止痛活血汤联合针刺对急性腰扭伤患者的临床疗效观察
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摘要
【目的】探讨止痛活血汤联合针刺对急性腰扭伤(ALS)患者血液流变学及临床疗效的影响。【方法】将160例ALS患者随机分为观察组和对照组,每组各80例。对照组给予对乙酰氨基酚口服和针刺治疗,观察组在此基础上给予止痛活血汤治疗,疗程为7 d,比较2组患者血液流变学、疼痛、腰功能、临床疗效和不良反应的情况。【结果】治疗后,观察组总有效率为97.50%,对照组为87.50%,观察组优于对照组,差异有统计学意义(P <0.05);治疗后,2组患者的血浆黏度(PV)、红细胞比容(HCT)、血小板聚集率(PAR)较治疗前明显改善(P <0.05),且观察组的改善作用均优于对照组(P <0.05);2组治疗4 d和7 d后疼痛视觉模拟评分法(VAS)、Oswestry功能障碍指数问卷表(ODI)评分均较治疗前改善(P <0.05),且观察组的改善作用均优于对照组(P<0.05);2组患者治疗期间均未出现明显不良反应。【结论】止痛活血汤联合针刺治疗ALS的疗效优于常规针刺法。
Objective To explore the effect of Zhitong Huoxue Decoction combined with acupuncture on the hemorheology and curative effect in patients with acute lumbar sprain(ALS). Methods One hundred and sixty patients with ALS were randomly divided into observation group and control group,80 cases in each group. The two groups were given acetaminophen orally together with acupuncture,additionally,the observation group was given treatment with Zhitong Huoxue Decoction. The treatment course of the two groups covered 7 days. The hemorheology,pain,lumbar function,curative effect,and adverse reaction were compared in the two groups.Results After treatment, the total effective rate in the observation group(97.50%)was superior to that in the control group(87.50%), the difference being statistically significant(P<0.05). After treatment, the plasma viscosity(PV),hematocrit(HCT),and platelet aggregation rate(PAR)were significantly improved in the two groups as compared with those before treatment(P < 0.05),and the improvement in the observation group was superior to that in the control group(P<0.05). After 4,7 days of treatment,the scores of pain visual analogue scale(VAS)and Oswestry dysfunction index questionnaire(ODI)were significantly improved in the two groups as compared with those before treatment(P < 0.05),the improvement in the observation group was superior to that in the control group(P<0.05).There were no adverse reactions occurred in the two groups. Conclusion The curative effect of Zhitong Huoxue Decoction combined with acupuncture in treating the hemorheology and curative effect in patients with ALS is superior to routine acupuncture.
Objective To explore the effect of Zhitong Huoxue Decoction combined with acupuncture on the hemorheology and curative effect in patients with acute lumbar sprain(ALS). Methods One hundred and sixty patients with ALS were randomly divided into observation group and control group,80 cases in each group. The two groups were given acetaminophen orally together with acupuncture,additionally,the observation group was given treatment with Zhitong Huoxue Decoction. The treatment course of the two groups covered 7 days. The hemorheology,pain,lumbar function,curative effect,and adverse reaction were compared in the two groups.Results After treatment, the total effective rate in the observation group(97.50%)was superior to that in the control group(87.50%), the difference being statistically significant(P<0.05). After treatment, the plasma viscosity(PV),hematocrit(HCT),and platelet aggregation rate(PAR)were significantly improved in the two groups as compared with those before treatment(P < 0.05),and the improvement in the observation group was superior to that in the control group(P<0.05). After 4,7 days of treatment,the scores of pain visual analogue scale(VAS)and Oswestry dysfunction index questionnaire(ODI)were significantly improved in the two groups as compared with those before treatment(P < 0.05),the improvement in the observation group was superior to that in the control group(P<0.05).There were no adverse reactions occurred in the two groups. Conclusion The curative effect of Zhitong Huoxue Decoction combined with acupuncture in treating the hemorheology and curative effect in patients with ALS is superior to routine acupuncture.
引文
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[10]江萍.活血止痛汤及中药熏洗联合锁定钢板治疗胫骨平台骨折[J].中医临床研究,2018,10(1):49.
[11]田跃军,徐彬,徐涛,等.活血止痛汤加减治疗骨折术后肢体肿胀疼痛[J].中医临床研究,2016,8(17):110.
[12]陈文革,袁林,姜锦林,等.归芍伤筋汤内服联合通络止痛散外敷治疗急性腰扭伤45例[J].中国实验方剂学杂志,2014,20(24):221.
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[15]肖银香,何晓华,杨立峰.扭伤穴配体针治疗急性腰扭伤166例[J].中医临床研究,2014,6(32):25.
[16]汤福来,宋德煌,周雄清.活血止痛汤对行脉冲冲洗术ⅢA型下肢长骨骨干开放性骨折术后肢体疼痛的疗效观察[J].云南中医中药杂志,2017,38(4):21.
[17]王坚,朱杭,潘浩,等.活血止痛汤治疗急性腰扭伤的疗效观察[J].中国中医药科技,2016,23(4):473.
[18]信金党.止痛活血汤联合针刺治疗急性腰扭伤41例疗效观察[J].河北中医,2013,35(1):42.
[19]张保恒.自拟活血通络止痛汤加减治疗带状疱疹后遗肋间神经痛的临床观察[J].临床和实验医学杂志,2015,14(7):550.
[20]李欣怡,李亚军.施雀啄式手法泻水沟穴治疗急性腰扭伤[J].医学研究与教育,2017,34(1):15.
[2]袁彬,陈艳,张巧玲,等.畲医针刺疗法治疗急性腰扭伤疗效观察[J].上海针灸杂志,2017,36(11):1344.
[3]王海平.活血止痛外洗汤治疗腰椎间盘突出症60例疗效观察[J].中医临床研究,2017,9(23):65.
[4]国家中医药管理局.中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:201-213.
[5]曹晔,王月秋,王静霞,等.CT引导下颈椎横突后结节小针刀松解与盲法进针松解治疗神经根型颈椎病的对照研究[J].广州中医药大学学报,2017,34(5):672.
[6]尚莉莉,刘凯,孙宏,等.孙氏“循经远取动法”治疗急性腰扭伤的临床研究[J].针灸临床杂志,2017,33(7):38.
[7]Lazaro R P.Complex regional pain syndrome and acute carpal tunnel syndrome following radial artery cannulation:a neurological perspective and review of the literature[J].Medicine(Baltimore),2015,94(3):e422.
[8]林东,周国柱.腰椎手法推拿结合桂枝加葛根汤治疗急性腰扭伤的效果观察[J].中国当代医药,2015,22(24):101.
[9]张倩,李敏,殷克敬,等.“经络别通”选穴针刺治疗急性腰扭伤疗效观察[J].上海针灸杂志,2014,33(8):757.
[10]江萍.活血止痛汤及中药熏洗联合锁定钢板治疗胫骨平台骨折[J].中医临床研究,2018,10(1):49.
[11]田跃军,徐彬,徐涛,等.活血止痛汤加减治疗骨折术后肢体肿胀疼痛[J].中医临床研究,2016,8(17):110.
[12]陈文革,袁林,姜锦林,等.归芍伤筋汤内服联合通络止痛散外敷治疗急性腰扭伤45例[J].中国实验方剂学杂志,2014,20(24):221.
[13]Ching C T,Chen Y C,Lu L H,et al.Characterization of the muscle electrical properties in low back pain patients by electrical impedance myography[J].PLoS One,2013,8(4):e61639.
[14]毛建平,张新平.止痛活血汤联合针刺辨治急性腰扭伤的临床观察[J].中国中医急症,2014,23(11):2087.
[15]肖银香,何晓华,杨立峰.扭伤穴配体针治疗急性腰扭伤166例[J].中医临床研究,2014,6(32):25.
[16]汤福来,宋德煌,周雄清.活血止痛汤对行脉冲冲洗术ⅢA型下肢长骨骨干开放性骨折术后肢体疼痛的疗效观察[J].云南中医中药杂志,2017,38(4):21.
[17]王坚,朱杭,潘浩,等.活血止痛汤治疗急性腰扭伤的疗效观察[J].中国中医药科技,2016,23(4):473.
[18]信金党.止痛活血汤联合针刺治疗急性腰扭伤41例疗效观察[J].河北中医,2013,35(1):42.
[19]张保恒.自拟活血通络止痛汤加减治疗带状疱疹后遗肋间神经痛的临床观察[J].临床和实验医学杂志,2015,14(7):550.
[20]李欣怡,李亚军.施雀啄式手法泻水沟穴治疗急性腰扭伤[J].医学研究与教育,2017,34(1):15.