脊髓损伤并发下肢感觉丧失性疼痛的临床研究
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摘要
对２１０例唐山大地震（１９７６年）时受到脊髓损伤而后继发下肢感觉丧失性疼痛的患者，在１９９１～１９９３年间（损伤后１５～１７年）进行了详细的观察、研究和治疗。其中弛缓型瘫痪占７１％，痉挛型占２９％。６５％的患者在发病一年内出现疼痛，疼痛的部位在脊髓损伤面以下，多发于两大腿、腹股沟以下及足部。疼痛区感觉完全丧失，但仍有灼痛和刀割样痛发生，因此称之为感觉丧失性疼痛。应用了中医、西医的１３种不同的方法进行治疗，其中以韩氏穴位神经刺激仪（ＨＡＮＳ，韩氏仪）效果最佳，近期有效率达到１００％。在应用韩氏仪治疗的４０名患者中有９人（将近１／４）在治疗后２年内未复发。该仪器携带方便，操作简便，用皮肤电极贴在穴位表面进行刺激，免除了扎针的操作，因此便于推广应用。
A clinical study was performed on 210 cases of the great Tangshan earthquake(1976) survivors who suffered from spinal cord injury cord injury(SCI) followed by anesthetic pain.Examination and treatment were given to the patients during 1991～1993, i. e., 15～17 years after the injury. Among the 210 cases, 71% were flaccid paralysis and 29% spastic. In 65% of the cases the pain appeared withen 1 year after the episode of cord injruy. The distribution of pain was always below the level of the cord crash. It was characterized by a burning or cutting pain appeared in the region of groins, thighs and legs where somatic sensation had been completely lost. More than 1 dozen of different kinds of treatments, western or traditional Chinese, were tried to suppress the pain, and the most satisfactory one was the Han'acupoint nerve stimulator(HANS) which is a kind of transcutaneous electrical nerve atimulator(TENS) develeped by Professor Ji-Sheng Han and colleagues based on their systemic study on the mechanisms of acupuncture analgesia for more than 3 decades. In 40 cases receiving HANS treatment, the short term effective rate was 100%, and in 9 cases (nearly 1/4) pain did not come back in 2 years as revealed by follow up study. The HANS device is of pocket size and easy to operate by the patient. The self-sticky skin electrode placed over the acupoint avoided the use of the acupuncture needle (acupuncture without a needle), thas facilitated its clinical use.
A clinical study was performed on 210 cases of the great Tangshan earthquake(1976) survivors who suffered from spinal cord injury cord injury(SCI) followed by anesthetic pain.Examination and treatment were given to the patients during 1991～1993, i. e., 15～17 years after the injury. Among the 210 cases, 71% were flaccid paralysis and 29% spastic. In 65% of the cases the pain appeared withen 1 year after the episode of cord injruy. The distribution of pain was always below the level of the cord crash. It was characterized by a burning or cutting pain appeared in the region of groins, thighs and legs where somatic sensation had been completely lost. More than 1 dozen of different kinds of treatments, western or traditional Chinese, were tried to suppress the pain, and the most satisfactory one was the Han'acupoint nerve stimulator(HANS) which is a kind of transcutaneous electrical nerve atimulator(TENS) develeped by Professor Ji-Sheng Han and colleagues based on their systemic study on the mechanisms of acupuncture analgesia for more than 3 decades. In 40 cases receiving HANS treatment, the short term effective rate was 100%, and in 9 cases (nearly 1/4) pain did not come back in 2 years as revealed by follow up study. The HANS device is of pocket size and easy to operate by the patient. The self-sticky skin electrode placed over the acupoint avoided the use of the acupuncture needle (acupuncture without a needle), thas facilitated its clinical use.
引文
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