针灸从心胆肾论治腰椎间盘突出的临床研究
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摘要
背景：
腰椎间盘突出症是临床多发病,常见病,复发率高。有人统计,近80%的人一生中或轻或重曾患下腰痛,其中多数由于腰椎间盘突出引起,很大程度上影响了患者日常生活与工作[1]。腰椎间盘突出症在治疗上,80%-90%的患者可通过手术治疗取效。在保守治疗方法中,针灸疗法在治疗腰椎间盘突出症有一定独特之处,针灸疗法治疗腰椎间盘突出症临床研究很多,其疗效确切,临床应用也非常广泛。针刺治疗腰椎间盘突出所致的痛症,可以促进患者局部炎症吸收及神经组织的修复,通过针刺,患者的痛阈值升高,从而达到镇痛的效果。
从文献查阅来看,目前针灸治疗腰椎间盘突出主要从肾、膀胱经着手,局部取穴以及按照经络循行取穴,临床收到一定疗效,然而亦有不效者；再者,部分腰椎间盘突出症患者取俯卧位针灸时,常有不适感,甚至会加重腰局部症状。
本研究根据中医理论,采用心胆肾治疗腰椎间盘突出之腰痛,目的是为了优化治疗方案,提高针刺治疗效果。本方案将针灸选穴、针灸操作、以及针灸方法规范化,选取针刺百会、印堂,内关双、阳陵泉双,艾灸双侧肾俞、膀胱俞,埋针双侧心俞、肾俞穴；采用“一针二灸三巩固”规范化操作,通过相关量表测评,为针灸治疗腰椎间盘突出症提供临床依据。
目的：
通过随机对照临床试验,客观评价从心、胆、肾治疗腰椎间盘突出症痛症临床疗效,以及腰椎间盘突出症患者生存质量改善情况。
方法：
所有病例来源于台湾永森中医门诊,将符合纳入标准的腰椎间盘突出症患者70例随机分为治疗组(心胆肾论治组)与对照组(常规针刺组),每组35例。
治疗组取穴：百会、印堂、内关双、阳陵泉双,艾灸双侧肾俞、双侧膀胱俞,埋针双侧心俞、双侧肾俞。
治疗组操作方法：患者取仰卧位,穴位用75%酒精常规消毒,先针刺双侧内关、阳陵泉穴,进针深度依据病人肥瘦而定,采取均匀提插捻转手法,以得气为度,并配合调气法(针完后行鼻子深呼吸6次,休息1分钟后再深呼吸6次,直到出针),再针百会、印堂穴,进针深度4-5mm,采取均匀捻转手法,得气即止。留针时间为30分钟。接着取腰四穴进行艾柱直接灸(艾柱大小约20mm×20mm×10mm),先于肾俞穴、膀胱俞穴处涂以万花油(既使得艾柱能与皮肤粘合而不至于脱落,还可防止烫伤皮肤),操作者将艾柱置于患者肾俞穴、膀胱俞穴处,点燃艾柱至患者感觉皮肤微微灼热感时,将艾柱移去,每穴5壮。后取双侧心俞和肾俞埋皮内针,穴位常规消毒后,用止血钳夹住皮内针针柄处,将止血钳咬合,针尖由外侧向脊柱方向,沿皮下横向平刺,针柄留于皮外,然后用医用胶布粘贴固定,留置3天后与脊柱反方向撕下胶布,取出皮内针；若患者在埋针过程中感觉有不适情况,可随时将皮内针取出。
对照组取穴：(根据“中国中医药出版社”所出版的《针灸学》中腰痛治疗选穴)取大肠俞、肾俞、环跳、委中、阳陵泉、悬钟、丘墟。
对照组操作方法：环跳穴以3寸针快速进针,入2寸左右(具体根据患者肥瘦而定)。大肠俞、肾俞及阳陵泉以1.5寸不锈钢毫针快速进针,刺入深度为1寸；丘墟取1寸针快速进针,针刺深度为0.5寸。采取均匀捻转手法,得气即止。留针时间为30分钟。
治疗组和对照组每日(周一至周五)治疗1次,10次为1疗程；2个疗程后统计疗效。
采用腰椎疾患治疗成绩评分、视觉类比量表(VAS)、语言评价量表(VRS)、数字评价量表(NRS)、行为疼痛测定表(BRS-6)、McGill问卷表(MPQ)以及简明疼痛问卷表(BPQ)评价两组的疗效,以及采用健康相关生活质量评分(SF-36)评价患者生活质量。评价时点为治疗前和治疗后。
临床资料及时汇总,输入计算机,建立数据库,将数据记录输入SPSS18.0进行统计分析。统计方法：计数资料用卡方检验,等级资料比较Wilcoxon秩和检验(校正),均数比较用Wilcoxon秩和检验或t检验,两样本自身前后比较用配对t检验或Wilcoxon配对秩和检验。
结果：
1.治疗前,治疗组与对照组的年龄构成、性别构成、教育背景、视觉类比量表(VAS)、语言评价量表(VRS)、数字评价量表(NRS)评分、行为疼痛测定评分、McGill简易疼痛量表评分以及BPQ量表评分、健康相关生活质量评分(SF-36)基线均一致,可比性良好。
2.腰椎疾患治疗成绩评分比较：治疗组治愈5例,显效12例,有效14例,无效4例,有效率为88.57%；对照组治愈2例,显效8例,有效9例,无效16例,有效率为54.29%。两组评分比较有显著性差异(P<0.05),治疗组明显优于对照组。3.视觉类比量表(VAS)评分、VRS评分、NRS评分：治疗组治疗后视觉类比量表(VAS)评分、VRS评分、NRS评分较治疗前降低,降低幅度有统计学差异(P<0.05)；对照组治疗后VAS、VRS评分比较较治疗前比较差异无统计学意义(P>0.05), NRS评分较治疗前比较有统计学差异(P 4.行为疼痛测定评分(BRS-6)评分比较：治疗组治疗后BRS-6评分较治疗前降低,降低幅度有统计学差异(P<0.05)；对照组治疗后BRS-6评分较治疗前降低,降低幅度有统计学差异(P<0.05)。组间比较有统计学差异,治疗组明显优于对照组(P<0.05)。
5. McGill简易疼痛量表(MPQ)评分比较：治疗组治疗后较治疗前降低,降低幅度有统计学差异(P<0.05)；对照组治疗后较治疗前降低,降低幅度有统计学差异(P<0.05)。两组间比较有显著性差异(P<0.05),治疗组明显优于对照组,提示治疗组能显著降低McGill简易疼痛量表PRI评分。
6.BPQ量表评分比较：治疗组治疗后较治疗前降低,降低幅度比较有差异有统计学意义(P<0.05)；对照组治疗后BPQ量表评分较治疗前无显著性差异(P>0.05)。组间比较有显著性差异(P<0.05),治疗组明显优于对照组,提示治疗组较对照组更能显著降低BPQ量表评分。
7.健康相关生存质量(SF-36)评分,治疗组在活力、社会职能及精神健康三个维度的改善程度优于对照组(P<0.05),其他五个维度的两组的改善程度差异无统计学意义(P>0.05)。
结论：
1.从心胆肾论治腰椎间盘突出症之腰痛症临床疗效好,其治疗效果优于对照组。
2.从心胆肾论治腰椎间盘突出之腰痛症能有效改善患者生存质量,特别在活力、社会职能及精神健康方面优于对照组。
Background
Lumbar disc herniation is a common and frequently-occurring disease with high recurrence rate. Some statistics show that nearly80%PeoPle have different level back Pain in their lives, most of them caused by lumbar disc herniation which would affect the Patients daily life and work. Treating the lumbar disc herniation, about80%-90%of the Patients get benefit from surgery. In the conservative treatments, acuPuncture theraPy has a unique Positive efficacy in treating lumbar disc herniation. There are a lot of clinical researches about acuPuncture theraPy treating lumbar disc herniation, APuncture theraPy has been aPPlicated widely because of its efficacy. AcuPuncture theraPy can cease the Pains caused by lumbar disc herniation, accelerate the absorPtion of local inflammation and rePairation of nerve, raise the Pain threshold of Patients so as to achieve analgesic effect.
By reviewing the literatures, the acuPuncture treatment of lumbar disc herniation mainly focuses on the kidney-bladder meridian, local Points and accordance with the meridian acuPoints. Patients could get benefift from the theraPy while some couldn't; Furthermore, a Part of Patients with lumbar disc herniation may get annoyed by acuPuncture from Prone Position, even, make the waist local symPtoms worse.
According to TCM theory, the PurPose of this study is to oPtimize the treatment on lumbar disc herniation by using heart, gallbladder and kidney meidians, imProve the effect of acuPuncture treatment. This system regulates the Points, the oPeration, as well as the method of acuPuncture. In the study, we adoPt acuPuncture on Baihui, Yin tang, Neiguan in double, Yanglinquan in double, moxibustion on double side shenshu, Pangguangshu, buring needle in xinshu, shenshu on both sides; Using "one acuPuncture two moxibustion three consolidation" to standardize the Prosedure, and Provide the clinical basis for the acuPuncture treatment of lumbar disc disease through relevant scale assessments.
Objective
By randomized controlled clinical trial, to objectively evaluate the efficacy of the methods treating from the heart, gallbladder and kidney meridians of lumbar disc herniation, also, the improvement of the Patients' quality of life.
Method
All Patients are from the Taiwan yongshen chinese medicine clinic who diagnosed of lumbar disc herniation. They are devided into two grouPs randomly,35of which is the heart, gallbladder and kidney treatment grouP and the rest of which belong to the general acuPuncture grouP.
The acuPoint selection of the treatment grouP:Baihui, yintang, Neiguan and Yanglingquan:the Point selection of moxa-moxibustion is shenshu Pangguangshu, and buried needle in bilateral Xinshu, shenshu.
Treatment grouP method of oPeration:the Patient suPine Position, Points with75%alcohol disinfection, acuPuncture on bilateral neiguan, Yanglingquan firstly, the dePth of the needle based on the Patients'weight. The dePth is about10-12mm. The tecnique is to give the aPuncture with regular sPeed to bring about the desired sensation combined with modulating QI-Xue. Then stimulate Baihui, Zhisan and the dePth is about4-5mm with the same method. The time fot the retention of the needle is about30mins. Then stimulate the Sihua directly using moxa cones. Remove the unburned moxa cones with cutton swab when2/3of the moxa cones was burnt and Patients feel warm or silght burning Pain.5cones for each Point. Finally, withdraw the imbedding needles in the bilateral Xinyu and Danyu. The intracutaneous5mm-long needle should be stimulated in and the needle handle should be left utside from the diection of outboard to the sPinal column through horizontal inserction of needle. Then use the medical Proof fabric to fix them. After2-day needle rentention, withdraw them, ubcutaneous ubcutaneous intracutaneous
The acuPoint selection of the Control grouP:(the waist Pain is the most obvious Point, take a Prone Position, Press3lumbar to sacral vertebral sPines 1down sides, tenderness is the most obvious Point), waist cliP ridge Point (according to locate acuPoints with herniation segment to determine), rubs, gb30; According to the meridian syndrome with acuPuncture Point:the bladder tyPe by bilateral, bl57, kunduz warehouse; Gallbladder meridian tyPe distribution wind city, gb34,xuanzhong.
Control grouP oPeration method:the Patients in Prone Position, regular meridians with75%alcohol disinfection, acuPuncture is Point o, waist cliP ridge, rubs and gb30, after acuPuncture meridian syndrome differentiation by the selected Points. Into the dePth of needle according to Patient measure. AdoPt uniform twisting technique, qi. The retaining needle time for30minutes. Treatment grouP and control grouP in treatment1times a day,10times for1course of treatment; Rest3～5days after1course of treatment, the curative effect after2courses of statistics.
Use the curative effect of TCM syndrome in TCM treatment Performance score, total lumbar disease, lumbar disease curative effect evaluation criteria, visual analog scale (VAS), language evaluation scale (VRS), numerical rating scale (NRS), behavior (BRS-6), McGill Pain measurement table questionnaire and the brief Pain questionnaire (BPQ) to evaluate the curative effect of two grouPs, and the health related quality of life scores (SF-36) in evaluation of Patients quality of life.
Clinical data timely summary, inPut comPuter, the establishment of database, inPut data records into SPSS18.0statistical analysis. Statistical methods: classification data with c2test, rank data comParing two samPles Wilcoxon rank and insPection (calibration), two samPle mean comPared with t test and Wilcoxon rank and insPection, itself before and after comParison with Paired t test or Wilcoxon Paired rank and insPection.
Results
1. Before treatment, between treatment grouP and control grouP, the baselines, of which about age, gender, education background, VAS, VRS, NRS, BRS-6, McGill simPle Pain scale score, BPQ Score and SF-36, are consistent. It is comParable between two grouPs.
2. Treatment result of Lumbar disc herniation:in the treatment grouP,5Patients were cured,12Patients were marked,14Patients were effective,4Patients were invalid, the efficient is88.57%; in the control grouP,2Patients were cured,8Patients were marked,9Patients were effective,16 Patients were invalid, the efficient is54.29%. There was significant difference(P<0.05), between two grouPs. The treatment result of treatment grouP is better.
3. Results of VAS, VRS, NRS:in treatment grouP, scores of the VAS, VRS, NRS became low after treatment, the rate of the reduction of scores was statistically significant (P<0.05); in control grouP, change of VAS&VRS were no significant difference after treatment (P>0.05), change of NRS was statistically significant after treatment (P>0.05). There was significant difference between two grouPs (P>0.05). And the treatment grouP was significantly better than the control grouP.
4. Result of BRS-6:in treatment grouP, scores of the BRS-6became low after treatment, the rate of the reduction of scores was statistically significant (P<0.05); in control grouP, scores of the BRS-6became low after treatment, the rate of the reduction of scores was statistically significant (P<0.05).
5. SimPle McGill Pain scale PRI score comParison:the treatment grouP after treatment was decreased, the decrease amPlitude was statistically difference (P<0.05); The control grouP after treatment than before treatment, reduction of statistically significant (P<0.05). ComParison between the two grouPs have significant difference (P<0.05), the treatment grouP was better than control grouP, the treatment grouP can significantly reduce PRI simPle McGill Pain scale score.
6. BPQ rating scale comParison:the treatment grouP after treatment was decreased, the reduction of comParative difference was statistically significant (P<0.05); Control BPQ scale score after treatment than before treatment there was no significant difference (P>0.05). ComParison between grouPs had significant difference (P<0.05), the treatment grouP was better than control grouP, the treatment grouP than the control grouP can significantly reduce BPQ rating scale.
7. Health-related quality of life (SF-36) score, the treatment grouP in the vitality, social functions and the improvement of the three dimensions of mental health level is better than that of control grouP (P<0.05), the improvement of the other five dimensions of two grouPs of level difference is not significant (P>0.05).
Conclusion
1. from the heart and gallbladder kidney treatment Painful disease clinical curative effect of lumbar disc ProlaPse, and its curative effect is suPerior to conventional acuPuncture Pick acuPuncture Point.
2. from the heart and gallbladder kidney treatment of lumbar disc Pains can effectively imProve the Patients'quality of life, esPecially in the asPect of Physiological function, body Pain, emotional functions is suPerior to conventional acuPuncture Pick acuPuncture Point.
腰椎间盘突出症是临床多发病,常见病,复发率高。有人统计,近80%的人一生中或轻或重曾患下腰痛,其中多数由于腰椎间盘突出引起,很大程度上影响了患者日常生活与工作[1]。腰椎间盘突出症在治疗上,80%-90%的患者可通过手术治疗取效。在保守治疗方法中,针灸疗法在治疗腰椎间盘突出症有一定独特之处,针灸疗法治疗腰椎间盘突出症临床研究很多,其疗效确切,临床应用也非常广泛。针刺治疗腰椎间盘突出所致的痛症,可以促进患者局部炎症吸收及神经组织的修复,通过针刺,患者的痛阈值升高,从而达到镇痛的效果。
从文献查阅来看,目前针灸治疗腰椎间盘突出主要从肾、膀胱经着手,局部取穴以及按照经络循行取穴,临床收到一定疗效,然而亦有不效者；再者,部分腰椎间盘突出症患者取俯卧位针灸时,常有不适感,甚至会加重腰局部症状。
本研究根据中医理论,采用心胆肾治疗腰椎间盘突出之腰痛,目的是为了优化治疗方案,提高针刺治疗效果。本方案将针灸选穴、针灸操作、以及针灸方法规范化,选取针刺百会、印堂,内关双、阳陵泉双,艾灸双侧肾俞、膀胱俞,埋针双侧心俞、肾俞穴；采用“一针二灸三巩固”规范化操作,通过相关量表测评,为针灸治疗腰椎间盘突出症提供临床依据。
目的：
通过随机对照临床试验,客观评价从心、胆、肾治疗腰椎间盘突出症痛症临床疗效,以及腰椎间盘突出症患者生存质量改善情况。
方法：
所有病例来源于台湾永森中医门诊,将符合纳入标准的腰椎间盘突出症患者70例随机分为治疗组(心胆肾论治组)与对照组(常规针刺组),每组35例。
治疗组取穴：百会、印堂、内关双、阳陵泉双,艾灸双侧肾俞、双侧膀胱俞,埋针双侧心俞、双侧肾俞。
治疗组操作方法：患者取仰卧位,穴位用75%酒精常规消毒,先针刺双侧内关、阳陵泉穴,进针深度依据病人肥瘦而定,采取均匀提插捻转手法,以得气为度,并配合调气法(针完后行鼻子深呼吸6次,休息1分钟后再深呼吸6次,直到出针),再针百会、印堂穴,进针深度4-5mm,采取均匀捻转手法,得气即止。留针时间为30分钟。接着取腰四穴进行艾柱直接灸(艾柱大小约20mm×20mm×10mm),先于肾俞穴、膀胱俞穴处涂以万花油(既使得艾柱能与皮肤粘合而不至于脱落,还可防止烫伤皮肤),操作者将艾柱置于患者肾俞穴、膀胱俞穴处,点燃艾柱至患者感觉皮肤微微灼热感时,将艾柱移去,每穴5壮。后取双侧心俞和肾俞埋皮内针,穴位常规消毒后,用止血钳夹住皮内针针柄处,将止血钳咬合,针尖由外侧向脊柱方向,沿皮下横向平刺,针柄留于皮外,然后用医用胶布粘贴固定,留置3天后与脊柱反方向撕下胶布,取出皮内针；若患者在埋针过程中感觉有不适情况,可随时将皮内针取出。
对照组取穴：(根据“中国中医药出版社”所出版的《针灸学》中腰痛治疗选穴)取大肠俞、肾俞、环跳、委中、阳陵泉、悬钟、丘墟。
对照组操作方法：环跳穴以3寸针快速进针,入2寸左右(具体根据患者肥瘦而定)。大肠俞、肾俞及阳陵泉以1.5寸不锈钢毫针快速进针,刺入深度为1寸；丘墟取1寸针快速进针,针刺深度为0.5寸。采取均匀捻转手法,得气即止。留针时间为30分钟。
治疗组和对照组每日(周一至周五)治疗1次,10次为1疗程；2个疗程后统计疗效。
采用腰椎疾患治疗成绩评分、视觉类比量表(VAS)、语言评价量表(VRS)、数字评价量表(NRS)、行为疼痛测定表(BRS-6)、McGill问卷表(MPQ)以及简明疼痛问卷表(BPQ)评价两组的疗效,以及采用健康相关生活质量评分(SF-36)评价患者生活质量。评价时点为治疗前和治疗后。
临床资料及时汇总,输入计算机,建立数据库,将数据记录输入SPSS18.0进行统计分析。统计方法：计数资料用卡方检验,等级资料比较Wilcoxon秩和检验(校正),均数比较用Wilcoxon秩和检验或t检验,两样本自身前后比较用配对t检验或Wilcoxon配对秩和检验。
结果：
1.治疗前,治疗组与对照组的年龄构成、性别构成、教育背景、视觉类比量表(VAS)、语言评价量表(VRS)、数字评价量表(NRS)评分、行为疼痛测定评分、McGill简易疼痛量表评分以及BPQ量表评分、健康相关生活质量评分(SF-36)基线均一致,可比性良好。
2.腰椎疾患治疗成绩评分比较：治疗组治愈5例,显效12例,有效14例,无效4例,有效率为88.57%；对照组治愈2例,显效8例,有效9例,无效16例,有效率为54.29%。两组评分比较有显著性差异(P<0.05),治疗组明显优于对照组。3.视觉类比量表(VAS)评分、VRS评分、NRS评分：治疗组治疗后视觉类比量表(VAS)评分、VRS评分、NRS评分较治疗前降低,降低幅度有统计学差异(P<0.05)；对照组治疗后VAS、VRS评分比较较治疗前比较差异无统计学意义(P>0.05), NRS评分较治疗前比较有统计学差异(P
5. McGill简易疼痛量表(MPQ)评分比较：治疗组治疗后较治疗前降低,降低幅度有统计学差异(P<0.05)；对照组治疗后较治疗前降低,降低幅度有统计学差异(P<0.05)。两组间比较有显著性差异(P<0.05),治疗组明显优于对照组,提示治疗组能显著降低McGill简易疼痛量表PRI评分。
6.BPQ量表评分比较：治疗组治疗后较治疗前降低,降低幅度比较有差异有统计学意义(P<0.05)；对照组治疗后BPQ量表评分较治疗前无显著性差异(P>0.05)。组间比较有显著性差异(P<0.05),治疗组明显优于对照组,提示治疗组较对照组更能显著降低BPQ量表评分。
7.健康相关生存质量(SF-36)评分,治疗组在活力、社会职能及精神健康三个维度的改善程度优于对照组(P<0.05),其他五个维度的两组的改善程度差异无统计学意义(P>0.05)。
结论：
1.从心胆肾论治腰椎间盘突出症之腰痛症临床疗效好,其治疗效果优于对照组。
2.从心胆肾论治腰椎间盘突出之腰痛症能有效改善患者生存质量,特别在活力、社会职能及精神健康方面优于对照组。
Background
Lumbar disc herniation is a common and frequently-occurring disease with high recurrence rate. Some statistics show that nearly80%PeoPle have different level back Pain in their lives, most of them caused by lumbar disc herniation which would affect the Patients daily life and work. Treating the lumbar disc herniation, about80%-90%of the Patients get benefit from surgery. In the conservative treatments, acuPuncture theraPy has a unique Positive efficacy in treating lumbar disc herniation. There are a lot of clinical researches about acuPuncture theraPy treating lumbar disc herniation, APuncture theraPy has been aPPlicated widely because of its efficacy. AcuPuncture theraPy can cease the Pains caused by lumbar disc herniation, accelerate the absorPtion of local inflammation and rePairation of nerve, raise the Pain threshold of Patients so as to achieve analgesic effect.
By reviewing the literatures, the acuPuncture treatment of lumbar disc herniation mainly focuses on the kidney-bladder meridian, local Points and accordance with the meridian acuPoints. Patients could get benefift from the theraPy while some couldn't; Furthermore, a Part of Patients with lumbar disc herniation may get annoyed by acuPuncture from Prone Position, even, make the waist local symPtoms worse.
According to TCM theory, the PurPose of this study is to oPtimize the treatment on lumbar disc herniation by using heart, gallbladder and kidney meidians, imProve the effect of acuPuncture treatment. This system regulates the Points, the oPeration, as well as the method of acuPuncture. In the study, we adoPt acuPuncture on Baihui, Yin tang, Neiguan in double, Yanglinquan in double, moxibustion on double side shenshu, Pangguangshu, buring needle in xinshu, shenshu on both sides; Using "one acuPuncture two moxibustion three consolidation" to standardize the Prosedure, and Provide the clinical basis for the acuPuncture treatment of lumbar disc disease through relevant scale assessments.
Objective
By randomized controlled clinical trial, to objectively evaluate the efficacy of the methods treating from the heart, gallbladder and kidney meridians of lumbar disc herniation, also, the improvement of the Patients' quality of life.
Method
All Patients are from the Taiwan yongshen chinese medicine clinic who diagnosed of lumbar disc herniation. They are devided into two grouPs randomly,35of which is the heart, gallbladder and kidney treatment grouP and the rest of which belong to the general acuPuncture grouP.
The acuPoint selection of the treatment grouP:Baihui, yintang, Neiguan and Yanglingquan:the Point selection of moxa-moxibustion is shenshu Pangguangshu, and buried needle in bilateral Xinshu, shenshu.
Treatment grouP method of oPeration:the Patient suPine Position, Points with75%alcohol disinfection, acuPuncture on bilateral neiguan, Yanglingquan firstly, the dePth of the needle based on the Patients'weight. The dePth is about10-12mm. The tecnique is to give the aPuncture with regular sPeed to bring about the desired sensation combined with modulating QI-Xue. Then stimulate Baihui, Zhisan and the dePth is about4-5mm with the same method. The time fot the retention of the needle is about30mins. Then stimulate the Sihua directly using moxa cones. Remove the unburned moxa cones with cutton swab when2/3of the moxa cones was burnt and Patients feel warm or silght burning Pain.5cones for each Point. Finally, withdraw the imbedding needles in the bilateral Xinyu and Danyu. The intracutaneous5mm-long needle should be stimulated in and the needle handle should be left utside from the diection of outboard to the sPinal column through horizontal inserction of needle. Then use the medical Proof fabric to fix them. After2-day needle rentention, withdraw them, ubcutaneous ubcutaneous intracutaneous
The acuPoint selection of the Control grouP:(the waist Pain is the most obvious Point, take a Prone Position, Press3lumbar to sacral vertebral sPines 1down sides, tenderness is the most obvious Point), waist cliP ridge Point (according to locate acuPoints with herniation segment to determine), rubs, gb30; According to the meridian syndrome with acuPuncture Point:the bladder tyPe by bilateral, bl57, kunduz warehouse; Gallbladder meridian tyPe distribution wind city, gb34,xuanzhong.
Control grouP oPeration method:the Patients in Prone Position, regular meridians with75%alcohol disinfection, acuPuncture is Point o, waist cliP ridge, rubs and gb30, after acuPuncture meridian syndrome differentiation by the selected Points. Into the dePth of needle according to Patient measure. AdoPt uniform twisting technique, qi. The retaining needle time for30minutes. Treatment grouP and control grouP in treatment1times a day,10times for1course of treatment; Rest3～5days after1course of treatment, the curative effect after2courses of statistics.
Use the curative effect of TCM syndrome in TCM treatment Performance score, total lumbar disease, lumbar disease curative effect evaluation criteria, visual analog scale (VAS), language evaluation scale (VRS), numerical rating scale (NRS), behavior (BRS-6), McGill Pain measurement table questionnaire and the brief Pain questionnaire (BPQ) to evaluate the curative effect of two grouPs, and the health related quality of life scores (SF-36) in evaluation of Patients quality of life.
Clinical data timely summary, inPut comPuter, the establishment of database, inPut data records into SPSS18.0statistical analysis. Statistical methods: classification data with c2test, rank data comParing two samPles Wilcoxon rank and insPection (calibration), two samPle mean comPared with t test and Wilcoxon rank and insPection, itself before and after comParison with Paired t test or Wilcoxon Paired rank and insPection.
Results
1. Before treatment, between treatment grouP and control grouP, the baselines, of which about age, gender, education background, VAS, VRS, NRS, BRS-6, McGill simPle Pain scale score, BPQ Score and SF-36, are consistent. It is comParable between two grouPs.
2. Treatment result of Lumbar disc herniation:in the treatment grouP,5Patients were cured,12Patients were marked,14Patients were effective,4Patients were invalid, the efficient is88.57%; in the control grouP,2Patients were cured,8Patients were marked,9Patients were effective,16 Patients were invalid, the efficient is54.29%. There was significant difference(P<0.05), between two grouPs. The treatment result of treatment grouP is better.
3. Results of VAS, VRS, NRS:in treatment grouP, scores of the VAS, VRS, NRS became low after treatment, the rate of the reduction of scores was statistically significant (P<0.05); in control grouP, change of VAS&VRS were no significant difference after treatment (P>0.05), change of NRS was statistically significant after treatment (P>0.05). There was significant difference between two grouPs (P>0.05). And the treatment grouP was significantly better than the control grouP.
4. Result of BRS-6:in treatment grouP, scores of the BRS-6became low after treatment, the rate of the reduction of scores was statistically significant (P<0.05); in control grouP, scores of the BRS-6became low after treatment, the rate of the reduction of scores was statistically significant (P<0.05).
5. SimPle McGill Pain scale PRI score comParison:the treatment grouP after treatment was decreased, the decrease amPlitude was statistically difference (P<0.05); The control grouP after treatment than before treatment, reduction of statistically significant (P<0.05). ComParison between the two grouPs have significant difference (P<0.05), the treatment grouP was better than control grouP, the treatment grouP can significantly reduce PRI simPle McGill Pain scale score.
6. BPQ rating scale comParison:the treatment grouP after treatment was decreased, the reduction of comParative difference was statistically significant (P<0.05); Control BPQ scale score after treatment than before treatment there was no significant difference (P>0.05). ComParison between grouPs had significant difference (P<0.05), the treatment grouP was better than control grouP, the treatment grouP than the control grouP can significantly reduce BPQ rating scale.
7. Health-related quality of life (SF-36) score, the treatment grouP in the vitality, social functions and the improvement of the three dimensions of mental health level is better than that of control grouP (P<0.05), the improvement of the other five dimensions of two grouPs of level difference is not significant (P>0.05).
Conclusion
1. from the heart and gallbladder kidney treatment Painful disease clinical curative effect of lumbar disc ProlaPse, and its curative effect is suPerior to conventional acuPuncture Pick acuPuncture Point.
2. from the heart and gallbladder kidney treatment of lumbar disc Pains can effectively imProve the Patients'quality of life, esPecially in the asPect of Physiological function, body Pain, emotional functions is suPerior to conventional acuPuncture Pick acuPuncture Point.
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