{"id":5797,"date":"2023-03-31T11:27:53","date_gmt":"2023-03-31T03:27:53","guid":{"rendered":"https:\/\/wilback.com\/?p=5797"},"modified":"2023-09-01T23:19:47","modified_gmt":"2023-09-01T15:19:47","slug":"guideline009","status":"publish","type":"post","link":"https:\/\/wilback.com\/guideline009\/","title":{"rendered":"\u8170\u80cc\u75db\u6307\u5357\uff5c\u5bc6\u897f\u6839\u91ab\u79d1\u5927\u5b78&#8211;\u81e8\u5e8a\u8b77\u7406\u6307\u5357"},"content":{"rendered":"\n<p class=\"is-style-icon_pen\">\u672c\u7bc7\u6587\u7ae0\u7531<strong><span class=\"swl-inline-color has-swl-deep-02-color\">\u591c\u9ece<\/span><\/strong>\u6700\u5f8c\u4e00\u6b21\u66f4\u65b0\u65bc<strong><span class=\"swl-inline-color has-swl-deep-03-color\">2023\u5e7403\u670831\u65e5<\/span><\/strong><\/p>\n\n\n\n<ul>\n<li><strong>\u4e3b\u984c\uff1a<\/strong><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK572334\/\" data-type=\"URL\" data-id=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK572334\/\">Low Back Pain Guideline<\/a><\/li>\n\n\n\n<li><strong>\u4f86\u6e90\uff1a<\/strong><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/\" data-type=\"URL\" data-id=\"https:\/\/www.ncbi.nlm.nih.gov\/\">National Library of Medicine<\/a> &amp; <a href=\"https:\/\/www.uofmhealth.org\/provider\/clinical-care-guidelines\" data-type=\"URL\" data-id=\"https:\/\/www.uofmhealth.org\/provider\/clinical-care-guidelines\">Michigan Medicine University of Michigan<\/a><\/li>\n\n\n\n<li><strong>\u4f5c\u8005\uff1a<span class=\"swl-inline-color has-swl-deep-02-color\">Anthony E. Chiodo<\/span><\/strong>, MD, Lead,&nbsp;<strong><span class=\"swl-inline-color has-swl-deep-02-color\">Suvarna N. Bhat<\/span><\/strong>, MBBS, <strong><span class=\"swl-inline-color has-swl-deep-02-color\">R. Van Harrison<\/span><\/strong>, PhD,<strong> <span class=\"swl-inline-color has-swl-deep-02-color\">Gregory D. Shumer<\/span><\/strong>, MD, <strong><span class=\"swl-inline-color has-swl-deep-02-color\">Ronald A. Wasserman<\/span><\/strong>, MD,<strong> <span class=\"swl-inline-color has-swl-deep-02-color\">Paul Park<\/span><\/strong>, MD, Consultant, <strong><span class=\"swl-inline-color has-swl-deep-02-color\">Rakesh D. Patel<\/span><\/strong>, MD, Consultant.<\/li>\n\n\n\n<li><strong>\u9580\u8a3a\u81e8\u5e8a\u6307\u5357\u76e3\u7763\uff1a<span class=\"swl-inline-color has-swl-deep-02-color\">R. Van Harrison<\/span><\/strong>, PhD,&nbsp;<strong><span class=\"swl-inline-color has-swl-deep-02-color\">April L. Proudlock<\/span><\/strong>, RN,  <strong><span class=\"swl-inline-color has-swl-deep-02-color\">Karl T. Rew<\/span><\/strong>, MD.<\/li>\n\n\n\n<li><strong>\u6587\u7ae0\u985e\u578b\uff1a<\/strong>Clinical Guidelines<small>\uff08\u81e8\u5e8a\u6307\u5357\uff09<\/small><\/li>\n\n\n\n<li><strong>\u767c\u8868\u65e5\u671f\uff1a<\/strong>2020\/11<\/li>\n\n\n\n<li><strong>\u7ffb\u8b6f\u7de8\u8f2f\uff1a<\/strong>\u591c\u9ece<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-group is-style-big_icon_caution\"><div class=\"wp-block-group__inner-container\">\n<ul>\n<li>\u70ba\u4e86\u4f7f\u5167\u5bb9\u6613\u65bc\u7406\u89e3\uff0c\u4e2d\u6587\u6a19\u9ede\u7b26\u865f\u7528\u5bb9\u6613\u7406\u89e3\u7684\u65b9\u5f0f\u6a19\u8a3b\uff0c\u800c\u975e\u4e2d\u6587\u6a19\u6e96\u8a9e\u6cd5\u3002<\/li>\n\n\n\n<li>\u4e00\u90e8\u5206\u5197\u9577\u7684\u53e5\u5b50\u6216\u55ae\u8fad\u8a3b\u89e3\u7528\u3008\u3009\u4f5c\u70ba which, that \u7684\u88dc\u5145\u8aaa\u660e\u3002<\/li>\n\n\n\n<li>\u4e00\u4e9b\u591a\u9805\u76ee\u5217\u8209<small class=\"mininote\">\uff08\u2026, \u2026 and\/or \u2026\uff09<\/small>\uff0c\u70ba\u4e86\u6613\u65bc\u7406\u89e3\uff0c\u6703\u52a0\u4e0a\u539f\u6587\u6c92\u6709\u7684\u300e\u300f\u6216\u662f\u7528<strong>\u5217\u8868<\/strong>\u8868\u793a\u3002<\/li>\n\n\n\n<li>\u500b\u4eba\u7368\u529b\u7de8\u8f2f\u96e3\u514d\u6709\u8aa4\uff0c\u5982\u679c\u6709\u767c\u73fe\u932f\u8aa4\u53ef\u4ee5\u5728\u8a55\u8ad6\u5340\u7559\u8a00\uff0c\u6211\u6703\u518d\u6b21\u6bd4\u5c0d\u3001\u4fee\u6b63\u3002\u611f\u6fc0\u4e0d\u76e1\uff01<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n<div class=\"swell-block-balloon\"><div class=\"c-balloon -bln-left\" data-col=\"blue\"><div class=\"c-balloon__icon -circle\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/wilback.com\/wp-content\/uploads\/\u771f\u4eba\u85dd\u7d20\u7167-tiny.png\" alt=\"\" class=\"c-balloon__iconImg\" width=\"80px\" height=\"80px\"><span class=\"c-balloon__iconName\">\u591c\u9ece<\/span><\/div><div class=\"c-balloon__body -speaking -border-none\"><div class=\"c-balloon__text\">\n<p>\u7248\u6b0a\u5c6c\u65bc\u00a9\u5bc6\u897f\u6839\u5927\u5b78\u8463\u4e8b\u6703\u3002\u672c\u6587\u6839\u64da <a rel=\"noreferrer noopener\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" data-type=\"URL\" data-id=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\">\u5275\u7528 CC BY-NC-SA 4.0 \u8072\u660e<\/a> \u91cd\u88fd\uff0c\u4e26\u4ee5\u76f8\u540c\u65b9\u5f0f\u5171\u4eab\u3002<\/p>\n<span class=\"c-balloon__shapes\"><span class=\"c-balloon__before\"><\/span><span class=\"c-balloon__after\"><\/span><\/span><\/div><\/div><\/div><\/div>\n\n\n<h2 class=\"wp-block-heading\">\u524d\u8a00<\/h2>\n\n\n\n<p><strong>\u60a3\u8005\u4eba\u7fa4\uff1a<\/strong>\u8170\u75db\u6642\u9593 &lt; 6 \u9031\u7684\u6210\u4eba\uff08\u2265 18 \u6b72\uff09<\/p>\n\n\n\n<p><strong>\u76ee\u6a19\uff1a<\/strong><\/p>\n\n\n\n<ol>\n<li>\u78ba\u5b9a\u6709\u6162\u6027\u5931\u80fd\u98a8\u96aa\u7684\u4eba\u4e26\u53ca\u65e9\u5e72\u9810\u3002<\/li>\n\n\n\n<li>\u6aa2\u6e2c\u5371\u96aa\u4f46\u4e0d\u5e38\u898b\u7684\u75c5\u8b8a\u3002<\/li>\n\n\n\n<li>\u6709\u6548\u5229\u7528\u8a3a\u65b7\u6e2c\u8a66\u3002<\/li>\n\n\n\n<li>\u958b\u59cb\u6cbb\u7642\u4e26\u5728\u9069\u7576\u6642\u8f49\u8a3a\u3002<\/li>\n<\/ol>\n\n\n\n<p><strong>\u95dc\u9375\u9ede<\/strong><\/p>\n\n\n\n<p><strong>\u81ea\u7136\u6b77\u53f2\u3002<\/strong> \u5927\u7d04 80% \u7684\u4eba\u5728\u4e00\u751f\u4e2d\u7684\u67d0\u500b\u6642\u5019\u6703\u51fa\u73fe\u6025\u6027\u8170\u75db [\u8b49\u64da D]\u3002 \u5728 6 \u9031\u5167\uff0c\u7121\u8ad6\u6cbb\u7642\u5982\u4f55\uff0c\u7d04 90% \u7684\u767c\u4f5c\u90fd\u6703\u4ee4\u4eba\u6eff\u610f\u5730\u89e3\u6c7a [D]\u3002<\/p>\n\n\n\n<p><strong>\u8a3a\u65b7\u548c\u6cbb\u7642\u6982\u8ff0\u3002<\/strong> \u6709\u95dc\u6982\u8ff0\uff0c\u8acb\u53c3\u898b\u5716 1\u3002<\/p>\n\n\n\n<div class=\"wp-block-group is-style-bg_grid\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<figure class=\"wp-block-image size-large is-resized\"><img decoding=\"async\" src=\"https:\/\/wilback.com\/wp-content\/uploads\/guideline009-01-webp-1280x1280.webp\" alt=\"\" class=\"wp-image-5872\" style=\"width:900px;height:900px\" width=\"900\" height=\"900\" srcset=\"https:\/\/wilback.com\/wp-content\/uploads\/guideline009-01-webp-1280x1280.webp 1280w, https:\/\/wilback.com\/wp-content\/uploads\/guideline009-01-webp-768x768.webp 768w, https:\/\/wilback.com\/wp-content\/uploads\/guideline009-01-webp.webp 1351w\" sizes=\"(max-width: 900px) 100vw, 900px\" \/><figcaption class=\"wp-element-caption\"><strong>\u57161\u3001\u6025\u6027\u8170\u75db\u7684\u8a3a\u6cbb<\/strong><\/figcaption><\/figure>\n\n\n\n<p>\u652f\u6301\u8a3a\u65b7\u65b9\u6cd5\u6216\u5e72\u9810\u63aa\u65bd\u7684\u8b49\u64da\u6c34\u5e73\uff1a<br>A = \u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u7684\u7cfb\u7d71\u6027\u56de\u9867\uff1b<br>B = \u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\uff1b<br>C = \u975e\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u7684\u7cfb\u7d71\u6027\u56de\u9867\u3001\u975e\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u3001\u5c0f\u7d44\u89c0\u5bdf\u7814\u7a76\uff1b<br>D = \u500b\u9ad4\u89c0\u5bdf\u63cf\u8ff0\u6027\u7814\u7a76\uff0c<br>E = \u5c08\u5bb6\u610f\u898b\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p><strong>\u521d\u59cb\u8a2a\u554f\u3002<\/strong><\/p>\n\n\n\n<p><u>\u8a55\u4f30\u3002<\/u> \u8a55\u4f30\u56b4\u91cd\u75be\u75c5\u7684\u300c\u7d05\u65d7\u300d\u9ad4\u5fb5\u548c\u75c7\u72c0\u4ee5\u53ca\u6162\u6027\u6b98\u75be\u7684\u5fc3\u7406\u548c\u793e\u6703\u98a8\u96aa\uff08\u8868 1\uff09\u3002 \u8a3a\u65b7\u6e2c\u8a66\u901a\u5e38\u662f\u4e0d\u5fc5\u8981\u7684 [ID]\u3002 \u8a55\u4f30\u810a\u67f1\u3001\u9aa8\u76c6\u548c\u81c0\u90e8\u3002 \u5982\u679c\u60a3\u8005\u6709\u3008\u5c0e\u81f4\u81e8\u5e8a\u61f7\u7591\u56b4\u91cd\u75be\u75c5\u7684\u3009\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\uff0c\u8acb\u9032\u884c\u76f8\u95dc\u7684\u8a3a\u65b7\u6e2c\u8a66\/\u6210\u50cf\u4e26\u8f49\u8a3a\u7d66\u5408\u9069\u7684\u5c08\u5bb6\u3002<\/p>\n\n\n\n<figure data-theadfix=\"both\" class=\"wp-block-table\"><table><thead><tr><th><strong>\u7d05\u65d7\u767c\u73fe<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>\u99ac\u5c3e<\/strong>\u75c7\u5019\u7fa4<\/th><th class=\"has-text-align-center\" data-align=\"center\">\u9aa8\u6298<\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>\u764c\u75c7<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>\u611f\u67d3<\/strong><\/th><\/tr><\/thead><tbody><tr><td>\u9032\u884c\u6027\u795e\u7d93\u529f\u80fd\u7f3a\u640d<\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>\u6700\u8fd1\u7684\u8178\u6216\u8180\u80f1\u529f\u80fd\u969c\u7919<\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>\u99ac\u978d\u5f0f\u611f\u89ba\u55aa\u5931<\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>\u5275\u50b7\u6027\u53d7\u50b7\/\u767c\u4f5c\uff0c\u7d2f\u7a4d\u5275\u50b7<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>\u985e\u56fa\u9187\u4f7f\u7528\u53f2<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u5973\u6027\u5e74\u9f61 &gt; 50<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>\u7537\u6027\u5e74\u9f61 &gt; 50<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>\u5ee2\u7528\u6027\u9aa8\u8cea\u758f\u9b06\u75c7\u6216\u58d3\u7e2e\u6027\u9aa8\u6298\u75c5\u53f2<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>\u764c\u75c7\u75c5\u53f2<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><\/tr><tr><td>\u7cd6\u5c3f\u75c5<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u767c\u75c5\u96b1\u533f<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u7761\u524d\u7121\u7de9\u89e3\u6216\u4ef0\u81e5\u6642\u52a0\u91cd<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u5168\u8eab\u75c7\u72c0\uff08\u5982\u767c\u71d2\u3001\u9ad4\u91cd\u6e1b\u8f15\uff09<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u5c3f\u8def\u611f\u67d3\u6216\u5176\u4ed6\u611f\u67d3\u53f2<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u975c\u8108\u7528\u85e5<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u827e\u6ecb\u75c5\u75c5\u6bd2<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u514d\u75ab\u6291\u5236<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><tr><td>\u5148\u524d\u7684\u624b\u8853<\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\"><\/td><td class=\"has-text-align-center\" data-align=\"center\">X<\/td><\/tr><\/tbody><\/table><figcaption class=\"wp-element-caption\"><strong>\u88681\u3001\u56b4\u91cd\u75be\u75c5\u7684\u300c\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u300d\u3002<\/strong><\/figcaption><\/figure>\n\n\n\n<p><u>\u901a\u5e38\u6c92\u6709\u9020\u5f71\u3002<\/u> \u4e0d\u63a8\u85a6\u5c0d\u301d\u51fa\u73fe\u75c7\u72c0\u7684\u524d 4-6 \u9031\u5167\u301e\u6709\u6025\u6027\u8170\u80cc\u554f\u984c\u7684\u60a3\u8005\u9032\u884c X \u5149\u3001MRI \u548c CT \u6383\u63cf\u7684\u5e38\u898f\u8a55\u4f30\uff0c\u9664\u975e\u5728\u81e8\u5e8a\u8a55\u4f30\u4e2d\u767c\u73fe\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\uff08\u5716 1\uff09\u3002<\/p>\n\n\n\n<p><u>\u60a3\u8005\u6559\u80b2\u3002<\/u> \u6559\u80b2\u60a3\u8005\u4ed6\u5011\u7684\u9810\u5f8c\u826f\u597d [IC*]\u3002<\/p>\n\n\n\n<p><u>\u6cbb\u7642\u3002<\/u> \u6cbb\u7642\u5f15\u8d77\u75bc\u75db\u7684\u75be\u75c5\u3002 \u5c0d\u65bc\u75bc\u75db\uff0c\u6cbb\u7642\u65b9\u6848\u5305\u62ec\uff1a\u71b1\u7642 [IIE]\u3001\u975e\u985e\u56fa\u9187\u6297\u767c\u708e\u85e5\uff08\u8868 8\uff09[IIA]\u3001\u975e\u82ef\u4e8c\u6c2e\u5e73\u985e\u808c\u8089\u9b06\u5f1b\u5291\uff08\u8868 8\uff09[IIA]\uff0c\u4e26\u6062\u5fa9\u65e5\u5e38\u6d3b\u52d5\u3002 \u4e0d\u63a8\u85a6\u5c07\u81e5\u5e8a\u4f11\u606f\u548c\u9d09\u7247\u985e\u85e5\u7269\u4f5c\u70ba\u4e00\u7dda\u6cbb\u7642 [IIIA]\u3002<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">\u5b9a\u7fa9<\/h2>\n\n\n\n<p><strong>\u8170\u80cc\u75db<\/strong><small class=\"mininote\">\u3014<u>Low&nbsp;back&nbsp;pain<\/u>\u3015<\/small>\u662f\u5f9e\u4e0b\u80f8\u8154\u5230\u6c34\u5e73\u81c0\u88c2\u7684\u8ec0\u5e79\u5f8c\u90e8\u75bc\u75db\u3002 \u5b83\u9084\u5305\u62ec\u7531\u8170\u80cc\u75be\u75c5\uff08\u5373\u5750\u9aa8\u795e\u7d93\u75db\u6216\u653e\u5c04\u6027\u8170\u80cc\u75db\uff09\u5f15\u8d77\u7684\u4e0b\u80a2\u75bc\u75db\uff0c\u7121\u8ad6\u662f\u5426\u6709\u8ec0\u5e79\u75db\u3002<\/p>\n\n\n\n<p><strong>\u5750\u9aa8\u795e\u7d93\u75db<\/strong><small class=\"mininote\">\u3014<u>Sciatica<\/u>\u3015<\/small>\u662f\u653e\u5c04\u6027\u4e0b\u80a2\u75bc\u75db\uff0c\u53ef\u80fd\u8207\u80cc\u75db\u6709\u95dc\uff0c\u4e5f\u53ef\u80fd\u7121\u95dc\u3002 \u61c9\u5c07\u5750\u9aa8\u795e\u7d93\u75db\u8207\u975e\u653e\u5c04\u6027\uff08\u8ef8\u5411\uff09\u8170\u80cc\u75db\u5340\u5206\u958b\u4f86\u3002<\/p>\n\n\n\n<p><strong>\u6025\u6027\u8170\u80cc\u75db<\/strong><small class=\"mininote\">\u3014<u>Acute low back pain<\/u>\u3015<\/small>\uff1a\u8170\u80cc\u75db\u6301\u7e8c\u6642\u9593&lt;6\u9031\u3002<\/p>\n\n\n\n<p><strong>\u4e9e\u6025\u6027\u8170\u80cc\u75db<\/strong><small class=\"mininote\">\u3014<u>Subacute low back pain<\/u>\u3015<\/small>\uff1a\u8170\u75db\u6301\u7e8c\u6642\u9593\u22656\u9031\uff0c\u4f46&lt;3\u500b\u6708\u3002<\/p>\n\n\n\n<p><strong>\u6162\u6027\u8170\u80cc\u75db<\/strong><small class=\"mininote\">\u3014<u>Chronic low back pain<\/u>\u3015<\/small>\uff1a\u8170\u80cc\u75db\u4f7f\u60a3\u8005\u7121\u6cd5\u9032\u884c\u67d0\u4e9b\u751f\u6d3b\u6d3b\u52d5 \u2265 3 \u500b\u6708\u3002<\/p>\n\n\n\n<p><strong>\u5fa9\u767c\u6027\u8170\u80cc\u75db<\/strong><small class=\"mininote\">\u3014<u>Recurrent low back pain<\/u>\u3015<\/small>\uff1a\u60a3\u8005\u7684\u6025\u6027\u8170\u80cc\u75db\uff0c\u5148\u524d\u66fe\u5728\u76f8\u4f3c\u90e8\u4f4d\u767c\u4f5c\u904e\u8170\u75db\uff0c\u5169\u6b21\u767c\u4f5c\u4e4b\u9593\u7121\u75c7\u72c0\u9593\u9694<small class=\"mininote\"><sup> [3] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">\u95dc\u6ce8\u9ede\u548c\u554f\u984c<\/h2>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u6982\u8981<\/span><\/div><div class=\"cap_box_content\">\n<ul>\n<li>\u8170\u80cc\u75db\u7684\u60a3\u75c5\u7387\u5f88\u9ad8\u3002<\/li>\n\n\n\n<li>\u8ca1\u52d9\u5f71\u97ff\u662f\u5de8\u5927\u7684\u3002<\/li>\n\n\n\n<li>\u96d6\u7136\u5927\u591a\u6578\u4eba\u7684\u6025\u6027\u9810\u5f8c\u826f\u597d\uff0c\u4f46\u5c11\u6578\u75c7\u72c0\u6301\u7e8c\u6642\u9593\u8f03\u9577\u7684\u60a3\u8005\u9810\u5f8c\u8f03\u5dee\u3002<\/li>\n\n\n\n<li>\u80a5\u80d6\u6216\u5438\u7159\u7684\u9810\u5f8c\u66f4\u5dee\u3002<\/li>\n\n\n\n<li>\u7576\u6709\u6162\u6027\u75bc\u75db\u7684\u60a3\u8005\u51fa\u73fe\u65b0\u7684\u6025\u6027\u8170\u75db\u6642\uff0c\u5c0d\u300c\u6025\u6027\u75bc\u75db\u7684\u8a3a\u65b7\u548c\u6cbb\u7642\u7684\u4e00\u822c\u5efa\u8b70\u300d\u8207\u6c92\u6709\u6162\u6027\u75bc\u75db\u7684\u60a3\u8005\u76f8\u540c\u3002<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<h3 class=\"wp-block-heading\">\u60a3\u75c5\u7387\u9ad8<\/h3>\n\n\n\n<p>\u7f8e\u570b\u4eba\u53e3\u4e2d\u8170\u80cc\u75db\u7684\u4e00\u5e74\u6d41\u884c\u7387\u70ba 15-20%<small class=\"mininote\"><sup> [4,5] <\/sup><\/small>\u3002 80% \u7684\u4eba\u53e3\u5728\u5176\u4e00\u751f\u4e2d\uff0c\u81f3\u5c11\u7d93\u6b77\u904e\u4e00\u6b21\u5931\u80fd\u6027\u8170\u80cc\u75db\u7684\u60c5\u7bc0\u3002 \u5927\u7d04 40% \u7684\u8170\u80cc\u75db\u60a3\u8005\u6700\u521d\u6703\u5c0b\u6c42\u521d\u7d1a\u4fdd\u5065\u91ab\u751f\u7684\u5e6b\u52a9\uff0c40% \u7684\u4eba\u6703\u5c0b\u6c42\u810a\u690e\u6309\u6469\u5e2b\u7684\u5e6b\u52a9\uff0c20% \u7684\u4eba\u6703\u5c0b\u6c42\u4e9e\u5c08\u79d1\u91ab\u751f\u7684\u5e6b\u52a9\u3002 <\/p>\n\n\n\n<p>\u6025\u6027\u8170\u80cc\u75db\u662f\u5c31\u8a3a\u65bc\u521d\u7d1a\u4fdd\u5065\u91ab\u751f\u7684\u7b2c\u4e8c\u5927\u5e38\u898b\u75c7\u72c0\u539f\u56e0\uff0c\u4e5f\u662f\u5c31\u8a3a\u65bc\u6574\u5f62\u5916\u79d1\u91ab\u751f\u3001\u795e\u7d93\u5916\u79d1\u91ab\u751f\u548c\u8077\u696d\u91ab\u5b78\u91ab\u751f\u7684\u6700\u5e38\u898b\u539f\u56e0\u3002 \u8170\u80cc\u75db\u7684\u5fa9\u767c\u5f88\u5e38\u898b\uff1b 60-80% \u7684\u60a3\u8005\u6703\u5728\u5169\u5e74\u5167\u5fa9\u767c\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u91cd\u5927\u7684\u8ca1\u52d9\u5f71\u97ff<\/h3>\n\n\n\n<p>\u8170\u80cc\u75db\u5c0d\u500b\u4eba\u3001\u793e\u6703\u548c\u8ca1\u52d9\u7684\u5f71\u97ff\u662f\u5de8\u5927\u7684<small class=\"mininote\"><sup> [6] <\/sup><\/small>\u3002 \u5728\u7f8e\u570b\uff0c\u6bcf\u5e74\u7684\u76f4\u63a5\u6210\u672c\u70ba 400 \u5104\u7f8e\u5143\uff0c\u6bcf\u5e74\u7684\u9593\u63a5\u6210\u672c\uff08\u5de5\u8cc7\u548c\u751f\u7522\u529b\u640d\u5931\u3001\u6cd5\u5f8b\u548c\u4fdd\u96aa\u8cbb\u7528\u4ee5\u53ca\u5c0d\u5bb6\u5ead\u7684\u5f71\u97ff\uff09\u8d85\u904e 100 \u7f8e\u5143 \u5341\u5104\u3002 \u904e\u5ea6\u4f7f\u7528\u8a3a\u65b7\u548c\u6cbb\u7642\u65b9\u5f0f\uff0c\u4ee5\u53ca\u4e0d\u9069\u7576\u7684\u6d3b\u52d5\u9650\u5236\u6703\u5c0e\u81f4\u91cd\u8981\u7684\u6025\u6027\u8b77\u7406\u8cbb\u7528\u3002 \u5c11\u6578\u6210\u70ba\u6162\u6027\u6b98\u75be\u7684\u4eba\u6d88\u8017\u4e8680%\u7684\u6210\u672c\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u6025\u6027\u9810\u5f8c\u826f\u597d\uff0c\u4f46\u96a8\u6642\u9593\u60e1\u5316<\/h3>\n\n\n\n<p>\u7d55\u5927\u591a\u6578\u60a3\u6709<u>\u975e\u653e\u5c04\u6027<\/u>\u8170\u80cc\u75db\u7684\u4eba\u6703\u5728 6 \u9031\u5167\u7de9\u89e3\u75c7\u72c0<small class=\"mininote\"><sup> [7] <\/sup><\/small>\u3002\u5927\u7d04\u4e00\u534a\u7684<u>\u653e\u5c04\u6027<\/u>\u8170\u80cc\u75db\u60a3\u8005\u6703\u5728 6 \u9031\u5167\u81ea\u767c\u5eb7\u5fa9\u3002<\/p>\n\n\n\n<p>\u96a8\u8457\u6642\u9593\u7684\u63a8\u79fb\uff0c\u9810\u5f8c\u6703\u60e1\u5316\u5230\uff1a\u4e00\u5c0f\u90e8\u5206\u56e0\u8170\u80cc\u75db\u800c\u5728\u4e09\u500b\u6708\u5167\u4ecd\u8655\u65bc\u5931\u80fd\u72c0\u614b\u7684\u4eba\uff0c\u5176\u5eb7\u5fa9\u7684\u6a5f\u6703\u4e0d\u5230 50%\uff0c\u4ee5\u53ca\u5982\u679c\u4e0d\u53ca\u6642\u6cbb\u7642\uff0c\u4e00\u5e74\u5f8c\u5931\u696d\u7684\u4eba\u6709 10% \u7684\u6a5f\u6703\u91cd\u65b0\u7372\u5f97\u6709\u916c\u5de5\u4f5c\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u6162\u6027\u75bc\u75db\u4e2d\u7684\u6025\u6027\u767c\u4f5c<\/h3>\n\n\n\n<p>\u7576\u6709\u6162\u6027\u75bc\u75db\u7684\u60a3\u8005\u51fa\u73fe\u65b0\u7684\u6025\u6027\u8170\u75db\u6642\uff0c\u5c0d\u300c\u6025\u6027\u75bc\u75db\u7684\u8a3a\u65b7\u548c\u6cbb\u7642\u7684\u4e00\u822c\u5efa\u8b70\u300d\u8207\u6c92\u6709\u6162\u6027\u75bc\u75db\u7684\u60a3\u8005\u76f8\u540c\u3002 \u5728\u5c0d\u7279\u5b9a\u60a3\u8005\u7684\u6025\u6027\u75bc\u75db\u9032\u884c\u500b\u9ad4\u5316\u6cbb\u7642\u6642\uff0c\u8003\u616e\u6162\u6027\u75bc\u75db\u7684\u539f\u56e0\u548c\u5f71\u97ff\uff0c\u4ee5\u53ca\u6162\u6027\u75bc\u75db\u7684\u6cbb\u7642\u65b9\u6cd5\u3002 \u5728\u8a55\u4f30\u6025\u6027\u75bc\u75db\u662f\u5426\u5df2\u7d93\u7de9\u89e3\u6642\uff0c\u9084\u8981\u8003\u616e\u4ee5\u524d\u7684\u6162\u6027\u75bc\u75db\u57fa\u7dda\u6c34\u5e73\u3002 \u6709\u95dc\u6cbb\u7642\u6162\u6027\u75bc\u75db\u7684\u66f4\u591a\u4fe1\u606f\uff0c\u8acb\u53c3\u95b1\u5bc6\u897f\u6839\u91ab\u5b78\u6162\u6027\u75bc\u75db\u6307\u5357\u3002<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">\u8a3a\u65b7<\/h2>\n\n\n\n<p><strong>\u8a3a\u65b7\u901a\u5e38\u5f88\u56f0\u96e3<\/strong><\/p>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u6982\u8981<\/span><\/div><div class=\"cap_box_content\">\n<p>\u5927\u591a\u6578\u8170\u80cc\u75db\u75c5\u4f8b\u7121\u6cd5\u9032\u884c\u89e3\u5256\u5b78\u8a3a\u65b7\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u8170\u80cc\u75db\u7684\u539f\u56e0\u53ef\u80fd\u662f\uff1a<\/p>\n\n\n\n<ul>\n<li>\u6a5f\u68b0\u6027\uff08\u6d89\u53ca\u810a\u67f1\u53ca\u5176\u652f\u6490\u7d50\u69cb\uff09<\/li>\n\n\n\n<li>\u795e\u7d93\u6027\uff08\u523a\u6fc0\u795e\u7d93\u6839\uff09<\/li>\n\n\n\n<li>\u7e7c\u767c\u65bc\u53e6\u4e00\u500b\u539f\u56e0\u3002<\/li>\n<\/ul>\n\n\n\n<p>\u4f5c\u70ba\u80cc\u666f\uff0c\u8170\u80cc\u75db\u7684\u9451\u5225\u8a3a\u65b7\u898b\u8868 3<small class=\"mininote\"><sup> [8-11] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u8170\u75db\u7684\u8a31\u591a\u5e38\u898b\u539f\u56e0\u7121\u6cd5\u901a\u904e\u8a3a\u65b7\u6e2c\u8a66\u4f86\u9a57\u8b49\u3002 \u9019\u4e9b\u5305\u62ec\u808c\u8089\u62c9\u50b7\u3001\u97cc\u5e36\u626d\u50b7\u6216\u690e\u9593\u76e4\u7e96\u7dad\u74b0\u7684\u5c0f\u6495\u88c2\uff0c\u9019\u4e9b\u5728\u76f4\u89ba\u4e0a\u4f3c\u4e4e\u662f\u75bc\u75db\u7684\u539f\u56e0\u3002 \u5176\u4ed6\u53ef\u80fd\u7684\u8a3a\u65b7\uff0c\u5982\u5c0f\u95dc\u7bc0\u95dc\u7bc0\u708e\uff08\u9000\u884c\u6027\u95dc\u7bc0\u75c5\uff09\u3001\u9ab6\u9ac2\u95dc\u7bc0\u4e0d\u5c0d\u7a31\u6216\u690e\u9593\u76e4\u7a81\u51fa\uff0c\u5728\u7d71\u8a08\u5b78\u4e0a\u8207\u5927\u91cf\u4eba\u7fa4\u4e2d\u75bc\u75db\u7684\u5b58\u5728\u6c92\u6709\u76f8\u95dc\u6027\uff0c\u5728\u8a2d\u8a08\u63a7\u5236\u6f5b\u5728\u504f\u5dee\u7684\u7814\u7a76\u4e2d\uff0c\u4e5f\u4e0d\u6703\u5728\u6aa2\u67e5\u6216\u6ce8\u5c04\u6642\u518d\u73fe\u75bc\u75db\u6216\u6e1b\u8f15\u75bc\u75db\u3002<\/p>\n\n\n\n<p>\u6709\u4e9b\u539f\u56e0\u7b26\u5408\u6709\u64da\u53ef\u67e5\u7684\u7d9c\u5408\u5fb5\uff0c\u4f8b\u5982\u690e\u9593\u76e4\u7a81\u51fa\u3001\u810a\u690e\u6ed1\u812b\u6216\u690e\u7ba1\u72f9\u7a84\u3002 \u5373\u4f7f\u5728\u9019\u4e9b\u60c5\u6cc1\u4e0b\uff0c\u8a3a\u65b7\u4e5f\u5f80\u5f80\u4e26\u4e0d\u7c21\u55ae\u3002 \u4f8b\u5982\uff0c\u4e09\u5206\u4e4b\u4e00\u7684\u7121\u75c7\u72c0\u5fd7\u9858\u8005\u5728 MRI \u4e0a\u6709\u690e\u9593\u76e4\u6539\u8b8a\u3002 \u653e\u5c04\u79d1\u91ab\u5e2b\u7684\u72f9\u7a84\u5831\u544a\u548c\u690e\u7ba1\u5f71\u50cf\u5b78\u6e2c\u91cf\u90fd\u4e0d\u80fd\u7528\u65bc\u80af\u5b9a\u8a3a\u65b7\u690e\u7ba1\u72f9\u7a84\u7684\u81e8\u5e8a\u7d9c\u5408\u5fb5\u3002 X \u5149\u6aa2\u67e5\u767c\u73fe\u7684\u8f15\u5ea6\u810a\u690e\u6ed1\u812b\u901a\u5e38\u6c92\u6709\u75c7\u72c0\u3002 \u5728\u9019\u4e9b\u60c5\u6cc1\u4e0b\uff0c\u5fc5\u9808\u7d50\u5408\u81e8\u5e8a\u75c5\u53f2\u548c\u9ad4\u683c\u6aa2\u67e5\u4f86\u89e3\u8b80\u8a3a\u65b7\u6e2c\u8a66\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u75c5\u53f2\u548c\u9ad4\u683c\u6aa2\u67e5<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u5c0d\u65bc\u8170\u80cc\u75db\u60a3\u8005\uff0c\u9032\u884c\u75c5\u53f2\u548c\u9ad4\u683c\u6aa2\u67e5\uff0c\u5305\u62ec\u8b58\u5225\u548c\u8a55\u4f30\uff1a<\/p>\n\n\n\n<ul>\n<li>\u56b4\u91cd\u75be\u75c5\u7684\u7d05\u65d7\u4fe1\u865f\u548c\u75c7\u72c0\uff0c\u5305\u62ec\u795e\u7d93\u529f\u80fd\u7f3a\u9677\u548c\u60e1\u6027\u816b\u7624\u3001\u9aa8\u6298\u6216\u611f\u67d3\u7684\u75c7\u72c0\uff08\u898b\u8868 1\uff09\u3002<\/li>\n\n\n\n<li>\u8207\u6162\u6027\u6b98\u75be\u76f8\u95dc\u7684\u975e\u5668\u8cea\u6027\u75bc\u75db\u548c\u793e\u6703\u5fc3\u7406\u56e0\u7d20\u7684\u9ad4\u5fb5\uff08\u898b\u8868 2\uff09\u3002<\/li>\n\n\n\n<li>\u53ef\u80fd\u6539\u8b8a\u6cbb\u7642\u7684\u5fc3\u7406\u5065\u5eb7\u72c0\u6cc1\u3002<\/li>\n\n\n\n<li>\u53ef\u5f71\u97ff\u7d50\u679c\u7684\u5171\u75c5\u6027\u80a5\u80d6\u3002<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<h4 class=\"wp-block-heading\">\u56b4\u91cd\u75be\u75c5\u7684\u7d05\u65d7\u4fe1\u865f\u548c\u75c7\u72c0<\/h4>\n\n\n\n<p>\u5c11\u6578\u60a3\u8005\u6703\u51fa\u73fe\u8170\u75db\u7684\u5371\u96aa\u539f\u56e0\uff08\u898b\u8868 1\uff09\u3002 \u5c0d\u75c5\u53f2\u548c\u9ad4\u683c\u6aa2\u67e5\u7d50\u679c\u7684\u654f\u611f\u6027\u6709\u9650\uff0c\u5305\u62ec\u5c0d\u5371\u96aa\u4fe1\u865f\u7d50\u679c\u7684\u8a55\u4f30\u3002 \u7136\u800c\uff0c\u300e\u907a\u6f0f\u91cd\u8981\u7684\u9032\u884c\u6027\u75be\u75c5\u7684\u98a8\u96aa\u300f\u6bd4\u300e\u5728\u5047\u967d\u6027\u75c5\u4f8b\u4e2d\u9032\u884c\u4e0d\u5fc5\u8981\u6aa2\u6e2c\u7684\u98a8\u96aa\u548c\u6210\u672c\u300f\u5177\u6709\u66f4\u5927\u7684\u5f8c\u679c\u3002 \u5fb9\u5e95\u7684\u6aa2\u67e5\u548c\u6e2c\u8a66\u53ef\u80fd\u6703\u767c\u73fe\u6f5b\u5728\u7684\u60e1\u6027\u816b\u7624\u6216\u9aa8\u6298\uff0c\u4f46\u5728\u8b58\u5225\u611f\u67d3\u6216\u99ac\u5c3e\u7d9c\u5408\u75c7\u65b9\u9762\u4e0d\u592a\u6e96\u78ba\u3002 \u907f\u514d\u5728\u8a55\u4f30\u904e\u7a0b\u4e2d\u9a5a\u52d5\u60a3\u8005\u4ee5\u9650\u5236\u5fc3\u7406\u56f0\u64fe<small class=\"mininote\"><sup> [12-18] <\/sup><\/small>\u3002 <\/p>\n\n\n\n<p><u>\u99ac\u5c3e\u7d9c\u5408\u75c7<\/u><small class=\"mininote\">\u3014Cauda equina syndrom\u3015<\/small>\u6703\u5c0e\u81f4\u795e\u7d93\u529f\u80fd\u9032\u884c\u6027\u55aa\u5931\uff0c\u5305\u62ec\u5927\u5c0f\u4fbf\u5931\u7981\uff0c\u662f\u4e00\u7a2e\u5916\u79d1\u6025\u75c7\u3002 \u9aa8\u8cea\u758f\u9b06\u75c7\u60a3\u8005\u53ef\u80fd\u56e0\u9ad8\u901f\u6c96\u64ca\u6216\u8f15\u5fae\u5916\u50b7\u800c\u767c\u751f<u>\u9aa8\u6298<\/u><small class=\"mininote\">\u3014Fractures\u3015<\/small>\u3002 \u9700\u8981\u9ad8\u5ea6\u61f7\u7591\u624d\u80fd\u8a3a\u65b7\u4e0d\u5e38\u898b\u7684\u554f\u984c\uff0c\u4f8b\u5982<u>\u816b\u7624<\/u><small class=\"mininote\">\u3014tumors\u3015<\/small>\uff08\u8f49\u79fb\u6027\u591a\u65bc\u539f\u767c\u6027\uff09\u548c<u>\u611f\u67d3<\/u><small class=\"mininote\">\u3014infections\u3015<\/small>\uff08\u4f8b\u5982\u786c\u819c\u5916\u81bf\u816b\u6216\u690e\u9593\u76e4\u611f\u67d3\uff09\u3002 <u>\u5168\u8eab\u6027\u75be\u75c5<\/u><small class=\"mininote\">\u3014infections\u3015<\/small>\u53ef\u8868\u73fe\u70ba\u80cc\u75db\uff0c\u5305\u62ec\u591a\u767c\u6027\u95dc\u7bc0\u708e\u3001\u814e\u7d50\u77f3\u3001\u814e\u81df\u611f\u67d3\u3001\u4e3b\u52d5\u8108\u7624\u3001\u795e\u7d93\u75be\u75c5\u3001\u808c\u8089\u75be\u75c5\u548c\u5404\u7a2e\u4ee3\u8b1d\u7d0a\u4e82\u3002 \u5728\u6975\u5c11\u6578\u60c5\u6cc1\u4e0b\uff0c\u4e3b\u8981\u8a3a\u65b7\u70ba\u7654\u75c7\u3001\u88dd\u75c5\u6216\u8ec0\u9ad4\u5316\u969c\u7919\u7b49<u>\u7cbe\u795e\u75be\u75c5<\/u><small class=\"mininote\">\u3014psychiatric diseases\u3015<\/small>\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u810a\u67f1\u548c\u81c0\u90e8<\/h4>\n\n\n\n<p>\u810a\u67f1\u548c\u81c0\u90e8\u7684\u9ad4\u683c\u6aa2\u67e5\u4f7f\u81e8\u5e8a\u91ab\u751f\u80fd\u5920\u8b58\u5225\u7279\u5b9a\u7684\u75be\u75c5<small class=\"mininote\"><sup> [12-18] <\/sup><\/small>\u3002 \u6709\u9ad6\u95dc\u7bc0\u75c5\u7406\u9ad4\u683c\u6aa2\u67e5\u7d50\u679c\u7684\u8170\u75db\u60a3\u8005\u901a\u5e38\u6709\u6b65\u614b\u529f\u80fd\u969c\u7919\u548c\u75bc\u75db\uff0c\u901a\u5e38\u6703\u653e\u5c04\u5230\u8179\u80a1\u6e9d\u3001\u81c0\u90e8\u548c\u5927\u817f\u4e0a\u90e8<small class=\"mininote\"><sup> [19] <\/sup><\/small>\u3002 \uff08\u5728\u9019\u4e9b\u60a3\u8005\u4e2d\uff0c\u91dd\u5c0d\u81c0\u90e8\u7684\u6cbb\u7642\u53ef\u6539\u5584\u75bc\u75db\u3001\u529f\u80fd\u548c\u60a3\u8005\u9810\u5f8c<small class=\"mininote\"><sup> [20] <\/sup><\/small>\u3002\uff09\u60a3\u6709\u653e\u5c04\u6027\u75bc\u75db\u7684\u60a3\u8005\u66f4\u6709\u53ef\u80fd\u5c07\u4ed6\u5011\u7684\u75bc\u75db\u63cf\u8ff0\u70ba\u69cd\u64ca\u6216\u523a\u75db\uff0c\u4e26\u4e14\u75bc\u75db\u6703\u653e\u5c04\u5230\u819d\u84cb\u4ee5\u4e0b\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u52d5\u4f5c<\/h4>\n\n\n\n<p>\u80cc\u75db\u7684\u6a5f\u68b0\u539f\u56e0\u901a\u5e38\u96a8\u8457\u52d5\u4f5c\u800c\u52a0\u91cd\uff0c\u96a8\u8457\u4f11\u606f\u800c\u6539\u5584\u3002 \u9577\u6642\u9593\u5750\u8457\u6216\u524d\u5c48\u53ef\u80fd\u6703\u52a0\u91cd\u690e\u9593\u76e4\u75be\u75c5\u3002 \u690e\u7ba1\u72f9\u7a84\u5f15\u8d77\u7684\u75bc\u75db\u901a\u5e38\u901a\u904e\u524d\u5c48\uff08\u63a8\u52d5\u5272\u8349\u6a5f\u6216\u96dc\u8ca8\u8eca\uff09\u7de9\u89e3\uff0c\u4e26\u96a8\u8457\u4f38\u5c55\u800c\u60e1\u5316\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u91cd\u9ede\u8a55\u4f30<\/h4>\n\n\n\n<p>\u91cd\u9ede\u8a55\u4f30\u5305\u62ec\uff1a<\/p>\n\n\n\n<div class=\"wp-block-group has-border -border04\"><div class=\"wp-block-group__inner-container\">\n<ul class=\"is-style-index -list-under-dashed\">\n<li>\u80cc\u90e8\u3002 \u8a55\u4f30\u80cc\u90e8\u58d3\u75db\u548c\u80cc\u90e8\u6d3b\u52d5\u5ea6\u7684\u5340\u57df\uff0c\u5305\u62ec\u5c48\u66f2\u3001\u4f38\u5c55\u548c\u5074\u5411\u65cb\u8f49\u7684\u7a0b\u5ea6\uff08\u898b\u8868 4\uff09\u3002<\/li>\n\n\n\n<li><u>\u808c\u8089<\/u>\u3002 \u6e2c\u8a66\u808c\u8089\u529b\u91cf\u3001\u53cd\u5c04\u548c\u904b\u52d5\u7bc4\u570d\u3002 \u61c9\u9032\u884c\u529b\u91cf\u6aa2\u67e5\uff0c\u4ee5\u4fbf\u6aa2\u67e5\u8005\u514b\u670d\u6bcf\u584a\u808c\u8089\u7684\u529b\u91cf\uff0c\u4ee5\u8a55\u4f30\u5176\u5b8c\u6574\u7684\u795e\u7d93\u652f\u914d\u3002 \u5728\u5fae\u5999\u7684\u60c5\u6cc1\u4e0b\uff0c\u5982\u679c\u4f86\u81ea\u4e0d\u540c\u795e\u7d93\u4f46\u540c\u4e00\u6839\u7684\u5169\u584a\u808c\u8089\u548c\u76f8\u61c9\u7684\u53cd\u5c04\u5747\u7570\u5e38\uff0c\u5247\u66f4\u78ba\u5b9a\u771f\u6b63\u7684\u795e\u7d93\u6839\u75c5\u3002 \u591a\u6839\u795e\u7d93\u529f\u80fd\u7f3a\u640d\u8868\u660e\u66f4\u56b4\u91cd\u7684\u810a\u67f1\u6216\u795e\u7d93\u7cfb\u7d71\u75be\u75c5\u6216\u75bc\u75db\u6291\u5236\uff08\u5927\u8166\u6291\u5236\u6216\u963b\u65b7\u9023\u7e8c\u75bc\u75db\u523a\u6fc0\u7684\u6b63\u5e38\u80fd\u529b\uff09\u3002<\/li>\n\n\n\n<li><u>\u76f4\u62ac\u817f\u6e2c\u8a66<\/u><small class=\"mininote\">\u3014Straight leg test\u3015<\/small>\u3002 \u76f4\u62ac\u817f\u8a66\u9a57\u967d\u6027\u9700\u8981\u819d\u84cb\u4ee5\u4e0b\u6709\u75bc\u75db\u8f3b\u5c04\u3002 \u76f4\u62ac\u817f\u8a66\u9a57\u53ef\u6aa2\u6e2c 90% \u4ee5\u4e0a\u7531\u690e\u9593\u76e4\u7a81\u51fa\u5f15\u8d77\u7684\u5177\u6709\u81e8\u5e8a\u610f\u7fa9\u7684\u795e\u7d93\u6839\u75c5\u3002<\/li>\n\n\n\n<li><u>\u80a1\u9aa8\u7684\u4f38\u5c55<\/u><small class=\"mininote\">\u3014Femoral stretch\u3015<\/small>\u3002 \u80a1\u9aa8\u7684\u4f38\u5c55\u8a66\u9a57\u5c0d\u4e0d\u592a\u5e38\u898b\u7684\u9ad8\u4f4d\u8170\u690e\u9593\u76e4\u7a81\u51fa\u75c7\u7684\u654f\u611f\u5ea6\u7d04\u70ba 50%\u3002 \u8a72\u6e2c\u8a66\u6d89\u53ca\u4fef\u81e5\u60a3\u8005\u7684\u9ad6\u90e8\u4f38\u5c55\uff1b \u5927\u817f\u524d\u5074 (L2\u20133) \u6216\u5c0f\u817f\u5167\u5074 (L4) \u75bc\u75db\u7684\u5b58\u5728\u8868\u660e\u5728\u6307\u5b9a\u7684\u6c34\u5e73\u4e0a\u5b58\u5728\u690e\u9593\u76e4\u7a81\u51fa\u3002<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<h4 class=\"wp-block-heading\">Waddell \u7684\u4e94\u500b\u300c\u975e\u5668\u8cea\u6027\u75bc\u75db\u300d\u9ad4\u5fb5<\/h4>\n\n\n\n<p>\u5982\u679c\u51fa\u73fe 5 \u500b Waddel \u5fb5\u4e2d\u7684\u4e09\u500b\u6216\u66f4\u591a\uff0c\u5247\u53ef\u80fd\u662f\u60a3\u8005\u75bc\u75db\u884c\u70ba\u7684\u5fc3\u56e0\u6027\u6210\u5206<small class=\"mininote\"><sup> [21-23] <\/sup><\/small>\u3002 <\/p>\n\n\n\n<div class=\"wp-block-group has-border -border04\"><div class=\"wp-block-group__inner-container\">\n<ol class=\"-list-under-dashed is-style-index\">\n<li><u>\u53cd\u61c9\u904e\u5ea6<\/u><small class=\"mininote\">\u3014Overreaction\u3015<\/small>\u3002 \u6e2c\u8a66\u671f\u9593\u7684\u53cd\u61c9\u904e\u5ea6\u3002<\/li>\n\n\n\n<li><u>\u6a21\u64ec\u7684\u6e2c\u8a66<\/u><small class=\"mininote\">\u3014Simulated testing\u3015<\/small>\u3002 \u7576\u8ef8\u5411\u8ca0\u8377\uff08\u58d3\u5728\u982d\u9802\uff09\u6216\u9aa8\u76c6\u548c\u80a9\u90e8\u5728\u540c\u4e00\u5e73\u9762\u4e0a\u65cb\u8f49\u6642\u5831\u544a\u75bc\u75db\u6642\uff0c\u9019\u662f\u967d\u6027\u7684\u3002<\/li>\n\n\n\n<li><u>\u76f4\u62ac\u817f\u6e2c\u8a66<\/u><small class=\"mininote\">\u3014Distracted testing\u3015<\/small>\u3002 \u5750\u8457\u5206\u5fc3\u7684\u6642\u5019\uff0c\u6e2c\u8a66\u76f4\u817f\u62ac\u9ad8\uff08\u4f8b\u5982\uff0c\u5728\u5750\u59ff\u6642\u4f38\u5c55\u819d\u84cb\uff0c\u540c\u6642\u8868\u73fe\u51fa\u5df4\u8cd3\u65af\u57fa\u53cd\u5c04<small class=\"mininote\">\u3014Babinski reflex\u3015<\/small>\uff09\u3002<\/li>\n\n\n\n<li><u>\u8868\u9762\u7684\u3001\u975e\u89e3\u5256\u5b78\u7684\u6216\u53ef\u8b8a\u7684\u58d3\u75db<\/u><small class=\"mininote\">\u3014Superficial, nonanatomical, or variable tenderness\u3015<\/small>\u3002 \u80cc\u90e8\u76ae\u819a\u6efe\u52d5\uff08\u5728\u808c\u8089\u4e0a\u79fb\u52d5\u76ae\u819a\uff0c\u89f8\u8a3a\u76f8\u5c0d\u8f03\u8f15\uff09\u6703\u986f\u8457\u589e\u52a0\u75bc\u75db\u3002 \u6a19\u8a18\u58d3\u75db\u5340\u57df\uff0c\u7a0d\u5f8c\u518d\u6b21\u6aa2\u67e5\u53ef\u91cd\u8907\u6027\u3002<\/li>\n\n\n\n<li><u>\u975e\u89e3\u5256\u5b78\u904b\u52d5\u6216\u611f\u89ba\u969c\u7919<\/u><small class=\"mininote\">\u3014Nonanatomical motor or sensory disturbances\u3015<\/small>\u3002 \u7576\u611f\u89ba\u55aa\u5931\u4e0d\u8ddf\u96a8\u76ae\u7bc0<small class=\"mininote\">\u3014dermatome\u3015<\/small>\uff0c\u6216\u6574\u689d\u817f\u9ebb\u6728\u6216\u7121\u529b\uff0c\u6216\u5728\u529b\u91cf\u6e2c\u8a66\u4e2d\u51fa\u73fe\u201c\u751f\u6f80\u7684<small class=\"mininote\">\u3014ratchety\u3015<\/small>\u201d\u8b93\u6b65\u6642\uff0c\u9019\u662f\u967d\u6027\u7684\u3002<\/li>\n<\/ol>\n<\/div><\/div>\n\n\n\n<p>\u5b58\u5728\u5169\u500b\u6216\u66f4\u591a\u9019\u4e9b\u767c\u73fe\u8207\u4e0d\u826f\u624b\u8853\u7d50\u679c\u76f8\u95dc\uff0c\u4f46\u8207\u5eb7\u5fa9\u7d50\u679c\u7121\u95dc\u3002 \u7814\u7a76\u7d50\u679c\u4e0d\u61c9\u88ab\u89e3\u91cb\u70ba\u7279\u5b9a\u65bc\u8a50\u75c5<small class=\"mininote\">\u3014malingering\u3015<\/small>\uff0c\u9019\u662f\u4e00\u7a2e\u4e0d\u5e38\u898b\u7684\u75be\u75c5\u3002 \u5728\u521d\u7d1a\u7167\u8b77\u6a5f\u69cb\u4e2d\uff0c\u6700\u597d\u5c07\u9019\u4e9b\u767c\u73fe\u8996\u70ba\u4e00\u7a2e\u8b66\u544a\uff0c\u5373\u60a3\u8005\u7684\u75bc\u75db\u5831\u544a\u4e0d\u6703\u6210\u70ba\u6cbb\u7642\u6210\u529f\u7684\u53ef\u9760\u6307\u5c0e\uff0c\u4e26\u4e14\u60a3\u8005\u6709\u6210\u70ba\u6162\u6027\u5931\u80fd\u7684\u98a8\u96aa\u3002 \u591a\u5b78\u79d1\u5eb7\u5fa9\u53ef\u80fd\u662f\u5fc5\u8981\u7684\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u793e\u6703\u5fc3\u7406\u98a8\u96aa\u56e0\u7d20<\/h4>\n\n\n\n<p>\u8207\u8170\u75db\u6210\u70ba\u6162\u6027\u5931\u80fd\u7684\u76f8\u95dc\u56e0\u7d20\uff0c\u8acb\u53c3\u898b\u8868 2\u3002 \u5177\u6709\u5371\u96aa\u56e0\u7d20\u7684\u60a3\u8005\u66f4\u6709\u53ef\u80fd\u9577\u671f\u767c\u5c55\u70ba\u6162\u6027\u80cc\u75db<small class=\"mininote\"><sup> [24-26] <\/sup><\/small>\u3002 \u8ec0\u9ad4\u5316<small class=\"mininote\">\u3014somatization\u3015<\/small>\u662f\u8b58\u5225\u6709\u9577\u671f\u6b98\u75be\u98a8\u96aa\u7684\u60a3\u8005\u7684\u91cd\u8981\u56e0\u7d20\u3002 \u97cc\u6027<small class=\"mininote\">\u3014resilience\u3015<\/small>\u548c\u61c9\u5c0d<small class=\"mininote\">\u3014coping\u3015<\/small>\u5c1a\u672a\u88ab\u8b49\u660e\u5177\u6709\u4fdd\u8b77\u4f5c\u7528<small class=\"mininote\"><sup> [27] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u5fc3\u7406\u5065\u5eb7\u7be9\u67e5<\/h4>\n\n\n\n<p>\u8f03\u5dee\u7684\u8170\u75db\u7d50\u679c\u8207\u5275\u50b7\u5f8c\u7cbe\u795e\u58d3\u529b\u969c\u7919<small class=\"mininote\">\u3014post-traumatic stress disorder\u3015<\/small>\u3001\u91cd\u5ea6\u6291\u9b31\u75c7<small class=\"mininote\">\u3014major depressive disorders\u3015<\/small>\u548c\u7126\u616e\u75c7<small class=\"mininote\">\u3014anxiety disorders\u3015<\/small>\u6709\u95dc<small class=\"mininote\"><sup> [24-26] <\/sup><\/small>\u3002 \u4f34\u6709\u6291\u9b31\u75c7<small class=\"mininote\">\u3014depression\u3015<\/small>\u7684\u8170\u75db\u60a3\u8005\u75bc\u75db\u5c0d\u751f\u6d3b\u7684\u5f71\u97ff\u66f4\u5927\u3001\u751f\u6d3b\u8cea\u91cf\u66f4\u4f4e\u3001\u7761\u7720\u554f\u984c\u66f4\u591a\uff0c\u4ee5\u53ca\u529f\u80fd\u969c\u7919\u66f4\u56b4\u91cd<small class=\"mininote\"><sup> [24-26] <\/sup><\/small>\u3002 \u6700\u8fd1\u7684\u96d9\u80de\u80ce\u7814\u7a76\u8b49\u660e\u4e86\u6291\u9b31\u75c7\u8207\u8170\u75db\u7684\u767c\u751f\u7387\u4e4b\u9593\u7684\u95dc\u4fc2\uff0c\u4f46\u8207\u5176\u9577\u671f\u6027\u7121\u95dc<small class=\"mininote\"><sup> [28,29] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u8d85\u91cd\u3001\u80a5\u80d6\u548c\u5438\u7159<\/h4>\n\n\n\n<p>\u8d85\u91cd\u3001\u80a5\u80d6\u548c\u5438\u7159\u662f\u8207\u300e\u7269\u7406\u6cbb\u7642\u7684\u529f\u80fd\u6cbb\u7642\u7d50\u679c\u5931\u6557\u300f\u76f8\u95dc\u7684\u95dc\u9375\u56e0\u7d20<small class=\"mininote\"><sup> [30] <\/sup><\/small>\u3002 \u60a3\u6709\u6025\u6027\u8170\u75db\u7684\u8d85\u91cd\u548c\u80a5\u80d6\u60a3\u8005\u5f80\u5f80\u8868\u73fe\u51fa\u66f4\u5927\u7684\u5931\u80fd\u3002 \u5c0d\u65bc II-III \u7d1a\u80a5\u80d6\u60a3\u8005\uff08BMI \u2265 35 kg\/m2\uff09\uff0c\u8207\u975e\u80a5\u80d6\u60a3\u8005\u76f8\u6bd4\uff0c\u7269\u7406\u6cbb\u7642\u5c0d\u8170\u75db\u7684\u5f71\u97ff\u8f03\u5c0f\uff0c\u4f46\u8b77\u7406\u8cbb\u7528\u589e\u52a0<small class=\"mininote\"><sup> [32] <\/sup><\/small>\u3002 \u5347\u9ad8\u7684 BMI\u3001\u8170\u570d\u3001\u8102\u80aa\u767e\u5206\u6bd4\u548c\u8102\u80aa\u91cf\u8207\u6162\u6027\u8170\u75db\u5931\u80fd\u6709\u95dc<small class=\"mininote\"><sup> [33] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u5be6\u9a57\u5ba4\u6e2c\u8a66<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u4e0d\u9700\u8981\u7279\u6b8a\u7684\u5be6\u9a57\u5ba4\u6aa2\u6e2c\uff0c\u9664\u975e\u662f\u5728\u5c0b\u627e\u56b4\u91cd\u75be\u75c5\u7684\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u548c\u75c7\u72c0\u6642\uff08\u8868 5\uff09\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u5c0d\u65bc\u5927\u591a\u6578\u6025\u6027\u8170\u75db\u60a3\u8005\uff0c\u5be6\u9a57\u5ba4\u6aa2\u67e5\u901a\u5e38\u7121\u6cd5\u78ba\u5b9a\u539f\u56e0\u6216\u6539\u8b8a\u6cbb\u7642\u3002<\/p>\n\n\n\n<p>\u5982\u679c\u61f7\u7591\u764c\u75c7\u6216\u611f\u67d3\uff0c\u5168\u8840\u7d30\u80de\u8a08\u6578<small class=\"mininote\">\u3014complete blood count\u3015<\/small> (CBC) \u548c\u7d05\u8840\u7403\u6c89\u964d\u7387<small class=\"mininote\">\u3014erythrocyte sedimentation rate\u3015<\/small> (ESR) \u6216 C \u53cd\u61c9\u86cb\u767d<small class=\"mininote\">\u3014C-reactive protein\u3015<\/small> (CRP) \u4f5c\u70ba\u521d\u59cb\u6aa2\u6e2c\u662f\u8db3\u5920\u4fbf\u5b9c\u548c\u6709\u6548\u7684\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u4fb5\u5165\u6027\u8a3a\u65b7\u6e2c\u8a66\/\u9020\u5f71<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u4f55\u6642\u7372\u5f97\u9020\u5f71\uff1a<\/p>\n\n\n\n<ul>\n<li>\u4e0d\u8981\u70ba\u5c40\u90e8\u548c\u975e\u653e\u5c04\u7684<u>\u6025\u6027<\/u>\u8170\u80cc\u75db\u8a02\u8cfc\u5f71\u50cf\u5b78\u6aa2\u67e5\u3002<\/li>\n\n\n\n<li>\u5c0d\u65bc\u4f34\u6709\u56b4\u91cd\u6216\u9032\u884c\u6027\u795e\u7d93\u529f\u80fd\u7f3a\u9677\u7684\u8170\u80cc\u75db\uff0c\u6216\u5b58\u5728\u5176\u4ed6\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u767c\u73fe\u6642\uff0c\u7372\u5f97\u8a3a\u65b7\u5f71\u50cf\u5b78\u548c\u9069\u7576\u7684\u5be6\u9a57\u5ba4\u6aa2\u6e2c\uff08\u8868 1\uff09\u3002<\/li>\n\n\n\n<li>\u8003\u616e\u5c0d\u6301\u7e8c\u8d85\u904e\u4e00\u500b\u6708\u4e14\u5c0d\u521d\u59cb\u6cbb\u7642\u6c92\u6709\u6539\u5584\u6216\u53cd\u61c9\u7684\u8170\u80cc\u75db\u9032\u884c\u5f71\u50cf\u5b78\u6aa2\u67e5\u3002<\/li>\n<\/ul>\n\n\n\n<p>\u9078\u64c7\u9020\u5f71\u65b9\u5f0f\uff08\u8868 5\uff09\uff1a<\/p>\n\n\n\n<ul>\n<li>\u5efa\u8b70\u5c0d\u7591\u4f3c\u9aa8\u6298\u9032\u884c X \u7dda\u5e73\u7247\u6aa2\u67e5\uff0c\u5c0d\u7591\u4f3c\u816b\u7624\u6216\u611f\u67d3\u53ef\u80fd\u6709\u5e6b\u52a9\u3002<\/li>\n\n\n\n<li>\u5c0d\u65bc\u4f34\u6709\u56b4\u91cd\u6216\u9032\u884c\u6027\u795e\u7d93\u529f\u80fd\u7f3a\u9677\u7684\u8170\u80cc\u75db\uff0c\u6216\u5b58\u5728\u5176\u4ed6\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u767c\u73fe\u6642\uff0c\u7372\u5f97\u8a3a\u65b7\u5f71\u50cf\u5b78\u548c\u9069\u7576\u7684\u5be6\u9a57\u5ba4\u6aa2\u6e2c\uff08\u8868 1\uff09\u3002<\/li>\n\n\n\n<li>\u8003\u616e\u5c0d\u6301\u7e8c\u8d85\u904e\u4e00\u500b\u6708\u4e14\u5c0d\u521d\u59cb\u6cbb\u7642\u6c92\u6709\u6539\u5584\u6216\u53cd\u61c9\u7684\u8170\u80cc\u75db\u9032\u884c\u5f71\u50cf\u5b78\u6aa2\u67e5\u3002<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<h4 class=\"wp-block-heading\">\u4f55\u6642\u53bb\u9020\u5f71\uff1f<\/h4>\n\n\n\n<p>\u5728\u80cc\u90e8\u75c7\u72c0\u51fa\u73fe\u7684\u524d 3-4 \u9031\u5167\uff0c\u5f71\u50cf\u5b78\u6aa2\u67e5\u901a\u5e38\u6c92\u6709\u5e6b\u52a9\uff0c\u4f46\u7576\u51fa\u73fe\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u6216\u81e8\u5e8a\u61f7\u7591\u56b4\u91cd\u75be\u75c5\uff0c\u6216\u8005\u60a3\u8005\u75bc\u75db\u548c\u865b\u5f31\u52a0\u5287\u6642\uff0c\u61c9\u8003\u616e\u9032\u884c\u5f71\u50cf\u5b78\u6aa2\u67e5<small class=\"mininote\"><sup> [34] <\/sup><\/small>\u3002 <\/p>\n\n\n\n<p>4 \u9031\u5f8c\uff0c\u5982\u679c\u8170\u80cc\u75c7\u72c0\u6301\u7e8c\u5b58\u5728\uff0c\u53ef\u80fd\u9700\u8981\u9032\u4e00\u6b65\u8a55\u4f30\uff0c\u5305\u62ec\u5f71\u50cf\u5b78\u6aa2\u67e5<small class=\"mininote\"><sup> [35] <\/sup><\/small>\u3002 \u5982\u679c\u795e\u7d93\u6839\u6027\u75c7\u72c0<small class=\"mininote\">\u3014radicular symptoms\u3015<\/small>\uff08\u817f\u90e8\u75bc\u75db\u548c\u7121\u529b\uff09\u6301\u7e8c\u5b58\u5728\u4e14\u672a\u6e1b\u8f15\uff0c\u5247\u5f37\u70c8\u5efa\u8b70\u9032\u884c\u5f71\u50cf\u5b78\u6aa2\u67e5<small class=\"mininote\"><sup> [36,37] <\/sup><\/small>\u3002 \u5f9e\u56de\u9867\u548c\u66f4\u65b0\u75c5\u53f2\u548c\u9ad4\u683c\u6aa2\u67e5\u958b\u59cb\uff0c\u91cd\u65b0\u8a55\u4f30\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u767c\u73fe\u6216\u975e\u810a\u67f1\u75be\u75c5\u5c0e\u81f4\u80cc\u90e8\u75c7\u72c0\u7684\u8b49\u64da\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u9020\u5f71\u6a21\u5f0f\u7684\u9078\u64c7<\/h4>\n\n\n\n<p>\u9020\u5f71\u7528\u65bc\u8a55\u4f30\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u767c\u73fe\u7684\u53ef\u7591\u539f\u56e0\u3002 \u9020\u5f71\u65b9\u5f0f\u7684\u9078\u64c7\u57fa\u65bc\u81e8\u5e8a\u5c0d\u6839\u672c\u539f\u56e0\u7684\u61f7\u7591\uff08\u8868 5\uff09\u3002<\/p>\n\n\n\n<p><u>X \u5149\u7247<\/u>\u3002 \u7576\u51fa\u73fe\u4ee5\u4e0b\u4efb\u4f55\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u6642\uff0c\u5efa\u8b70\u9032\u884c\u5e73\u7247 X \u5149\u6aa2\u67e5\u4ee5\u6392\u9664\u9aa8\u6298\uff1a<\/p>\n\n\n\n<ul>\n<li>\u6700\u8fd1\u7684\u91cd\u5927\u5275\u50b7\uff08\u4efb\u4f55\u5e74\u9f61\uff09<\/li>\n\n\n\n<li>\u8fd1\u671f\u8f15\u5ea6\u5916\u50b7\uff0850\u6b72\u4ee5\u4e0a\u60a3\u8005\uff09<\/li>\n\n\n\n<li>\u9577\u671f\u4f7f\u7528\u985e\u56fa\u9187\u7684\u6b77\u53f2<\/li>\n\n\n\n<li>\u9aa8\u8cea\u758f\u9b06\u75c7<\/li>\n\n\n\n<li>70\u6b72\u4ee5\u4e0a\u7684\u60a3\u8005<small class=\"mininote\"><sup> [35] <\/sup><\/small><\/li>\n<\/ul>\n\n\n\n<p>\u7576\u51fa\u73fe\u4ee5\u4e0b\u4efb\u4f55\u5371\u96aa\u4fe1\u865f\u6642\uff0cX \u5149\u7d50\u5408\u5168\u8840\u7d30\u80de\u8a08\u6578 (CBC) \u548c\u7d05\u8840\u7403\u6c89\u964d\u7387 (ESR) \u53ef\u80fd\u6709\u52a9\u65bc\u6392\u9664\u816b\u7624\u6216\u611f\u67d3\uff1a<\/p>\n\n\n\n<ul>\n<li>\u5148\u524d\u9577\u671f\u4f7f\u7528\u985e\u56fa\u9187<\/li>\n\n\n\n<li>\u8170\u75db\u5728\u591c\u9593\u548c\u4f11\u606f\u6642\u52a0\u91cd<\/li>\n\n\n\n<li>\u4e0d\u660e\u539f\u56e0\u7684\u9ad4\u91cd\u6e1b\u8f15<\/li>\n\n\n\n<li>\u4e0d\u660e\u539f\u56e0\u7684\u767c\u71d2\u4f34\u6709\u80cc\u75db<\/li>\n<\/ul>\n\n\n\n<p>X \u5149\u9020\u5f71\u7684\u5176\u4ed6\u6ce8\u610f\u4e8b\u9805\uff1a<\/p>\n\n\n\n<ul>\n<li>\u5982\u679c\u5b58\u5728\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\uff0c\u7279\u5225\u662f\u5c0d\u65bc\u816b\u7624\u6216\u611f\u67d3\uff0c\u81e8\u5e8a\u4e0a\u53ef\u80fd\u9700\u8981\u4f7f\u7528\u5176\u4ed6\u5f71\u50cf\u5b78\u6aa2\u67e5\uff0c\u4f8b\u5982 CT \u6216 MRI\uff0c\u5373\u4f7f X \u7dda\u5e73\u7247\u6210\u50cf\u70ba\u9670\u6027\u3002<\/li>\n\n\n\n<li>\u8170\u690e X \u5149\u5f88\u5c11\u80fd\u63d0\u4f9b\u6709\u95dc\u810a\u67f1\u9000\u884c\u6027\u8b8a\u5316\u3001\u810a\u67f1\u5074\u5f4e\u3001\u810a\u690e\u88c2\u3001\u810a\u690e\u6ed1\u812b\u6216\u5148\u5929\u6027\u7570\u5e38\u7684\u6709\u7528\u81e8\u5e8a\u4fe1\u606f\u3002<\/li>\n\n\n\n<li>\u61f7\u5b55\u671f\u9593\u61c9\u907f\u514d X \u5149\u6aa2\u67e5<\/li>\n<\/ul>\n\n\n\n<p><u>MRI\u3001CT\u3001CT-\u810a\u9ad3\u651d\u5f71<\/u>\u3002 \u5728\u8170\u75db\u60a3\u8005\u4e2d\uff0c\u9019\u4e9b\u5f71\u50cf\u5b78\u65b9\u6cd5\u7684\u4f7f\u7528\u662f\u70ba\u4e86\u300e\u78ba\u5b9a\u53ef\u6cbb\u7652\u75c5\u7406\u72c0\u6cc1\u7684\u91ab\u5b78\u6216\u4fb5\u5165\u6027\u7642\u6cd5\uff08\u4f8b\u5982\uff0c\u91dd\u5c0d\u795e\u7d93\u6839\u6027\u75bc\u75db\u7684\u624b\u8853\u6216\u786c\u819c\u5916\u6ce8\u5c04\uff09\u3002<\/p>\n\n\n\n<p>\u7d50\u5408\u81e8\u5e8a\u75c5\u53f2\u548c\u9ad4\u683c\u6aa2\u67e5\u4f86\u89e3\u91cb\u5f71\u50cf\u5b78\u7814\u7a76\u7684\u7d50\u679c\uff0c\u4ee5\u78ba\u5b9a\u5f71\u50cf\u5b78\u7d50\u679c\u662f\u5426\u5177\u6709\u81e8\u5e8a\u610f\u7fa9\u3002 \u7570\u5e38\u767c\u73fe\u5f88\u5e38\u898b\u3002 \u4f8b\u5982\uff0cMRI \u5728 50% \u4ee5\u4e0a\u7684\u7121\u75c7\u72c0\u8001\u5e74\u4eba\u4e2d\u986f\u793a\u51fa\u660e\u986f\u7684\u9000\u884c\u6027\u8b8a\u5316\u548c\u9010\u6f38\u5e72\u64fe\u690e\u7ba1\uff0c\u800c\u5728 30 \u591a\u6b72\u7684\u4eba\u7fa4\u4e2d\uff0c\u7121\u75c7\u72c0\u690e\u9593\u76e4\u7a81\u51fa\u7684\u767c\u751f\u7387\u7d04\u70ba 20%<small class=\"mininote\"><sup> [38-41] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u4e00\u822c\u4f86\u8aaa\uff0cMRI \u662f\u8170\u75db\u4f34\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u767c\u73fe\u7684\u9996\u9078\u9020\u5f71\u65b9\u5f0f<small class=\"mininote\"><sup> [42] <\/sup><\/small>\u3002 \u5982\u679c MRI \u662f\u7981\u5fcc\u75c7\uff0c\u8003\u616e\u5c0d\u5177\u6709\u4ee5\u4e0b\u81e8\u5e8a\u60c5\u6cc1\u4e4b\u4e00\u7684\u60a3\u8005\u9032\u884c CT \u6216 CT \u810a\u9ad3\u9020\u5f71\uff1a<\/p>\n\n\n\n<ul>\n<li>\u75c5\u53f2\u3001\u81e8\u5e8a\u6aa2\u67e5\u6216\u5176\u4ed6\u767c\u73fe\u8868\u660e\u5f71\u97ff\u810a\u67f1\u7684\u56b4\u91cd\u60c5\u6cc1\uff0c\u4f8b\u5982\u99ac\u5c3e\u7d9c\u5408\u5fb5\u3001\u810a\u67f1\u9aa8\u6298\u3001\u611f\u67d3\u3001\u816b\u7624\u6216\u5176\u4ed6\u816b\u584a\u75c5\u8b8a\u6216\u7f3a\u640d<small class=\"mininote\"><sup> [1,43,44] <\/sup><\/small>\u3002<\/li>\n\n\n\n<li>\u53d7\u9650\u65bc\u653e\u5c04\u6027\u8170\u80cc\u75db\u8d85\u904e 2 \u9031\u4e14\u6709\u795e\u7d93\u6839\u53d7\u640d\u7684\u751f\u7406\u8b49\u64da\uff0c\u4e26\u4e14\u75c7\u72c0\u6216\u6b98\u75be\u56b4\u91cd\u5230\u8db3\u4ee5\u8003\u616e\u6ce8\u5c04\u6216\u624b\u8853\u5e72\u9810\u7684\u60a3\u8005<small class=\"mininote\"><sup> [1,43,44] <\/sup><\/small>\u3002<\/li>\n\n\n\n<li>\u795e\u7d93\u6e90\u6027\u8ddb\u884c\u75c5\u53f2\u548c\u8001\u5e74\u60a3\u8005\u7684\u5176\u4ed6\u767c\u73fe\u8868\u660e\u300e\u690e\u7ba1\u72f9\u7a84\u7684\u75c7\u72c0\u56b4\u91cd\u5230\u8db3\u4ee5\u8003\u616e\u6ce8\u5c04\u6216\u624b\u8853\u5e72\u9810\u300f<small class=\"mininote\"><sup> [1,15,43,44] <\/sup><\/small>\u3002<\/li>\n<\/ul>\n\n\n\n<p>\u5c0d\u65bc\u5148\u524d\u63a5\u53d7\u904e\u80cc\u90e8\u624b\u8853\u7684\u6025\u6027\u8170\u80cc\u554f\u984c\u60a3\u8005\uff0c\u589e\u5f37 MRI <small class=\"mininote\">\u3014MRI with contrast\u3015<\/small>\u901a\u5e38\u662f\u5340\u5206\u690e\u9593\u76e4\u7a81\u51fa\u8207\u5148\u524d\u624b\u8853\u76f8\u95dc\u75a4\u75d5\u7d44\u7e54\u7684\u9996\u9078\u5f71\u50cf\u5b78\u6aa2\u67e5<small class=\"mininote\"><sup> [43,44] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u61f7\u5b55\u7684\u5973\u6027\uff1a<\/p>\n\n\n\n<ul>\n<li>\u907f\u514d X \u5149\u548c CT \u6383\u63cf\u3002<\/li>\n\n\n\n<li>\u5728\u8003\u616e MRI \u6642\uff0c\u8acb\u8aee\u8a62\u653e\u5c04\u79d1\u91ab\u751f\u3002<\/li>\n<\/ul>\n\n\n\n<p><u>\u808c\u96fb\u5716 (EMG)<\/u>\u3002 EMG \u53ef\u7528\u65bc\u5e6b\u52a9\u63cf\u7e6a\u3008\u5177\u6709\u795e\u7d93\u75c5\u8b8a\u5371\u96aa\u56e0\u7d20\uff08\u4f8b\u5982\uff0c\u9152\u7cbe\u6216\u7cd6\u5c3f\u75c5\uff09\u7684\u3009\u60a3\u8005\u7684\u7570\u5e38\u795e\u7d93\u7cfb\u7d71\u6aa2\u67e5\u3002 \u4f46\u662f\uff0c\u5982\u679c\u795e\u7d93\u6839\u75c5\u7684\u8a3a\u65b7\u5728\u81e8\u5e8a\u6aa2\u67e5\u4e2d\u5f88\u660e\u986f\uff0c\u5247\u4e0d\u8981\u4f7f\u7528 EMG \u6e2c\u8a66\u3002 \u5728\u60a3\u8005\u51fa\u73fe\u986f\u8457\u4e14\u6301\u7e8c\u7684\u795e\u7d93\u6839\u75c5\u8d85\u904e 3 \u9031\u4e4b\u524d\uff0c\u808c\u96fb\u5716\u7d50\u679c\u5728\u6aa2\u6e2c\u7d30\u5fae\u795e\u7d93\u640d\u50b7\u65b9\u9762\u53ef\u80fd\u4e0d\u53ef\u9760<small class=\"mininote\"><sup> [45] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u9032\u884c\u5f71\u50cf\u5b78\u6aa2\u67e5\u5f8c\uff0c\u4e0b\u80a2\u548c\u810a\u67f1\u65c1\u808c\u8089\u7684 EMG \u53ef\u80fd\u5c0d\u60a3\u8005\u6709\u5e6b\u52a9<small class=\"mininote\"><sup> [45] <\/sup><\/small>\uff1a<\/p>\n\n\n\n<ul>\n<li>\u53d7\u9650\u65bc\u653e\u5c04\u6027\u8170\u80cc\u75db\u8d85\u904e 4 \u9031\uff0c\u6c92\u6709\u660e\u78ba\u7684\u795e\u7d93\u6839\u640d\u5bb3\u5f71\u50cf\u5b78\u8b49\u64da\u3002<\/li>\n\n\n\n<li>\u5176\u5f71\u50cf\u5b78\u7814\u7a76\u986f\u793a\u3008\u8207\u81e8\u5e8a\u8868\u73fe\u4e0d\u76f8\u95dc\u7684\u3009\u75c5\u8b8a\u3002 \uff08EMG \u7684\u8aa4\u5831\u7387\u975e\u5e38\u4f4e\u3002\uff09<\/li>\n\n\n\n<li>\u5728\u6c92\u6709\u690e\u9593\u76e4\u7a81\u51fa\u7684\u5f71\u50cf\u5b78\u8868\u73fe\u7684\u60c5\u6cc1\u4e0b\u4f34\u6709\u653e\u5c04\u75db\u6216\u795e\u7d93\u529f\u80fd\u7f3a\u640d\uff0c\u4ee5\u8a55\u4f30\u53ef\u80fd\u985e\u4f3c\u65bc\u653e\u5c04\u6027\u8170\u80cc\u75db\u7684\u795e\u7d93\u75c5\u3001\u795e\u7d93\u6839\u708e\u548c\u5c40\u7076\u6027\u795e\u7d93\u640d\u50b7\u3002<\/li>\n\n\n\n<li>\u5177\u6709\u591a\u5c64\u6b21 MRI \u7570\u5e38\u548c\u81e8\u5e8a\u6aa2\u67e5\u4e0d\u660e\u78ba\u5c64\u6b21\u7684\u81e8\u5e8a\u610f\u7fa9\u3002<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">\u6cbb\u7642<\/h2>\n\n\n\n<p>\u53ef\u4ee5\u4f7f\u7528\u591a\u7a2e\u65b9\u6cd5\u6cbb\u7642\u8170\u80cc\u75db\u3002 \u901a\u5e38\u4f7f\u7528\u4e0d\u6b62\u4e00\u7a2e\u65b9\u6cd5\u3002 \u95dc\u65bc\u6cbb\u7642\u7684\u6c7a\u5b9a\u901a\u5e38\u7531\u91ab\u751f\u548c\u60a3\u8005\u5171\u540c\u505a\u51fa\uff08\u57fa\u65bc\u91ab\u751f\u7684\u81e8\u5e8a\u898b\u89e3\u548c\u60a3\u8005\u7684\u6cbb\u7642\u504f\u597d\uff09\u3002 \u6cbb\u7642\u9078\u64c7\u5305\u62ec\u4ee5\u4e0b\u5e7e\u985e\uff1a<\/p>\n\n\n\n<ul class=\"is-style-check_list\">\n<li>\u60a3\u8005\u6559\u80b2<small class=\"mininote\">\u3014Patient education\u3015<\/small><\/li>\n\n\n\n<li>\u7269\u7406\u65b9\u5f0f<small class=\"mininote\">\u3014Physical modalities\u3015<\/small><\/li>\n\n\n\n<li>\u85e5\u7269<small class=\"mininote\">\u3014Medication\u3015<\/small><\/li>\n\n\n\n<li>\u6ce8\u5c04<small class=\"mininote\">\u3014Injections\u3015<\/small><\/li>\n\n\n\n<li>\u5916\u79d1\u624b\u8853<small class=\"mininote\">\u3014Surgery\u3015<\/small><\/li>\n\n\n\n<li>\u5fc3\u7406\u5065\u5eb7\u5e72\u9810<small class=\"mininote\">\u3014Mental health interventions\u3015<\/small><\/li>\n\n\n\n<li>\u591a\u5b78\u79d1\u65b9\u6cd5<small class=\"mininote\">\u3014Multidisciplinary approaches\u3015<\/small><\/li>\n<\/ul>\n\n\n\n<p>\u8868 6 \u7e3d\u7d50\u4e86\u975e\u653e\u5c04\u6027\u8170\u80cc\u75db\uff08\u4e0d\u5ef6\u4f38\u81f3\u819d\u84cb\u4ee5\u4e0b\u7684\u8ef8\u6027\u75bc\u75db\uff09\u7684\u6cbb\u7642\u3002\u8868 7 \u7e3d\u7d50\u4e86\u653e\u5c04\u6027\u8170\u80cc\u75db\uff08\u5ef6\u4f38\u81f3\u819d\u84cb\u4ee5\u4e0b\u7684\u75bc\u75db\uff09\u7684\u6cbb\u7642\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u60a3\u8005\u6559\u80b2<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u544a\u8a34\u60a3\u8005\u4ed6\u5011\u7684\u9810\u671f\u904e\u7a0b\u3002<\/p>\n\n\n\n<p>\u5efa\u8b70\u4ed6\u5011\u4fdd\u6301\u6d3b\u8e8d\u3002<\/p>\n\n\n\n<p>\u8003\u616e\u6dfb\u52a0\u6559\u80b2\u5167\u5bb9\u4f5c\u70ba\u81ea\u6211\u7ba1\u7406\u5e72\u9810\u63aa\u65bd\u7684\u4e00\u90e8\u5206\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u544a\u77e5\u60a3\u8005\u75c7\u72c0\u7684\u9810\u671f\u75c5\u7a0b\u548c\u6301\u7e8c\u6642\u9593\uff0c\u4e26\u8a0e\u8ad6\u57fa\u65bc\u8b49\u64da\u7684\u81ea\u6211\u8b77\u7406\u65b9\u6848\u3002 \u9069\u7576\u7684\u60a3\u8005\u6559\u80b2\u53ef\u4ee5\u6e1b\u5c11\u6050\u61fc\uff0c\u589e\u52a0\u7a4d\u6975\u614b\u5ea6\uff0c\u4e26\u5c0d\u672a\u4f86\u7684\u7d50\u679c\u7522\u751f\u6709\u5229\u5f71\u97ff<small class=\"mininote\"><sup> [12,14] <\/sup><\/small>\u3002 \u4f8b\u5982\uff0c\u8207\u5c0d\u7167\u7d44\u76f8\u6bd4\uff0c\u63a5\u53d7\u6559\u80b2\u624b\u518a\uff08\u975e\u7d50\u69cb\u5316\u6559\u80b2<small class=\"mininote\">\u3014nonstructured education\u3015<\/small>\uff09\u7684\u60a3\u8005\u5728\u63a5\u4e0b\u4f86\u7684\u4e00\u5e74\u4e2d\u6709\u66f4\u597d\u7684\u7d50\u679c\u548c\u660e\u986f\u66f4\u5c11\u7684\u5f8c\u7e8c\u96a8\u8a2a<small class=\"mininote\"><sup> [46] <\/sup><\/small>\u3002 \u500b\u6027\u5316\u7684\u81ea\u6211\u7167\u8b77\u6559\u80b2\uff08\u7d50\u69cb\u5316\u6559\u5b78<small class=\"mininote\">\u3014structured teaching\u3015<\/small>\uff09\u4ee5\u53ca\u66f4\u4e00\u822c\u7684\u4fe1\u606f\uff08\u4f7f\u7528 Back Book \u7b49\u8cc7\u6e90\uff09\u53ef\u4ee5\u63d0\u9ad8\u60a3\u8005\u5c0d\u9810\u5f8c\u7684\u7406\u89e3\u3002<\/p>\n\n\n\n<p>\u5efa\u8b70\u60a3\u8005\u76e1\u53ef\u80fd\u4fdd\u6301\u6d3b\u8e8d<small class=\"mininote\"><sup> [12,14] <\/sup><\/small>\u3002 \u5169\u9805\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u8868\u660e\uff0c\u529f\u80fd\u6062\u5fa9\u8207\u57fa\u65bc\u6307\u5357\u7684\u6559\u80b2\u76f8\u7d50\u5408\u512a\u65bc\u55ae\u7d14\u7684\u6559\u80b2<small class=\"mininote\"><sup> [47,48] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u300e\u7a76\u7adf\u63d0\u4f9b\u4ec0\u9ebc\u6559\u80b2\u300f\u9084\u6c92\u6709\u88ab\u89e3\u6c7a\u3002 \u4e0d\u540c\u7814\u7a76\u4e2d\u300e\u6559\u80b2\u5167\u5bb9\u7684\u5dee\u7570\u300f\u662f\u4e00\u500b\u91cd\u8981\u539f\u56e0\uff0c\u6700\u8fd1\u7684\u7cfb\u7d71\u56de\u9867\u548c\u7d71\u5408\u5206\u6790\u767c\u73fe\u300e\u50c5\u901a\u904e\u6559\u80b2\u5c0d\u8170\u75db\u6c92\u6709\u6301\u7e8c\u7684\u597d\u8655\u300f<small class=\"mininote\"><sup> [49,50] <\/sup><\/small>\u3002 \u95dc\u65bc\u4f7f\u7528\u201c\u80cc\u90e8\u5b78\u6821<small class=\"mininote\">\u3014back schools\u3015<\/small>\u201d\u7684\u8b49\u64da\u8cea\u91cf\u975e\u5e38\u4f4e\uff0c\u4e26\u4e14\u986f\u793a\u51fa\u4e0d\u78ba\u5b9a\u7684\u597d\u8655<small class=\"mininote\"><sup> [51] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u7269\u7406\u65b9\u5f0f<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u6d3b\u52d5\uff1a\u9f13\u52f5\u60a3\u8005\u76e1\u53ef\u80fd\u4fdd\u6301\u6d3b\u8e8d\u3002<\/p>\n\n\n\n<p>\u71b1\uff1a\u5efa\u8b70\u60a3\u8005\u300e\u71b1\u53ef\u4ee5\u8f49\u79fb\u5c0d\u75bc\u75db\u7684\u6ce8\u610f\u529b\u4e26\u53ef\u80fd\u653e\u9b06\u808c\u8089\u300f\u3002<\/p>\n\n\n\n<p>\u935b\u7149\u8a08\u5283<\/p>\n\n\n\n<ul>\n<li>\u5c0d\u65bc\u6025\u6027\u8170\u75db\uff0c\u8003\u616e\u81e8\u5e8a\u91ab\u751f\u6307\u5c0e\u7684\u935b\u7149\u3002<\/li>\n\n\n\n<li>\u5c0d\u65bc\u6162\u6027\u8170\u75db\uff0c\u5efa\u8b70\u958b\u59cb\u935b\u7149\u8a08\u5283\u4e26\u8003\u616e\u81e8\u5e8a\u91ab\u751f\u6307\u5c0e\u7684\u935b\u7149\u3002<\/li>\n<\/ul>\n\n\n\n<p>\u7269\u7406\u6cbb\u7642\uff1a\u8003\u616e\u81e8\u5e8a\u91ab\u751f\u6307\u5c0e\u7684\u935b\u7149\u3001\u810a\u67f1\u624b\u6cd5\u6cbb\u7642\u6216\u810a\u67f1\u7a69\u5b9a\u935b\u7149\u3002<\/p>\n\n\n\n<p>\u63a8\u85a6\u4f7f\u7528\u808c\u5167\u6548\u8cbc\u4f48<small class=\"mininote\">\u3014kinesio tape\u3015<\/small>\u3001\u8170\u690e\u727d\u5f15\u3001\u91dd\u7078\u3001\u8d85\u8072\u6216\u7d93\u76ae\u795e\u7d93\u96fb\u523a\u6fc0 (TENS) \u9032\u884c\u6cbb\u7642\u7684\u8b49\u64da\u4e0d\u8db3\u3002<\/p>\n<\/div><\/div>\n\n\n\n<h4 class=\"wp-block-heading\">\u6d3b\u52d5\u9650\u5236<\/h4>\n\n\n\n<p>\u5f37\u6709\u529b\u7684\u8b49\u64da\u8868\u660e\uff0c\u81e5\u5e8a\u4f11\u606f\u4e0d\u662f\u6cbb\u7642\u6025\u6027\u8170\u75db\u7684\u6709\u6548\u9078\u64c7\u3002 \u4fdd\u6301\u65e5\u5e38\u6d3b\u52d5\u5df2\u88ab\u8b49\u660e\u53ef\u4ee5\u6539\u5584\u6062\u5fa9\u3002 \u5728\u8003\u616e\u5230\u60a3\u8005\u5de5\u4f5c\u7684\u6027\u8cea\u548c\u75bc\u75db\u7684\u56b4\u91cd\u7a0b\u5ea6\u5f8c\uff0c\u5728\u67d0\u4e9b\u60c5\u6cc1\u4e0b\u9650\u5236\u8eab\u9ad4\u6d3b\u52d5\u53ef\u80fd\u662f\u5408\u9069\u7684\u3002 \u7531\u65bc\u75bc\u75db\u6c92\u6709\u5ba2\u89c0\u91cf\u5316\uff0c\u800c\u4e14\u91ab\u751f\u901a\u5e38\u4e0d\u662f\u60a3\u8005\u5de5\u4f5c\u60c5\u6cc1\u7684\u5c08\u5bb6\uff0c\u56e0\u6b64\u5728\u8003\u616e\u9650\u5236\u521d\u59cb\u6d3b\u52d5\u6642\u8981\u8003\u616e\u60a3\u8005\u5c0d\u9019\u4e9b\u56e0\u7d20\u7684\u4e86\u89e3<small class=\"mininote\"><sup> [52] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u4e0b\u73ed\u6642\u9593\u7684\u9577\u77ed\u8207\u9577\u671f\u5931\u80fd\u7684\u98a8\u96aa\u76f4\u63a5\u76f8\u95dc\u3002 \u56e0\u6b64\uff0c\u8acb\u8003\u616e\u5982\u4f55\u6700\u5927\u9650\u5ea6\u5730\u6e1b\u5c11\u6d3b\u52d5\u9650\u5236\u3002 \u6d3b\u52d5\u9650\u5236\u61c9\u91dd\u5c0d\u7279\u5b9a\u6642\u9593\u6bb5\u3002 \u5728\u8b93\u60a3\u8005\u5b8c\u5168\u505c\u6b62\u5de5\u4f5c\u4e4b\u524d\uff0c\u8acb\u8003\u616e\u8207\u96c7\u4e3b\u6e9d\u901a\uff0c\u770b\u770b\u662f\u5426\u53ef\u4ee5\u63d0\u4f9b\u6709\u9650\u7684\u5de5\u4f5c\u6642\u9593\u6216\u8f15\u578b\u5de5\u4f5c\u3002 \u5de5\u4f5c\u5834\u6240\u6539\u9020\u63d0\u9ad8\u4e86\u91cd\u8fd4\u5de5\u4f5c\u7387\u4e26\u6e1b\u5c11\u4e86\u5931\u80fd\u6642\u9593\u3002 \u8003\u616e\u8aee\u8a62\u5177\u6709\u5de5\u4f5c\u73fe\u5834\u8a55\u4f30\u5c08\u696d\u77e5\u8b58\u7684\u8077\u696d\u6cbb\u7642\u5e2b\u6216\u5176\u4ed6\u5c08\u8077\u91ab\u7642\u4eba\u54e1\u3002 \u6bcf\u5169\u9031\u8ddf\u8e2a\u4e00\u6b21\u60a3\u8005\uff0c\u6839\u64da\u75c7\u72c0\u8b8a\u5316\u548c\u6cbb\u7642\u9032\u5c55\u66f4\u65b0\u9032\u5c55\u3001\u5de5\u4f5c\u6642\u9593\u548c\u9650\u5236\u3002 \u81e8\u5e8a\u91ab\u751f\u6307\u5c0e\u7684\u935b\u7149\u53ef\u4ee5\u7531\u4e3b\u6cbb\u91ab\u751f\u6216\u4e3b\u6cbb\u7269\u7406\u6cbb\u7642\u5e2b\u9032\u884c\uff0c\u540c\u6642\u8003\u616e\u5230\u60a3\u8005\u904e\u53bb\u548c\u73fe\u5728\u7684\u5177\u9ad4\u75c5\u53f2\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u71b1<\/h4>\n\n\n\n<p>\u4ee5\u6eab\u6c34\u6dcb\u6d74\u3001\u6c90\u6d74\u6216\u71b1\u6577\u7684\u5f62\u5f0f\u65bd\u52a0\u71b1\u91cf\uff0c\u4e26\u4f7f\u7528\u201c\u6df1\u5ea6\u201d\u52a0\u71b1\u5316\u5408\u7269\u7b49\u6297\u523a\u6fc0\u5291<small class=\"mininote\">\u3014counterirritants\u3015<\/small>\uff0c\u9019\u4e9b\u65b9\u6cd5\u53ef\u4ee5\u5206\u6563\u60a3\u8005\u5c0d\u75bc\u75db\u7684\u6ce8\u610f\u529b\uff0c\u4e26\u53ef\u80fd\u653e\u9b06\u808c\u8089<small class=\"mininote\"><sup> [53] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u6700\u521d\u7528\u51b0\u6216\u51b7\u9032\u884c\u6cbb\u7642\u901a\u5e38\u6c92\u6709\u7528\uff0c\u56e0\u70ba\u6f5b\u5728\u7684\u75c5\u7406\u90e8\u4f4d\u901a\u5e38\u4e0d\u5728\u8868\u9762\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u935b\u7149<\/h4>\n\n\n\n<p>\u5efa\u8b70\u60a3\u8005\u76e1\u53ef\u80fd\u4fdd\u6301\u6d3b\u8e8d\u662f\u5e38\u898f\u8b77\u7406\u7684\u6709\u76ca\u90e8\u5206\uff08\u8acb\u53c3\u95b1\u60a3\u8005\u6559\u80b2\uff09\u3002 \u5c0d\u65bc\u6025\u6027\u8170\u80cc\u75db\u60a3\u8005\uff0c\u7531\u65bc\u8b49\u64da\u6709\u9650\uff0c\u589e\u52a0\u81e8\u5e8a\u91ab\u751f\u6307\u5c0e\u904b\u52d5\u7684\u984d\u5916\u50f9\u503c\u5c1a\u4e0d\u78ba\u5b9a<small class=\"mininote\"><sup> [6,53\u201358] <\/sup><\/small>\u3002 \u5c0d\u65bc\u6162\u6027\u8170\u75db\u60a3\u8005\uff0c\u5efa\u8b70\u958b\u59cb\u935b\u7149\u8a08\u5283\u3002 \u63a8\u85a6\u935b\u934a\u5982\u666e\u62c9\u63d0\u3001\u745c\u4f3d\u3001\u592a\u6975\u62f3\u3001\u529b\u91cf\u6216\u963b\u529b\u8a13\u7df4\u3001\u810a\u67f1\u7a69\u5b9a\u3001\u6c34\u4e0a\u904b\u52d5\u3001\u9a0e\u81ea\u884c\u8eca\u548c\u6b65\u884c\u7b49\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u7269\u7406\u7642\u6cd5<\/h4>\n\n\n\n<p>\u8003\u616e\u63d0\u4f9b\u81e8\u5e8a\u91ab\u751f\u6307\u5c0e\u7684\u935b\u934a<small class=\"mininote\"><sup> [52,59] <\/sup><\/small>\u3002 \u5118\u7ba1\u81e8\u5e8a\u91ab\u751f\u6307\u5c0e\u7684\u935b\u7149\u986f\u793a\u51fa\u6975\u5c11\u5230\u4e2d\u5ea6\u7684\u50f9\u503c\u8b49\u64da\uff0c\u4f46\u5b83\u7684\u98a8\u96aa\u76f8\u5c0d\u8f03\u4f4e\uff0c\u6536\u76ca\u53ef\u80fd\u8d85\u904e\u98a8\u96aa\u3002 \u4f5c\u70ba\u591a\u6a21\u5f0f\u5e72\u9810\u7684\u4e00\u90e8\u5206\uff0c\u81e8\u5e8a\u91ab\u751f\u6307\u5c0e\u7684\u935b\u7149\u512a\u65bc\u55ae\u7368\u4f7f\u7528\u3002<\/p>\n\n\n\n<p>\u7531\u7269\u7406\u6cbb\u7642\u5e2b\u3001\u6574\u9aa8\u91ab\u5e2b\u6216\u810a\u690e\u6309\u6469\u5e2b\u63d0\u4f9b\u7684\u810a\u67f1\u624b\u6cd5\u6cbb\u7642<small class=\"mininote\">\u3014Spinal manual therapy\u3015<\/small>\u53ef\u5728\u611f\u77e5\u6539\u5584\u3001\u8b77\u7406\u6eff\u610f\u5ea6\u548c\u6e1b\u5c11\u85e5\u7269\u4f7f\u7528\u65b9\u9762\u63d0\u4f9b\u9577\u671f\u76ca\u8655\u3002 \u8207\u76e3\u7763\u935b\u7149\u3001\u5bb6\u5ead\u935b\u7149\u3001McKenzie \u65b9\u6cd5\u91cd\u8907\u904b\u52d5\u935b\u7149\u6216\u80cc\u90e8\u5b78\u6821\u8a13\u7df4\u76f8\u6bd4\uff0c\u5b83\u53ef\u80fd\u6709\u4e00\u500b\u5c0f\u7684\uff08\u81e8\u5e8a\u4e0a\u5fae\u4e0d\u8db3\u9053\u7684\uff09\u512a\u52e2<small class=\"mininote\"><sup> [6,53\u201356] <\/sup><\/small>\u3002 \u8207\u6c92\u6709\u624b\u6cd5\u6cbb\u7642\u6025\u6027\u8170\u75db\u76f8\u6bd4\uff0c\u810a\u67f1\u624b\u6cd5\u6cbb\u7642\u65e2\u6c92\u6709\u6e1b\u5c11\u75c5\u5047\u7387\u4e5f\u6c92\u6709\u6e1b\u5c11\u518d\u8aee\u8a62\u7387\u3002 \u5b83\u4e26\u6c92\u6709\u3008\u901a\u904e\u66ff\u4ee3\u5176\u4ed6\u91ab\u7642\u670d\u52d9\u6216\u6d88\u9664\u6210\u672c\u4f86\u3009\u5e36\u4f86\u6709\u610f\u7fa9\u7684\u7bc0\u7701<small class=\"mininote\"><sup> [60] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u810a\u67f1\u7a69\u5b9a\u935b\u934a<small class=\"mininote\">\u3014Spine stabilization exercises\u3015<\/small>\u8207\u624b\u6cd5\u6cbb\u7642\u76f8\u7576\uff0c\u5728\u6e1b\u8f15\u8170\u75db\u548c\u6539\u5584\u529f\u80fd\u65b9\u9762\u512a\u65bc\u4e00\u822c\u935b\u934a<small class=\"mininote\"><sup> [58] <\/sup><\/small>\u3002 <\/p>\n\n\n\n<p>\u63a8\u85a6\u4f7f\u7528\u808c\u5167\u6548\u8cbc\u5e03<small class=\"mininote\">\u3014kinesio tape\u3015<\/small>\u6cbb\u7642\u8170\u75db\u7684\u8b49\u64da\u4e0d\u8db3<small class=\"mininote\"><sup> [61] <\/sup><\/small>\u3002 \u6c92\u6709\u8b49\u64da\u8868\u660e\u8170\u690e\u727d\u5f15<small class=\"mininote\">\u3014lumbar traction\u3015<\/small>\u6709\u597d\u8655<small class=\"mininote\"><sup> [57] <\/sup><\/small>\uff0c\u4e26\u4e14\u8207\u55ae\u7368\u7684\u57fa\u65bc\u4f38\u5c55\u7684\u935b\u7149\u8a08\u5283\u76f8\u6bd4\uff0c\u8170\u690e\u727d\u5f15\u6c92\u6709\u70ba\u8170\u75db\u63d0\u4f9b\u4efb\u4f55\u984d\u5916\u7684\u7d50\u679c\u76ca\u8655<small class=\"mininote\"><sup> [62] <\/sup><\/small>\u3002 \u8b49\u64da\u57fa\u790e\u4e0d\u8db3\u4ee5\u652f\u6301\u4f7f\u7528\u8d85\u8072\u6ce2\u6cbb\u7642\u8170\u80cc\u75db<small class=\"mininote\"><sup> [53] <\/sup><\/small>\u6216\u4f7f\u7528\u96fb\u523a\u6fc0\u6cbb\u7642\u8170\u80cc\u75db<small class=\"mininote\"><sup> [53,63] <\/sup><\/small>\u3002 \u96d6\u7136\u7d93\u76ae\u795e\u7d93\u96fb\u523a\u6fc0 (TENS) \u78ba\u5be6\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u6539\u5584\u4e86\u795e\u7d93\u6839\u6027\u548c\u975e\u795e\u7d93\u6839\u6027\u75bc\u75db\uff0c\u4f46\u5176\u4f7f\u7528\u4e26\u672a\u6539\u8b8a\u60a3\u8005\u7684\u9810\u5f8c<small class=\"mininote\"><sup> [64] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u88dc\u5145\u548c\u66ff\u4ee3\u7642\u6cd5<\/h4>\n\n\n\n<p>\u5f88\u5927\u4e00\u90e8\u5206\u51fa\u73fe\u8170\u80cc\u75db\u7684\u4eba\u6703\u9996\u5148\u5c0b\u6c42\u66ff\u4ee3\u91ab\u7642\u670d\u52d9\u63d0\u4f9b\u8005\u7684\u6cbb\u7642\u3002 \u8a55\u4f30\u6cbb\u7642\u6548\u679c\u5f88\u56f0\u96e3\uff0c\u56e0\u70ba\u6240\u61c9\u7528\u7684\u6280\u8853\u5dee\u7570\u5f88\u5927\uff0c\u800c\u4e14\u7531\u65bc\u6cbb\u7642\u7684\u7269\u7406\u6027\u8cea\uff0c\u5f88\u96e3\u5c07\u9019\u4e9b\u7814\u7a76\u96a8\u6a5f\u5316\u3002 \u5c0d\u6025\u6027\u8170\u80cc\u75db\u88dc\u5145\u7642\u6cd5\u7684\u8a55\u8ad6\u8868\u660e\uff0c\u6c92\u6709\u8db3\u5920\u7684\u8b49\u64da\u652f\u6301\u4f7f\u7528\u91dd\u7078\u3001\u810a\u690e\u6309\u6469\u7642\u6cd5\u3001\u6309\u6469\u7642\u6cd5\u6216\u745c\u4f3d<small class=\"mininote\"><sup> [57] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u85e5\u7269<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u8003\u616e\u5230\u80c3\u8178\u9053\u98a8\u96aa\uff0c\u7528\u975e\u985e\u56fa\u9187\u985e\u6297\u767c\u708e\u85e5<small class=\"mininote\">\u3014NSAIDs\u3015<\/small>\u6cbb\u7642\u6025\u6027\u8170\u75db\uff08\u5305\u62ec\u6162\u6027\u8170\u75db\u7684\u6025\u6027\u52a0\u91cd\uff09\uff08\u898b\u8868 9\uff09\u3002<\/p>\n\n\n\n<p>\u8003\u616e\u6cbb\u7642\uff1a<\/p>\n\n\n\n<ul>\n<li>\u5916\u7528\u88fd\u5291\uff0c\u5982\u5229\u591a\u5361\u56e0<small class=\"mininote\">\u3014lidocaine\u3015<\/small>\u548c\u8fa3\u6912\u7d20<small class=\"mininote\">\u3014capsaicin\u3015<\/small>\u3002<\/li>\n\n\n\n<li>\u77ed\u671f\u4f7f\u7528\u975e\u82ef\u4e8c\u6c2e\u5e73\u985e\u808c\u8089\u9b06\u5f1b\u5291<small class=\"mininote\">\u3014nonbenzodiazepine muscle relaxants\u3015<\/small>\u3002<\/li>\n\n\n\n<li>\u5982\u679c\u75bc\u75db\u5c0d\u975e\u985e\u56fa\u9187\u985e\u6297\u767c\u708e\u85e5\u548c\u975e\u82ef\u4e8c\u6c2e\u5e73\u985e\u808c\u8089\u9b06\u5f1b\u5291\u7121\u6548\uff0c\u53ef\u8003\u616e\u4f7f\u7528\u9650\u6642\u7642\u7a0b\u7684\u9d09\u7247\u985e\u85e5\u7269<small class=\"mininote\">\u3014opioids\u3015<\/small>\u3002 \uff08\u9d09\u7247\u985e\u93ae\u75db\u85e5\u901a\u5e38\u4e0d\u9069\u7528\u65bc\u6025\u6027\u8170\u75db\u3002\uff09<\/li>\n<\/ul>\n\n\n\n<p><strong>\u4e0d\u8981<\/strong>\u4f7f\u7528\u5c0d\u4e59\u91af\u80fa\u915a<small class=\"mininote\">\u3014acetaminophen\u3015<\/small>\u3001\u82ef\u4e8c\u6c2e\u5e73\u985e\u85e5\u7269<small class=\"mininote\">\u3014benzodiazepines\u3015<\/small>\u3001\u5168\u8eab\u6027\u76ae\u8cea\u985e\u56fa\u9187<small class=\"mininote\">\u3014systemic corticosteroids\u3015<\/small>\u3001\u9078\u64c7\u6027\u8840\u6e05\u7d20\u518d\u5438\u6536\u6291\u5236\u5291<small class=\"mininote\">\u3014SSRIs\u3015<\/small>\u3001\u8840\u6e05\u7d20\u53ca\u53bb\u7532\u814e\u4e0a\u817a\u7d20\u518d\u651d\u53d6\u6291\u5236\u5291\u3014SNRIs\u3015\u6216\u4e09\u74b0\u6297\u6182\u9b31\u5291<small class=\"mininote\">\u3014tricyclic antidepressants\u3015<\/small>\u9032\u884c\u6cbb\u7642\u3002<\/p>\n\n\n\n<p>\u8b49\u64da\u5c1a\u7121\u5b9a\u8ad6\uff0c\u4f7f\u7528\u666e\u745e\u5df4\u6797<small class=\"mininote\">\u3014pregabalin\u3015<\/small>\u3001\u52a0\u5df4\u5674\u4e01<small class=\"mininote\">\u3014gabapentin\u3015<\/small>\u548c\u8349\u85e5<small class=\"mininote\">\u3014herbal medications\u3015<\/small>\u6216\u88dc\u5145\u5291\u7684\u6f5b\u5728\u5371\u5bb3\u53ef\u80fd\u8d85\u904e\u76ca\u8655\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u8868 8 \u5217\u51fa\u4e86\u5e38\u7528\u7684\u85e5\u7269\u3002\u67d0\u4e9b\u85e5\u7269\u5df2\u88ab\u8b49\u660e\u53ef\u4ee5\u6e1b\u8f15\u6025\u6027\u8170\u75db\u7684\u4e0d\u9069\u3002 \u6c92\u6709\u4e00\u7a2e\u85e5\u7269\u80fd\u6e1b\u5c11\u5931\u80fd\u6216\u6539\u8b8a\u75be\u75c5\u7684\u81ea\u7136\u75c5\u7a0b\u3002<\/p>\n\n\n\n<p>\u5efa\u8b70\u60a3\u8005\u4e0d\u8981\u7b49\u5230\u611f\u5230\u4e0d\u9069\u6216\u75bc\u75db\u6642\u624d\u670d\u7528\u3002 \u6307\u5c0e\u4ed6\u5011\u6309\u898f\u5b9a\u7684\u6642\u9593\u9593\u9694\u670d\u7528\u85e5\u7269\u6cbb\u7642\u4e0d\u9069\u6216\u75bc\u75db\uff0c\u800c\u4e0d\u662f\u6309\u9700\u670d\u7528\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u975e\u985e\u56fa\u9187\u6d88\u708e\u85e5<\/strong>\uff08NSAIDs\uff09<\/h4>\n\n\n\n<p>\u5c0d\u65bc\u6025\u6027\u8170\u75db\u60a3\u8005\uff0c\u975e\u985e\u56fa\u9187\u6d88\u708e\u85e5\uff08NSAIDs\uff09\u6bd4\u5b89\u6170\u5291\u66f4\u6709\u6548<small class=\"mininote\"><sup> [54,55] <\/sup><\/small>\u3002 \u50b3\u7d71\u7684 NSAIDs \u548c COX-2 NSAIDs \u5c0d\u6025\u6027\u8170\u75db\u5177\u6709\u985e\u4f3c\u7684\u93ae\u75db\u4f5c\u7528<small class=\"mininote\"><sup> [54] <\/sup><\/small>\u3002 \u95dc\u65bc NSAIDs \u6539\u5584\u5931\u80fd\u548c\u529f\u80fd\u7d50\u679c\u7684\u6578\u64da\u5c1a\u7121\u5b9a\u8ad6\u3002<\/p>\n\n\n\n<p>NSAID \u7684\u9078\u64c7\u53d6\u6c7a\u65bc\u6210\u672c\u548c\u526f\u4f5c\u7528\u60c5\u6cc1\u3002 \u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u63d0\u4f9b\u4e86\u95dc\u65bc\u300e\u50b3\u7d71 NSAID \u8207\u5b89\u6170\u5291\u5728\u526f\u4f5c\u7528\u65b9\u9762\uff0c\u5b58\u5728\u4efb\u4f55\u5dee\u7570\u7684\u975e\u6c7a\u5b9a\u6027\u8b49\u64da\u300f<small class=\"mininote\"><sup> [56] <\/sup><\/small>\u3002 \u8207\u50b3\u7d71 NSAID \u76f8\u6bd4\uff0cCOX-2 NSAID \u7684\u80c3\u8178\u9053\u526f\u4f5c\u7528\u66f4\u5c11<small class=\"mininote\"><sup> [54] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u5728\u4f7f\u7528 NSAIDs \u4e4b\u524d\u8a55\u4f30\u80c3\u8178\u9053\u548c\u5fc3\u8840\u7ba1\u98a8\u96aa\uff08\u898b\u8868 9\uff09\u3002<\/p>\n\n\n\n<ul>\n<li>\u5728\u6709\u80c3\u8178\u9053\u98a8\u96aa\u7684\u60a3\u8005\u4e2d\uff0cCOX-2 \u9078\u64c7\u6027\u6291\u88fd\u5291<small class=\"mininote\">\u3014selective inhibitors\u3015<\/small>\u7684\u98a8\u96aa\u53ef\u80fd\u76f8\u5c0d\u8f03\u4f4e\u3002 \u4f7f\u7528 NSAIDs \u6cbb\u7642\u6703\u589e\u52a0\u80c3\u8178\u9053\u51fa\u8840\u7684\u98a8\u96aa\u3002 \u9577\u671f\u4f7f\u7528\u6703\u589e\u52a0\u60a3\u6162\u6027\u814e\u75c5\u7684\u98a8\u96aa\u3002 \u6dfb\u52a0\u6c2b\u96e2\u5b50\u5e6b\u6d66\u963b\u65b7\u5291<small class=\"mininote\">\u3014proton pump inhibitor\u3015<\/small> (PPI) \u53ef\u964d\u4f4e\u80c3\u8178\u9053\u51fa\u8840\u7684\u98a8\u96aa\u3002 \u7136\u800c\uff0c\u9577\u671f\u4f7f\u7528 PPI \u53ef\u80fd\u6703\u589e\u52a0\u60a3\u9aa8\u8cea\u758f\u9b06\u75c7\u3001\u5438\u5165\u6027\u80ba\u708e<small class=\"mininote\">\u3014aspiration pneumonia\u3015<\/small>\u548c\u56f0\u96e3\u68ad\u72c0\u687f\u83cc\u7d50\u8178\u708e<small class=\"mininote\">\u3014C. difficile colitis\u3015<\/small>\u7684\u98a8\u96aa\u3002<\/li>\n\n\n\n<li>\u5373\u4f7f\u77ed\u671f\u4f7f\u7528 NSAIDs \u4e5f\u6703\u589e\u52a0\u5fc3\u9ad2\u75c5\u767c\u4f5c\u548c\u4e2d\u98a8\u7684\u98a8\u96aa\uff0c\u5982\u679c\u6cbb\u7642\u50c5\u5e7e\u9031\u5f8c\u5c31\u6703\u958b\u59cb\u51fa\u73fe\u9019\u7a2e\u98a8\u96aa\u3002 \u5c0d\u65bc\u90a3\u4e9b\u60a3\u6709\u5df2\u77e5\u5fc3\u9ad2\u75c5\u548c\u670d\u7528\u6700\u9ad8\u5291\u91cf\u7684\u4eba\u4f86\u8aaa\uff0c\u98a8\u96aa\u6700\u5927\u3002 \u5efa\u8b70\u9650\u5236\u4f7f\u7528 NSAID \u7684\u6642\u9593\u548c\u5291\u91cf\uff0c\u5c24\u5176\u662f\u5c0d\u65bc\u60a3\u6709\u5df2\u77e5\u5fc3\u9ad2\u75c5\u7684\u60a3\u8005\u3002<\/li>\n\n\n\n<li>\u5c0d\u65bc\u6709\u986f\u8457\u5fc3\u8840\u7ba1\u98a8\u96aa\u7684\u60a3\u8005\uff0c\u8418\u666e\u751f\u7d50\u5408\u6c2b\u96e2\u5b50\u5e6b\u6d66\u963b\u65b7\u5291<small class=\"mininote\">\u3014naproxen with PPI\u3015<\/small>\u53ef\u80fd\u662f\u4e00\u500b\u53ef\u884c\u7684\u9078\u64c7\u3002<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">\u5916\u7528\u88fd\u5291<\/h4>\n\n\n\n<p>\u5f88\u5c11\u6709\u7814\u7a76\u63a2\u8a0e\u5916\u7528\u88fd\u5291\uff08\u5982\u5229\u591a\u5361\u56e0\u3001\u8fa3\u6912\u7d20\uff09\u5c0d\u6025\u6027\u8170\u75db\u7684\u76ca\u8655\u3002 \u7136\u800c\uff0c\u9019\u4e9b\u5916\u7528\u88fd\u5291\u53ef\u80fd\u5c0d\u795e\u7d93\u6027\u8170\u75db\u6709\u76ca<small class=\"mininote\"><sup> [57] <\/sup><\/small>\u3002 \u8207\u5927\u591a\u6578\u53e3\u670d\u85e5\u7269\u76f8\u6bd4\uff0c\u5916\u7528\u6cbb\u7642\u7684\u5168\u8eab\u4e0d\u826f\u53cd\u61c9\u767c\u751f\u7387\u8f03\u4f4e\u3002 \u9700\u8981\u66f4\u591a\u7684\u6578\u64da\uff0c\u4f86\u5c31\u5916\u7528\u88fd\u5291\u7684\u6709\u6548\u81e8\u5e8a\u4f7f\u7528\u63d0\u51fa\u660e\u78ba\u7684\u5efa\u8b70<small class=\"mininote\"><sup> <\/sup><\/small>\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u975e\u82ef\u4e8c\u6c2e\u5e73\u985e\u808c\u8089\u9b06\u5f1b\u5291<\/h4>\n\n\n\n<p>\u808c\u8089\u9b06\u5f1b\u5291\u7684\u597d\u8655\u4f3c\u4e4e\u50c5\u9650\u65bc\u77ed\u671f\u4f7f\u7528 3-7 \u5929<small class=\"mininote\"><sup> [58,59] <\/sup><\/small>\u3002 \u5c07\u55ae\u7368\u4f7f\u7528 NSAID \u8207\u806f\u5408\u4f7f\u7528 NSAID \u548c\u808c\u8089\u9b06\u5f1b\u5291\u9032\u884c\u6bd4\u8f03\u6642\uff0c\u6025\u6027\u8170\u75db\u6c92\u6709\u5dee\u7570<small class=\"mininote\"><sup> [60] <\/sup><\/small>\u3002 \u808c\u8089\u9b06\u5f1b\u5291\u7684\u4f5c\u7528\u6a5f\u5236\u5c1a\u4e0d\u78ba\u5b9a\u3002<\/p>\n\n\n\n<p>\u8003\u616e\u808c\u8089\u9b06\u5f1b\u5291\u7684\u526f\u4f5c\u7528\u3002 \u5e38\u898b\u7684\u5831\u544a\u6709\u55dc\u7761\u3001\u982d\u75db\u3001\u5641\u5fc3\u548c\u982d\u6688\u3002 \u95dc\u65bc\u4e00\u7a2e\u85e5\u7269\u512a\u65bc\u53e6\u4e00\u7a2e\u85e5\u7269\u7684\u8b49\u64da\u5f88\u5c11\u3002 \u74b0\u82ef\u624e\u6797<small class=\"mininote\">\u3014Cyclobenzaprine\u3015<\/small>\u50f9\u683c\u4f4e\u5ec9\u4e14\u5e38\u7528\uff0c\u4f46\u5b83\u5177\u6709\u8f03\u9ad8\u7684\u6297\u81bd\u9e7c\u4f5c\u7528<small class=\"mininote\">\u3014anticholinergic effects\u3015<\/small>\uff0c\u9019\u53ef\u80fd\u662f\u8001\u5e74\u4eba\u53e3\u4e2d\u7684\u4e00\u500b\u554f\u984c\u3002 \u82ef\u4e8c\u6c2e\u5e73\u985e\u85e5\u7269<small class=\"mininote\">\u3014Benzodiazepines\u3015<\/small>\uff08\u5305\u62ec\u5730\u897f\u6cee<small class=\"mininote\">\u3014diazepam\u3015<\/small>\uff09\u4e0d\u662f\u6709\u6548\u7684\u808c\u8089\u9b06\u5f1b\u5291\uff0c\u4e0d\u61c9\u4f7f\u7528\u3002 \u4e0d\u63a8\u85a6\u5361\u7acb\u8212<small class=\"mininote\">\u3014Carisoprodol\u3015<\/small>\uff0c\u56e0\u70ba\u5b83\u6709\u4e2d\u6a1e\u795e\u7d93\u7cfb\u7d71\u6291\u5236\u548c\u4f9d\u8cf4\u7684\u98a8\u96aa\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u9d09\u7247\u985e\u85e5\u7269<\/strong><\/h4>\n\n\n\n<p>\u8207\u901a\u5e38\u7684\u505a\u6cd5\u76f8\u53cd\uff0c\u9d09\u7247\u985e\u93ae\u75db\u85e5\u901a\u5e38\u4e0d\u9069\u7528\u65bc\u6025\u6027\u8170\u75db\u3002 \u5b83\u5011\u7684\u5fae\u5c0f\u4e14\u81e8\u5e8a\u4e0a\u4e0d\u91cd\u8981\u7684\u597d\u8655\u88ab\u6f5b\u5728\u7684\u5371\u5bb3\u6240\u62b5\u6d88\u3002<\/p>\n\n\n\n<p>\u7cfb\u7d71\u8a55\u50f9\u548c\u7d71\u5408\u5206\u6790\u8868\u660e\uff0c\u8207\u5b89\u6170\u5291\u76f8\u6bd4\uff0c\u9d09\u7247\u985e\u85e5\u7269\u7642\u6cd5\u50c5\u63d0\u4f9b\u4e86\u5f88\u5c0f\u7684\u984d\u5916\u93ae\u75db\u4f5c\u7528<small class=\"mininote\"><sup> [54,59] <\/sup><\/small>\u3002 \u5728\u7d71\u5408\u5206\u6790\u4e2d\uff0c\u8207\u5b89\u6170\u5291\u76f8\u6bd4\uff0c\u9d09\u7247\u985e\u85e5\u7269\u7684\u4f7f\u7528\u5728 30-91 \u5929\u6642\u6c92\u6709\u63d0\u4f9b\u81e8\u5e8a\u4e0a\u91cd\u8981\u7684\u529f\u80fd\u6539\u5584<small class=\"mininote\"><sup> [59] <\/sup><\/small>\u3002 \u4e00\u9805\u7cfb\u7d71\u8a55\u50f9\u767c\u73fe\uff0c\u8207\u5b89\u6170\u5291\u76f8\u6bd4\uff0c\u4f7f\u7528\u5f37\u6548\u9d09\u7247\u985e\u85e5\u7269\u6703\u5c0e\u81f4\u8f15\u5fae\u7684\u3001\u81e8\u5e8a\u4e0a\u4e0d\u91cd\u8981\u7684\u529f\u80fd\u6539\u5584<small class=\"mininote\"><sup> [54] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u9d09\u7247\u985e\u85e5\u7269\u5177\u6709\u986f\u8457\u7684\u526f\u4f5c\u7528\uff0c\u5305\u62ec\u55dc\u7761\u3001\u547c\u5438\u6291\u5236\u3001\u4fbf\u79d8\u4ee5\u53ca\u6210\u766e\u548c\u8f49\u79fb\u6ce8\u610f\u529b\u7684\u53ef\u80fd\u6027\u3002 \u4e00\u9805\u7d71\u5408\u5206\u6790\u8868\u660e\uff0c\u9d09\u7247\u985e\u85e5\u7269\u6cbb\u7642\u7d44\u4e0d\u826f\u4e8b\u4ef6\u7684\u4e2d\u4f4d\u767c\u751f\u7387\u70ba 68.9%\uff0c\u800c\u5b89\u6170\u5291\u7d44\u70ba 49.1%<small class=\"mininote\"><sup> [59] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u5c07\u9d09\u7247\u985e\u85e5\u7269\u8207\u5176\u4ed6\u85e5\u7269\u7642\u6cd5\uff08\u4f8b\u5982\uff0c\u5c0d\u4e59\u91af\u80fa\u915a<small class=\"mininote\">\u3014acetaminophen\u3015<\/small>\u3001NSAIDs\uff09\u9032\u884c\u6bd4\u8f03\u7684\u8a66\u9a57\u6709\u9650\u4e14\u5c1a\u7121\u5b9a\u8ad6\u3002 \u9d09\u7247\u985e\u85e5\u7269\u53ef\u80fd\u5c0d \u201cNSAIDs\u201d \u548c \u201c\u975e\u82ef\u4e8c\u6c2e\u5e73\u985e\u808c\u8089\u9b06\u5f1b\u5291\u201d \u96e3\u4ee5\u6cbb\u7642\u7684\u6025\u6027\u8170\u75db\u6709\u4e00\u5b9a\u7642\u6548\u3002 \u7136\u800c\uff0c\u5728\u6c7a\u5b9a\u5617\u8a66\u9650\u6642\u9d09\u7247\u985e\u85e5\u7269\u7642\u7a0b\u4e4b\u524d\uff0c\u5c0b\u627e\u75bc\u75db\u771f\u6b63\u5287\u70c8\u7684\u5ba2\u89c0\u767c\u73fe\uff0c\u8003\u616e\u53ef\u80fd\u6392\u9664\u4f7f\u7528\u9d09\u7247\u985e\u85e5\u7269\u7684\u56e0\u7d20\uff08\u4f8b\u5982\uff0c\u5e74\u9f61\u3001\u865b\u5f31\u3001\u85e5\u7269\u76f8\u4e92\u4f5c\u7528\u7684\u53ef\u80fd\u6027\u3001\u793e\u6703\u554f\u984c\u3001\u7cbe\u795e\u554f\u984c\u3001\u6feb\u7528\u53f2\u3001\u75bc\u75db\u6216\u5931\u80fd\u56b4\u91cd\u7a0b\u5ea6\uff09\uff0c\u6aa2\u67e5\u4ee5\u524d\u4f7f\u7528\u9d09\u7247\u985e\u85e5\u7269\u7684\u5065\u5eb7\u8a18\u9304\uff0c\u4e26\u67e5\u8a62\u4f60\u6240\u5728\u5dde\u7684\u8655\u65b9\u85e5\u76e3\u6e2c\u8a08\u5283\uff08\u5bc6\u6b47\u6839\u5dde\u7684 MAPS\uff09\u4ee5\u7372\u53d6\u5176\u4ed6\u53d7\u63a7\u7269\u8cea\u8655\u65b9\u3002<\/p>\n\n\n\n<p>UMHS \u81e8\u5e8a\u6307\u5357\u89e3\u6c7a\u4e86\u963f\u7247\u985e\u85e5\u7269\u7528\u65bc\u6162\u6027\u75bc\u75db\u7684\u554f\u984c\uff0c\u300a<a href=\"https:\/\/www.med.umich.edu\/1info\/FHP\/practiceguides\/pain\/pain.pdf\" data-type=\"URL\" data-id=\"https:\/\/www.med.umich.edu\/1info\/FHP\/practiceguides\/pain\/pain.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">\u7ba1\u7406\u6210\u4eba\u6162\u6027\u975e\u7d42\u672b\u671f\u75bc\u75db\uff0c\u5305\u62ec\u958b\u5177\u53d7\u63a7\u85e5\u7269\u8655\u65b9<\/a>\u300b\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u4e59\u91af\u80fa\u915a<\/h4>\n\n\n\n<p>\u8b49\u64da\u8868\u660e\u4f7f\u7528\u4e59\u91af\u80fa\u915a<small class=\"mininote\">\u3014acetaminophen\u3015<\/small>\u5c0d\u8170\u75db\u6c92\u6709\u597d\u8655\uff0c\u56e0\u6b64\u4e3b\u8981\u8003\u616e\u50b7\u5bb3\u6216\u8ca0\u64d4\u3002 \u56e0\u6b64\uff0c\u4e59\u91af\u80fa\u915a\u4e0d\u63a8\u85a6\u7528\u65bc\u6cbb\u7642\u8170\u75db\u3002<\/p>\n\n\n\n<p>\u5169\u9805\u5927\u578b\u7cfb\u7d71\u8a55\u50f9\u767c\u73fe\uff0c\u8207\u5b89\u6170\u5291\u76f8\u6bd4\uff0c\u5c0d\u4e59\u91af\u80fa\u915a\u5728 12 \u9031\u6642\u7684\u75bc\u75db\u3001\u5931\u80fd\u3001\u529f\u80fd\u6216\u751f\u6d3b\u8cea\u91cf\u65b9\u9762\u6c92\u6709\u5be6\u8cea\u6027\u76ca\u8655<small class=\"mininote\"><sup> [54,61] <\/sup><\/small>\u3002 \u540c\u6a23\uff0c\u5728\u4e00\u9805\u5927\u578b\u9ad8\u8cea\u91cf\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u7684\u4efb\u4f55\u6642\u9593\u9ede\uff0c\u5c0d\u4e59\u91af\u80fa\u915a\u548c\u5b89\u6170\u5291\u4e4b\u9593\u6c92\u6709\u5dee\u7570<small class=\"mininote\"><sup> [62] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u4e59\u91af\u80fa\u915a\u5f88\u5bb9\u6613\u5728\u6ac3\u6aaf\u4e0a\u8cb7\u5230\uff0c\u88ab\u60a3\u8005\u8a8d\u70ba\u662f\u4e00\u7a2e\u201c\u5b89\u5168\u201d\u85e5\u7269\uff0c\u5c24\u5176\u662f\u56e0\u70ba\u5b83\u6c92\u6709 NSAID \u5e38\u898b\u7684\u80c3\u8178\u9053\u3001\u814e\u81df\u548c\u51fa\u8840\u526f\u4f5c\u7528\u3002 \u4f46\u662f\uff0c\u5982\u679c\u6c92\u6709\u9069\u7576\u7684\u6559\u80b2\uff0c\u5b83\u5f88\u5bb9\u6613\u88ab\u904e\u5ea6\u4f7f\u7528\u3002 \u8001\u5e74\u4eba\u548c\u809d\u529f\u80fd\u4e0d\u5168\u60a3\u8005\u53ef\u80fd\u662f\u6700\u5bb9\u6613\u53d7\u5230\u50b7\u5bb3\u7684\u5b50\u7fa4\u7d44\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>\u82ef\u4e8c\u6c2e\u5e73\u985e\u85e5\u7269<\/strong><\/h4>\n\n\n\n<p>\u4f4e\u8cea\u91cf\u6578\u64da\u8868\u660e\u82ef\u4e8c\u6c2e\u5e73\u985e\u85e5\u7269<small class=\"mininote\">\u3014benzodiazepines\u3015<\/small>\u7684\u5371\u5bb3\u5927\u65bc\u76ca\u8655\u3002 \u907f\u514d\u5b83\u5011\u7684\u4ee4\u4eba\u4fe1\u670d\u7684\u7406\u7531\u662f\u6feb\u7528\u3001\u6210\u766e\u548c\u904e\u91cf\u5c0e\u81f4\u547c\u5438\u6291\u5236\u548c\u6b7b\u4ea1\u7684\u5de8\u5927\u53ef\u80fd\u6027\u3002<\/p>\n\n\n\n<p>\u652f\u6301\u5728\u6025\u6027\u8170\u75db\u4e2d\u4f7f\u7528\u82ef\u4e8c\u6c2e\u5e73\u985e\u85e5\u7269\u7684\u8b49\u64da\u4ecd\u7136\u4e0d\u8db3\u3002 \u4e00\u9805\u7cfb\u7d71\u8a55\u50f9\u767c\u73fe\u5730\u897f\u6cee<small class=\"mininote\">\u3014diazepam\u3015<\/small>\u548c\u5b89\u6170\u5291\u5728\u6539\u5584\u8170\u75db\u65b9\u9762\u5c1a\u7121\u5b9a\u8ad6<small class=\"mininote\"><sup> [54] <\/sup><\/small>\u3002 \u8207\u5b89\u6170\u5291\u76f8\u6bd4\uff0c\u540c\u4e00\u9805\u4f4e\u8cea\u91cf\u8b49\u64da\u7684\u7d9c\u8ff0\u5831\u544a\u4e86\u82ef\u4e8c\u6c2e\u5e73\u985e\u85e5\u7269\u66f4\u983b\u7e41\u7684\u4e2d\u6a1e\u795e\u7d93\u7cfb\u7d71\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5982\u75b2\u52de\u3001\u982d\u6688\u548c\u55dc\u7761\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u5168\u8eab\u6027\u76ae\u8cea\u985e\u56fa\u9187<\/h4>\n\n\n\n<p>\u5e7e\u4e4e\u6c92\u6709\u8b49\u64da\u8868\u660e\u300e\u5168\u8eab\u6027\u76ae\u8cea\u985e\u56fa\u9187<small class=\"mininote\">\u3014systemic corticosteroids\u3015<\/small>\u5c0d\u6025\u6027\u8170\u75db\u7684\u75bc\u75db\u6216\u5931\u80fd\u6709\u6548\u300f\u3002 \u4e2d\u7b49\u8cea\u91cf\u7684\u7814\u7a76\u767c\u73fe\u300e\u75bc\u75db\u65b9\u9762\u7121\u986f\u8457\u5dee\u7570\uff0c\u4e26\u4e14\u8207\u91ab\u7642\u7167\u8b77\u5229\u7528\u76f8\u95dc\u7684\u7d50\u679c\u4e0d\u4e00\u300f<small class=\"mininote\"><sup> [54,63] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u76ae\u8cea\u985e\u56fa\u9187\u7684\u4f7f\u7528\u5728\u77ed\u671f\u548c\u9577\u671f\u90fd\u6709\u4e00\u5b9a\u7684\u98a8\u96aa\u3002 \u5728\u4e00\u9805\u4e2d\u7b49\u8cea\u91cf\u7684\u7814\u7a76\u4e2d\uff0c\u5c07\u666e\u8cf4\u9b06<small class=\"mininote\">\u3014prednisone\u3015<\/small>\u8207\u5b89\u6170\u5291\u9032\u884c\u6bd4\u8f03\u6642\uff0c\u666e\u8cf4\u9b06\u6703\u7522\u751f\u660e\u986f\u66f4\u591a\u7684\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5305\u62ec\u7dca\u5f35\u3001\u982d\u75db\u3001\u98df\u617e\u589e\u52a0\u3001\u5931\u7720\u548c\u51fa\u6c57<small class=\"mininote\"><sup> [63,64] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">SSRIs\u3001SNRIs \u548c\u4e09\u74b0\u6297\u6182\u9b31\u5291<\/h4>\n\n\n\n<p>\u5c0d\u65bc\u6025\u6027\u8170\u75db\uff0c\u6587\u737b\u4e0d\u652f\u6301\u4f7f\u7528 \u201c\u9078\u64c7\u6027\u8840\u6e05\u7d20\u518d\u5438\u6536\u6291\u5236\u5291\uff08SSRI\uff09\u201d \u3001\u201c\u8840\u6e05\u7d20\u53ca\u53bb\u7532\u814e\u4e0a\u817a\u7d20\u518d\u651d\u53d6\u6291\u5236\u5291\uff08SNRI\uff09\u201d \u6216\u4e09\u74b0\u6297\u6182\u9b31\u5291\u3002 \u7136\u800c\uff0c\u5c0d\u65bc\u6162\u6027\u8170\u75db\uff0c\u5176\u4e2d\u4e00\u4e9b\u85e5\u7269\uff08\u7279\u5225\u662f SNRI \u5ea6\u6d1b\u897f\u6c40<small class=\"mininote\">\u3014duloxetine\u3015<\/small>\uff09\u5df2\u8b49\u660e\u5c0d\u75bc\u75db\u548c\u529f\u80fd\u6539\u5584\u90fd\u6709\u597d\u8655<small class=\"mininote\"><sup> [54,65] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u6b64\u985e\u85e5\u7269\u4e4b\u9593\u7684\u4e0d\u826f\u53cd\u61c9\u8ca0\u64d4\u53ef\u80fd\u5dee\u7570\u5f88\u5927\uff0c\u5728\u9078\u64c7\u7279\u5b9a\u85e5\u7269\u6642\u61c9\u4e88\u4ee5\u8003\u616e\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u52a0\u5df4\u5674\u4e01\u985e\u85e5\u7269\uff08\u666e\u745e\u5df4\u6797\u3001\u52a0\u5df4\u5674\u4e01\uff09<\/h4>\n\n\n\n<p>\u5118\u7ba1\u95dc\u65bc\u4f7f\u7528\u52a0\u5df4\u5674\u4e01\u985e\u85e5\u7269<small class=\"mininote\">\u3014gabapentinoids\u3015<\/small>\u6cbb\u7642\u6025\u6027\u8170\u75db\u7684\u8b49\u64da\u4e0d\u4e00\uff0c\u4f46\u4e0d\u63a8\u85a6\u4f7f\u7528\u666e\u745e\u5df4\u6797<small class=\"mininote\">\u3014pregabalin\u3015<\/small>\u548c\u52a0\u5df4\u5674\u4e01<small class=\"mininote\">\u3014gabapentin\u3015<\/small>\uff0c\u56e0\u70ba\u8207\u6f5b\u5728\u5371\u5bb3\u76f8\u6bd4\u7372\u76ca\u751a\u5fae<small class=\"mininote\"><sup> [66] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u6c92\u6709\u8a66\u9a57\u6d89\u53ca\u52a0\u5df4\u5674\u4e01\u985e\u85e5\u7269<small class=\"mininote\">\u3014gabapentinoids\u3015<\/small>\u548c\u5176\u4ed6\u6297\u7672\u7647\u85e5<small class=\"mininote\">\u3014antiepileptic\u3015<\/small>\u5728\u6025\u6027\u975e\u795e\u7d93\u6839\u6027\u8170\u75db\u4e2d\u7684\u61c9\u7528\u3002 \u5169\u9805\u4f4e\u8cea\u91cf\u7684\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u8868\u660e\u300e\u77ed\u671f\u5167\u75bc\u75db\u7684\u5dee\u7570\u5f88\u5c0f\u300f\u3002 \u4e00\u9805\u4e2d\u7b49\u8cea\u91cf\u7684\u7814\u7a76\u8868\u660e\u300e\u52a0\u5df4\u5674\u4e01\u548c\u5b89\u6170\u5291\u5728\u6cbb\u7642\u795e\u7d93\u6839\u6027\u6216\u975e\u795e\u7d93\u6839\u6027\u6162\u6027\u8170\u75db\u65b9\u9762\u6c92\u6709\u5dee\u7570\u300f<small class=\"mininote\"><sup> [69] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u4e0d\u826f\u4e8b\u4ef6\u662f\u5c0d\u666e\u745e\u5df4\u6797<small class=\"mininote\">\u3014pregabalin\u3015<\/small>\u548c\u52a0\u5df4\u5674\u4e01<small class=\"mininote\">\u3014gabapentin\u3015<\/small>\u7684\u64d4\u5fc3\u3002 \u6bcf\u7a2e\u85e5\u7269\u90fd\u5728\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u4e2d\u9032\u884c\u4e86\u7814\u7a76\u3002 \u9019\u5169\u7a2e\u85e5\u7269\u90fd\u6703\u5c0e\u81f4\u66f4\u9ad8\u7684\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5305\u62ec\u75b2\u52de\u3001\u6ce8\u610f\u529b\u4e0d\u96c6\u4e2d\u548c\u5931\u53bb\u5e73\u8861<small class=\"mininote\"><sup> [69,70] <\/sup><\/small>\u3002 \u6b64\u5916\uff0c\u666e\u745e\u5df4\u6797\u548c\u52a0\u5df4\u5674\u4e01\u662f\u53d7\u63a7\u7269\u8cea\uff0c\u5177\u6709\u4e00\u5b9a\u7684\u6feb\u7528\u548c\u4f9d\u8cf4\u6027\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u8349\u85e5\u548c\u88dc\u5145\u54c1<\/h4>\n\n\n\n<p>\u5e7e\u4e4e\u6c92\u6709\u9ad8\u8cea\u91cf\u7684\u8b49\u64da\u53ef\u4ee5\u652f\u6301\u4f7f\u7528\u8349\u85e5\u548c\u88dc\u5145\u54c1\u3002 \u7f3a\u4e4fFDA\u76e3\u7ba1\u3001\u7a2e\u985e\u7e41\u591a\u7684\u88fd\u5291\uff0c\u4ee5\u53ca\u5176\u751f\u7269\u6d3b\u6027<small class=\"mininote\">\u3014bioactivity\u3015<\/small>\u5f15\u8d77\u4e86\u4eba\u5011\u5c0d\u5371\u5bb3\u53ef\u80fd\u8d85\u904e\u5229\u76ca\u7684\u64d4\u6182\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u8461\u8404\u7cd6\u80fa<small class=\"mininote\">\u3014glucosamine\u3015<\/small>\uff0c\u4e00\u9805\u975e\u5e38\u4f4e\u8cea\u91cf\u8b49\u64da\u7684\u4e09\u8a66\u7cfb\u7d71\u6027\u56de\u9867\u986f\u793a\uff0c\u5169\u9805\u7d0d\u5165\u7814\u7a76\u4e2d\u7684\u8461\u8404\u7cd6\u80fa\u548c\u5b89\u6170\u5291\u4e4b\u9593\u6c92\u6709\u5dee\u7570\u3002 \u4f7f\u7528\u5b50\u81e8\u5e8a\u5291\u91cf\u7684\u8461\u8404\u7cd6\u80fa\uff0c\u5f15\u8d77\u4eba\u5011\u5c0d\u7d50\u679c\u6709\u6548\u6027\u7684\u64d4\u6182<small class=\"mininote\"><sup> [71] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u5169\u7a2e\u53e3\u670d\u8349\u85e5\uff08\u9b54\u9b3c\u722a<small class=\"mininote\">\u3014devil\u2019s claw\u3015<\/small>\u548c\u767d\u67f3\u6a39\u76ae<small class=\"mininote\">\u3014white willow bark\u3015<\/small>\uff09\uff0c\u4e00\u7bc7\u7cfb\u7d71\u6027\u56de\u9867\u5305\u62ec\u4e86\u6025\u6027\u548c\u6162\u6027\u8170\u80cc\u75db\u7684\u5341\u9805\u8a66\u9a57\uff0c\u5728\u77ed\u671f\u5167\u986f\u793a\u51fa\u826f\u597d\u7684\u6548\u679c\u3002 \u4f46\u662f\uff0c\u5c1a\u672a\u7814\u7a76\u5b89\u5168\u6027\u548c\u9577\u671f\u529f\u6548\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u6ce8\u5c04<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u5f88\u5c11\u6709\u8b49\u64da\u652f\u6301\u5c07\u4efb\u4f55\u985e\u578b\u7684\u6ce8\u5c04\u7528\u65bc\u975e\u7279\u7570\u6027\u6025\u6027\u8170\u80cc\u75db\u3002<\/p>\n\n\n\n<p>\u786c\u810a\u819c\u5916\u985e\u56fa\u9187\u6ce8\u5c04<small class=\"mininote\">\u3014epidural steroid injections\u3015<\/small>\u53ef\u80fd\u6703\u63d0\u4f9b\u653e\u5c04\u6027\u75bc\u75db\uff08\u56e0\u690e\u9593\u76e4\u7a81\u51fa\u75c7\u6216\u810a\u67f1\u72f9\u7a84\u800c\u5f15\u8d77\uff09\u7684\u77ed\u671f\u7de9\u89e3\u3002 \u4f46\u662f\uff0c\u9577\u671f\u7684\u7d50\u679c\u5c1a\u4e0d\u6e05\u695a\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u5c0d\u65bc\u975e\u7279\u7570\u6027\u6025\u6027\u8170\u80cc\u75db\uff0c\u5f88\u5c11\u6709\u8b49\u64da\u652f\u6301\u4f7f\u7528\u4efb\u4f55\u985e\u578b\u7684\u6ce8\u5c04<small class=\"mininote\"><sup> [73] <\/sup><\/small>\u3002 \u5c0d\u65bc\u690e\u9593\u76e4\u7a81\u51fa\u75c7\u6216\u810a\u67f1\u72f9\u7a84\uff0c\u786c\u810a\u819c\u5916\u985e\u56fa\u9187\u6ce8\u5c04\u53ef\u80fd\u6703\u6e1b\u8f15\u653e\u5c04\u6027\u817f\u75db\u7684\u77ed\u671f\u7de9\u89e3\uff0c\u4f46\u5c0d\u9577\u671f\u7d50\u5c40\u7684\u5f71\u97ff\u5c1a\u4e0d\u6e05\u695a<small class=\"mininote\"><sup> [74,75] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u5728\u7d9c\u5408\u5eb7\u5fa9\u8a08\u5283\u7684\u7bc4\u570d\u4e4b\u5916\u5b8c\u6210\u6642\uff0c\u5c07\u985e\u56fa\u9187\u6ce8\u5c04\u5230\u5c0f\u9762\u95dc\u7bc0<small class=\"mininote\">\u3014facet joints\u3015<\/small>\u548c\u85a6\u9ac2\u95dc\u7bc0<small class=\"mininote\">\u3014sacroiliac joints\u3015<\/small>\u4e2d\u4f3c\u4e4e\u6c92\u6709\u91cd\u5927\u5f71\u97ff\u3002 \u6ce8\u5c04\u5c40\u90e8\u9ebb\u9189\u548c \u201c\u5e79\u91dd<small class=\"mininote\">\u3014dry needling\u3015<\/small>\u201d \u7684\u89f8\u767c\u9ede\u6ce8\u5c04\u5df2\u986f\u793a\u300e\u5728\u8170\u75db\u7684\u7ba1\u7406\u4e2d\u5177\u6709\u77ed\u671f\u6709\u6548\u6027\u300f\u3002 \u8207\u89f8\u767c\u9ede\u6ce8\u5c04\u76f8\u6bd4\uff0c\u5728\u6025\u6027\u8170\u80cc\u75db\u7ba1\u7406\u4e2d\u4f7f\u7528\u8089\u6bd2\u687f\u83cc\u6bd2\u7d20\u6ce8\u5c04<small class=\"mininote\">\u3014botulinum toxin injections\u3015<\/small>\u986f\u793a\u300e\u6c92\u6709\u4efb\u4f55\u512a\u52e2\uff0c\u4e26\u4e14\u6210\u672c\u589e\u52a0\u300f<small class=\"mininote\"><sup> [73,76\u201379]<\/sup><\/small>\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u624b\u8853<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u5728\u9032\u884c\u6027\u795e\u7d93\u7cfb\u7d71\u7f3a\u9677<small class=\"mininote\">\u3014progressive neurologic deficits\u3015<\/small>\u6216\u99ac\u5c3e\u75c7\u5019\u7fa4<small class=\"mininote\">\u3014cauda equina syndrome\u3015<\/small>\u7684\u60a3\u8005\u4e2d\uff0c\u8acb\u6c42\u7dca\u6025\u7684\u624b\u8853\u8a55\u4f30\u3002<\/p>\n\n\n\n<p>\u5728\u6709\u75c7\u72c0\u6027\u810a\u690e\u6ed1\u812b<small class=\"mininote\">\u3014spondylolisthesis\u3015<\/small>\uff0c\u810a\u67f1\u72f9\u7a84<small class=\"mininote\">\u3014spinal stenosis\u3015<\/small>\u548c\/\u6216\u7bc0\u6bb5\u6027\u904e\u5ea6\u904b\u52d5\u904e\u5ea6<small class=\"mininote\">\u3014segmental hypermobility\u3015<\/small>\u7684\u60a3\u8005\u4e2d\uff0c\u8acb\u8003\u616e\u624b\u8853\u8a55\u4f30\u3002<\/p>\n\n\n\n<p>\u5728\u4f34\u96a8\u653e\u5c04\u6027\u75bc\u75db\u7684\u60a3\u8005\u4e2d\uff0c\u4fdd\u5b88\u6cbb\u76424\u9031\u5931\u6557\u5f8c\uff0c\u8acb\u8003\u616e\u624b\u8853\u8a55\u4f30\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u60a3\u6709\u9032\u884c\u6027\u795e\u7d93\u529f\u80fd\u7f3a\u640d\u6216\u99ac\u5c3e\u7d9c\u5408\u5fb5\u7684\u60a3\u8005\u9700\u8981\u7dca\u6025\u624b\u8853\u8a55\u4f30\uff0c\u56e0\u70ba\u96a8\u8457\u6642\u9593\u7684\u63a8\u79fb\uff0c\u9019\u4e9b\u795e\u7d93\u554f\u984c\u53ef\u80fd\u8b8a\u5f97\u4e0d\u53ef\u9006\u8f49\u3002 \u8207\u4fdd\u5b88\u6cbb\u7642\u76f8\u6bd4\uff0c\u300e\u819d\u4e0b\u653e\u5c04\u6027\u75bc\u75db\u300f\u3001\u300e\u967d\u6027\u795e\u7d93\u7cfb\u7d71\u6aa2\u67e5\u7d50\u679c\u300f\u548c\u300e\u5f71\u50cf\u5b78\u6aa2\u67e5\u767c\u73fe\u690e\u9593\u76e4\u7a81\u51fa\u300f\u7684\u60a3\u8005\u53ef\u4ee5\u901a\u904e\u624b\u8853\u66f4\u5feb\u5730\u7de9\u89e3\u75c7\u72c0\u3002 \u5c0d\u65bc\u690e\u9593\u76e4\u7a81\u51fa\u75c7\uff0c\u8207\u4fdd\u5b88\u6cbb\u7642\u76f8\u6bd4\uff0c\u624b\u8853\u6cbb\u7642\u53ef\u7e2e\u77ed\u5931\u80fd\u6642\u9593\uff0c\u4f46\u5169\u7a2e\u65b9\u6cd5\u7684\u9577\u671f\u7d50\u679c\u76f8\u4f3c\u3002<\/p>\n\n\n\n<p>\u8003\u616e\u5c0d\u6709\u75c7\u72c0\u7684\u810a\u690e\u6ed1\u812b\u3001\u690e\u7ba1\u72f9\u7a84\u548c\/\u6216\u7bc0\u6bb5\u6027\u6d3b\u52d5\u904e\u5ea6\u7684\u60a3\u8005\u9032\u884c\u624b\u8853\u8a55\u4f30\uff0c\u56e0\u70ba\u9019\u4e9b\u60c5\u6cc1\u53ef\u4ee5\u901a\u904e\u624b\u8853\u77ef\u6b63<small class=\"mininote\"><sup> [78,82] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u8a31\u591a\u653e\u5c04\u6027\u75bc\u75db\u60a3\u8005\u6703\u5728\u6700\u521d\u5e7e\u9031\u5167\u597d\u8f49\u3002 \u56e0\u6b64\uff0c\u901a\u5e38\u5728\u60a3\u8005\u81f3\u5c11 4 \u9031\u7684\u4fdd\u5b88\u6cbb\u7642\u5931\u6557\u5f8c\u624d\u8003\u616e\u624b\u8853\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u5fc3\u7406\u5065\u5eb7\u5e72\u9810<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u9032\u884c\u5fc3\u7406\u5065\u5eb7\u7be9\u67e5\u4f5c\u70ba\u8170\u80cc\u75db\u521d\u6b65\u8a55\u4f30\u7684\u4e00\u90e8\u5206\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u5408\u4f75\u6709\u7cbe\u795e\u548c\u60c5\u7dd2\u969c\u7919<small class=\"mininote\">\u3014psychiatric and mood disorders\u3015<\/small>\u7684\u60a3\u8005\uff0c\u8003\u616e\u8aee\u8a62\u6216\u5fc3\u7406\u6cbb\u7642\u3002<\/p>\n\n\n\n<p>\u8003\u616e\u57fa\u65bc\u6b63\u5ff5\u7684\u6e1b\u58d3\u7642\u6cd5\u4f86\u6539\u5584\u77ed\u671f\u7d50\u679c\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u5c0d\u65bc\u5408\u4f75\u6709\u7cbe\u795e\u548c\u60c5\u7dd2\u969c\u7919\u7684\u60a3\u8005\uff0c\u6025\u6027\u8170\u80cc\u75db\u53ef\u80fd\u5f15\u767c\u6182\u9b31\u548c\u7126\u616e\u75c7\u72c0\u60e1\u5316\u3002 \u8aee\u8a62\u6216\u5fc3\u7406\u6cbb\u7642\u662f\u9810\u9632\u6f5b\u5728\u60c5\u7dd2\u969c\u7919\u60e1\u5316\u7684\u6709\u6548\u7b56\u7565<small class=\"mininote\"><sup> [24,26,28] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u8003\u616e\u57fa\u65bc\u6b63\u5ff5\u7684\u6e1b\u58d3\u7642\u6cd5\uff1b \u8207\u5e38\u898f\u8b77\u7406\u76f8\u6bd4\uff0c\u5b83\u53ef\u4ee5\u6539\u5584\u75bc\u75db\u5f37\u5ea6\u548c\u8eab\u9ad4\u6a5f\u80fd\u7684\u77ed\u671f\u7d50\u679c\uff0c\u4f46\u4e0d\u6703\u986f\u8457\u6539\u8b8a\u9577\u671f\u7d50\u679c<small class=\"mininote\"><sup> [83] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u96d6\u7136\u751f\u7269\u53cd\u994b<small class=\"mininote\">\u3014biofeedback\u3015<\/small>\u548c\u81ea\u6211\u50ac\u7720<small class=\"mininote\">\u3014self-hypnosis\u3015<\/small>\u662f\u5b89\u5168\u7684\u4e26\u4e14\u53ef\u80fd\u6709\u7528\uff0c\u4f46\u6578\u64da\u4e0d\u8db3\u4ee5\u63d0\u4f9b\u652f\u6301\u6216\u53cd\u5c0d\u5b83\u5011\u7684\u5efa\u8b70\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u591a\u5b78\u79d1\u65b9\u6cd5<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u5c0d\u65bc\u6025\u6027\u8170\u80cc\u75db\u60a3\u8005\uff0c\u4e0d\u63d0\u4f9b\u591a\u5b78\u79d1\u751f\u7269\u5fc3\u7406\u793e\u6703\u5eb7\u5fa9<\/p>\n\n\n\n<p>\u5c0d\u65bc\u6162\u6027\u6216\u4e9e\u6025\u6027\u8170\u80cc\u75db\u60a3\u8005\uff0c\u5c0d\u66f4\u6709\u9650\u7684\u65b9\u6cd5\u53cd\u61c9\u4e0d\u6eff\u610f\uff0c\u63d0\u4f9b\u591a\u5b78\u79d1\u7684\u751f\u7269\u5fc3\u7406\u793e\u6703\u5eb7\u5fa9\u8a08\u5283\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u6162\u6027\u8170\u80cc\u75db\u60a3\u8005\uff0c\u5efa\u8b70\u63a1\u7528\u591a\u6210\u5206\u81ea\u6211\u7ba1\u7406\u5e72\u9810\uff0c\u4e26\u8003\u616e\u589e\u52a0\u5305\u62ec\u75bc\u75db\u795e\u7d93\u751f\u7406\u5b78<small class=\"mininote\">\u3014pain neurophysiology\u3015<\/small>\u5728\u5167\u7684\u7d50\u69cb\u5316\u6559\u80b2\u6210\u5206\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u591a\u5b78\u79d1\u751f\u7269\u5fc3\u7406\u793e\u6703\u5eb7\u5fa9<small class=\"mininote\">\u3014Multidisciplinary biopsychosocial rehabilitation\u3015<\/small>\u5c0d\u6025\u6027\u8170\u75db\u5e7e\u4e4e\u6c92\u6709\u76ca\u8655\uff0c\u56e0\u70ba\u5b83\u901a\u5e38\u6703\u5728 4 \u9031\u5167\u6d88\u9000<small class=\"mininote\"><sup> [84] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u6162\u6027\u8170\u75db\u60a3\u8005\uff0c\u591a\u5b78\u79d1\u751f\u7269\u5fc3\u7406\u793e\u6703\u5eb7\u5fa9\u5177\u6709\u826f\u597d\u7684\u98a8\u96aa\u6536\u76ca\u6bd4<small class=\"mininote\"><sup> [85\u201388] <\/sup><\/small>\u3002 \u5b83\u9084\u8b49\u660e\u5c0d\u4e9e\u6025\u6027\u8170\u75db\u6709\u597d\u8655<small class=\"mininote\"><sup> [89] <\/sup><\/small>\u3002 \u591a\u5b78\u79d1\u751f\u7269\u5fc3\u7406\u793e\u6703\u5eb7\u5fa9\u61c9\u8a72\u5305\u62ec\u300e\u81f3\u5c11\u4e00\u500b\u7269\u7406\u6210\u5206\u300f\u548c\u300e\u751f\u7269\u5fc3\u7406\u793e\u6703\u6a21\u578b\u7684\u81f3\u5c11\u4e00\u500b\u5176\u4ed6\u6210\u5206\uff08\u5fc3\u7406\u3001\u793e\u6703\u3001\u8077\u696d\uff09\u300f\u3002 \u9019\u4e9b\u6210\u5206\u61c9\u8a72\u4ee5\u660e\u78ba\u5354\u8abf\u7684\u65b9\u5f0f\u4f7f\u7528\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u6162\u6027\u8170\u75db\u60a3\u8005\uff0c\u5efa\u8b70\u63a1\u7528\u591a\u6210\u5206\u81ea\u6211\u7ba1\u7406\u5e72\u9810\uff0c\u4e26\u8003\u616e\u589e\u52a0\u5305\u62ec\u75bc\u75db\u795e\u7d93\u751f\u7406\u5b78\u5728\u5167\u7684\u7d50\u69cb\u5316\u6559\u80b2\u6210\u5206\u3002<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">\u5c08\u984c<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">\u521d\u7d1a\u9810\u9632<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u70ba\u964d\u4f4e\u5065\u5eb7\u4eba\u7fa4\u51fa\u73fe\u6025\u6027\u8170\u75db\u7684\u53ef\u80fd\u6027\uff0c\u5efa\u8b70\uff1a<\/p>\n\n\n\n<ul>\n<li>\u55ae\u7368\u6216\u8207\u6559\u80b2\u76f8\u7d50\u5408\u7684\u8eab\u9ad4\u6d3b\u52d5\u6216\u935b\u7149\u3002<\/li>\n\n\n\n<li>\u6e1b\u5c11\u5371\u96aa\u56e0\u7d20\uff1a\u80a5\u80d6\u3001\u5438\u7159\u3001\u5287\u70c8\u9ad4\u529b\u52de\u52d5\u3002<\/li>\n<\/ul>\n\n\n\n<p>\u50c5\u9760\u6559\u80b2\u3001\u80cc\u5e36\u3001\u978b\u588a\u6216\u4eba\u9ad4\u5de5\u5b78\u8a08\u5283\u7121\u6cd5\u63d0\u4f9b\u4efb\u4f55\u9810\u9632\u76ca\u8655\u3002<\/p>\n\n\n\n<p>\u4e0d\u8981\u4f7f\u7528 X \u5149\u6216\u5176\u4ed6\u5f71\u50cf\u6aa2\u67e5\u8170\u75db\u98a8\u96aa\u8f03\u9ad8\u7684\u500b\u9ad4\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u8eab\u9ad4\u6d3b\u52d5\u548c\u935b\u7149\u53ef\u4ee5\u9632\u6b62\u8170\u80cc\u75db\u7684\u767c\u751f\u3002 \u6bcf\u9031 2-4 \u6b21\u62c9\u4f38\u3001\u529b\u91cf\u8a13\u7df4\u548c\u6709\u6c27\u904b\u52d5\u76f8\u7d50\u5408\u662f\u5408\u7406\u7684\u3002 \u4e00\u9805\u7cfb\u7d71\u6027\u56de\u9867\u767c\u73fe\uff0c\u8207\u5c0d\u7167\u7d44\u76f8\u6bd4\uff0c\u55ae\u7368\u935b\u7149\u53ef\u5c07\u767c\u751f\u8170\u80cc\u75db\u7684\u98a8\u96aa\u964d\u4f4e 33%\u3002 \u904b\u52d5\u7d44\u7684\u8170\u75db\u56b4\u91cd\u7a0b\u5ea6\u548c\u8207\u8170\u75db\u76f8\u95dc\u7684\u5931\u80fd\u4e5f\u8f03\u4f4e\u3002 \u935b\u7149\u8207\u6559\u80b2\u76f8\u7d50\u5408\u53ef\u5c07\u98a8\u96aa\u964d\u4f4e 27%<small class=\"mininote\"><sup> [90] <\/sup><\/small>\u3002 \u53e6\u4e00\u9805\u56de\u9867\u9084\u767c\u73fe\uff0c\u201c\u935b\u7149\u201d\u548c\u201c\u935b\u7149\u52a0\u6559\u80b2\u201d\u53ef\u4ee5\u964d\u4f4e\u5065\u5eb7\u4eba\u60a3\u8170\u75db\u7684\u98a8\u96aa<small class=\"mininote\"><sup> [91,92] <\/sup><\/small>\u3002\u6b65\u884c\u6216\u9a0e\u81ea\u884c\u8eca\u4e0a\u73ed\u7684\u4eba\uff0c\u65b0\u767c\u8170\u80cc\u75db\u7684\u7a0b\u5ea6\u8f03\u4f4e<small class=\"mininote\"><sup> [93] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u767c\u751f\u65b0\u767c\u8170\u80cc\u75db\u7684\u91cd\u8981\u5371\u96aa\u56e0\u7d20\u5305\u62ec\u4ee5\u8170\u570d\u6e2c\u91cf\u7684\u8179\u90e8\u80a5\u80d6\uff08\u7537\u6027 &gt; 102 \u5398\u7c73 [40 \u82f1\u5bf8]\uff0c\u5973\u6027 &gt; 88 \u5398\u7c73 [35 \u82f1\u5bf8]\uff09\u3001\u5168\u8eab\u80a5\u80d6\uff08BMI \u2265 30 kg\/m2 )\u3001\u5438\u7159\u548c\u5287\u70c8\u7684\u9ad4\u529b\u52de\u52d5<small class=\"mininote\"><sup> [93] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u767c\u751f\u8170\u80cc\u75db\u7684\u98a8\u96aa\u8f03\u9ad8\u7684\u4eba\uff0c\u4f7f\u7528 X \u5149\u6216\u5176\u4ed6\u9020\u5f71\u9032\u884c\u7be9\u67e5\u662f\u6c92\u6709\u7528\u7684\u3002 \u9019\u4e00\u53cd\u5c0d\u9020\u5f71\u7684\u5efa\u8b70\u5f97\u5230\u4e86\u591a\u500b\u91ab\u751f\u548c\u63d0\u4f9b\u8005\u5718\u9ad4\u7684\u652f\u6301\uff0c\u5305\u62ec\u7f8e\u570b\u5bb6\u5ead\u91ab\u5e2b\u5b78\u6703<small class=\"mininote\">\u3014American Academy of Family Physicians\u3015<\/small>\u3001\u7f8e\u570b\u9ebb\u9189\u5e2b\u5354\u6703<small class=\"mininote\">\u3014American Society of Anesthesiologists\u3015<\/small>\u3001\u7f8e\u570b\u810a\u9aa8\u795e\u7d93\u5b78\u6703<small class=\"mininote\">\u3014American Chiropractic Association\u3015<\/small>\u548c\u7f8e\u570b\u91ab\u5e2b\u5b78\u6703<small class=\"mininote\">\u3014American College of Physicians\u3015<\/small><small class=\"mininote\"><sup> [94] <\/sup><\/small>\u3002 \u5c0d\u7d05\u65d7\u5371\u96aa\u4fe1\u865f\u767c\u73fe\u9032\u884c\u8a3a\u65b7\u9020\u5f71\u3002<\/p>\n\n\n\n<p>\u5176\u4ed6\u521d\u7d1a\u9810\u9632\u7b56\u7565\uff0c\u5305\u62ec\u55ae\u7368\u6559\u80b2\u3001\u80cc\u5e36\u3001\u978b\u588a\u548c\u4eba\u9ad4\u5de5\u7a0b\u5b78\u8a08\u5283\uff0c\u5728\u9810\u9632\u8170\u75db\u65b9\u9762\u4e26\u4e0d\u6bd4\u5c0d\u7167\u7d44\u66f4\u6709\u6548\u3002 \u7f8e\u570b\u810a\u9aa8\u795e\u7d93\u5b78\u6703<small class=\"mininote\">\u3014American Chiropractic Association\u3015<\/small>\u652f\u6301\u300e\u53cd\u5c0d\u4f7f\u7528\u8170\u90e8\u652f\u6490\u4f86\u9810\u9632\u6216\u6cbb\u7642\u6025\u6027\u8170\u75db\u300f\u7684\u5efa\u8b70<small class=\"mininote\"><sup> [95] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u5fa9\u767c\u6027\u8170\u80cc\u75db<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u5982\u679c\u5fa9\u767c\u6027\u8170\u80cc\u75db\u8207\u4e4b\u524d\u7684\u767c\u4f5c\u76f8\u4f3c\u4e26\u4e14\u4e4b\u524d\u7684\u6cbb\u7642\u6210\u529f\uff0c\u5247\u91cd\u65b0\u958b\u59cb\u4e4b\u524d\u4f7f\u7528\u7684\u6cbb\u7642\u3002<\/p>\n\n\n\n<p>\u5982\u679c\u75bc\u75db\u8207\u4e4b\u524d\u7684\u767c\u4f5c\u4e0d\u540c\u6216\u66f4\u56b4\u91cd\uff0c\u5247\u5c07\u5176\u4f5c\u70ba\u6025\u6027\u8170\u80cc\u75db\u7684\u65b0\u5be6\u4f8b\u9032\u884c\u8655\u7406\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u5927\u591a\u6578\u80cc\u75db\u767c\u4f5c\u7684\u60a3\u8005\u6703\u5728\u4e00\u5e74\u5167\u5fa9\u767c\u4e00\u6b21\u6216\u591a\u6b21\u3002 \u5fa9\u767c\u7684\u767c\u751f\u7387\u5c1a\u4e0d\u6e05\u695a\uff0c\u4f46\u5df2\u986f\u793a 1 \u5e74\u5167\u5fa9\u767c\u7387\u9ad8\u9054 33%\u3002 \u4ee5\u524d\u6709\u5169\u6b21\u4ee5\u4e0a\u8170\u80cc\u75db\u767c\u4f5c\u7684\u60a3\u8005\u518d\u6b21\u767c\u751f\u7684\u53ef\u80fd\u6027\u6703\u589e\u52a0\u3002<\/p>\n\n\n\n<p>\u5982\u679c\u75bc\u75db\u8207\u4e4b\u524d\u7684\u767c\u4f5c\u76f8\u4f3c\uff0c\u5247\u53ef\u4ee5\u91cd\u65b0\u958b\u59cb\u4e4b\u524d\u4f7f\u7528\u7684\u6cbb\u7642\u3002 \u5982\u679c\u75bc\u75db\u8207\u4e4b\u524d\u7684\u767c\u4f5c\u4e0d\u540c\u6216\u66f4\u56b4\u91cd\uff0c\u5247\u5c07\u5176\u4f5c\u70ba\u6025\u6027\u8170\u75db\u7684\u65b0\u5be6\u4f8b\u9032\u884c\u8655\u7406\u3002 \u5728\u8f03\u9577\u6642\u9593\u5167\u53cd\u5fa9\u51fa\u73fe\u9650\u5236\u6d3b\u52d5\u7684\u6025\u6027\u767c\u4f5c\u60a3\u8005\u53ef\u80fd\u9700\u8981\u9032\u4e00\u6b65\u7684\u8a3a\u65b7\u548c\u6cbb\u7642\uff0c\u4e26\u4e14\u53ef\u80fd\u9700\u8981\u8aee\u8a62\u5c08\u79d1\u91ab\u751f<small class=\"mininote\"><sup> [91,92] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u61f7\u5b55\u548c\u8170\u80cc\u75db<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u808c\u8089\u9aa8\u9abc\u8170\u75db\u5728\u61f7\u5b55\u671f\u9593\u5f88\u5e38\u898b\u3002 \u8a72\u8a3a\u65b7\u57fa\u65bc\u81e8\u5e8a\u767c\u73fe\uff0c\u4e26\u4e14\u901a\u5e38\u4e0d\u9700\u8981\u984d\u5916\u8a55\u4f30\u3002<\/p>\n\n\n\n<p>\u5c0d\u65bc\u5728\u61f7\u5b55\u671f\u7684\u80cc\u75db\uff0c\u9032\u4e00\u6b65\u8a55\u4f30\u4efb\u4f55\u53ef\u7591\u7684\u6ccc\u5c3f\u7cfb\u7d71\u3001\u795e\u7d93\u7cfb\u7d71\u6216\u7522\u79d1\u539f\u56e0\u3002<\/p>\n\n\n\n<p>\u5efa\u8b70\u6240\u6709\u53ef\u4ee5\u5b89\u5168\u5730\u9032\u884c\u8eab\u9ad4\u6d3b\u52d5\u7684\u5b55\u5a66\u9032\u884c\u935b\u7149\u3002 \u591a\u7a2e\u8eab\u9ad4\u6d3b\u52d5\u53ef\u6709\u6548\u9810\u9632\u548c\u6cbb\u7642\u61f7\u5b55\u671f\u7684\u808c\u8089\u9aa8\u9abc\u8170\u80cc\u75db\u3002 \u6bcf\u9031 2-4 \u6b21\u62c9\u4f38\u3001\u529b\u91cf\u8a13\u7df4\u548c\u6709\u6c27\u904b\u52d5\u76f8\u7d50\u5408\u662f\u5408\u7406\u7684\u3002<\/p>\n\n\n\n<p>\u53ef\u80fd\u5c0d\u61f7\u5b55\u671f\u8170\u80cc\u75db\u6709\u6548\u7684\u975e\u85e5\u7269\u6cbb\u7642\u5305\u62ec\u91dd\u7078\u3001\u6574\u9aa8\u7642\u6cd5\u3001\u7d93\u76ae\u795e\u7d93\u96fb\u523a\u6fc0 (TENS) \u548c\u808c\u5167\u6548\u8cbc\u5e03\u3002<\/p>\n\n\n\n<p>\u5982\u679c\u8981\u5728\u61f7\u5b55\u671f\u9593\u4f7f\u7528\u85e5\u7269\uff0c\u5efa\u8b70\u4f7f\u7528\u4e59\u91af\u80fa\u915a<small class=\"mininote\">\u3014acetaminophen\u3015<\/small>\u3002 \u907f\u514d\u975e\u985e\u56fa\u9187\u6d88\u708e\u85e5<small class=\"mininote\">\u3014NSAIDS\u3015<\/small>\u3002<\/p>\n\n\n\n<p>\u907f\u514d\u5728\u61f7\u5b55\u671f\u9593\u9032\u884c X \u5149\u548c CT \u9020\u5f71\u3002 \u7576\u795e\u7d93\u7cfb\u7d71\u75c7\u72c0\u6d89\u53ca\u99ac\u5c3e\u75c7\u5019\u7fa4\u3001\u9032\u884c\u6027\u795e\u7d93\u529f\u80fd\u7f3a\u640d\u6216\u6301\u7e8c\u7684\u653e\u5c04\u6027\u8170\u80cc\u75db\u5728 4 \u9031\u5167\u6c92\u6709\u6539\u5584\u6642\uff0c\u8003\u616e MRI\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>50-80% \u7684\u5b55\u5a66\u6703\u51fa\u73fe\u8170\u80cc\u75db\u3002 \u767c\u4f5c\u6700\u5e38\u898b\u65bc\u7b2c\u4e8c\u5b55\u671f\u548c\u7b2c\u4e09\u5b55\u671f\uff0c\u5927\u7d04\u5728\u61f7\u5b55 18-31 \u9031\u4e4b\u9593<small class=\"mininote\"><sup> [96] <\/sup><\/small>\u3002 \u5927\u591a\u6578\u5b55\u671f\u8170\u80cc\u75db\u662f\u7531\u808c\u8089\u9aa8\u9abc\u52de\u640d\u5f15\u8d77\u7684\uff0c\u9019\u7a2e\u52de\u640d\u662f\u7531\u591a\u7a2e\u56e0\u7d20\u5171\u540c\u9020\u6210\u7684\uff0c\u5305\u62ec\u810a\u67f1\u524d\u51f8\u589e\u52a0\u3001\u9ad4\u91cd\u589e\u52a0\u548c\u8edf\u7d44\u7e54\u9b06\u5f1b\u589e\u52a0\u3002<\/p>\n\n\n\n<p>\u61f7\u5b55\u671f\u808c\u8089\u9aa8\u9abc\u8170\u75db\u662f\u4e00\u7a2e\u81e8\u5e8a\u8a3a\u65b7\uff0c\u901a\u5e38\u4e0d\u9700\u8981\u984d\u5916\u8a55\u4f30\u3002 \u7136\u800c\uff0c\u5c0d\u65bc\u6709\u6ccc\u5c3f\u7cfb\u7d71\u75c7\u72c0\uff08\u4f8b\u5982\uff0c\u6392\u5c3f\u56f0\u96e3\u3001\u808b\u810a\u89d2\u58d3\u75db\u3001\u767c\u71b1\uff09\u3001\u795e\u7d93\u7cfb\u7d71\u75c7\u72c0\uff08\u4f8b\u5982\uff0c\u99ac\u978d\u5f0f\u611f\u89ba\u55aa\u5931<small class=\"mininote\">\u3014saddle anesthesia\u3015<\/small>\u3001\u5c3f\u6eef\u7559<small class=\"mininote\">\u3014urinary retention\u3015<\/small>\u3001\u5feb\u901f\u9032\u884c\u6027\u9ebb\u6728\u6216\u865b\u5f31\uff09\u6216\u7522\u79d1\u75c7\u72c0\uff08\u4f8b\u5982\uff0c\u9670\u9053\u6d41\u8840\u3001\u80ce\u52d5\u8b8a\u5316\u3001\u5287\u70c8\u8179\u75db\u3001\u5b50\u5bae\u6536\u7e2e\uff09\u7684\u500b\u9ad4\uff0c\u9700\u8981\u5c0d\u9019\u4e9b\u53ef\u80fd\u5c0e\u81f4\u8170\u80cc\u75db\u7684\u56b4\u91cd\u539f\u56e0\u9032\u884c\u9069\u7576\u7684\u8a55\u4f30\u548c\u95dc\u6ce8<small class=\"mininote\"><sup> [97] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u935b\u934a\u53ef\u4ee5\u6e1b\u8f15\u61f7\u5b55\u671f\u9593\u7684\u8170\u80cc\u75db\u3002 \u5408\u7406\u7684\u505a\u6cd5\u662f\u5efa\u8b70\u6bcf\u9031\u9032\u884c 2-4 \u6b21\u62c9\u4f38\u3001\u529b\u91cf\u8a13\u7df4\u548c\u6709\u6c27\u904b\u52d5\u76f8\u7d50\u5408\u7684\u904b\u52d5\u3002 \u4e00\u9805\u7cfb\u7d71\u6027\u56de\u9867\u767c\u73fe\uff0c\u8207\u5e38\u898f\u7522\u524d\u8b77\u7406\u76f8\u6bd4\uff0c\u5728\u5e38\u898f\u7522\u524d\u8b77\u7406\u4e2d\u52a0\u5165\u4efb\u4f55\u9678\u4e0a\u904b\u52d5\u90fd\u80fd\u986f\u8457\u6e1b\u5c11\u8170\u75db\u3002 \u6240\u7814\u7a76\u7684\u935b\u7149\u8a08\u5283\u985e\u578b\u591a\u7a2e\u591a\u6a23\uff0c\u6c92\u6709\u7279\u5b9a\u985e\u578b\u7684\u935b\u7149\u8a08\u5283\u88ab\u8a8d\u70ba\u512a\u65bc\u5176\u4ed6\u985e\u578b<small class=\"mininote\"><sup> [98] <\/sup><\/small>\u3002 \u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u8868\u660e\uff0c\u6c34\u4e0a\u904b\u52d5\u548c\u7522\u524d\u745c\u4f3d\u53ef\u4ee5\u6e1b\u8f15\u8170\u75db\u7684\u56b4\u91cd\u7a0b\u5ea6<small class=\"mininote\"><sup> [99,100] <\/sup><\/small>\u3002 \u6b64\u5916\uff0c\u7522\u524d\u745c\u4f3d\u53ef\u4ee5\u6539\u5584\u60c5\u7dd2\uff0c\u4e26\u53ef\u4ee5\u6e1b\u8f15\u5b55\u5a66\u7684\u6182\u9b31\u548c\u7126\u616e\u75c7\u72c0<small class=\"mininote\"><sup> [101] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u500b\u5225\u7814\u7a76\u8868\u660e\uff0c\u4ee5\u4e0b\u65b9\u5f0f\u53ef\u4ee5\u6e1b\u8f15\u61f7\u5b55\u671f\u9593\u7684\u8170\u80cc\u75db\uff1a\u91dd\u7078\u3001TENS\u3001\u6f38\u9032\u5f0f\u97f3\u6a02\u653e\u9b06\u808c\u8089\u3001\u6574\u9aa8\u7642\u6cd5\u548c\u808c\u5167\u6548\u8cbc\u5e03<small class=\"mininote\"><sup> [98,102\u2013105] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u51fa\u65bc\u5c0d\u6bcd\u89aa\u548c\u5b69\u5b50\u7684\u5b89\u5168\u8003\u616e\uff0c\u5b55\u671f\u7528\u85e5\u53d7\u5230\u9650\u5236\u3002 \u96d6\u7136\u7814\u7a76\u672a\u80fd\u986f\u793a\u4e59\u91af\u80fa\u915a<small class=\"mininote\">\u3014acetaminophen\u3015<\/small>\u5c0d\u4e00\u822c\u4eba\u7fa4\u7684\u8170\u75db\u6709\u6cbb\u7642\u4f5c\u7528\uff0c\u4f46\u901a\u5e38\u8a8d\u70ba\u5b83\u5728\u61f7\u5b55\u671f\u9593\u662f\u5b89\u5168\u7684\u3002 \u5c0d\u65bc \u3008\u5118\u7ba1\u9032\u884c\u4e86\u975e\u85e5\u7269\u6cbb\u7642\u3009\u4ecd\u7d93\u6b77\u4e2d\u5ea6\u81f3\u91cd\u5ea6\u75bc\u75db\u7684\u5b55\u5a66\uff0c\u4e59\u91af\u80fa\u915a\u662f\u7de9\u89e3\u75bc\u75db\u7684\u4e00\u7dda\u85e5\u7269<small class=\"mininote\"><sup> [106,103] <\/sup><\/small>\u3002 \u61f7\u5b55\u671f\u9593\u907f\u514d\u4f7f\u7528\u963f\u53f8\u5339\u9748<small class=\"mininote\">\u3014aspirin\u3015<\/small>\u3001\u5e03\u6d1b\u82ac<small class=\"mininote\">\u3014ibuprofen\u3015<\/small>\u548c\u5176\u4ed6\u975e\u985e\u56fa\u9187\u6297\u767c\u708e\u85e5\u7269<small class=\"mininote\">\u3014NSAIDs\u3015<\/small>\u3002 \u907f\u514d\u5728\u61f7\u5b55\u671f\u9593\u4f7f\u7528\u9d09\u7247\u985e\u85e5\u7269<small class=\"mininote\">\u3014opioid medications\u3015<\/small>\uff0c\u9664\u975e\u51fa\u73fe\u56b4\u91cd\u7684\u9811\u56fa\u6027\u80cc\u75db\uff0c\u6b64\u6642\u53ef\u4ee5\u8b39\u614e\u8003\u616e\u77ed\u671f\u7528\u9d09\u7247\u985e\u85e5\u7269\u7de9\u89e3\u3002 \u7531\u65bc\u5b55\u5a66\u6feb\u7528\u6216\u4f9d\u8cf4\u7684\u98a8\u96aa\uff0c\u4ee5\u53ca\u65b0\u751f\u5152\u9d09\u7247\u985e\u85e5\u7269\u6212\u65b7<small class=\"mininote\">\u3014opioid withdrawal\u3015<\/small>\u7684\u98a8\u96aa\uff0c\u8acb\u52ff\u958b\u59cb\u9577\u671f\u4f7f\u7528\u9d09\u7247\u985e\u85e5\u7269<small class=\"mininote\"><sup> [106] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u61f7\u5b55\u671f\u9593\u7684\u9020\u5f71\u53d7\u5230\u6bcd\u89aa\u548c\u5b69\u5b50\u5b89\u5168\u554f\u984c\u7684\u9650\u5236\u3002 \u5c0d\u65bc\u61f7\u5b55\u671f\u808c\u8089\u9aa8\u9abc\u6027\u8170\u80cc\u75db\uff0c\u907f\u514d\u9032\u884c X \u5149\u548c CT \u9020\u5f71\u3002 \u7576\u795e\u7d93\u7cfb\u7d71\u75c7\u72c0\u8207\u99ac\u5c3e\u75c7\u5019\u7fa4\u6709\u95dc\u6642\uff0c\u8003\u616e MRI<small class=\"mininote\"><sup> [106] <\/sup><\/small>\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u8077\u696d\u6027\u8170\u80cc\u75db\u548c\u5de5\u4f5c\u9650\u5236<\/h3>\n\n\n\n<div class=\"swell-block-capbox cap_box is-style-onborder_ttl\" data-colset=\"col2\"><div class=\"cap_box_ttl\"><span>\u5efa\u8b70<\/span><\/div><div class=\"cap_box_content\">\n<p>\u5728\u53d7\u50b7\u767c\u751f\u6642\uff0c\u5411\u54e1\u5de5\u63d0\u4f9b\u6709\u95dc\u7ba1\u7406\u6025\u6027\u8170\u75db\u7684\u6559\u80b2\u4fe1\u606f\u3002<\/p>\n\n\n\n<p>\u5f37\u8abf\u5118\u65e9\u91cd\u8fd4\u5de5\u4f5c\u5d17\u4f4d\uff0c\u4ee5\u76e1\u91cf\u6e1b\u5c11\u6162\u6027\u5931\u80fd\u3002<\/p>\n\n\n\n<p>\u6839\u64da\u9ad4\u6aa2\u3001\u8a3a\u65b7\u6e2c\u8a66\u548c\u591a\u5b78\u79d1\u8a55\u4f30\u7684\u5ba2\u89c0\u7d50\u679c\uff0c\u4f7f\u7528\u81e8\u5e8a\u5224\u65b7\u5efa\u8b70\u4f55\u6642\u91cd\u8fd4\u5de5\u4f5c\u5d17\u4f4d\u3002<\/p>\n<\/div><\/div>\n\n\n\n<p>\u5728\u54e1\u5de5\u53d7\u50b7\u6642\uff0c\u5411\u5176\u63d0\u4f9b\u6709\u95dc\u6025\u6027\u975e\u7279\u7570\u6027\u8170\u80cc\u75db\u7ba1\u7406\u7684\u4fe1\u606f\u5177\u6709\u6210\u672c\u6548\u76ca\u3002 \u6b64\u4fe1\u606f\u53ef\u4ee5\u6e1b\u5c11\u5de5\u4f5c\u6642\u9593\uff0c\u4e26\u6709\u52a9\u65bc\u9650\u5236\u91ab\u7642\u7167\u8b77\u8cbb\u7528<small class=\"mininote\"><sup> [107] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u301d\u8ec0\u5e79\u6bcf\u5929\u5411\u524d\u5f4e\u66f2\u7684\u6301\u7e8c\u6642\u9593\u301e\u8207\u301d\u8170\u75db\u7684\u767c\u5c55\u6216\u52a0\u91cd\u301e\u4e4b\u9593\u6c92\u6709\u767c\u73fe\u986f\u8457\u95dc\u806f<small class=\"mininote\"><sup> [108] <\/sup><\/small>\u3002 \u5728\u5973\u6027\uff08OR 4.09\uff0c95% CI 1.62 \u81f3 10.31\uff09\u548c\u7537\u6027\uff08OR 2.01\uff0c95% CI 1.06 \u81f3 3.82\uff09\u4e2d\uff0c\u7e41\u91cd\u7684\u9ad4\u529b\u8ca0\u8377\u8207\u653e\u5c04\u6027\u8170\u80cc\u75db\u76f8\u95dc\u3002 \u8170\u80cc\u75db\u53f2\u5728\u7537\u6027\u4e2d\u589e\u5f37\u4e86\u9019\u7a2e\u806f\u7e6b<small class=\"mininote\"><sup> [109] <\/sup><\/small>\u3002<\/p>\n\n\n\n<p>\u7576\u8981\u6c42\u81e8\u5e8a\u91ab\u751f\u63d0\u4f9b\u6c38\u4e45\u6027\u9650\u5236<small class=\"mininote\">\u3014permanent restrictions\u3015<\/small>\u6216\u5931\u80fd\u8a55\u7d1a<small class=\"mininote\">\u3014disability ratin\u3015<\/small>\u6642\uff0c\u5c08\u5bb6\u7684\u5efa\u8b70\u53ef\u80fd\u6703\u6709\u6240\u5e6b\u52a9\u3002 \u301d\u6cd5\u5b9a\u5931\u80fd\u8a55\u7d1a\u7cfb\u7d71\uff08\u4f8b\u5982 AMA \u8eab\u9ad4\u640d\u50b7\u6307\u5357\u6216\u8a31\u591a\u5176\u4ed6\u5dde\u7684\u88dc\u511f\u7cfb\u7d71\uff09\u301e\u8207\u301d\u5be6\u969b\u7684\u672a\u4f86\u53d7\u50b7\u6216\u5931\u80fd\u98a8\u96aa\u301e\u5e7e\u4e4e\u6c92\u6709\u6216\u6c92\u6709\u76f8\u95dc\u6027\u3002<\/p>\n\n\n\n<p>\u95dc\u65bc\u810a\u67f1\u75be\u75c5\u7684\u7279\u5b9a\u5de5\u4f5c\u9650\u5236\u7684\u8b49\u64da\u5f88\u5c11\u3002 \u4e00\u822c\u4f86\u8aaa\uff0c\u65e9\u65e5\u91cd\u8fd4\u5de5\u4f5c\u5d17\u4f4d\u8207\u66f4\u597d\u7684\u7d50\u679c\u76f8\u95dc\u3002 \u7136\u800c\uff0c\u63d0\u91cd\u7269\u3001\u626d\u52d5\u548c\u5750\u59ff\u632f\u52d5\uff08\u5982\u5728\u6c7d\u8eca\u6216\u5361\u8eca\u4e2d\uff09\u662f\u80cc\u75db\u7684\u5371\u96aa\u56e0\u7d20\u3002 \u7576\u5b58\u5728\u9019\u4e9b\u98a8\u96aa\u56e0\u7d20\u6642\uff0c\u5728\u78ba\u5b9a\u5de5\u4f5c\u9650\u5236\u6642\u4f7f\u7528\u81e8\u5e8a\u5224\u65b7\u3002<\/p>\n\n\n\n<p>\u301d\u901a\u904e\u4f7f\u7528\u8eab\u9ad4\u6aa2\u67e5\u548c\u8a3a\u65b7\u6e2c\u8a66\u7684\u5ba2\u89c0\u7d50\u679c\u301e\u4f86\u6c7a\u5b9a\u6c38\u4e45\u6027\u5de5\u4f5c\u9650\u5236\u3002 \u591a\u5b78\u79d1\u8a55\u4f30\u53ef\u80fd\u6709\u52a9\u65bc\u8a18\u9304\u8eab\u9ad4\u80fd\u529b\u3002 \u7136\u800c\uff0c\u5728\u8868\u73fe\u53d7\u9650\u7684\u60c5\u6cc1\u4e0b\u8003\u616e\u53ef\u9006\u7684\u539f\u56e0\uff0c\u5305\u62ec\u5931\u8abf\u6216\u793e\u6703\u5fc3\u7406\u56e0\u7d20\u3002<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">\u76f8\u95dc\u7684\u570b\u5bb6\u6307\u5357\u548c\u8868\u73fe\u6e2c\u91cf<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">\u570b\u5bb6\u6307\u5357<\/h3>\n\n\n\n<p>\u8a72\u6307\u5357\u901a\u5e38\u8207\u4ee5\u4e0b\u5167\u5bb9\u4e00\u81f4\uff1a<\/p>\n\n\n\n<p class=\"is-style-bg_stripe\">VA\/DoD \u8170\u75db\u8a3a\u65b7\u548c\u6cbb\u7642\u81e8\u5e8a\u5be6\u8e10\u6307\u5357\u3002 \u83ef\u76db\u9813\u7279\u5340\uff1a\u9000\u4f0d\u8ecd\u4eba\u4e8b\u52d9\u90e8\u548c\u570b\u9632\u90e8\uff0c2017 \u5e74\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u8868\u73fe\u6e2c\u91cf<\/h3>\n\n\n\n<p>\u5177\u6709\u8170\u80cc\u75db\u8b77\u7406\u81e8\u5e8a\u8868\u73fe\u6e2c\u91cf\u7684\u570b\u5bb6\u548c\u5730\u5340\u8a08\u5283\u5305\u62ec\u4ee5\u4e0b\u5167\u5bb9\u3002<\/p>\n\n\n\n<ul>\n<li>\u7f8e\u570b\u806f\u90a6\u91ab\u7642\u4fdd\u96aa\u548c\u88dc\u52a9\u670d\u52d9\u4e2d\u5fc3\uff08\u91ab\u7642\u4fdd\u96aa\uff09<small class=\"mininote\">\u3014Centers for Medicare &amp; Medicaid Services\u3015<\/small><\/li>\n\n\n\n<li>\u5bc6\u897f\u6839\u85cd\u5341\u5b57\u85cd\u76fe\uff08BCBSM\uff09<small class=\"mininote\">\u3014Blue Cross Blue Shield of Michigan\u3015<\/small><\/li>\n\n\n\n<li>\u85cd\u8272\u7167\u8b77\u7db2[HMO]\u81e8\u5e8a\u8868\u73fe\u6e2c\u91cf\uff08BCN\uff09<small class=\"mininote\">\u3014Blue Care Network : clinical performance measures\u3015<\/small><\/li>\n<\/ul>\n\n\n\n<p>\u96d6\u7136\u5177\u9ad4\u7684\u6e2c\u91cf\u7d30\u7bc0\u56e0\u9805\u76ee\u800c\u7570\uff08\u4f8b\u5982\uff0c\u6578\u64da\u6536\u96c6\u65b9\u6cd5\u3001\u4eba\u53e3\u7d0d\u5165\u548c\u6392\u9664\uff09\uff0c\u4f46\u4e00\u822c\u8861\u91cf\u6a19\u6e96\u662f\uff1a<\/p>\n\n\n\n<p class=\"is-style-bg_stripe\">\u5f71\u50cf\u5b78\u7814\u7a76\u3002 \u521d\u6b65\u8a3a\u65b7\u70ba\u8170\u80cc\u75db\uff0c\u4f46\u5728\u8a3a\u65b7\u5f8c 28 \u5929\u5167\u672a\u9032\u884c\u5f71\u50cf\u5b78\u6aa2\u67e5\uff08\u666e\u901a X \u5149\u3001MRI \u6216 CT \u6383\u63cf\uff09\u7684 18-50 \u6b72\u6210\u5e74\u4eba\uff08BCBSM\u3001BCN\u3001Medicare\uff09\u3002<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">\u6307\u5357\u5236\u5b9a\u65b9\u6cd5<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">\u8cc7\u91d1<\/h3>\n\n\n\n<p>\u672c\u6307\u5357\u7684\u88fd\u5b9a\u7531 UMHS \u8cc7\u52a9\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u6307\u5357\u5236\u5b9a\u5718\u968a\u548c\u62ab\u9732<\/h3>\n\n\n\n<p>\u591a\u5b78\u79d1\u6307\u5357\u5236\u5b9a\u5718\u968a\u5305\u62ec\uff1a<\/p>\n\n\n\n<ul>\n<li>\u521d\u7d1a\u7167\u8b77\u91ab\u5e2b\uff1aSuvarna N. Bhat MBBS\uff0c\u666e\u901a\u5167\u79d1\uff1b Gregory D. Shumer\uff0c\u91ab\u5b78\u535a\u58eb\uff0c\u5bb6\u5ead\u91ab\u5b78\u3002<\/li>\n\n\n\n<li>\u8170\u80cc\u75db\u7167\u8b77\u5c08\u5bb6\uff1aAnthony E. Chiodo\uff0c\u91ab\u5b78\u535a\u58eb\uff0c\u7269\u7406\u91ab\u5b78\u8207\u5eb7\u5fa9\uff1b Ronald A. Wasserman\uff0c\u91ab\u5b78\u535a\u58eb\uff0c\u9ebb\u9189\u5b78\u3001\u80cc\u90e8\u548c\u75bc\u75db\u4e2d\u5fc3\u3002<\/li>\n\n\n\n<li>\u9867\u554f\u5c08\u5bb6\uff1aPaul Park\uff0c\u91ab\u5b78\u535a\u58eb\uff0c\u795e\u7d93\u5916\u79d1\uff1b Rakesh D. Patel\uff0c\u91ab\u5b78\u535a\u58eb\uff0c\u6574\u5f62\u5916\u79d1\u3002<\/li>\n\n\n\n<li>\u6307\u5357\u5236\u5b9a\u65b9\u6cd5\u5b78\u5bb6\uff1aR. Van Harrison \u535a\u58eb\uff0c\u5b78\u7fd2\u5065\u5eb7\u79d1\u5b78\u3002<\/li>\n\n\n\n<li>\u6587\u737b\u6aa2\u7d22\u670d\u52d9\u7531\u5bc6\u897f\u6839\u5927\u5b78\u91ab\u5b78\u9662 Taubman\u5065\u5eb7\u79d1\u5b78\u5716\u66f8\u9928\u7684\u4fe1\u606f\u54e1\u63d0\u4f9b\u3002<\/li>\n<\/ul>\n\n\n\n<p>UMHS \u8a8d\u53ef\u7e7c\u7e8c\u91ab\u5b78\u6559\u80b2\u8a8d\u8b49\u59d4\u54e1\u6703\u7684\u6a19\u6e96\uff0c\u5373\u958b\u5c55\u6559\u80b2\u6d3b\u52d5\u7684\u500b\u4eba\u62ab\u9732\u8207\u8a0e\u8ad6\u5176\u7522\u54c1\u6216\u670d\u52d9\u7684\u5546\u696d\u516c\u53f8\u7684\u91cd\u8981\u95dc\u4fc2\u3002 \u5177\u6709\u76f8\u95dc\u8ca1\u52d9\u95dc\u4fc2\u7684\u5718\u968a\u6210\u54e1\u7684\u8ca2\u737b\u7531\u6c92\u6709\u76f8\u95dc\u8ca1\u52d9\u95dc\u4fc2\u7684\u5718\u968a\u6210\u54e1\u5be9\u67e5\uff0c\u4ee5\u78ba\u4fdd\u4fe1\u606f\u7684\u5448\u73fe\u6c92\u6709\u504f\u898b\u3002<\/p>\n\n\n\n<p>\u5718\u968a\u6210\u54e1\u6216\u9867\u554f\u5747\u6c92\u6709\u76f8\u95dc\u7684\u500b\u4eba\u8ca1\u52d9\u95dc\u4fc2\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u7cfb\u7d71\u6027\u6587\u737b\u56de\u9867<\/h3>\n\n\n\n<p>\u76f8\u95dc\u7684 UMHS \u6587\u4ef6\u300a\u6025\u6027\u8170\u80cc\u75db\uff0c2019 \u5e74\uff1a\u6587\u737b\u7d9c\u8ff0\u65b9\u6cd5\u548c\u7d50\u679c\u300b\u4e2d\u8a73\u7d30\u63cf\u8ff0\u4e86\u672c\u6307\u5357\u6240\u4f9d\u64da\u7684\u7cfb\u7d71\u6aa2\u7d22\u548c\u6587\u737b\u56de\u9867\u3002 \u4ee5\u4e0b\u90e8\u5206\u91cd\u9ede\u4ecb\u7d39\u4e86\u6587\u737b\u6aa2\u7d22\u548c\u5be9\u67e5\u904e\u7a0b\u7684\u4e3b\u8981\u65b9\u9762\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u6587\u737b\u6aa2\u7d22<\/h4>\n\n\n\n<p>\u8a72\u5718\u968a\u901a\u904e\u63a5\u53d7 2016 \u5e74\u9032\u884c\u7684\u7cfb\u7d71\u6027\u6587\u737b\u56de\u9867\u7684\u7d50\u679c\u958b\u59cb\u6587\u737b\u6aa2\u7d22\uff1a<\/p>\n\n\n\n<p class=\"is-style-bg_stripe\">VA\/DoD \u8170\u80cc\u75db\u8a3a\u65b7\u548c\u6cbb\u7642\u81e8\u5e8a\u5be6\u8e10\u6307\u5357\u3002 \u83ef\u76db\u9813\u7279\u5340\uff1a\u9000\u4f0d\u8ecd\u4eba\u4e8b\u52d9\u90e8\u548c\u570b\u9632\u90e8\uff0c2017 \u5e74\uff08\u641c\u7d22\u548c\u7d9c\u5408\u622a\u81f3 2016 \u5e74 10 \u6708\u7684\u6587\u737b\uff09\u3002<\/p>\n\n\n\n<p>\u70ba\u4e86\u66f4\u65b0\u9019\u4e9b\u7d50\u679c\uff0c\u6211\u5011\u5728 Medline \u548c Cochrane \u7cfb\u7d71\u6027\u56de\u9867\u6578\u64da\u5eab\u4e2d\u5c0d 2016 \u5e74 1 \u6708 1 \u65e5\u81f3 2019 \u5e74 5 \u6708 31 \u65e5\u671f\u9593\u7684\u6587\u737b\u9032\u884c\u4e86\u7cfb\u7d71\u6aa2\u7d22\u3002<\/p>\n\n\n\n<p>\u4e3b\u8981\u641c\u7d22\u8a5e\u662f\u8170\u80cc\u75db\u3002 \u641c\u7d22\u7684\u76ee\u7684\u662f\u5c0b\u627e\u6307\u5357\u3001\u5c0d\u7167\u8a66\u9a57\uff08\u5305\u62ec\u7d71\u5408\u5206\u6790\uff09\u548c\u968a\u5217\u7814\u7a76\uff0c\u5c0b\u627e\u95dc\u65bc\u4eba\u985e\u7684\u82f1\u8a9e\u6587\u737b\u3002 \u5728\u9019\u4e9b\u53c3\u6578\u4e2d\uff0c\u5c0d\u4ee5\u4e0b\u4e3b\u984c\u9032\u884c\u4e86\u55ae\u7368\u641c\u7d22\uff1a<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>A. <\/td><td>\u75c5\u56e0\uff1a\u6162\u6027\u8170\u80cc\u75db\uff0c\u5371\u96aa\u56e0\u7d20<\/td><\/tr><tr><td>B. <\/td><td>\u6025\u6027\u8170\u80cc\u75db\u7684\u8a3a\u65b7\uff1a\u75c5\u53f2\u3001\u9ad4\u683c\u6aa2\u67e5\u3001\u6aa2\u67e5\uff1a\u5be6\u9a57\u5ba4\u6aa2\u67e5\u3001\u5f71\u50cf\u5b78\uff08\u5982 X \u7dda\u3001CT\u3001\u810a\u9ad3\u9020\u5f71\uff09\u3001\u808c\u96fb\u5716 (EMG)\u3001\u9aa8\u6383\u63cf\u3001B \u4e2d\u672a\u5305\u62ec\u7684\u5176\u4ed6\u8a3a\u65b7\u3002<\/td><\/tr><tr><td>C. <\/td><td>\u6025\u6027\u8170\u80cc\u75db\u7684\u6cbb\u7642\uff1a\u60a3\u8005\u6559\u80b2\uff1b \u6cbb\u7642\uff1a\u71b1\u7642\u3001\u810a\u67f1\u63a8\u62ff\u3001\u935b\u934a\u3001\u8d85\u8072\u3001\u900f\u71b1\u7642\u6cd5\u3001\u8d85\u8072\u900f\u5165\u7642\u6cd5\u3001\u85e5\u7269\u96e2\u5b50\u900f\u5165\u7642\u6cd5\u3001\u7d93\u76ae\u795e\u7d93\u96fb\u523a\u6fc0\u5668 (TENS)\u3001\u978b\u588a\u3001\u8170\u90e8\u7dca\u8eab\u80f8\u8863\/\u8170\u5e36\u3001\u727d\u5f15\u3001\u6d3b\u52d5\u9650\u5236\uff1b \u85e5\u7269\u6cbb\u7642\uff1a\u9d09\u7247\u985e\u85e5\u7269\u3001\u82ef\u4e8c\u6c2e\u5e73\u985e\u85e5\u7269\u3001\u9d09\u7247\u985e\u85e5\u7269\u548c\u82ef\u4e8c\u6c2e\u5e73\u985e\u85e5\u7269\u4ee5\u5916\u7684\u85e5\u7269\uff08\u4f8b\u5982\u4e59\u91af\u80fa\u915a\u3001\u975e\u985e\u56fa\u9187\u985e\u6297\u767c\u708e\u85e5\u3001\u201c\u808c\u8089\u9b06\u5f1b\u5291\u201d\u7b49\uff09\uff1b \u6ce8\u5c04\uff1b \u5916\u79d1\u624b\u8853 ; \u8aee\u5546\uff1b \u591a\u5b78\u79d1\u65b9\u6cd5\uff1b C. \u672a\u5305\u62ec\u7684\u5176\u4ed6\u6cbb\u7642\u3002<\/td><\/tr><tr><td>D. <\/td><td>\u5c08\u984c\uff1a\u6025\u6027\u8170\u80cc\u75db\u7684\u9810\u9632\u3001\u5fa9\u767c\u6027\u8170\u80cc\u75db\u3001\u6162\u6027\u8170\u80cc\u75db\u5f8c\u6025\u6027\u8170\u80cc\u75db\u7684\u767c\u751f\u3001\u61f7\u5b55\u548c\u8170\u80cc\u75db\u3001\u8077\u696d\u6027\u8170\u80cc\u75db\u548c\u6025\u6027\u8170\u80cc\u75db\u7684\u5de5\u4f5c\u9650\u5236\u3001\u6025\u6027\u8170\u80cc\u75db\u7684\u66ff\u4ee3\u548c\u88dc\u5145\u85e5\u7269\uff0c\u4e00\u822c\u6025\u6027\u8170\u80cc\u75db\u4e0d\u5305\u62ec\u5728 D \u4e2d\u3002<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>\u5305\u542b\u548c\u6392\u9664\u6a19\u6e96\u7684\u66f4\u6b63\u5f0f\u4ecb\u7d39\u5728\u96a8\u9644\u7684\u6587\u737b\u56de\u9867\u65b9\u6cd5\u548c\u7d50\u679c\u7684\u7b2c\u4e8c\u90e8\u5206\u4e2d\u3002<\/p>\n\n\n\n<p>\u8a73\u7d30\u7684\u641c\u7d22\u7b56\u7565\u5728\u96a8\u9644\u7684\u6587\u737b\u56de\u9867\u65b9\u6cd5\u548c\u7d50\u679c\u7684\u7b2c\u4e09\u90e8\u5206\u4e2d\u4ecb\u7d39\u3002<\/p>\n\n\n\n<p>\u641c\u7d22\u662f\u5728\u6b63\u5f0f\u554f\u984c\u7d50\u69cb\uff08\u4e0a\u6587\u6982\u8ff0\uff09\u7684\u7d44\u4ef6\u4e2d\u9032\u884c\u7684\u3002 \u8a72\u641c\u7d22\u5f97\u5230\u4e86\u5c08\u5bb6\u7d44\u5c08\u5bb6\u6210\u54e1\u5df2\u77e5\u7684\u6700\u65b0\u81e8\u5e8a\u8a66\u9a57\u7684\u88dc\u5145\u3002 \u641c\u7d22\u662f\u4e00\u500b\u55ae\u4e00\u7684\u5468\u671f\u3002 \u78ba\u5b9a\u7684\u51fa\u7248\u7269\u6578\u91cf\u5728\u96a8\u9644\u7684\u6587\u737b\u56de\u9867\u65b9\u6cd5\u548c\u7d50\u679c\u7684\u7b2c\u56db\u90e8\u5206\u4e2d\u4ecb\u7d39\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u6587\u737b\u56de\u9867\u548c\u8a55\u4f30<\/h4>\n\n\n\n<p>\u6307\u5357\u5c0f\u7d44\u6210\u54e1\u5be9\u67e5\u4e86\u8207\u7279\u5b9a\u4e3b\u984c\u76f8\u95dc\u7684\u51fa\u7248\u7269\uff0c\u4ee5\u9078\u64c7\u5177\u6709\u6700\u4f73\u8b49\u64da\u7684\u51fa\u7248\u7269\u3002 \u78ba\u5b9a\u7e3d\u9ad4\u6700\u4f73\u8b49\u64da\u7684\u6a19\u6e96\u5305\u62ec\u7814\u7a76\u74b0\u5883\u548c\u4eba\u7fa4\u7684\u76f8\u95dc\u6027\u3001\u7814\u7a76\u8a2d\u8a08\u3001\u6a23\u672c\u91cf\u3001\u6e2c\u91cf\u65b9\u6cd5\uff08\u8b8a\u91cf\u3001\u6e2c\u91cf\u3001\u6578\u64da\u6536\u96c6\uff09\u3001\u5e72\u9810\u65b9\u6cd5\uff08\u9069\u7576\u6027\u3001\u57f7\u884c\uff09\u3001\u5206\u6790\u7684\u9069\u7576\u6027\u548c\u63cf\u8ff0\u7684\u6e05\u6670\u5ea6\u3002<\/p>\n\n\n\n<p>\u5728\u8003\u616e\u57fa\u65bc\u7814\u7a76\u8a2d\u8a08\u7684\u8b49\u64da\u6c34\u5e73\u6642\uff0c\u5206\u985e\u70ba\uff1a<\/p>\n\n\n\n<p class=\"is-style-bg_stripe\">A = \u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\uff08\u6709\u6216\u6c92\u6709\u7d71\u5408\u5206\u6790\uff09\u7684\u7cfb\u7d71\u8a55\u50f9<br>B = \u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57<br>C = \u975e\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u6216\u89c0\u5bdf\u6027\u7814\u7a76\u3001\u975e\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u3001\u7d44\u89c0\u5bdf\u7814\u7a76\uff08\u968a\u5217\u3001\u6a6b\u65b7\u9762\u3001\u75c5\u4f8b\u5c0d\u7167\uff09\u7684\u7cfb\u7d71\u8a55\u50f9<br>D = \u500b\u9ad4\u89c0\u5bdf\u7814\u7a76\uff08\u6848\u4f8b\u7814\u7a76\u6216\u6848\u4f8b\u4fc2\u5217\uff09<br>E = \u95dc\u65bc\u76ca\u8655\u548c\u5371\u5bb3\u7684\u5c08\u5bb6\u610f\u898b\u3002<\/p>\n\n\n\n<p>\u5f9e VA\/DoD \u7cfb\u7d71\u6587\u737b\u7d9c\u8ff0\u78ba\u5b9a\u7684\u6700\u4f73\u8b49\u64da\u958b\u59cb\uff0c\u5718\u968a\u6210\u54e1\u6aa2\u67e5\u4e86\u5728\u6700\u8fd1\u7684\u641c\u7d22\uff082016 \u5e74 1 \u6708 1 \u65e5 \u2013 2019 \u5e74 5 \u6708 31 \u65e5\uff09\u4e2d\u78ba\u5b9a\u7684\u51fa\u7248\u7269\uff0c\u4ee5\u78ba\u5b9a\u662f\u5426\u6709\u66f4\u597d\u7684\u8b49\u64da\u53ef\u7528\u3002 \u5718\u968a\u6210\u54e1\u9084\u53ef\u4ee5\u9078\u64c7\u8003\u616e\u6700\u8fd1\u7684\u6587\u737b\uff08\u81ea 2019 \u5e74 5 \u6708 31 \u65e5\u8d77\u767c\u8868\uff09\u4f86\u78ba\u5b9a\u662f\u5426\u6709\u66f4\u597d\u7684\u8b49\u64da\u53ef\u7528\u3002<\/p>\n\n\n\n<p>\u5be9\u67e5\u548c\u8a55\u4f30\u7684\u904e\u7a0b\u5728\u96a8\u9644\u7684\u6587\u737b\u5be9\u67e5\u65b9\u6cd5\u548c\u7d50\u679c\u7684\u7b2c\u4e94\u90e8\u5206\u4e2d\u6709\u66f4\u8a73\u7d30\u7684\u63cf\u8ff0\u3002<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">\u6700\u4f73\u8b49\u64da\u548c\u5efa\u8b70<\/h4>\n\n\n\n<p>\u5718\u968a\u6210\u54e1\u78ba\u5b9a\u4e86\u95dc\u65bc\u7279\u5b9a\u4e3b\u984c\u5177\u6709\u6700\u4f73\u8b49\u64da\u7684\u6587\u7ae0\u6216\u5176\u4ed6\u51fa\u7248\u7269\u3002<\/p>\n\n\n\n<p>\u6307\u5357\u5c0f\u7d44\u5be9\u67e5\u4e86\u8b49\u64da\uff0c\u4e26\u4e14\u78ba\u5b9a\u4e86\u57f7\u884c\u6216\u4e0d\u57f7\u884c\u7167\u8b77\u95dc\u9375\u65b9\u9762\u7684\u91cd\u8981\u6027\uff08\u5217\u5728\u672c\u6307\u5357\u7684\u7b2c\u4e00\u9801\uff09\u3002 \u5728\u7f3a\u4e4f\u5be6\u8b49\u8b49\u64da\u7684\u60c5\u6cc1\u4e0b\uff0c\u6307\u5357\u5c0f\u7d44\u6839\u64da\u5c08\u5bb6\u610f\u898b\u63d0\u51fa\u5efa\u8b70\u3002<\/p>\n\n\n\n<p>\u95dc\u65bc\u7167\u8b77\u7684\u63a8\u85a6\u5f37\u5ea6\u5206\u70ba\uff1a<\/p>\n\n\n\n<p class=\"is-style-bg_stripe\">I = \u901a\u5e38\u61c9\u8a72\u57f7\u884c<br>II = \u57f7\u884c\u8d77\u4f86\u53ef\u80fd\u662f\u5408\u7406\u7684<br>III = \u901a\u5e38\u4e0d\u61c9\u57f7\u884c<\/p>\n\n\n\n<p>\u96a8\u9644\u7684\u6587\u737b\u56de\u9867\u65b9\u6cd5\u548c\u7d50\u679c\u7684\u7b2c\u56db\u90e8\u5206\u63d0\u4f9b\u4e86\u301d\u6bcf\u9805\u5efa\u8b70\u7684\u8868\u683c\u301e\u4ee5\u53ca\u301d\u8a72\u5efa\u8b70\u6240\u57fa\u65bc\u7684\u6700\u4f73\u8b49\u64da\u4f86\u6e90\u301e\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">\u5be9\u67e5\u548c\u8a8d\u53ef<\/h3>\n\n\n\n<p>\u8a72\u6307\u5357\u7684\u8349\u6848\u7531 UMHS \u5167\u8207\u5167\u5bb9\u6700\u76f8\u95dc\u7684\u55ae\u4f4d\u5be9\u67e5\u3002 \u85e5\u5b78\u670d\u52d9\u9032\u884c\u4e86\u521d\u6b65\u5be9\u67e5\u3002 \u7136\u5f8c\u5728\u81e8\u5e8a\u6703\u8b70\u4e0a\u9032\u884c\u5be9\u67e5\u6216\u5728\u4ee5\u4e0b\u81e8\u5e8a\u79d1\u5ba4\u548c\u79d1\u5ba4\u9032\u884c\u8a55\u8ad6\uff1a\u80cc\u90e8\u548c\u75bc\u75db\u4e2d\u5fc3\u3001\u5bb6\u5ead\u91ab\u5b78\u3001\u5168\u79d1\u91ab\u5b78\u3001\u8001\u5e74\u91ab\u5b78\u3001\u795e\u7d93\u5916\u79d1\u3001\u5a66\u7522\u79d1\uff08\u5a66\u5973\u5065\u5eb7\uff09\u3001\u9aa8\u79d1\u624b\u8853\u4ee5\u53ca\u7269\u7406\u91ab\u5b78\u548c\u5eb7\u5fa9\u3002 \u8349\u6848\u6839\u64da\u9019\u4e9b\u5718\u9ad4\u7684\u610f\u898b\u9032\u884c\u4e86\u4fee\u8a02\u3002<\/p>\n\n\n\n<p>\u8a72\u6307\u5357\u7684\u6700\u7d42\u7248\u672c\u5f97\u5230\u4e86\u5bc6\u897f\u6839\u5927\u5b78\u91ab\u9662\u548c\u5065\u5eb7\u4e2d\u5fc3\u81e8\u5e8a\u4e8b\u52d9\u57f7\u884c\u59d4\u54e1\u6703\u7684\u8a8d\u53ef\u3002<\/p>\n\n\n\n<p class=\"is-style-balloon_box2\">\u66f4\u65b0\u7d00\u9304<\/p>\n\n\n\n<p class=\"is-style-bg_stripe\">2023\/3\/31 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