电针联合推拿治疗弹力型腰椎间盘突出症的临床观察
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摘要
目的临床评价电针联合推拿治疗弹力型腰椎间盘突出症的疗效。方法将180例弹力型腰椎间盘突出症患者随机分为电针组、推拿组、针推组,每组60例。电针组取穴:取病变椎体及上下各1个椎体两侧的夹脊穴及病变侧秩边、环跳、委中、阳陵泉等穴,电针正负电极成对跨脊椎连接病变节段的2对夹脊穴,且相邻两组导线的正负极方向相反。推拿组治疗顺序:舒筋晃腰、痛点镇定、俯卧牵抖、侧卧旋转整骨、虚掌拍脊。针推组的即先行推拿治疗,再行电针治疗,方法同电针组、推拿组。治疗2个疗程后比较治疗前后的VAS评分、JOA积分及优良率。结果三组患者治疗前后VAS评分及JOA积分变化有统计学意义(P<0.05),电针组治疗后VAS评分及JOA积分优于电针组及推拿组,差异有统计学意义(P<0.05)。电针组、推拿组、针推组优良率分别为:78%、75%、93%。针推组与电针组优良率比较有统计学意义(P<0.05),针推组与推拿组优良率比较差异具有显著统计学意义(P<0.01)。结论电针联合推拿治疗弹力型腰椎间盘突出症疗效优于单纯电针及单纯推拿治疗,可作为临床保守治疗该病的首选方案。
Objective To evaluate the effect of electro-acupuncture(EA) combined with massage in treatment of elastic lumbar disc herniation(LDH). Methods 180 cases of patients with LDH were randomly into EA group, massage group and EA combined massage group, 60 cases in each group. EA group was taken Jiaji point on both sides of the lesion vertebral body and the upper and lower 1 vertebral body respectively and Zhibian, Huantiao, Yanglingquan points on the pathological side.Combine the two Jiaji points of the segmental lesions with pairs of positive and negative electrodes of EA, be aware that the positive and negative electrodes of the neighboring wires must be put in the opposite direction. The treatment order of massage group was: stretch the physique and shake the waist, pain stabilization, prone traction, lateral lying rotation osteopathy, beat spine with empty palm. EA combined massage group was firstly taken the treatment of massage and then the treatment of EA.The treatment was the same as the former two groups. After 2 courses of treatment, the data of VAS, JOA and excellent rates were compared before and after treatment. Results The data changes of VAS and JOA before and after treatment of the three groups were statistically significant(P<0.05). The excellent rate of the three groups were 78%,75%,93%. Conclusion EA combined massage is more effective than, simple EA or massage in treatment of elastic LDH, so it can be used as the first choice for the treatment of LDH.
Objective To evaluate the effect of electro-acupuncture(EA) combined with massage in treatment of elastic lumbar disc herniation(LDH). Methods 180 cases of patients with LDH were randomly into EA group, massage group and EA combined massage group, 60 cases in each group. EA group was taken Jiaji point on both sides of the lesion vertebral body and the upper and lower 1 vertebral body respectively and Zhibian, Huantiao, Yanglingquan points on the pathological side.Combine the two Jiaji points of the segmental lesions with pairs of positive and negative electrodes of EA, be aware that the positive and negative electrodes of the neighboring wires must be put in the opposite direction. The treatment order of massage group was: stretch the physique and shake the waist, pain stabilization, prone traction, lateral lying rotation osteopathy, beat spine with empty palm. EA combined massage group was firstly taken the treatment of massage and then the treatment of EA.The treatment was the same as the former two groups. After 2 courses of treatment, the data of VAS, JOA and excellent rates were compared before and after treatment. Results The data changes of VAS and JOA before and after treatment of the three groups were statistically significant(P<0.05). The excellent rate of the three groups were 78%,75%,93%. Conclusion EA combined massage is more effective than, simple EA or massage in treatment of elastic LDH, so it can be used as the first choice for the treatment of LDH.
引文
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[12]杨友发.中西医结合治疗腰椎间盘突出症痰瘀虚型130例[J].实用中医药杂志,2016,32(4):350-351.
[13]蒋位庄,周卫,张禄堂,等.椎间盘源性腰腿痛诊治规范化研究[J].中国骨伤,2004,17(11):643-646.
[2]蒋位庄.脊源性腰腿痛[M].北京:人民卫生出版社,2002:139-140,305-306.
[3]陈佑邦.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:201-202.
[4]杨松柏,梅志刚,蔡三金,等.不同连接方式电针夹脊穴治疗腰椎间盘突出症的疗效观察[J].湖北中医药杂志,2011,33(6):14-16.
[5]谭冠先.疼痛诊疗学[M].北京:人民卫生出版社,2004:8.
[6]蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:118-119.
[7]王升旭,李树成,老锦雄,等.电针夹脊穴治疗腰椎间盘突出症的临床观察及机理探讨[J].中国针灸,2000,20(3):166-168.
[8]卜彦青,杜广中.腰椎间盘突出症现代针灸的腧穴谱[J].中国中医基础医学杂志,2009,15(9):691-693.
[9]王浩然,贾红玲,张永臣,等.腰椎间盘突出症针刺机制研究进展[J].山东中医杂志,2016,35(5):479-481.
[10]单衍丽.电针腰夹脊穴与膀胱经穴为主治疗腰椎间盘突出症疗效观察[J].中国针灸,2011,31(11):987-990.
[11]南登崑.康复医学[M].北京:人民卫生出版社,2013:220-223.
[12]杨友发.中西医结合治疗腰椎间盘突出症痰瘀虚型130例[J].实用中医药杂志,2016,32(4):350-351.
[13]蒋位庄,周卫,张禄堂,等.椎间盘源性腰腿痛诊治规范化研究[J].中国骨伤,2004,17(11):643-646.