察到脉冲电磁场对大鼠骨质疏松治疗后的骨组织表面超微结构的变化,其疗效与阿仑膦酸钠相当,为脉冲电磁场治疗骨质疏松提供了一定的理论依据。     

鲑鱼降钙素鼻喷剂结合脉冲电磁场治疗仪治疗骨质疏松性腰痛疗效观察

目的探讨和分析鲑鱼降钙素鼻喷剂结合脉冲电磁场治疗仪治疗骨质疏松性腰痛效果。方法选取本院2012年1月至2013年12月期间所收治的78例骨质疏松性腰痛患者作为研究对象。按照随机数字表法将其分组为对照组和治疗组。对照组：采用鲑鱼降钙素鼻喷剂治疗，200IU／d；治疗组：采用鲑鱼降钙素鼻喷剂，200IU／d＋脉冲电磁场治疗仪治疗。观察两组患者治疗前、后疼痛评分情况及不良反应。结果治疗前，治疗组患者疼痛评分为（6．75±1．12）分与对照组（6．74±1．15）分比较（t=0．159，P〉0．05）。治疗后，治疗组患者疼痛评分为（1．39±0．41）分，对照组为（3.58±0．49）分，两组患者均出现明显下降，但治疗组优于对照组（t=2．432，P〈0．05）。此外，治疗组不良反应率为2．56％（1／39）明显低于对照组10．26％（4／39）（P〈0．05）。结论骨质疏松性腰痛患者采用鲑鱼降钙素鼻喷剂结合脉冲电磁场治疗仪治疗，其可有效缓解患者疼痛，且不良反应少，值得推广与应用。     

脉冲磁场对成骨细胞和破骨细胞的影响

近年来,脉冲磁场(PEMFs,pulsed electromagnetic fields)在骨质疏松治疗中已得到广泛的关注。PEMFs对参与骨重建的成骨细胞和破骨细胞都有显著影响。本文从PEMFs及其对骨质疏松的影响、PEMFs对成骨细胞和破骨细胞的影响以及可能机制方面加以综述。     

骨质疏松症的物理治疗研究进展

骨质疏松症是一种中老年人易患的骨骼性疾病,骨质疏松的治疗方法种类繁多,主要包括药物治疗和物理治疗。药物治疗效果确切,但存在治疗周期长,患者依从性差、费用较高及药物不良反应等问题。相比其他几种方法,物理疗法具有副作用小的优点。为了更全面阐释物理治疗方法的相关研究工作,本文主要从物理治疗的角度对脉冲电磁场(PEMFs)、高压氧、超声波、电针、体外冲击波、振动以及运动疗法对骨质疏松的治疗作用进行探讨,分析它们的作用机制、临床应用研究新进展,以指导临床更合理地选择治疗方法,找出各自的优势,扬长避短,以达到更好的治疗效果。     

Discogenic pain in acute nonspecific low-back pain

Acute nonspecific low-back pain is characterized by the sudden onset and severe unendurable low-back pain without radicular pain or neurological deficit in the lower extremities. The study was carried out using 55 patients who visited our hospital for acute nonspecific low-back pain, who exhibited degeneration on T2-weighted MR images, and underwent intradiscal injection of local anesthetics,steroid and contrast medium. Intervertebral disc sites with an obvious enhanced region in the posterior annulus of the disc on enhanced T1-weghted MR images was selected for intradiscal injection. When no enhaced region was detected, the most severely degenerated disc on T2-weighted MR images was selected. Acute nonspecific low-back pain with an improvement rate of 70% or higher 5min after injection was judged to be discogenic. The clinical characteristics and pathogenesis of discogenic acute nonspecific low-back pain were investigated. Forty of the 55 patients (73%) had discogenic acute nonspecific low-back pain. As for the characteristics of patients, the mean age was 37 years, and onset occurred upon casual daily movements in 18 patients (45%). Nineteen patients (48%) had bilateral low-back pain, and 29 patients (73%) had no tenderness in the paravertebral muscles. On plain X-ray radiograms, degeneration of the disc was normal or mild in 36 patients(91%). On the discograms, a radial tear extending to the posterior annulus was noted in all patients, but epidural leakage was seen only in six patients (15%). The degree of disc degeneration on T2-weighted MR images (Gibsons classification) was grade 3 in 30 patients (75%). Gadolinium-DTPA enhanced T1-weighted MR images showed an obvious enhanced region in the posterior annulus of the intervertebral disc in 19 patients (48%). As for the clinical characteristics of discogenic acute nonspecific low-back pain, the relatively young adult patients had no tenderness in the paravertebral muscles, and showed moderately degererated intervertebral discs. The pathogenesis of discogenic acute nonspecific low-back pain is mostly considered to be a re-rupture in an asymptomatic ruputured region in the posterior annulus, repaired by granulation tissue, in a moderately degenerated intervertebral disc with a radial tear.     

Myofascial pain in patients with postthoracotomy pain syndrome

OBJECTIVE: Postthoracotomy pain syndrome is generally considered to be neuropathic pain due to intercostal nerve injury. However, nonneuropathic pain can also occur following thoracic surgery. We present a series of cases with postthoracotomy pain syndrome in which myofascial pain was thought to be a causative component of postthoracotomy pain syndrome. CASE REPORT: Twenty-seven patients (17 men and 10 women) were treated with trigger point injections, intercostal nerve blocks, and/or epidural blocks. Clinical criteria were used to diagnose the myofascial pain. A visual analogue scale was used, and sensory disturbances were recorded before and after treatment. A trigger point in a taut muscular band within the scapular region, which we diagnosed as myofascial pain, was observed in 67% of the patients. The existence of this trigger point significantly increased the rate of success for the treatments. CONCLUSIONS: Postthoracotomy pain may result, at least in part, from a nonneuropathic origin (myofascial pain). It is recommended that each patient be examined in detail to determine whether there is a trigger point in a taut muscular band within the scapular region. If found, this point is suggested as a good area for anesthetic injection.     

Improvement in physician pain perception with using pain scales

Background and aims

Acute pain is the most common reason for visits to the emergency department (ED). The underuse of analgesics occurs in a large proportion of ED patients. The physician’s accurate assessment of patients’ pain is a key element to improved pain management. The purpose of this study was to assess if physicians’ perception of pain can improve with looking at the pain score of the patient marked on VAS.

Study design

This was a single-center, cross-sectional prospective observational study, that took place in an academic ED.

Methods

All adult ED patients presenting with a painful condition were enrolled to the study. In the first phase of the study, the physician rated his/her opinion about the patient’s pain on a 100 mm VAS, in a blinded fashion to the patient’s pain score. In the second phase, the physician rated his/her opinion after looking at the pain scale marked by patient.

Results

587 patients (295, in first and 292, in second phase) were enrolled. The groups were not statistically different for demographic data. The physician’s perception of pain was lower than the patient’s pain score at both phases of the study. Insight of the patient’s pain score on VAS increased the physician’s pain perception significantly (p?=?0.03). During the second phase, physicians ordered significantly more analgesic medications to the patients (p?=?0.03).

Conclusion

The physicians’ perception of the patients’ pain differs significantly from the pain that the patient is experiencing. VAS helps to bring the physicians impression of pain perception to the level of pain that the patient is actually experiencing and resulted in ordering more analgesics to the patients. Implementation of a pain assessment tool can raise the physician’s perception of the pain and may improve pain management practices and patient satisfaction.