王静,陶熔,夏令杰,等.体外冲击波联合背根神经节脉冲射频治疗脊柱源性腹痛的疗效观察[J].中华物理医学与康复杂志,2019,41(2):121-126
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| 体外冲击波联合背根神经节脉冲射频治疗脊柱源性腹痛的疗效观察 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.02.010 |
| 中文关键词: 背根神经节 脉冲射频 体外冲击波 脊柱源性腹痛 |
| 英文关键词: Dorsal root ganglia Pulsed radio frequency irradiation Extracorporeal shock waves Spinal cord-derived abdominal pain Abdominal pain |
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| 中文摘要: |
| 目的 观察体外冲击波联合背根神经节脉冲射频治疗脊柱源性腹痛的临床疗效。 方法 采用随机数字表法将88例脊柱源性腹痛患者分为对照组、冲击波组、脉冲射频组及联合组，所有患者均连续口服药物依托考昔、普瑞巴林3周；冲击波组患者在此基础上辅以体外冲击波治疗，脉冲射频组在此基础上辅以背根神经节脉冲射频治疗，联合组患者则辅以体外冲击波及背根神经节脉冲射频治疗。于治疗前、治疗1周、4周及12周时分别采用视觉模拟评分法（VAS）、生活质量评估量表（QOL-SF36）、汉密尔顿焦虑量表（HAMA）及汉密尔顿抑郁量表（HAMD）对4组患者进行疗效评定，并于治疗结束后2年随访4组患者疾病发展、胃肠道功能、就诊情况以及医疗花费等。 结果 治疗4周时发现4组患者疼痛VAS、QOL-SF36、HAMA及HAMD评分均较治疗前明显改善（P<0.05）；其中联合组疼痛VAS评分［（0.67±0.72）分］、QOL-SF36评分［（139.00±10.54）分］、HAMA评分［（3.81±3.78）分］及HAMD评分［（4.36±4.16）分］亦显著优于对照组、冲击波组及脉冲射频组水平，组间差异均具有统计学意义（P<0.05），并且联合组这种疗效优势持续保持至治疗12周时。治疗结束后通过2年随访，发现联合组患者胃肠道症状、就诊次数、医疗花费等均较对照组、冲击波组及脉冲射频组明显减少，组间差异均具有统计学意义（P<0.05）。 结论 体外冲击波联合背根神经节脉冲射频治疗脊柱源性腹痛临床疗效显著，同时还能显著降低患者医疗费用，具有明显经济、社会效益，值得临床推广、应用。 |
| 英文摘要: |
| Objective To observe the clinical effect of combining extracorporeal shock waves with pulsed radiofrequency irradiation of the dorsal root ganglia in the treatment of spinal cord-derived abdominal pain. Methods A total of 88 patients were randomly divided into a control group, a shock wave group, a pulsed irradiation group and a combination group, each of 22. All of the patients were given etocoxib and pregabalin medication for 3 weeks. In addition to the drugs, the shock wave group received extracorporeal shock wave therapy, and the irradiation group received pulsed radio frequency irradiation of the dorsal root ganglia. The combination group received both. A visual analogue scale was used to assess perceived pain. The quality of life short form 36 (QOL-SF36), Hamilton anxiety scale and Hamilton depression scale were administered to all 4 groups before the treatments and after 1, 4 and 12 weeks of the treatments. The development of diseases, gastrointestinal function, medical treatment and medical expenses of the 4 groups were observed for two years after the treatments. Results After 4 weeks of treatment, the average scores of all four groups in all of the evaluations had improved significantly compared with before the treatment. In combination group′s average results were significantly better than those of the other 3 groups from 4 weeks until 12 weeks after the treatment. During the subsequent two years that group′s gastrointestinal symptoms, hospital visits and medical expenses were all significantly lower, on average, than those of the other groups. Conclusion Extracorporeal shock waves combined with pulsed radio frequency irradiation of the dorsal root ganglia has significant clinical efficacy for alleviating spinal cord-derived abdominal pain. It can significantly reduce medical costs and is worthy of clinical promotion. |
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