烙灸联合腰背肌功能锻炼对后纵韧带破裂型腰椎间盘突出症患者髓核重吸收及复发率的影响
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摘要
目的观察烙灸联合腰背肌功能锻炼对后纵韧带破裂型腰椎间盘突出症患者髓核重吸收及复发率的影响。方法将经过常规保守治疗达到临床治愈的24例后纵韧带破裂型腰椎间盘突出症患者随机分为治疗组和对照组,各12例。对照组予腰背肌功能锻炼;治疗组在腰背肌功能锻炼的基础上予烙灸疗法,每周烙灸1次,每次30 min,治疗6月后追踪随访1年,比较2组的髓核吸收率及复发率。结果治疗组髓核吸收率为41.67%,对照组为16.67%,2组比较差异有统计学意义(P<0.05);经过1年随访,治疗组复发率为25.00%,对照组为50.00%,2组比较差异有统计学意义(P <0.05);治疗组中髓核重吸收的患者复发率为20.00%,未发生髓核重吸收的患者复发率为28.57%,比较差异有统计学意义(P<0.05)。结论在腰背肌功能锻炼的基础上联合烙灸疗法,可以促进后纵韧带破裂型腰椎间盘突出症患者的髓核重吸收,进而降低腰椎间盘突出症的复发率,值得临床推广。
Objective To observe the effects of flipping moxibustion combined with lumbodorsal muscle function exercise on pulpiform nucleus reabsorption and recurrence rate of patients with prolapse of lumbar intervertebral disc of posterior longitudinal lignmentous rupture type.Methods Twenty-four cases with prolapse of lumbar intervertebral disc of posterior longitudinal lignmentous rupture type which had achieved the clinical cure effect after routine conservative treatment were randomly divided into treatment group and control group,with 12 cases in each.The control group was given lumbodorsal muscle function exercise;while the treatment group was given flipping moxibustion on the basis of lumbodorsal muscle function exercise,flipping moxibustion once a week,30 min per time.Follow-up 1 year after 6 months of treatment,the pulpiform nucleus reabsorption rate and recurrence rate of the 2 groups were compared.Results The pulpiform nucleus reabsorption rate of the treatment group was 41.67%,that of the control group was 16.67%,there was statistically significant difference between the two groups(P<0.05).After 1 year of follow-up,the recurrence rate of the treatment group was 25.00%,that of the control group was50.00%,there was statistically significant difference between the two groups(P<0.05).In the treatment group,the recurrence rate of patients with pulpiform nucleus reabsorption was 20.00%,and that of patients without pulpiform nucleus reabsorption was 28.57%,there was statistically significant difference(P<0.05).Conclusion Combined flipping moxibustion on the basis of lumbodorsal muscle function exercise can promote the pulpiform nucleus reabsorption of patients with prolapse of lumbar intervertebral disc of posterior longitudinal lignmentous rupture type,and then reduce the recurrence rate of prolapse of lumbar intervertebral disc,which deserves clinical promotion.
Objective To observe the effects of flipping moxibustion combined with lumbodorsal muscle function exercise on pulpiform nucleus reabsorption and recurrence rate of patients with prolapse of lumbar intervertebral disc of posterior longitudinal lignmentous rupture type.Methods Twenty-four cases with prolapse of lumbar intervertebral disc of posterior longitudinal lignmentous rupture type which had achieved the clinical cure effect after routine conservative treatment were randomly divided into treatment group and control group,with 12 cases in each.The control group was given lumbodorsal muscle function exercise;while the treatment group was given flipping moxibustion on the basis of lumbodorsal muscle function exercise,flipping moxibustion once a week,30 min per time.Follow-up 1 year after 6 months of treatment,the pulpiform nucleus reabsorption rate and recurrence rate of the 2 groups were compared.Results The pulpiform nucleus reabsorption rate of the treatment group was 41.67%,that of the control group was 16.67%,there was statistically significant difference between the two groups(P<0.05).After 1 year of follow-up,the recurrence rate of the treatment group was 25.00%,that of the control group was50.00%,there was statistically significant difference between the two groups(P<0.05).In the treatment group,the recurrence rate of patients with pulpiform nucleus reabsorption was 20.00%,and that of patients without pulpiform nucleus reabsorption was 28.57%,there was statistically significant difference(P<0.05).Conclusion Combined flipping moxibustion on the basis of lumbodorsal muscle function exercise can promote the pulpiform nucleus reabsorption of patients with prolapse of lumbar intervertebral disc of posterior longitudinal lignmentous rupture type,and then reduce the recurrence rate of prolapse of lumbar intervertebral disc,which deserves clinical promotion.
引文
[1]Idiris Altun,Kasim Zafer Yüksel.Lumbar herniated disc:spontaneous regression[J].Korean J Pain,2017,30(1):44-50.
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[11]林瑞珠,孙改玲,朱宁,等.回医烙灸对兔膝骨关节炎软骨细胞Bcl-2和Bax表达的影响[J].长春中医药大学学报,2017,33(1):34-36.
[12]XU Jianfeng,LIN Ruizhu,WU Yongli,et al.Effect of stimulating acupoint Guanyuan(CV4)on low back pain by burning moxa heat for different time lengths:a randomised controlled clinical trial[J].Journal of Traditional Chinese Medicine,2015,35(1):36-40.
[13]许建峰,白帅,林瑞珠,等.回医烙灸疗法对大鼠腰椎间盘退变模型软骨细胞凋亡的影响[J].辽宁中医药大学学报,2017,19(12):63-65.
[14]Hong J,Bal I P A.Images in clinical medicine resolution of lumber disk herniation without surgery[J].N End J Med,2016,374(16):1564.
[2]侯黎升,白雪东,程实,等.腰椎间盘突出后重吸收[J].颈腰痛杂志,2016,37(6):534-536.
[3]许建峰,林瑞珠,牛子瞻,等.关元穴灸法治疗腰椎间盘突出症30例疗效观察[J].甘肃中医学院学报,2012,29(6):55-58.
[4]许建峰,林瑞珠,牛子瞻,等.回医烙灸疗法对退变腰椎间盘中基质MMP-3表达的影响[J].福建中医药,2013,44(2):33-34.
[5]胥少汀,葛宝丰,徐印坎.实用骨科学[M].3版.北京:人民军医出版社,2008:1687.
[6]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:246.
[7]Bostelmann R,Steiger H J.An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc hemiation with radiculopath[J].Spine,2014,14(1):180-191.
[8]Veli Citisli,Muhammet Ibrahimoglu.Spontaneous remission of a big subligamentous extruded disc herniation:case report and review of the literature[J].Korean J Spine,2015,12(1):19-21.
[9]朱宇,姜宏,俞鹏飞.腰椎间盘突出后重吸收的研究进展[J].中国脊柱脊髓杂志,2014,24(12):1124-1128.
[10]赵平.腰椎间盘髓核脱出的回缩与吸收及临床评价[J].中国骨伤,2013,26(4):314-318.
[11]林瑞珠,孙改玲,朱宁,等.回医烙灸对兔膝骨关节炎软骨细胞Bcl-2和Bax表达的影响[J].长春中医药大学学报,2017,33(1):34-36.
[12]XU Jianfeng,LIN Ruizhu,WU Yongli,et al.Effect of stimulating acupoint Guanyuan(CV4)on low back pain by burning moxa heat for different time lengths:a randomised controlled clinical trial[J].Journal of Traditional Chinese Medicine,2015,35(1):36-40.
[13]许建峰,白帅,林瑞珠,等.回医烙灸疗法对大鼠腰椎间盘退变模型软骨细胞凋亡的影响[J].辽宁中医药大学学报,2017,19(12):63-65.
[14]Hong J,Bal I P A.Images in clinical medicine resolution of lumber disk herniation without surgery[J].N End J Med,2016,374(16):1564.