中西医康复疗法结合揿针留针候气对胸腰椎骨折合并脊髓损伤术后功能恢复作用的临床研究
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摘要
【目的】观察中西医康复疗法结合揿针持续的留针候气对胸腰椎骨折合并脊髓损伤行手术治疗后患者功能恢复的疗效。【方法】将40例确诊为胸腰椎骨折合并脊髓损伤行手术治疗的患者随机分为对照组和治疗组,每组各20例。对照组给予术后常规中西医康复治疗(包括运动康复、甲钴胺口服和针刺夹脊穴);治疗组在对照组的基础上增加揿针留针候气治疗,疗程均为90 d。观察2组患者治疗前1 d和治疗后第30、60、90天的美国脊髓损伤协会(ASIA)运动功能评分、感觉功能评分以及不良反应等方面的情况。【结果】2组患者治疗后的ASIA运动和感觉功能评分均较治疗前1 d明显改善,差异有统计学意义(P<0.01);组间比较,治疗组治疗后第30天、第60天的ASIA感觉功能评分及治疗后第60天的ASIA运动评分的改善作用优于同期对照组,差异有统计学意义(P<0.01)。【结论】中西医康复疗法结合揿针留针候气对胸腰椎骨折合并脊髓损伤术后患者的感觉、运动功能改善有确切疗效。
Objective To study the effect of traditional Chinese and western medicine rehabilitation therapycombined with thumbtack needle retention gathering Qi on post-operative functional recovery in thoracolumbarfracture patients complicated with spinal cord injury. Methods Forty patients with thoracolumbar fracturescomplicated with spinal cord injury were randomly divided into control group and treatment group,20 cases ineach group. The two groups were treated with routine post-operative traditional Chinese and western medicinerehabilitation regimen including exercises rehabilitation, oral use of methylcobalamin and acupuncture on Jiaji points, and the treatment group was additionally treated with thumbtack needle retention gathering Qi. Thetreatment for the two groups lasted for 90 days. American Spinal Cord Injury Association(ASIA)motor functionscores and ASIA sensory function scores as well as adverse action were observed in the two groups one day beforetreatment and 30,60,90 days after treatment. Results The ASIA sensory and motor function scores of the twogroups were significantly improved(P < 0.01 compared with those one day before treatment); the inter-group comparison results showed that the ASIA sensory function scores on the 30 th and 60 th day after treatment and theASIAmotorfunctionscoresonthe 60 thdayaftertreatment inthetreatmentgroupdifferedfromthoseinthecontrolgroup,the difference being significant(P < 0.01). Conclusion Traditional Chinese and western medicine rehabilitationTherapy combined with thumbtack needle retention gathering Qi is effective on improving the sensory and motorfunction of thoracolumbar fracture patients complicated with spinal cord injury.
Objective To study the effect of traditional Chinese and western medicine rehabilitation therapycombined with thumbtack needle retention gathering Qi on post-operative functional recovery in thoracolumbarfracture patients complicated with spinal cord injury. Methods Forty patients with thoracolumbar fracturescomplicated with spinal cord injury were randomly divided into control group and treatment group,20 cases ineach group. The two groups were treated with routine post-operative traditional Chinese and western medicinerehabilitation regimen including exercises rehabilitation, oral use of methylcobalamin and acupuncture on Jiaji points, and the treatment group was additionally treated with thumbtack needle retention gathering Qi. Thetreatment for the two groups lasted for 90 days. American Spinal Cord Injury Association(ASIA)motor functionscores and ASIA sensory function scores as well as adverse action were observed in the two groups one day beforetreatment and 30,60,90 days after treatment. Results The ASIA sensory and motor function scores of the twogroups were significantly improved(P < 0.01 compared with those one day before treatment); the inter-group comparison results showed that the ASIA sensory function scores on the 30 th and 60 th day after treatment and theASIAmotorfunctionscoresonthe 60 thdayaftertreatment inthetreatmentgroupdifferedfromthoseinthecontrolgroup,the difference being significant(P < 0.01). Conclusion Traditional Chinese and western medicine rehabilitationTherapy combined with thumbtack needle retention gathering Qi is effective on improving the sensory and motorfunction of thoracolumbar fracture patients complicated with spinal cord injury.
引文
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[10]刘小康,徐建广.药物治疗急性脊髓损伤的研究进展[J].中国矫形外科杂志,2012,20(12):1108.
[11]王想福,王兴盛,王国玉.脊髓损伤的药物治疗研究进展[J].中国中医骨伤科杂志,2014,22(8):76.
[12] Hachem L D, Ahuja C S, Fehlings M G. Assessment and management of acute spinal cord injury:from point of injury to rehabilitation[J]. J Spinal Cord Med,2017,40(6):665.
[13] Luo D,Chen R,Feng X L. Modulation of acupuncture on cell apoptosis and autophagy[J]. Evid Based Complement Alternat Med,2017,17:826.
[2]徐秀梅,徐彦龙.康复训练结合针灸治疗脊髓损伤神经源性膀胱患者临床疗效观察[J].中国针灸,2015,35(7):670.
[3]陆凤连.腹部八卦推拿手法对脊髓损伤便秘患者排便的影响[J].西部中医药,2014,27(6):152.
[4]吴俊哲,王伟群,曾元桂,等.中医药治疗脊髓损伤及骨质松疏的研究进展[J].中药材,2014,37(9):1699.
[5]黄彬洋,何延智,刘晓瑞,等.新型揿针联合低频电刺激治疗脊髓损伤后感觉功能障碍多中心随机平行对照研究[J].实用中医内科杂志,2015,29(9):80.
[6]王蔚文.临床疾病诊断与疗效判断标准[M].北京:人民卫生出版社,2010:1233-1235.
[7] Molliqaj G,Payer M,Schaller K,et al. Actue traumatic central cord syndrome:a comprehensive review[J]. Neurochirurgie,2014,60(1-2):5.
[8] Ur R M N, Ali B, Khan M Z, et al. Neurological recovery in traumatic spinal cord injuries after surgical intervention[J]. J Ayub Med Coll Abbottabad,2018,30(1):58.
[9]勾丽洁,许世奇,刘旭东,等.早期康复对脊髓损伤患者功能恢复及并发症的影响[J].中国老年学杂志,2014,34(2):313.
[10]刘小康,徐建广.药物治疗急性脊髓损伤的研究进展[J].中国矫形外科杂志,2012,20(12):1108.
[11]王想福,王兴盛,王国玉.脊髓损伤的药物治疗研究进展[J].中国中医骨伤科杂志,2014,22(8):76.
[12] Hachem L D, Ahuja C S, Fehlings M G. Assessment and management of acute spinal cord injury:from point of injury to rehabilitation[J]. J Spinal Cord Med,2017,40(6):665.
[13] Luo D,Chen R,Feng X L. Modulation of acupuncture on cell apoptosis and autophagy[J]. Evid Based Complement Alternat Med,2017,17:826.