祛风止痛片辅助治疗腰椎间盘突出症疗效及对疼痛的影响
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摘要
目的:探讨祛风止痛片联合推拿治疗腰椎间盘突出症患者疗效观察及对患者疼痛影响。方法:选自医院于2015年3月—2017年3月期间收治的腰椎间盘突出症患者114例,按照随机表法分为观察组57例与对照组57例。两组均采用常规西医治疗。对照组采用推拿治疗,观察组在对照组基础上结合祛风止痛片治疗。两组疗程均为4周。比较两组治疗疗效,治疗前后腰腿功能评分、VAS评分、JOA量表评分及生活质量各量表评分。结果:观察组治疗总有效率(94.74%)高于对照组(75.44%)(P<0.05)。两组治疗后腰腿功能评分增加而VAS评分降低(观察组:t=42.009 9、19.401 4,对照组:t=27.099 0、9.338 8,P<0.05);观察组治疗后腰腿功能评分高于对照组而VAS评分低于对照组(t=18.6706、15.638 9,P<0.05)。两组治疗后主观症状、临床体征、日常生活受限度评分及总分增加(观察组:t=13.823 0、16.596 7、16.861 3、17.441 3,对照组:t=8.501 4、11.016 0、9.923 8,P<0.05);观察组治疗后主观症状、临床体征、日常生活受限度评分及总分高于对照组(t=5.916 2、7.490 7、7.606 7、7.219 6,P<0.05)。两组治疗后生活质量各量表评分增加(观察组:t=22.151 0、14.405 7、20.384 1、15.604 3、16.991 9、19.058 5、18.091 5、19.340 6,对照组:t=13.717 6、10.462 8、9.679 9、8.566 1、11.038 5、10.997 1、11.623 4、11.421 7,P<0.05);观察组治疗后生活质量各量表评分高于对照组(t=9.478 1、6.388 1、10.642 4、7.128 0、6.819 6、8.848 7、6.832 6、8.620 2,P<0.05)。结论:祛风止痛片辅助治疗腰椎间盘突出症患者疗效明显,可减轻疼痛,及改善患者生活质量,具有重要研究意义。
Objective: To observe the effect of removing wind and analgesic tablets combined with massage on the treatment of lumbar intervertebral disc herniation and its effect on patients' pain. Methods:A total of 114 cases of lumbar disc herniation were selected from our hospital in March 2015-March 2017. According to the random table method, the patients were divided into the observation group 57 casesand the control group57 cases. The two groups were treated with conventional Western medicine. The control group was treated with massage therapy. The observation group on the basis ofthe control group used removing wind and analgesic tablets. The two groups were treated for 4 weeks. The therapeutic effects of the two groups were compared. The scores of lower back function, VAS score, JOA scale score and quality of life scale were measured before and after treatment. Results:The total effective rate of the observation group(94.74%) was higher than that of the control group(75.44%)(P<0.05). The two groups' function score increases and VAS score after treatment were lower(observation group: t=42.009 9, 19.401 4;control group: t=27.099 0, 9.338 8, P<0.05). The observation group's functional scores after treatment were higher than that of the control group and the VAS score was lower than that of the control group(t=18.670 6, 15.638 9, P<0.05). Subjective symptoms, clinical signs, daily life limitation and the total score increased after treatment in two groups(observation group: t=13.823 0, 16.596 7, 16.861 3, 17.441 3;control group: t=8.501 4, 11.016 0, 9.923 8, P<0.05).The observation group's subjective symptoms, clinical signs, daily life limitation and the total score after treatment were higher than those of the control group(t=5.916 2, 7.490 7, 7.606 7, 7.219 6, P<0.05). The two groups' quality of life score after treatmentincreased(observation group: t=22.151 0, 14.405 7, 20.384 1, 15.604 3, 16.991 9, 19.058 5, 18.091 5, 19.340 6;control group: t=13.717 6, 10.462 8, 9.679 9, 8.566 1, 11.038 5, 10.997 1, 11.623 4, 11.421 7, P<0.05). The observation group's quality of life score after treatment was higher than that of the control group(t=9.478 1, 6.388 1, 10.642 4, 7.128 0, 6.819 6, 8.848 7, 6.832 6, 8.620 2, P<0.05). Conclusion:The treatment of lumbar intervertebral disc herniation is effective in the treatment of lumbar intervertebral disc herniationand it can reduce the pain and improve the quality of life of the patients.
Objective: To observe the effect of removing wind and analgesic tablets combined with massage on the treatment of lumbar intervertebral disc herniation and its effect on patients' pain. Methods:A total of 114 cases of lumbar disc herniation were selected from our hospital in March 2015-March 2017. According to the random table method, the patients were divided into the observation group 57 casesand the control group57 cases. The two groups were treated with conventional Western medicine. The control group was treated with massage therapy. The observation group on the basis ofthe control group used removing wind and analgesic tablets. The two groups were treated for 4 weeks. The therapeutic effects of the two groups were compared. The scores of lower back function, VAS score, JOA scale score and quality of life scale were measured before and after treatment. Results:The total effective rate of the observation group(94.74%) was higher than that of the control group(75.44%)(P<0.05). The two groups' function score increases and VAS score after treatment were lower(observation group: t=42.009 9, 19.401 4;control group: t=27.099 0, 9.338 8, P<0.05). The observation group's functional scores after treatment were higher than that of the control group and the VAS score was lower than that of the control group(t=18.670 6, 15.638 9, P<0.05). Subjective symptoms, clinical signs, daily life limitation and the total score increased after treatment in two groups(observation group: t=13.823 0, 16.596 7, 16.861 3, 17.441 3;control group: t=8.501 4, 11.016 0, 9.923 8, P<0.05).The observation group's subjective symptoms, clinical signs, daily life limitation and the total score after treatment were higher than those of the control group(t=5.916 2, 7.490 7, 7.606 7, 7.219 6, P<0.05). The two groups' quality of life score after treatmentincreased(observation group: t=22.151 0, 14.405 7, 20.384 1, 15.604 3, 16.991 9, 19.058 5, 18.091 5, 19.340 6;control group: t=13.717 6, 10.462 8, 9.679 9, 8.566 1, 11.038 5, 10.997 1, 11.623 4, 11.421 7, P<0.05). The observation group's quality of life score after treatment was higher than that of the control group(t=9.478 1, 6.388 1, 10.642 4, 7.128 0, 6.819 6, 8.848 7, 6.832 6, 8.620 2, P<0.05). Conclusion:The treatment of lumbar intervertebral disc herniation is effective in the treatment of lumbar intervertebral disc herniationand it can reduce the pain and improve the quality of life of the patients.
引文
[1] Atlas SJ. Point of View: Avoiding Opioids in Patients With Work-related Lumbar Disc Herniation[J]. Spine, 2018, 43(8):603-604.
[2] Yang SD, Chen Q, Ding WY. Cauda Equina Syndrome Due to Vigorous Back Massage With Spinal Manipulation in a Patient With Pre-Existing Lumbar Disc Herniation: A Case Report and Literature Review[J]. Am J Phys Med Rehabil, 2018, 97(4):23-26.
[3] 谢峰, 边俊, 王智伟,等. 成人腰椎间盘突出症与腰椎管狭窄症患者脊柱骨盆矢状面差异[J]. 中国骨伤, 2018, 31(1):43-46.
[4] Lee SH, Yun SJ, Jo HH, et al. Diagnostic accuracy of low-dose versus ultra-low-dose CT for lumbar disc disease and facet joint osteoarthritis in patients with low back pain with MRI correlation[J]. Skeletal Radiol, 2018, 47(4):491-504.
[5] 张建洛, 杨宏涛, 冯宏伟,等. 身痛逐瘀汤联合西医治疗腰椎间盘突出症半椎板切除减压术后下肢疼痛及麻木残余症状疗效观察[J]. 现代中西医结合杂志, 2018, 13(4):415-418.
[6] 何晓, 周茹建. 腹部推拿联合中药治疗腰椎间盘突出症(寒湿痹阻证)的临床观察[J]. 中国中医急症, 2018, 14(1):137-139.
[7] 倪春林, 陆爱清, 施建东,等. 不同治疗周期骶管滴注联合四步松解手法治疗腰椎间盘突出症的临床效果分析[J]. 中国中医急症, 2018, 14(1):57-59.
[8] 鲁玉来, 蔡钦林. 腰椎间盘突出症[M]. 2版. 北京:人民军医出版社, 2008:182.
[9] 郑莜萸. 中药新药临床研究指导原则(试行)[S]. 北京:中国医药科技出版社, 2002:338-356.
[10] Munarriz PM, Paredes I, Alen JF, et al. Assessment of the correlation between histological degeneration and radiological and clinical parameters in a series of patients who underwent lumbar disc herniation surgery[J]. Neurocirugia, 2018, 4(2):79-85.
[11] Daly CD, Ghosh P, Zannettino ACW, et al. Mesenchymal progenitor cells primed with pentosan polysulfate promote lumbar intervertebral disc regeneration in an ovine model of microdiscectomy[J]. Spine J, 2018, 18(3):491-506.
[12] 徐奎, 覃正仕, 赵权. 腰椎间盘突出症微创治疗研究进展[J]. 现代中西医结合杂志, 2016, 25(1):109-112.
[13] Tao S, Jin L, Hou Z, et al. A New radiographic feature of lower lumbar disc herniation in young patients[J]. Int Orthop, 2018, 42(3):583-586.
[14] 张之栋, 杜怡斌, 储建军. 经皮椎间孔镜腰椎间盘摘除术与微创经椎间孔腰椎融合术治疗腰椎间盘突出症的前瞻性随机对照研究[J]. 中国微创外科杂志, 2015, 14(7):583-587.
[15] 刘世伟, 王翔奕. 椎间孔镜手术与传统开窗手术治疗腰椎间盘突出症的术后疼痛介质、炎性因子比较[J]. 海南医学院学报, 2017, 23(3):383-386.
[16] 赵犹太, 朱先龙, 李伟. 中医骨伤手法结合独活寄生汤加减治疗腰椎间盘突出症疗效观察[J]. 医学理论与实践, 2017, 26(10):57-59.
[17] 戚艳, 崔荣荣. 中西医结合保守治疗腰椎间盘突出症临床观察[J]. 湖北中医药大学学报, 2017, 19(1):84-87.
[18] 陈子前, 马太平, 刁虹. 中西医结合治疗腰椎间盘突出症患者的临床疗效观察及对血清炎性因子的影响[J]. 世界中医药, 2017, 12(2):299-302.
[19] 熊春龙, 李永清, 刘晓英. 中医推拿治疗腰椎间盘突出症的临床可行性[J]. 黑龙江医药科学, 2016, 39(4):128-129.
[20] 李中锋, 邓强, 张彦军,等. 中药熏蒸联合推拿治疗腰椎间盘突出症的临床效果[J]. 现代生物医学进展, 2015, 15(36):7067-7069.
[2] Yang SD, Chen Q, Ding WY. Cauda Equina Syndrome Due to Vigorous Back Massage With Spinal Manipulation in a Patient With Pre-Existing Lumbar Disc Herniation: A Case Report and Literature Review[J]. Am J Phys Med Rehabil, 2018, 97(4):23-26.
[3] 谢峰, 边俊, 王智伟,等. 成人腰椎间盘突出症与腰椎管狭窄症患者脊柱骨盆矢状面差异[J]. 中国骨伤, 2018, 31(1):43-46.
[4] Lee SH, Yun SJ, Jo HH, et al. Diagnostic accuracy of low-dose versus ultra-low-dose CT for lumbar disc disease and facet joint osteoarthritis in patients with low back pain with MRI correlation[J]. Skeletal Radiol, 2018, 47(4):491-504.
[5] 张建洛, 杨宏涛, 冯宏伟,等. 身痛逐瘀汤联合西医治疗腰椎间盘突出症半椎板切除减压术后下肢疼痛及麻木残余症状疗效观察[J]. 现代中西医结合杂志, 2018, 13(4):415-418.
[6] 何晓, 周茹建. 腹部推拿联合中药治疗腰椎间盘突出症(寒湿痹阻证)的临床观察[J]. 中国中医急症, 2018, 14(1):137-139.
[7] 倪春林, 陆爱清, 施建东,等. 不同治疗周期骶管滴注联合四步松解手法治疗腰椎间盘突出症的临床效果分析[J]. 中国中医急症, 2018, 14(1):57-59.
[8] 鲁玉来, 蔡钦林. 腰椎间盘突出症[M]. 2版. 北京:人民军医出版社, 2008:182.
[9] 郑莜萸. 中药新药临床研究指导原则(试行)[S]. 北京:中国医药科技出版社, 2002:338-356.
[10] Munarriz PM, Paredes I, Alen JF, et al. Assessment of the correlation between histological degeneration and radiological and clinical parameters in a series of patients who underwent lumbar disc herniation surgery[J]. Neurocirugia, 2018, 4(2):79-85.
[11] Daly CD, Ghosh P, Zannettino ACW, et al. Mesenchymal progenitor cells primed with pentosan polysulfate promote lumbar intervertebral disc regeneration in an ovine model of microdiscectomy[J]. Spine J, 2018, 18(3):491-506.
[12] 徐奎, 覃正仕, 赵权. 腰椎间盘突出症微创治疗研究进展[J]. 现代中西医结合杂志, 2016, 25(1):109-112.
[13] Tao S, Jin L, Hou Z, et al. A New radiographic feature of lower lumbar disc herniation in young patients[J]. Int Orthop, 2018, 42(3):583-586.
[14] 张之栋, 杜怡斌, 储建军. 经皮椎间孔镜腰椎间盘摘除术与微创经椎间孔腰椎融合术治疗腰椎间盘突出症的前瞻性随机对照研究[J]. 中国微创外科杂志, 2015, 14(7):583-587.
[15] 刘世伟, 王翔奕. 椎间孔镜手术与传统开窗手术治疗腰椎间盘突出症的术后疼痛介质、炎性因子比较[J]. 海南医学院学报, 2017, 23(3):383-386.
[16] 赵犹太, 朱先龙, 李伟. 中医骨伤手法结合独活寄生汤加减治疗腰椎间盘突出症疗效观察[J]. 医学理论与实践, 2017, 26(10):57-59.
[17] 戚艳, 崔荣荣. 中西医结合保守治疗腰椎间盘突出症临床观察[J]. 湖北中医药大学学报, 2017, 19(1):84-87.
[18] 陈子前, 马太平, 刁虹. 中西医结合治疗腰椎间盘突出症患者的临床疗效观察及对血清炎性因子的影响[J]. 世界中医药, 2017, 12(2):299-302.
[19] 熊春龙, 李永清, 刘晓英. 中医推拿治疗腰椎间盘突出症的临床可行性[J]. 黑龙江医药科学, 2016, 39(4):128-129.
[20] 李中锋, 邓强, 张彦军,等. 中药熏蒸联合推拿治疗腰椎间盘突出症的临床效果[J]. 现代生物医学进展, 2015, 15(36):7067-7069.