Objective To investigate the effect of combination therapy of nerve block and acupuncture to phantom limb pain of upper extremity after amputation.Methods Eighty patients with phantom limb pain of upper limb were randomly divided into four groups (n=20):20 patients received basic treatment (A group),which included Medications and Psychotherapy,20 patients recieved acupuncture and basic treatment (B group),20 patients recieved nerve block and basic treatment (C group),20 patients recieved nerve block,acupuncture and basic treatment (D group).Scores of VAS,SR-36 and comprehensive comparison of efficacy were used to assess before and after treatment among the four groups.Results visual analogue scales (VAS) scores and SF-36 scores of four groups of patients were significant differences after treatment compared with before treatment (P＜0.05).VAS scores decreased after treatment,while SF-36 scores were significantly increased.When compared with A group (52±6),VAS scores of B group (42±8),C group (42±8) and D group (32±6) after treatment decreased significantly,and the differences were statistically significant(P＜0.05).Compared with A group(Mental:58±9,Physical:36±5),SF-36 scores of B group(Mental:67±9,Physical:43± 4),C group(Mental:66±6,Physical:43±5) and D group(Mental:77±10,Physical:50±6) after treatment increased significantly,and the differences were statistically significant (P＜0.05).When compared with B group and C group,VAS scores of D group decreased significantly after treatment,and SF-36 scores were significantly increased(P＜0.05).Comprehensive comparison of efficacy of four groups of patients:After treatment for 5 weeks,compared with A group (70％),there was significant difference in comprehensive comparison of efficacy of B group(85％),C group(85％) and D group(100％) (P＜0.05).The results suggest that the treatment effect of B group,C group and D group is better than A group,the treatment effect of D group is best among four groups.Conclusions The use of basic drug and psychology therapy combined with sympathetic blockade therapy and acupuncture treatment can significantly improve the treatment effect of phantom limb pain of upper limb after amputation,improve the patient 's quality of life.%目的 研究探讨针刺复合神经阻滞治疗上肢截肢术后幻肢痛(phantom limb pain,PLP)的疗效. 方法 80例上肢PLP患者采用随机数字表法分为4组(每组20例):基本治疗组(A组)、针刺+基本治疗组(B组)、神经阻滞+基本治疗组(C组)、神经阻滞+针刺+基本治疗组(D组).治疗前后分别采用视觉模拟评分法(visual analogue scales,VAS)、简明健康状况调查表(the MOS item short from health survy,SF-36)和综合疗效评估,并分别进行治疗前后和组间比较. 结果 4组患者治疗前后VAS评分及SF-36评分差异均有统计学意义(P＜0.05),治疗后VAS评分降低,SF-36评分明显升高;与A组(52±6)比较,B组(42±8)、C组(42±8)、D组(32±6)治疗后VAS评分明显降低,差异有统计学意义(P＜0.05);与A组[(精神评分(58±9),身体评分(36±5)]比较,B组[(精神评分(67±9),身体评分(43±4)]、C组[(精神评分(66±6),身体评分(43±5)]、D组[(精神评分(77±10),身体评分(50±6)]治疗后SF-36评分明显升高,差异有统计学意义(P＜0.05);与B组、C组比较,D组治疗后VAS评分明显降低,SF-36评分明显升高,差异有统计学意义(P＜0.05);4组患者综合疗效比较:治疗5周后,与A组(70％)比较,B组(85％)、C组(85％)、D组(100％)的综合疗效差异有统计学意义(P＜0.05),提示B组、C组、D组疗效优于A组,D组疗效优于B组和C组. 结论 采用基本药物和心理治疗联合交感神经阻滞治疗、针刺治疗的中西结合治疗方案能明显提高上肢截肢术后的PLP的疗效,改善患者的生活质量.
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