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腰背痛照X光没用
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     路透社纽约健康消息 《英国医学杂志》最近发表的一项研究指出,拍X线片或进行放射影像检查来揭开腰背痛之源并不能减少痛苦。事实上,这些患者在三个月后比不照片的患者主诉疼痛更剧烈。

    根据这项研究的作者之一,英国诺丁汉郡派克大学社区卫生学院的麦克·普瑞格博士的介绍,目前尚未有证据表明进行放射影像检查有助于医生处理单纯腰痛的患者。相反,有证据表明,进行X线照片可能使患者认为病情更严重,从而延迟康复。

    腰背痛是一个常见的医学问题,医生通常会让患者拍低位脊柱X线片以诊断疼痛的病因。然而,在大部份病例中,X线照片的结果极少改变腰背痛的治疗方案,进行X线照片是为了让患者或医生放心。

    为了测试X线照片究竟有什么用,普瑞格的研究小组研究了421位腰背痛平均持续了10周的患者。所有的患者都接受标准的腰背痛治疗,但是随机安排一半患者进行低位脊柱X线照片。三个月后,两组患者的腰背痛病情都有了改善,但是接受X线照射的患者仍然遭受腰背痛之苦的可能性更大,并且全身状况更差。这些患者也较多地抱怨疼痛加重并且干扰了他们的正常活动。
, 百拇医药
    研究人员认为,当医生要求进行X线照片以寻找腰背痛的原因时,患者可能认为这种检查是他们不健康的一个征象,所以接受照片的患者更可能报告有疼痛,并认为疼痛干扰了他们的日常活动。

    但是,尽管X线照片看起来无助于缓解腰背痛,两组中80%的患者都说如果可能的话,他们会选择进行X线照片。到第9个月为止,两组患者间的差异大部份消失了。尽管接受X线照片看来没有任何益处,但是接受X线照片的一组患者对治疗更满意。

    研究结果突出一点:应该让人们了解X线照片对腰背痛患者用处不大。由于有这么多的人相信放射影响检查是处理腰背痛的基本手段,因此需要加强宣传让公众了解实情。了解X线极少会缓解腰背痛,可能会减少对医疗系统的需求,因为接受X线照片的患者在研究中的头三个月中看医生更频繁。

    X-Rays Deemed Unnecessary for Most Low Back Pain
, 百拇医药
    NEW YORK (Reuters Health) - Getting an x-ray to uncover the source of lower back pain does not reduce suffering, researchers report. In fact, in a new study, patients who had an x-ray, or radiography, reported more pain 3 months later than those who did not have an x-ray.

    ``There is no evidence that having radiography helps doctors to care for people with simple back pain,‘‘ according to one of the study‘s authors, Dr. Mike Pringle, of the School of Community Health Sciences at University Park in Nottingham, UK.
, 百拇医药
    ``Indeed, the evidence is that the act of having an x-ray can, perhaps by appearing to increase the perception of severity, delay recovery,‘‘ he told Reuters Health.

    Low back pain is a common medical problem, and doctors often x-ray the lower spine to diagnose the cause of the pain. In most cases, however, x-ray results do little to change the treatment of back pain, Pringle and his colleagues note in an article in the February 17th issue of the British Medical Journal. Most of the time, x-rays are performed to reassure patients or doctors, according to the researchers.
, 百拇医药
    To test the benefits of x-rays, Pringle‘s team conducted a study of 421 people with low back pain that had lasted for an average of 10 weeks. All patients received the standard care for low back pain, but half of the patients were randomly assigned to have an x-ray of their lower spine.

    Three months later, back pain had improved on average in both groups, but patients who had been x-rayed were more likely to still be suffering from back pain and to have poorer overall health. These patients were also somewhat more likely to complain of more severe pain and to have their back pain interfere with their normal activities.
, 百拇医药
    But even though x-rays did not appear to help relieve back pain, more than 80% of patients in both groups said they would choose to have an x-ray if they could.

    By 9 months, most of the differences between the groups diminished, although having an x-ray still did not appear to provide any benefits, the report indicates. Patients in the x-ray group tended to be more satisfied with their care, however.

    The findings highlight the need to let people know that x-rays are of little use to most people with low back pain, according to Pringle.
, 百拇医药
    ``Since so many people believe that radiography is an essential feature of the management of back pain, there is a need for a campaign to inform the public,‘‘ he said.

    When doctors order an x-ray to investigate low back pain, patients may interpret the move as a sign that they really are unwell, so they may be more likely to report pain and to think that the pain interferes with their activities, Pringle‘s team notes in the report.

    Getting the message out that x-rays do little to relieve low back pain may reduce demands on the healthcare system, according to the authors, who report that patients who were x-rayed went to the doctor more frequently during the first 3 months of the study.

    SOURCE: British Medical Journal 2001;322:400-405., 百拇医药