甘露醇加维生素B对梨状肌综合征患者的治疗效果

Effect of Mannitol plus Vitamins B in the management of patients with piriformis syndrome.

作者信息

Huang Zhi-Fa, Lin Bing-Quan, Torsha Tahsin Tarik, Dilshad Sabil, Yang De-Sheng, Xiao Jun

机构信息

Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

Department of Orthopaedic Surgery, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.

出版信息

J Back Musculoskelet Rehabil. 2019;32(2):329-337. doi: 10.3233/BMR-170983.

DOI:10.3233/BMR-170983

PMID:30412481

Abstract

BACKGROUND

Piriformis syndrome (PS) is an entrapment of the sciatic nerve by the piriformis muscle, or myofascial pain from the piriformis muscle.

OBJECTIVE

The aim of this study was to investigate the effectiveness of Mannitol plus Vitamins B regime in the management of PS.

METHODS

Twenty two patients were included in this study and received 250 ml of mannitol 20% intravenous infusion for 5 days + Vitamins B (vitamin B1 10 mg + vitamin B2 10 mg + vitamin B12 50 μg PO) for 6 weeks. Clinical outcomes were assessed systematically by clinical tests (tenderness, FAIR test, Beatty's, Freiberg's and Pace's maneuver), Numeric Rating Scale (NRS), Likert Analogue Scale (LAS), and MR examination.

RESULTS

The clinical evaluations showed a significant reduction (p< 0.05) of tenderness, FAIR test, Beatty's maneuver, Freiberg's maneuver and Pace's maneuver when compared with baseline evaluation during the 3rd and 6th month follow-ups. A statistically significant improvement of pain was measured by NRS at resting (p< 0.001), at night (p< 0.001) and during activities (p< 0.001) and LAS with prolonged sitting (p< 0.001), standing (p< 0.001) and lying (p< 0.001). Concomitantly, swelling of SN revealed a significant reduction (p= 0.003) from 86.4% to 18.2%.

CONCLUSIONS

Mannitol plus Vitamins B is effective in the management of piriformis syndrome and it could be an alternative regime in treating PS.

摘要

背景

梨状肌综合征（PS）是指坐骨神经被梨状肌卡压，或由梨状肌引起的肌筋膜疼痛。

目的

本研究旨在探讨甘露醇联合维生素B疗法治疗梨状肌综合征的有效性。

方法

本研究纳入22例患者，接受250毫升20%甘露醇静脉输注，持续5天，同时口服维生素B（维生素B1 10毫克+维生素B2 10毫克+维生素B12 50微克），持续6周。通过临床检查（压痛、FAIR试验、贝蒂试验、弗赖贝格试验和佩斯试验）、数字评分量表（NRS）、李克特模拟量表（LAS）和磁共振检查对临床疗效进行系统评估。

结果

临床评估显示，与基线评估相比，在第3个月和第6个月随访时，压痛、FAIR试验、贝蒂试验、弗赖贝格试验和佩斯试验均有显著降低（p<0.05）。NRS测量显示，静息时（p<0.001）、夜间（p<0.001）和活动时（p<0.001）疼痛有统计学意义的改善，LAS测量显示，长时间坐位（p<0.001）、站立位（p<0.001）和卧位（p<0.001）时疼痛也有统计学意义的改善。同时，坐骨神经肿胀从86.4%显著降低至18.2%（p=0.003）。