浮针治疗骨质疏松性胸椎压缩骨折术后遗留肋间痛疗效分析
Clinical study of Fu’s Subcutaneous Needling on costal pain related to osteoporotic thoracic compression fractures
  
DOI:10.3969/j.issn.1006-7108.2019.04.015
中文关键词:  浮针  骨质疏松  胸椎  椎体  压缩骨折  术后  肋间痛
英文关键词:Fu,s Subcutaneous Needling  osteoporotic thoracic compression fractures  post-operation  costal pain
基金项目:2015年度河南省重点中医学科(专科)学术带头人培养项目专项课题(2015ZY03013)
作者单位
吕成国 杨勇* 陈爽 孙宜保 梅伟 郑州市骨科医院微创脊柱科, 河南 郑州 450052 
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中文摘要:
      目的 部分骨质疏松性椎体压缩骨折患者术后仍会遗留肋间痛,严重影响手术疗效。浮针是一种特殊的针刺疗法,在治疗疼痛方面有着立竿见影的效果,但未见该技术运用在椎体压缩骨折术后遗留肋间痛方面的报道。本研究旨在观察浮针疗法治疗胸椎压缩性骨折术后遗留肋间痛的有效性及安全性。方法 收集2014年1月至2017年6月获得完整随访的23例老年骨质疏松性胸椎压缩骨折术后遗留肋间痛患者资料,所有患者均为在接受经皮灌注骨水泥椎体强化术治疗后肋间痛减轻不明显,接受浮针疗法进一步治疗。记录连续3次浮针治疗前、治疗后1d、3个月、12个月的视觉模拟评分值(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index, ODI)值、针刺皮下血肿、血气胸等相关并发症情况。结果 所有患者均完成连续3次的浮针治疗,VAS评分值分别为7.1±0.8(治疗前)、3.2±0.6(治疗后1d)、2.8±0.7(治疗后3个月)、3.1±0.8(治疗后12个月),与治疗前比较,治疗后VAS评分值均显著性降低(P<0.05)。ODI值分别为42.6±2.3(治疗前)、27.9±4.2(治疗后1d)、23.2±8.3(治疗后3个月)、28.2±1.3(治疗后12个月),与治疗前比较,术后ODI值均显著下降(P<0.05),所有患者均未发生针刺后血肿、血气胸等胸腔脏器损伤的并发症。结论 浮针疗法可有效治疗骨质疏松性胸椎压缩骨折术后遗留肋间痛,可以获得即刻的止痛效果,改善患者生活质量,安全性较高,值得临床推广使用。
英文摘要:
      Objective Osteoporotic thoracic compression fractures is a serious complication of osteoporosis in the aged, and percutaneous vertebroplasty (pvp) and percutaneous kyphoplasty (pkp) are the effective treatment. Some patients with osteoporotic vertebral compression fractures still have intercostal pain after surgery, which seriously affects the curative effect. Fu’s Subcutaneous Needling is a special acupuncture treatment that has an immediate effect in treating pain, but there have been no reports of the use of this technique for residual intercostal pain after vertebral compression fracture. The purpose of this study was to evaluate the efficacy and safety of Fu’s Subcutaneous Needling (FSN) in the treatment of residual intercostal pain after thoracic compression fractures. Methods From January 2014 to June 2017, 23 osteoporotic thoracic compression fracture patients with postoperative costal pain and who had undergone FSN with complete follow-up were reviewed retrospectively. All patients underwent percutaneous vertebroplasty, but pain relief was not obvious. They then received further treatment with Fu’s Subcutaneous Needling. One needle or two needles applied for each patient. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) of all patients were measured pre-needling and 1 day, 3 months and 12 months post-needling. Complications such as subcutaneous hematoma and Chemothorax were recorded. Results All the patients had three consecutive FSN treatments. The VAS was significant decreased: 7.1±0.8 (pre-needling) to 3.2±0.6 (1d), 2.8±0.7 (3m), 3.1±0.8 (12m) , P<0.05; the ODI was significant decreased: 42.6±2.3 (pre-needling) to 27.9±4.2 (1d), 23.2±8.3 (3m), 28.2±1.3 (12m), P<0.05, and there was no complication. Conclusion The FSN can effectively treat costal pain related to osteoporotic thoracic compression fractures with high safety, can relieve the pain and improved the quality of life. The FSN are worthy of clinical application.
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