Objectives The purpose of this study is to evaluate the efficacy and safety of herbal medication for the treatment of functional abdominal pain in children by analyzing randomized controlled trials conducted in China. Methods Literatures from China National Knowledge Infrastructure published up to 23 November, 2020 were searched. Then they were collected and analyzed by their publication year, demographic information, treatment methods used, duration of illnesses, duration of treatments, follow-up periods, outcome measurement and adverse events. Results A total of 27 studies were selected for the analysis. In all studies, the total efficacy of the herbal medicine treatment group was reported to be higher than that of the control group. The most frequently used medical herb was Root of Glycyrrhiza uralensis Fischer (甘草). The most frequently used classes of herbal medications are Qi regulating medicine (理氣藥), Qi tonics (補氣藥), Aromatic wet medicine (芳香化濕藥), and Digestant (消食藥). The adverse events rate for the herbal medicine treatment group were significantly lower than those in the Western medicine treatment group. Conclusions This study showed that herbal medicine treatment can be effective and safe option for treating pediatric functional abdominal pain. However, additional well-designed clinical studies are needed to solidify the findings.
Objective: The purpose of this study was to investigate the effect of sprinter pattern bridging exercise using theraband on activation of lower extremity and abdominal muscle and to find out postures that can effectively improve abdominal and lower extremity muscle strength and increase abdominal stability. Methods: This study was designed as a cross-sectional study. The following research was done with applicants attending S university in Seoul to compare the difference in muscle activity between one-leg-Support bridging exercise and sprinter-pattern bridging exercise using theraband. For 48 study participants, we first measured their MVC. Then, we applied one-leg-support bridging exercise and sprinter-pattern bridging exercise at random order. These data were expressed as the percentage of maximal voluntary contraction (%MVC).Electromyography analysis was performed by measuring the external obliques, internal obliques, biceps femoris, and gluteus maximus. Results: There was a statistically significant increment of muscle activity in external and internal oblique muscle(p<0.001)by sprinter-pattern bridging exercise using theraband. On the lower body, statistically significant increment of muscle activity in biceps femoris and gluteus maximus was found(p<0.05). On the other hand, on erector spinae, there was statistically significant decrease in muscle activity(p<0.05). Conclusions: Efficient treatment is expected when sprinter-pattern bridging exercise using theraband is applied clinically.For patients with chronic knee and ankle pain who have difficulty bearing weight, including low back pain and internal rotation of the femur, starting with a low weight bearing, we think it will be helpful in planning systematic training aimed at progressively strengthening the lower extremities.
The purpose of this study was to assess the fatigue in lumbar and abdominal muscles in patients with chronic low back pain compared with normal subjects using spectral analysis with mean power frequency and median power frequency. The experimental group consisted of twenty subjects who had experienced chronic low back pain for over one year after the onset day. A control group consisted of twenty normal subjects with no history of low back pain. All subjects stood in an apparatus to perform sustained contraction in the lumbar and abdominal muscles for 30 seconds with 60% maximal voluntary isometric contraction (MVIC). The resulting electromyographic (EMG) recorded time serial data were transformed into frequency serial data by Fast Fourier Transformation (FFT). The results were as follows: 1) lumbar muscles measured, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group group (p<0.05). In measured two abdominal muscles (inferior rectus abdominis, obliquus externus abdominis) except superior rectus abdominis, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group (p<0.05). 2) In all three (longissimus thoracis, iliocostalis lumborum, multifidus) lumbar muscles measured, the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). In the two (inferior rectus abdominis, obliquus externus abdominis) abdominal muscles measured (superior rectus abdominis not included), the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). These results suggest that in patients with chronic low back pain there is a trend for more fatigue to occur in both lumbar and abdominal muscles than in the normal control group. This would seem to suggest that in treatment programs for patients with chronic low back pain, improvement of endurance in all trunk muscles should be considered.
Traumatic abdominal wall hernia is a very rare clinical entity. Herein, we report the case of a patient who was transferred from a local clinic to the emergency department because of left lower abdominal pain. Initially, an intra-abdominal hematoma was observed on computed tomography and no extravasation was noted. Conservative treatment was initiated, and the patient's symptoms were slightly relieved. However, though abdominal pain was relieved during the hospital stay, bowel herniation was suspected in the left periumbilical area. Follow-up computed tomography showed traumatic abdominal wall hernia with hemoperitoneum in the abdomen. We performed a laparoscopic exploration of the injury site and hernia lesion. The anterior abdominal wall hernia was successfully closed.
The purpose of this study was to identify the effect of foot reflexology on premenstrual syndrome and dysmenorrhea in female college students. The research design of this study was a quasi-experimental design. Of the forty female college students, twenty were assigned to the experimental group and, twenty to the control group. The data were obtained over 2 months(November 26, 2001 to January 31, 2002) from a nursing of C college located in S city. The instrument used to assess premenstrual syndrome and dysmenorrhea was Keele's VAS(Visual Analogue Scale) and opening records. Subjects in the experimental group received foot reflexology for 6 times with 1 hours during 60 days, and subjects assigned to the control group did not receive foot reflexology. Data were analysed with percentage, mean, standard deviation, $x^2$-test, unpaired t-test, and repeated measure ANOVA, using SAS Program. The results of the study are as follow, 1.The symptoms which the group of experimental and the group of control discomforts the most are sensitiveness(35%), abdominal pain (30%),lower abdominal pain (30%) and lumbago (20%). The method of relieve premenstrual syndrome and dysmenorrhea by which the subjects employ the most to solve their premenstrual syndrome and dysmenorrhea is the getting along by enduring(67.5%) and bed rest (32.5%). 2.The mean score of the premenstrual syndromes and dysmenorrhea before foot reflexology was 8.35, it was 4.16 at the first menstruation after foot reflexology and 3.25 at the second menstruation for the experimental group. 3.The relieved symptoms after foot reflexology was fatigue(50%), insomnia(40%), abdominal pain(35%), lower abdominal pain (30%) and constipation(30%). Foot reflexology was effective in improve the symptoms of the female college students who have the premenstrual syndrome and dysmenorrhea.
Background: This study comparatively evaluated the effects of equipment-based pilates exercises (EPE) and lumbar stability exercises (LSE) in patients with chronic low back pain in terms of their Visual Analogue Scale(VAS), Oswestry Disability Index(ODI), and abdominal muscle thickness. Methods: A total of 30 participants were recruited and randomly assigned to either the EPE or the LSE. The VAS, ODI, and abdominal muscle thicknesses of the participants were measured before and after the intervention. Results: The EPE were more effective in terms of the duration of a sustained reduction in VAS scores. post hoc test revealed that EPE were more efficacious in terms of a sustained improvement in ODI scores. With respect to changes in abdominal muscle thickness, there was a significant difference in the thickness of internal oblique muscles(IO) and the external oblique muscles(EO) between the two groups. Conclusion: In this study, both types of exercise interventions resulted in improvements in the VAS, ODI scores, and abdominal muscle thickness in patients with chronic low back pain. However, EPE were found to be more effective than LPE in terms of longer sustained improvements in VAS and ODI scores. Also, with respect to abdominal muscle thickness, the thickness of EO and IO improved only in the EPE group.
PURPOSE: This study was designed to investigate the effects of keeping contraction of abdominal and pelvic floor muscles on 3D pelvic stability in individuals with nonspecific chronic low back pain (CLBP) during normal speed walking. METHODS: The subjects were 20 adults with CLBP deformity and had moderate pain intensity of the visual analog scale. A three-dimensional camera capture system was used to collect kinematic pelvic motion data with and without contraction of the abdominal and pelvic floor muscles during gait. The subjects were asked to walk on a walkway in the lab room and they were attached 40 reflective markers to their pelvic segment and lower extremities. A Visual3D Professional V6 program and Vicon Nexus software were used to analyze 3D pelvic kinematic data. RESULTS: There were significant differences between with and without contraction of the abdominal and pelvic floor muscles of the pelvic depression and the total pelvic motion in coronal plane during gait (p < .05). However, there were no significant differences in any of the maximal motion of the pelvic segment in sagittal and transverse motion plane according to the different muscle contraction conditions (p > .05). CONCLUSION: The results of this study suggest that maintaining co-contraction of the abdominal and pelvic floor muscles in individuals with CLBP increased pelvic stability and contributed to preventing excessive pelvic movements during gait.
The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.
Background : This study was designed to evaluate the continuous effects of single intravenous injection of antiemetics on nausea and vomiting during continuous morphine injection for postoperative pain control. Methods : Prior to the study, we divided patients into two major groups according to the type of surgery performed intra-abdominal(Open: O) and non intra-abdominal(Close: C). When patients regained orientation after routine general anesthesia, enflurane-$O_2-N_2O$, we injected bolus dose of morphine and started continuous injection of morphine for postoperative pain control(Group I; Control). After bolus injection and just before continuous injection, we injected single dose of droperidol(Group II) or ondansetron(Group III). Mean arterial blood pressure, heart rate, pain score and symptom-therapy score were checked at 10 minutes, 4, 8, 16, 24, 36 hours after continuous morphine injection. Results : The pain score of group III was lower than group II(10 min.) and group I(24, 36 hours) in the open group. Symptom-therapy score of group III(10 min., 4, 24 hours) and group II(10 min.) were lower than group I in the open group. In the close group, symptom-therapy score of group III(8 hours) was lower than group I. Conclusions : Single intravenous injection of antiemetics have a tendency of lowering symptom-therapy score for 36 hours in spite of their relatively short elimination half-life.
Kwak, Hyun Jeong;Lim, Oh Kyung;Baik, Jae Myung;Jo, Youn Yi
Korean Journal of Anesthesiology
/
제71권6호
/
pp.459-466
/
2018
Background: To compare the effects of intraoperative infusions of balanced electrolyte solution (BES)-based hydroxyethyl starch (HES) and saline-based albumin on metabolic acidosis and acid/base changes during major abdominal surgery conducted using Stewart's approach. Methods: Forty patients, aged 20-65 years, undergoing major abdominal surgery, were randomly assigned to the HES group (n = 20; received 500 ml of BES-based 6% HES 130/0.4) or the albumin group (n = 20; received 500 ml of normal saline-based 5% albumin). Acid-base parameters were measured and calculated using results obtained from arterial blood samples taken after anesthesia induction (T1), 2 hours after surgery commencement (T2), immediately after surgery (T3), and 1 hour after arriving at a postanesthetic care unit (T4). Results: Arterial pH in the HES group was significantly higher than that in the albumin group at T3 ($7.40{\pm}0.04$ vs. $7.38{\pm}0.04$, P = 0.043), and pH values exhibited significant intergroup difference over time (P = 0.002). Arterial pH was significantly lower at T3 and T4 in the HES group and at T2, T3, and T4 in the albumin group than at T1. Apparent strong ion difference (SIDa) was significantly lower at T2, T3, and T4 than at T1 in both groups. Total plasma weak nonvolatile acid ($A_{TOT}$) was significantly lower in the HES group than in the albumin group at T2, T3 and T4 and exhibited a significant intergroup difference over time (P < 0.001). Conclusions: BES-based 6% HES infusion was associated with lower arterial pH values at the end of surgery than saline-based 5% albumin infusion, but neither colloid caused clinically significant metabolic acidosis (defined as an arterial pH < 7.35).
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