小针刀松解神经根外口对臀上皮神经损伤治疗的研究
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摘要
目的探究小针刀松解神经根外口对臀上皮神经损伤的临床疗效。方法选择2016年5月-2018年5月在新疆医科大学第一附属医院针灸推拿科收治的臀上皮神经损伤患者60例为研究对象,按就诊先后顺序随机分为对照组(30例)和治疗组(30例)。对照组患者选取三焦俞、肾俞、气海俞、环跳、秩边、居髎、承扶、委中、风市及阿是穴电针治疗后行推拿治疗,2项治疗每天1次,连续5 d为1个疗程。治疗组患者采用针刀治疗,定点:腰1-腰3患侧神经根外口体表投映点及腰1-腰4棘突间隙6个点为进针刀点。治疗组1次为1个疗程。以上2组患者治疗1个疗程后,比较两组患者治疗前后VAS评分和疗效。结果与治疗前2组患者VAS评分比较,2组患者治疗后VAS评分均降低,差异有统计学意义(P<0.05)。与对照组患者治疗后VAS评分(3.89±1.52)分比较,治疗组患者治疗后VAS评分(1.47±1.06)分降低,差异有统计学意义(P<0.05)。2组患者治疗后,治疗组患者总有效率(83.33%)高于对照组患者总有效率(56.67%),差异有统计学意义(P<0.05)。结论小针刀松解神经根外口对臀上皮神经损伤具有良好的治疗效果。
Objective To explore the clinical effect of small needle knife release of the external orifice of nerve root on gluteal epithelial nerve injury. Methods 60 patients with gluteal epithelial nerve injury admitted to the department of Acupuncture, Massage and Moxibustion of the First Affiliated Hospital of Xinjiang Medical University from May 2016 to May 2018 were randomly divided into control group(30 cases) and treatment group(30 cases). The patients in the control group were treated with massage once a day for 5 consecutive days after electro-acupuncture at Sanjiao Yu, Shenshu, Qihai Yu, Huanjuan, Ranbian, Juqiao, Chengfu, Weizhong, Fengshi and Ashi points. The patients in the treatment group were treated with needle-knife therapy. The needle-knife points were the projection points of the external orifice of the nerve root on the affected side of L1-L3 and the 6 points of the space between L1-L4 spinous processes. The treatment group was treated once as a course of treatment. After one course of treatment, VAS scores and curative effects of the two groups were compared before and after treatment. Results Compared with the VAS scores of the two groups before treatment, the VAS scores of the two groups after treatment were lower significantly(P<0.05). Compared with the VAS score of the control group(3.89±1.52) after treatment, the VAS score of the treatment group(1.47±1.06) after treatment was decreased significantly(P<0.05). After treatment, the total effective rate in the treatment group(83.33%) was higher than that in the control group(56.67%) significantly(P<0.05). Conclusion The small needle knife has a good therapeutic effect on gluteal epithelial nerve injury by releasing the external orifice of nerve root.
Objective To explore the clinical effect of small needle knife release of the external orifice of nerve root on gluteal epithelial nerve injury. Methods 60 patients with gluteal epithelial nerve injury admitted to the department of Acupuncture, Massage and Moxibustion of the First Affiliated Hospital of Xinjiang Medical University from May 2016 to May 2018 were randomly divided into control group(30 cases) and treatment group(30 cases). The patients in the control group were treated with massage once a day for 5 consecutive days after electro-acupuncture at Sanjiao Yu, Shenshu, Qihai Yu, Huanjuan, Ranbian, Juqiao, Chengfu, Weizhong, Fengshi and Ashi points. The patients in the treatment group were treated with needle-knife therapy. The needle-knife points were the projection points of the external orifice of the nerve root on the affected side of L1-L3 and the 6 points of the space between L1-L4 spinous processes. The treatment group was treated once as a course of treatment. After one course of treatment, VAS scores and curative effects of the two groups were compared before and after treatment. Results Compared with the VAS scores of the two groups before treatment, the VAS scores of the two groups after treatment were lower significantly(P<0.05). Compared with the VAS score of the control group(3.89±1.52) after treatment, the VAS score of the treatment group(1.47±1.06) after treatment was decreased significantly(P<0.05). After treatment, the total effective rate in the treatment group(83.33%) was higher than that in the control group(56.67%) significantly(P<0.05). Conclusion The small needle knife has a good therapeutic effect on gluteal epithelial nerve injury by releasing the external orifice of nerve root.
引文
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[9] STRONG E K,DAVILA J C.The cluneal nerve syndrome:a distinct type of lower back pain[J]. Indian Med Sury,1957,26:417-419.
[10] 奚向东.改良扬刺法加蜻蜓点水术治疗臀上皮神经炎59例[J].中国针灸,2013,33(8):730-731.
[11] 吴绪平.针刀医学[M].北京:中国中医药出版社,2008:66.
[12] 朱汉章.小针刀疗法[M].北京:中国中医药出版社,2012:84.
[13] 王羽丰,邓忠明,陈博来.铍针结合蜡疗治疗颈肩部皮神经卡压综合征的临床研究[J].新中医,2009,41(11):48-50.
[14] 唐军,粟汝峰.电针配合穴位注射治疗臀上皮神经卡压综合征疗效观察[J].上海针灸杂志,2013,32(1):17-18.
[2] 梁木荣.苍龟探穴法治疗督上皮神经卡压综合征的临床研究[D].广州:广州中医药大学,2013.
[3] 王小珲,刘方铭.小针刀治疗腰椎间盘突出症的临床观察[D].济南:山东中医药大学,2012.
[4] 张甲升,奚剑辉.臀上皮神经卡压综合征的临床治疗评价[J].中外医疗,2014,6(98):48-49.
[5] 董福慧,郭振芳,张春美,等.皮神经卡压综合征[M].北京:科学技术出版社,2002:133-135.
[6] 袁周萍.针刀松解治疗臀上皮神经卡压综合征的临床研究[D].济南:山东中医药大学,2014.
[7] 国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,1994:214-215.
[8] 冯天有.中西医结合治疗软组织损伤的临床研[M].北京:中国科学技术出版社, 2002:160-173.
[9] STRONG E K,DAVILA J C.The cluneal nerve syndrome:a distinct type of lower back pain[J]. Indian Med Sury,1957,26:417-419.
[10] 奚向东.改良扬刺法加蜻蜓点水术治疗臀上皮神经炎59例[J].中国针灸,2013,33(8):730-731.
[11] 吴绪平.针刀医学[M].北京:中国中医药出版社,2008:66.
[12] 朱汉章.小针刀疗法[M].北京:中国中医药出版社,2012:84.
[13] 王羽丰,邓忠明,陈博来.铍针结合蜡疗治疗颈肩部皮神经卡压综合征的临床研究[J].新中医,2009,41(11):48-50.
[14] 唐军,粟汝峰.电针配合穴位注射治疗臀上皮神经卡压综合征疗效观察[J].上海针灸杂志,2013,32(1):17-18.