斑点药物刺激:90例腰骶部病变患者的随机研究

L. Agasarov, E. S. Saakyan, T. Konchugova, Tatyana V. Apkhanova, O. V. Yurova
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摘要

的目标。采用随机安慰剂对照研究,评价维什涅夫斯基麻醉阻断和软骨保护药物穿刺术治疗脊柱病变的疗效。材料和方法。对90例29 ~ 65岁急性腰骶背部病变患者进行观察。采用“多边人格研究”和“自我活动-情绪”方法评估临床状况动态、热成像、四极血流成像和心理测试结果。在确定患者是否符合纳入和不纳入标准后,将患者随机分为治疗方法不同的3组(每组30例)。第一组(对照组)患者给予基本的标准治疗,另外两组患者在腰椎和下肢反射治疗点进行局部用药。方法上按Vishnevsky法在腰椎穴位注射麻醉剂,远端穴位分别注射软骨保护药物(2组)或生理溶液(3组,安慰剂)。总共10个程序,按每周三次的顺序进行。采用Statistica for Windows v.7程序进行统计分析。结果发现,治疗结束后,两组患者的神经学表现、热成像数据和下肢血流流变学指标的消退与对照组有显著差异,其中分析指标无显著变化。两种不同的局部刺激,以明显的反射效应为特征,在疗效方面确实优于基础疗法。然而,尽管第二组和第三组的疼痛减轻率相当,但在治疗过程结束时,第二组患者的疼痛感觉水平明显较低,因为第二组患者不仅接受了腰椎区域的麻醉阻断,而且还接受了软骨保护剂药物穿刺。在同一组中,根据心理测试的结果,得到了更显著的变化。注意到的现象可以通过药物应用的要点来解释:由于麻醉阻断而实现快速疼痛缓解和软骨保护器药物穿刺提供的总体最大性能。随访资料更大程度上证明了第二组患者在反射疗法的影响下取得的阳性结果的稳定性。采用维什奈夫斯基法麻醉阻断联合下肢区域软骨保护药物穿刺治疗腰背病疗效显著。根据疼痛综合征的严重程度、心理测试结果和随访数据,与仅在腰椎区域接受麻醉注射的组相比,这一组有明显更显著的积极变化。
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Spot Drug Stimulation: а Randomized Study of 90 Patients with Lumbosacral Dorsopathies
AIM. A randomized placebo-controlled study was conducted to evaluate the therapeutic efficacy of Vishnevsky anesthetic blockade and chondroprotective drug pharmacopuncture in dorsopathies. MATERIALS AND METHODS. 90 patients aged 29–65 years with acute lumbosacral dorsopathy were under observation. Clinical condition dynamics, thermography, tetrapolar rheovasography and results of psychological testing by the methods of «Multilateral personality study» and «Self-activity-mood» were assessed. After determining compliance with the inclusion and noninclusion criteria, the patients were divided into 3 randomized groups (each of 30 patients)differing in treatment methods. In the 1st (control) group, the patients received basic standard treatment, and in the other two groups we additionally performed local medication on the lumbar region and lower extremities on reflexotherapy points. Methodically, anesthetic was injected into the lumbar points according to the Vishnevsky method, and a chondroprotective drug (Group 2) or physiological solution (Group 3, placebo) was differentially injected into the distal points. A course of 10 procedures was carried out in the order of three times a week. Statistica for Windows v.7 program was used for statistical analysis. RESULTS. It was found that upon completion of the treatment there were significant differences in the regression of neurological manifestations, thermographic data and rheographic markers of lower extremity blood flow between the two resultant groups and the control group, in which no significant shifts in the analyzed indices were detected. Both variants of local stimulation, characterized by a pronounced reflex effect, were reliably superior to the basic therapy in terms of efficacy. However, despite the comparable rates of algia reduction in the 2nd and 3rd groups, the level of pain sensations by the end of the treatment course was significantly lower in the patients of the 2nd group that received not only anesthetic blockade in the lumbar region, but also chondroprotector pharmacopuncture. In the same group, more significant shifts were obtained according to the results of psychological testing. The noted phenomenon can be explained by the points of medication application: achieving rapid pain relief due to anesthetic blockade and the overall maximum performance provided by chondroprotector pharmacopuncture. The follow-up data obtained testify to the stability of the achieved positive results under the influence of the reflexotherapy techniques to a greater degree in the patients of the 2-nd group. CONCLUSION. The combined method including anesthetic blockade by Vishnevsky’s method and chondroprotective pharmacopuncture in the region of the lower extremities was highly effective in treating patients with lumbar dorsopathy. In this group, there were notably more significant positive shifts compared to the group that received only anesthetic injections on the lumbar region, according to the severity of the pain syndrome, the results of psychological testing and follow-up data.
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