三金片辅助治疗慢性前列腺炎的疗效观察

目的 了解三金片在辅助治疗慢性前列腺炎的临床疗效.方法 将120例前列腺炎患者随机分为4组:三金片组30例,给予三金片口服治疗;舍尼通组30例,给予舍尼通治疗;联合治疗组30例,给予三金片及舍尼通联合治疗;对照组30例,给予前列康及氟哌酸治疗,比较分析四组症状缓解情况.结果 三金片组总有效率70.00%,联合治疗组总有效率86.67%,对照组总有效率40.00%.单独使用或联合运用三金片组与对照组、舍尼通组相比,总有效率明显升高,差异有统计学意义(x2=4.27,p＜o.05;x2=6.53,p＜0.01).结论 三金片辅助治疗慢性前列腺炎有助于改善患者的症状.     

微生态制剂联合氟哌噻吨美利曲辛治疗肠易激综合征疗效分析

目的探讨微生态制剂联合氟哌噻吨美利曲辛治疗肠易激综合征的疗效。方法 82例肠易激综合征患者随机分成对照组和治疗组,治疗组采用微生态制剂和氟哌噻吨美利曲辛片;对照组单用氟哌噻吨美利曲辛片,疗程均为4周。结果治疗组总有效率为90.5%;对照组总有效率为80.0%,两组比较差异有统计学意义（P〈0.05）,均无不良反应发生。结论微生态制剂联合氟哌噻吨美利曲辛是治疗肠易激综合征的有效治疗方案。     

口服氨酚羟考酮片用于人工流产的临床效果观察

目的观察氨酚羟考酮片(泰勒宁)口服给药在人工流产(人流)中的镇痛效果、宫颈松弛度和不良反应。方法选择自愿接受人流的健康未产妇150例,采用双盲随机对照试验分为三组,每组50例,Ⅰ组口服氨酚羟考酮片,II组口服氯芬待因复方片,III组为对照组(口服维生素C),三组均1 h后行人流术。按世界卫生组织疼痛分级标准观察镇痛效果,宫颈松弛度,术毕记录不良反应。结果Ⅰ组和II组镇痛效果比较有显著性差异(P<0.05),Ⅰ组I、I组与III组比较有显著性差异(P<0.05)。Ⅰ组宫颈松弛,与II组和III组比较有显著性差异(P<0.05)。III组不良反应明显高于其他两组(P<0.05)。结论人流术前口服氨酚羟考酮片镇痛效果确切、方法简便、无创、宫颈松弛作用良好、不良反应少,值得推广应用。     

三黄膏联合地奥司明片治疗血栓性外痔45例疗效观察

目的:观察中药制剂三黄膏联合地奥司明片治疗血栓性外痔的临床疗效。方法:将2021年6月至2022年6月,本院治疗的90例血栓性外痔患者随机分为治疗组和对照组,各45例。治疗组采用三黄膏外敷联合地奥司明片口服治疗,对照组采用肛泰软膏外敷联合地奥司明片口服治疗。观察比较2组疗效、肛门坠胀疼痛、痔核大小及生活质量等指标。结果:治疗组临床总有效率为95.6%,高于对照组的68.9%(P<0.05),肛门坠胀疼痛,痔核大小及生活质量评分均明显优于对照组(P<0.05)。结论:三黄膏联合地奥司明片治疗血栓性外痔引起的肛门坠胀疼痛有较好的效果,可基本消除血栓,减轻患者痛苦,避免手术,有较高的临床应用价值。     

地佐辛联合丙泊酚用于假体隆乳手术镇痛效果观察

目的:探讨地佐辛联合丙泊酚用于假体隆乳手术的镇痛效果。方法:选取笔者医院行假体隆乳手术的患者60例,随机分为对照组和观察组,每组30例。对照组予以瑞芬太尼联合丙泊酚麻醉,观察组予以地佐辛联合丙泊酚麻醉,麻醉后均行假体隆乳术。观察并比较两组患者麻醉效果、术后疼痛、镇静及并发症发生情况。结果:观察组麻醉总有效率为96.67%,显著高于对照组的73.33%,差异具有统计学意义(P<0.05)。术后6h、12h、24h,观察组患者VAS评分及Ramsay评分均显著低于对照组,差异具有统计学意义(P<0.05)。观察组术后并发症总发生率为16.67%,显著低于对照组的70.00%,差异具有统计学意义(P<0.05)。结论:地佐辛联合丙泊酚能够达到更满意的麻醉效果,避免患者出现麻醉过度,降低患者术后并发症的发生率及疼痛情况。     

疏肝益肾汤治疗绝经后骨质疏松的临床疗效观察

目的观察疏肝益肾汤治疗绝经后骨质疏松的疗效。方法 60例随机分2组,中药治疗组30例,给予自拟疏肝益肾汤煎服;西药对照组30例,给予阿仑膦酸钠片、阿法D3胶丸及钙尔奇D口服。结果中药组总有效率90%,疼痛缓解率96.7%;对照组总有效率73.3%,疼痛缓解率83.3%。两组对骨矿物质含量有一定改善,不具统计学意义。结论疏肝益肾汤治疗绝经后骨质疏松有显著疗效。     

Q开关Nd:YAG 1064nm激光联合口服氨甲环酸片治疗黄褐斑疗效观察

目的:观察Q开关Nd:YAG 1064nm激光联合口服氨甲环酸片治疗黄褐斑的临床疗效。方法:2011年7月～2012年10月,选取门诊就诊的黄褐斑患者30例,随机分为治疗组和对照组,每组各15例。治疗组:接受Q开关Nd:YAG 1064nm激光联合口服氨甲环酸片治疗;对照组:仅接受Q开关Nd:YAG激光治疗。每次治疗后都辅以维C导入及胶原蛋白修复面膜外敷,每2周治疗1次,10次为1个疗程;治疗组同时口服氨甲环酸片,每日2次,每次250mg,连服半年。1个疗程结束即评判疗效,治疗期间及1个疗程结束后3个月观察疗效及不良反应。结果:治疗组总有效率为93.3%,对照组为73.4%,两组疗效比较,差异均有统计学意义(P<0.05),未见明显不良反应。结论:Q开关Nd:YAG 1064nm激光联合口服氨甲环酸片治疗黄褐斑优于单用Q开关Nd:YAG激光治疗,且不良反应少,适合临床应用。     

腹腔镜手术后应用米非司酮治疗子宫内膜异位症

目的探讨腹腔镜手术后应用米非司酮治疗子宫内膜异位症的临床疗效。方法将68例子宫内膜异位症患者随机分为2组:经腹腔镜手术后应用米非司酮治疗组(治疗组)和单纯腹腔镜组(对照组)各34例,对2组的有效率和复发率进行对比。结果治疗组总有效率为88.2%,复发率为8.8%。对照组的总有效率为61.8%,复发率为20.6%。治疗组的总有效率明显高于对照组,复发率明显低于对照组。2组相比较,差异有统计学意义(P(0.05)。结论米非司酮用于子宫内膜异位症手术后巩固治疗,疗效显著,术后复发率低且不良反应小,值得临床推广。     

中药治疗宫颈癌放射性直肠炎临床观察

目的:观察中药灌肠治疗宫颈癌放射性直肠炎的临床效果.方法:将62例宫颈癌放射性直肠炎患者随机分成治疗组和对照组,治疗组予中药保留灌肠,对照组予温血液透析用水、利多卡因、黄连素片研末灌肠,云南白药、安络血、维生素B6口服,对照两组的治疗效果.结果:经过1个疗程治疗后,治疗组总有效率为93.55%,对照组总有效率为74.19%,两组总有效率比较差异有显著性意义(P＜0.05).结论:中药治疗宫颈癌放射性直肠炎可以提高临床效果.     

布托啡诺超前镇痛用于隆乳术后镇痛的临床效果观察

目的:评价术前给予布托啡诺超前镇痛用于隆乳手术后患者静脉自控镇痛的临床效果。方法:于2013-8—2014-8间,选择ASA分级I~II级,静脉全麻下行硅胶假体隆乳需术后镇痛患者120例,随机分为术前给药组(A组)和对照组(B组)各60例;A组术前30min给予酒石酸布托啡诺20μg/kg静脉滴注,B组术前给于等量生理盐水静脉滴注。结果:A组患者手术后48h内各观察点的VAS评分均明显低于B组(P均0.05)。A组患者术后48h内PICA按压总次数、镇痛药用量、镇痛期间总不良反应发生率,均明显少于B组(P0.05)。结论:术前给予布托啡诺行超前镇痛增强自控镇痛的效果,减少镇痛药用量及不良反应发生率,提高镇痛的质量与安全性。     

Etoricoxib pre-medication combined with intra-operative subacromial block for pain after arthroscopic acromioplasty

BACKGROUND: Arthroscopic shoulder surgery under general anaesthesia is often associated with severe post-operative pain which may delay discharge and the start of rehabilitation. Etoricoxib is a new cyclo-oxygenase-2 inhibitor with a long duration of action and a lack of a deteriorating effect on platelet function. Therefore, the effect of pre-operative etoricoxib combined with local anaesthesia on post-operative pain and the discharge profile was studied in day-surgery patients undergoing arthroscopic shoulder surgery under general anaesthesia. METHODS: Thirty ASA I-II adult patients scheduled for arthroscopic shoulder surgery were enrolled in this randomized prospective study. Half of the patients received etoricoxib 120 mg orally (group E) and the other half received placebo tablet orally (group C) 1 h before surgery. All patients received 20 ml of bupivacaine 2.5 mg/ml solution with epinephrine at the start of surgery and 20 ml of bupivacaine 5.0 mg/ml solution with epinephrine at the end of surgery into the subacromial space. All patients received general anaesthesia with spontaneous breathing via a laryngeal mask. In the post-anaesthesia care unit, pain was assessed on a scale from 0 to 10 (visual analogue scale, VAS) and intravenous fentanyl 25 microg was administered as scheduled (VAS > or = 3). In the day-surgery unit and at home, the analgesic was a tablet containing paracetamol 500 mg + codeine 30 mg (VAS > or = 3), as needed. RESULTS: Patients in group E reported lower post-operative pain scores at 30, 60, 120 (P < 0.01) and 180 min (P < 0.05) after surgery, and longer time to first analgesic use (P < 0.05). Patients in group E required less fentanyl (P < 0.05) and were discharged more quickly (P < 0.05) than patients in group C. Patients in group E had a lower cumulative consumption of paracetamol + codeine tablets (P < 0.05) and lower pain scores (P < 0.05) during 7 days at home than patients in group C. Adverse events were rare in both groups. CONCLUSION: In patients having arthroscopic shoulder surgery under general anaesthesia combined with intra-operative subacromial regional analgesia, etoricoxib 120 mg reduced immediate and late post-operative pain, and facilitated early post-operative discharge.     

Effects of somatostatin peridurally administered in the treatment of postoperative pain

Somatostatin (SMS), a hormone extensively found within the CNS, has shown to have a powerful analgesic effects administered either via the epidural or subdural route. The aim of the present study was to evaluate the efficacy of SMS administered epidurally compared with placebo, for the treatment of post-operative pain in patients receiving epidural anaesthesia for surgery. Of the 86 patients observed, 58 entered the study and were randomized to receive either SMS or placebo in a double blind fashion. They were also divided into 3 groups according to the site of the operation (group A: procto-anal; group B: inguino-crural; group C: other), 28 of them receiving SMS and 30 placebo. The post-operative pain evaluation was obtained via VAS at the moment of request of treatment (basal) and after an hour. Twenty-eight of the 86 observed (32.5%) didn't complain of pain that necessitated analgesic treatment. A statistically significant difference in reduction of intensity of pain was observed in the somatostatin treated group (6.42 +/- 0.37 vs 3.64 +/- 0.59) and in the somatostatin treated subgroup A and B (6.4 +/- 0.4 vs 3.8 +/- 0.7 and 6.3 +/- 0.8 vs 3.0 +/- 0.6 respectively). No adverse reactions of any kind were observed. SMS has shown to be a safe and effective drug, reducing by 50% the intensity of pain in patients undergone procto-anal or inguino-crural surgery.     

Intrathecal buprenorphine for postoperative analgesia in the elderly patient

Ninety patients aged 56-85 years scheduled for suprapubic prostatectomy, randomly received intrathecally either bupivacaine 30 mg (group A, n = 30), bupivacaine 30 mg plus buprenorphine 0.03 mg (group B, n = 30) or bupivacaine 30 mg plus buprenorphine 0.045 mg (group C, n = 30). Prolonged postoperative analgesia, minimal disturbance of consciousness and comfortable breathing were common to the groups that received buprenorphine. The higher concentration of buprenorphine improved the quality and duration of analgesia. The only side effects found in the buprenorphine groups were nausea and vomiting in 11 and 14 patients, respectively, in groups B and C. Our study shows that buprenorphine is an effective analgesic, suitable for the management of postoperative pain in elderly patients.     

酒石酸布托啡诺在隆乳术后镇痛中的应用

目的:观察酒石酸布托啡诺用于隆乳术后镇痛的效果。方法:选择术后短期留院观察,行硅胶假体隆乳手术的患者90例,ASA I～I I级。静脉复合气管插管麻醉手术后,随机将要求镇痛的患者分为芬太尼自控镇痛F组、酒石酸布托啡诺自控镇痛B组,开始自控静脉镇痛;拒绝实施术后镇痛的患者作为对照C组,观察患者术后24h内镇痛评分及不良反应的发生情况。结果:酒石酸布托啡诺自控镇痛B组与芬太尼自控镇痛F组镇痛效果显著。B组患者术后疼痛评分明显低于对照组;不良反应发生率依次为:B组相似文献   

The effect of preoperative intravenous use of tenoxicam: a prospective, double-blind, placebo-controlled study.

In this study, we aimed to investigate the postoperative pain relief effect of preoperative tenoxicam usage in patients who undergo elective laparoscopic cholecystectomy or groin hernia repair. Eighty patients undergoing laparoscopic cholecystectomy or groin hernia repair procedures were randomized to receive either physiologic serum at 100 mL (group I, n = 40) or 20 mg iv tenoxicam (group II, n = 40) immediately before induction. Postoperative analgesic requirement, peroperative side effects and complications of drugs, operating time, post-operative mobilization time and pain score, hospitalization time, and patient pleasure were recorded. Postoperative pain was assessed by the visual analogue scale (VAS) on the recovery unit (RU), at 4, 8, and 24 h and every day at the same times in the morning. The RU median VAS score was also not different when Group 1 was compared with Group 2 (p = .97). However, the postoperative 4-h and 8-h median VAS score was significantly less (p = .01 and p = .03, respectively); first postoperative mobilization time was earlier in group 2 (p = .32). The median pain score and intramuscular analgesic requirement of patients were also reduced in Group 2 in postoperative day 1 (p = .015). The median duration of intramuscular analgesic requirement and total amount of intramuscular analgesic used in patients were also significantly less in Group 2 (p = .0001 and p = .0001, respectively). Thus, this study showed that preoperative use of iv tenoxicam is safe, simple, and effective for postoperative pain relief after laparoscopic cholecystectomy or inguinal hernia repair.     

Analgesic and anti-inflammatory efficacy of tenoxicam and diclofenac sodium after third molar surgery.

Tenoxicam and diclofenac sodium were compared with each other for analgesic efficacy following removal of third molars under general anesthesia. Thirty-five healthy patients between the ages of 18 and 28 yr were randomly allocated to two groups to participate in this study. Patients in Group A (n = 17) received a single intravenous injection of tenoxicam 40 mg at induction of anesthesia, followed by a 20-mg tablet given in the evening of the day of the operation and thereafter, one 20-mg tablet daily from days 2 to 7. Group B (n = 18) received a single intramuscular injection of diclofenac sodium 75 mg at induction of anesthesia, followed by a 50-mg tablet 4 to 6 hr after the operation and again, between 2100 hr and 2200 hr the same day. Thereafter, a 50-mg tablet was taken 3 times daily for the next 6 days. Pain was measured hourly for the first 4 hr postoperatively, then at 21 hr, and thereafter in the morning and the evenings on days 2 to 7. The highest pain scores were obtained 1 hr postoperatively for both trial groups. At 1 and 2 hr postoperatively, no statistical significant differences in pain scores could be shown for both groups. However, at 3 and 4 hr postoperatively, patients in the tenoxicam group experienced significantly (P < or = 0.05) less pain than those in the diclofenac sodium group. On the evening of the third postoperative day, the tenoxicam group of patients experienced significantly less pain (P < or = 0.05) than those in the diclofenac sodium group. This was again the case on the morning of the fourth postoperative day. On the fifth, sixth, and seventh postoperative days, the average pain scores for patients in the tenoxicam group were statistically significantly lower, both mornings and evenings, than those in the diclofenac sodium group of patients (P = 0.05).     

Analgesia during extracorporeal shockwave lithotripsy: fentanyl citrate versus parecoxib sodium

BACKGROUND AND PURPOSE: Shockwave-induced pain may become an important issue during extracorporeal shockwave lithotripsy (SWL), although the new generation of lithotriptors generally produces less pain than previous models. The aim of the study was to compare the analgesic effect of a cyclooxygenase-2-specific inhibitor (parecoxib sodium) with that of our standard method of analgesia (fentanyl citrate) in patients who needed pain relief when undergoing SWL. PATIENTS AND METHODS: Fifty-eight patients who were undergoing SWL for renal calculi were randomized to receive intravenously either fentanyl citrate (group A, n = 30) or parecoxib sodium (group B, n = 28) when they felt that their pain during the session became intolerable. Lithotripsy was recommenced 10 minutes after administration of analgesia. The severity of pain before and after administration of the analgesic regimens was evaluated using a five-level verbal scale. The effectiveness of each drug was evaluated with respect to degree of pain relief and ensuing tolerance of the procedure to completion, as well as the need for supplementary analgesia (half the standard dose of fentanyl citrate). RESULTS: The patients in the two groups were comparable with regard to age, sex, body mass index, and stone size. There was no statistically significant difference in the maximum energy level achieved as well as in the total number of shock waves given in the two groups. Administration of fentanyl citrate resulted in alleviation of pain and completion of SWL in 27 patients (90%), whereas parecoxib sodium was effective in five patients (17.8%) (P < 0.01). The remaining 23 patients in group B received supplementary analgesia, and 22 completed the lithotripsy session. CONCLUSIONS: Parecoxib sodium was not as effective as fentanyl citrate in alleviating pain during SWL. Its use, however, may lower the dose of opioid-based analgesia in this group of patients.     

P-糖蛋白表达对晚期癌痛病人吗啡或丁丙诺啡镇痛效果的影响

目的 评价P-糖蛋白(P-gp)表达对晚期癌痛病人吗啡或丁丙诺啡镇痛效果的影响.方法 晚期癌痛病人150例,其中50例肿瘤组织P-gp表达阴性病人随机分为2组(n=25):M1组和B1组,100例肿瘤组织P-gp表达阳性病人随机分为4组(n=25):M2组、M3组、B2组和B3组.各组静脉注射负荷量后进行PCIA,M1组、M2组和M3组负荷量为吗啡2.5 mg,B1组、B2组和B3组负荷量为丁丙诺啡0.15 mg,各组PCIA时药物配方分别为:M1组和M2组吗啡35 mg+氟哌利多5mg,M3组吗啡55 mg+氟哌利多5 mg;B1组和B2组丁丙诺啡0.9 mg+氟哌利多5 mg,B3组丁丙诺啡1.5 mg+氟哌利多5 mg,所用药物均用生理盐水稀释至100 ml,背景输注速率2 ml/h,PCA量0.5 ml,锁定时间15 min.分别于镇痛开始时、4、12、24、48 h时进行VAS评分,分别于镇痛4、12、24、48 h时采集静脉血样,检测血药浓度.结果 M1组和M3组VAS评分低于M2组,M3组血药浓度高于M1组和M2组(P＜0.05);B1组和B3组VAS评分低于B2组,B3组血药浓度高于B1组和B2组(P＜0.05);M1组与M2组间及B1组与B2组比较血药浓度差异无统计学意义(P＞0.05).结论 P-gp表达阳性可减弱晚期癌痛病人吗啡或丁丙诺啡的镇痛效果.     

Effect of low-dose intravenous ketamine in postoperative analgesia for hysterectomy and adnexectomy

OBJECTIVE: To evaluate the efficacy of low dose ketamine (0.15 mg/Kg i.v.) as a pre-emptive pain relief after general anesthesia. METHOD: Sixty-nine gynecological surgery patients were enrolled in this prospective, double-blind study. All received total intravenous anesthesia and were randomized to group A (n = 23) to receive preoperative ketamine, to group B (n = 23) to receive postoperative ketamine or to group C (n = 23) to receive placebo. A patient-controlled anesthesia device with morphine and ketorolac was used to provide postoperative pain relief. We evaluated the time taken to resume spontaneous breathing and to administer the first analgesic dose; the pain score on a visual analogue scale at rest at 1, 6, 24, 48 h and on the fifth day, and upon movement on the first and fifth days; and morphine consumption at 6, 24 and 48 h. RESULTS: Recovery of spontaneous breathing occurred later in group B (10 +/- 5 min) than in group A (6.68 +/- 3.64 min; p < 0.05) or in group C (8 +/- 4 min). The first analgesic dose was infused later in group B (45.24 +/- 16.16 min; p < 0.001) than in group A (26.45 +/- 11.65 min) or in group C (25.47 +/- 9.19 min). The pain scores at rest were similar. On the fifth day, pain upon movement was less intense for patients treated with ketamine (group A 12 [10-21] and group B 13.5 [2-22]) than in patients treated with placebo (group C 23 [15.5-36.75]) (p < 0.05 group C vs. group A; and p < 0.01 group C vs. group B). Morphine consumption at 6 h was less in group B than group C (p < 0.01). CONCLUSIONS: A low dose of ketamine has no preemptive analgesic effect.     

Relief of postoperative pain by ibuprofen: a report of two studies

The value of ibuprofen (Motrin) as an analgesic was assessed in two consecutive studies in 425 patients with postherniorrhaphy pain. In the first study, 400 mg ibuprofen proved superior to placebo and as effective as one tablet of a compound containing 375 mg of acetylsalicylic acid, 30 mg caffeine and 8 mg codeine (ACC-8). In the second study, the analgesic effectiveness of 400 mg of ibuprofen was intermediate between that of two tablets of ACC-8 and one tablet of ACC-30 (a compound containing 375 mg ASA, 30 mg caffeine and 30 mg codeine). The side effects of all drugs were negligible. Ibuprofen should be a suitable alternative analgesic in postoperative pain of this type.