定点旋转复位法联合雷火灸治疗腰椎间盘突出患者的临床疗效及其对患者脊柱稳定性的影响
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摘要
目的:探讨定点旋转复位法联合雷火灸治疗腰椎间盘突出患者的临床疗效及其对患者脊柱稳定性的影响。方法:选取2017年5月至2018年9月梧州市妇幼保健院收治的腰椎间盘突出患者100例作为研究对象,按照随机数字表法分为对照组和观察组,每组50例。对照组给予定点旋转复位法治疗;观察组在对照组的基础上联合雷火灸治疗,2组均治疗2周。治疗后统计2组临床疗效;比较2组治疗前后社会活动功能、脊柱稳定情况、腰痛缓解情况及直腿抬高角度。结果:治疗后观察组临床总有效率为88. 00%,显著高于对照组的72. 00%,差异有统计学意义(P <0. 05);与治疗前比较,治疗后2组患者腰椎曲度、腰椎前凸角度、腰骨倾斜角、平均椎间隙高度、日本骨科学会腰痛评分(JOA)及直腿抬高角度(ASLR)显著升高,且观察组显著高于对照组,差异有统计学意义(P <0. 05),2组Oswestry功能障碍指数(ODI)及视觉模拟评分法(VAS)评分显著降低,且观察组显著低于对照组,差异有统计学意义(P <0. 05)。结论:定点旋转复位法联合雷火灸可显著缓解腰间盘突出症患者疼痛及下腰痛症状,提高其社会活动功能、直抬腿高度及脊柱稳定性,疗效显著优于单独定点旋转复位法治疗。
Objective: To explore the clinical effects of fixed point rotation reduction combined with thunder fire moxibustion in treatment of lumbar disc herniation and its effects on spinal stability. Methods: A total of 100 patients with lumbar disc herniation admitted to Wuzhou Maternal and Child Health Hospital from May 2017 to September 2018 were selected and divided into a control group( n = 50) and an observation group( n = 50) according to random number table method. The control group received fixed point rotation reduction treatment,and the observation group received thunder fire moxibustion therapy on the basis of control group. After 2-week treatment,the clinical efficacy of the 2 groups was statistically analyzed. And the social activities function,spine stability situation,backache relief situation and angle of straight leg raising were compared before and after treatment in the 2 groups. Results: The clinical total effective rate in observation group after treatment was 88. 00%,which was significantly higher than that 72. 00% in control group( P < 0. 05). The lumbar curvature,lumbar lordosis angle,lumbar inclination angle,average intervertebral height,JOA score and ASLR angle significantly increased in the 2 groups compared with before,and the observation group was significantly higher than the control group( P < 0. 05). The ODI and VAS score after treatment significantly decreased in the 2 groups,and the observation group was significantly lower than the control group( P < 0. 05). Conclusion: Fixed point rotation reduction combined with thunder fire moxibustion can significantly alleviate the symptoms of pain and backache in patients with lumbar disc herniation,improve their social activity function,straight leg height and spinal stability. And the curative effect is significantly superior to that of single fixed point rotation reduction.
Objective: To explore the clinical effects of fixed point rotation reduction combined with thunder fire moxibustion in treatment of lumbar disc herniation and its effects on spinal stability. Methods: A total of 100 patients with lumbar disc herniation admitted to Wuzhou Maternal and Child Health Hospital from May 2017 to September 2018 were selected and divided into a control group( n = 50) and an observation group( n = 50) according to random number table method. The control group received fixed point rotation reduction treatment,and the observation group received thunder fire moxibustion therapy on the basis of control group. After 2-week treatment,the clinical efficacy of the 2 groups was statistically analyzed. And the social activities function,spine stability situation,backache relief situation and angle of straight leg raising were compared before and after treatment in the 2 groups. Results: The clinical total effective rate in observation group after treatment was 88. 00%,which was significantly higher than that 72. 00% in control group( P < 0. 05). The lumbar curvature,lumbar lordosis angle,lumbar inclination angle,average intervertebral height,JOA score and ASLR angle significantly increased in the 2 groups compared with before,and the observation group was significantly higher than the control group( P < 0. 05). The ODI and VAS score after treatment significantly decreased in the 2 groups,and the observation group was significantly lower than the control group( P < 0. 05). Conclusion: Fixed point rotation reduction combined with thunder fire moxibustion can significantly alleviate the symptoms of pain and backache in patients with lumbar disc herniation,improve their social activity function,straight leg height and spinal stability. And the curative effect is significantly superior to that of single fixed point rotation reduction.
引文
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[14]杨硕,杨孝芳,江瑜,等.隔药饼灸对腰椎间盘突出症患者腰腿痛功能及血浆P物质的影响[J].针刺研究,2014,39(6):491-495.
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[16]刘红,李永江,赵保东,等.牵引康复与针灸治疗腰椎间盘突出症疗效观察[J].陕西中医,2015,36(4):441-443.
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[18]徐翠香.透灸法治疗腰椎间盘突出症透灸效应与疗效的研究[D].郑州:河南中医学院,2014.
[19]张彦军,赵继荣,邓强,等.脊柱定点旋转复位法联合熥敷合剂治疗腰椎间盘突出症100例[J].中国中医骨伤科杂志,2014,22(8):49-51.
[20]杨英昕,张维斌,董世龙.雷火灸联合常规治疗急性椎间盘源性疼痛的疗效观察[J].人民军医,2016,59(7):697-698.
[2]尹劲,段洪,周兆文,等.K.Rod脊柱动态稳定系统治疗腰椎间盘突出症近期疗效观察[J].山东医药,2017,57(2):94-96.
[3]李新顺,李必军.针灸联合磁振热治疗腰椎间盘突出症35例疗效观察[J].贵州医药,2014,38(7):647-648.
[4]杜婷婷,丁炜.雷火灸刺激华佗夹脊穴改善强直性脊柱炎患者脊柱功能临床研究[J].中医学报,2017,32(11):2263-2265.
[5]李艳,徐兰凤,刘兰英,等.赵氏雷火灸治疗痛证疗效评价及效应机制研究[J].吉林中医药,2016,36(6):619-622.
[6]胡有谷.腰椎间盘突出症[M].北京:人民卫生出版社,1995:46-47.
[7]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:201-202.
[8]黄爱华.独活寄生汤联合温针灸治疗腰椎间盘突出症寒湿型的临床疗效[J].贵阳医学院学报,2015,40(10):1126-1128.
[9]Li X,Han Y,Cui J,et al.Efficacy of Warm Needle Moxibustion on Lumbar Disc Herniation:A Meta-Analysis[J].J Evid Based Complementary Altern Med,2016,21(4):311-319.
[10]Kamper SJ,Ostelo RW,Rubinstein SM,et al.Minimally invasive surgery for lumbar disc herniation:a systematic review and meta-analysis[J].Eur Spine J,2014,23(5):1021-1043.
[11]张卫东,李俊莲,高丽娜,等.调神、温经、通督综合疗法治疗腰椎间盘突出症31例临床观察[J].中医杂志,2015,56(8):672-675.
[12]叶壮益.手法加针灸治疗巨大型腰椎间盘突出症的疗效研究[J].医学综述,2014,20(5):942-943.
[13]张洁文,黄增彬.正气理筋液配合正骨手法治疗椎动脉型颈椎病的疗效观察[J].广东医学,2017,38(5):791-792,796.
[14]杨硕,杨孝芳,江瑜,等.隔药饼灸对腰椎间盘突出症患者腰腿痛功能及血浆P物质的影响[J].针刺研究,2014,39(6):491-495.
[15]石可松,杜中平.PLDD结合针灸治疗腰椎间盘突出症临床观察[J].颈腰痛杂志,2015,36(1):85-86.
[16]刘红,李永江,赵保东,等.牵引康复与针灸治疗腰椎间盘突出症疗效观察[J].陕西中医,2015,36(4):441-443.
[17]杨丽艳,李志峰,何佳,等.针刺配合赵氏雷火灸治疗腰椎间盘突出症的疗效观察[J].成都中医药大学学报,2015,38(2):59-61.
[18]徐翠香.透灸法治疗腰椎间盘突出症透灸效应与疗效的研究[D].郑州:河南中医学院,2014.
[19]张彦军,赵继荣,邓强,等.脊柱定点旋转复位法联合熥敷合剂治疗腰椎间盘突出症100例[J].中国中医骨伤科杂志,2014,22(8):49-51.
[20]杨英昕,张维斌,董世龙.雷火灸联合常规治疗急性椎间盘源性疼痛的疗效观察[J].人民军医,2016,59(7):697-698.