黎药烫熨联合电针治疗腰椎间盘突出症的随机对照研究
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摘要
目的观察比较黎药烫熨联合电针夹脊穴和单纯电针夹脊穴治疗腰椎间盘突出症的临床疗效。方法将90例腰椎间盘突出症患者随机分为治疗组、对照组、安慰组,每组30例。对照组采用电针夹脊穴治疗,治疗组在电针基础上联合黎药复方局部烫熨,安慰组采用套迭式顿头安慰针作用于夹脊穴,均隔日1次,10次为1个疗程,每疗程间休息2 d,连续治疗3个疗程。观察比较3组患者治疗前及治疗1周、3周和疗程结束后1个月疼痛视觉模拟量表评分(VAS)、Oswestry功能障碍指数评分,并统计疗程结束后临床疗效。结果治疗1周、3周和疗程结束后1个月,治疗组和对照组患者疼痛VAS评分及Oswestry功能障碍指数评分均较治疗前明显降低(P均<0. 05),且治疗组治疗1周和疗程结束后1个月上述评分均明显低于对照组(P均<0. 05);治疗组总有效率为96. 67%,明显高于对照组的83. 33%和安慰组的13. 33%(P均<0. 05)。结论黎药联合电针夹脊穴可明显改善腰椎间盘突出症患者疼痛及临床症状,疗效明显优于单纯电针夹脊穴,且镇痛作用持久,值得临床推广应用。
Objective It is to observe the clinical efficacy of the treatment on lumbar disc herniation between the combination of ironing with medicine of Li nationality combined with electroacupuncture at Jiaji points and simple electroacupuncture at Jiaji points. Methods 90 patients with lumbar disc herniation were randomly divided into treatment group,control group and placebo group,30 cases in each group. The control group was treated with electroacupuncture at Jiaji points.The treatment group was treated with the combination of local ironing with medicine of Li nationality combined with electroacupuncture at Jiaji points. The placebo group was treated with a set of flat-headed comforting needles on the Jiaji points,all the groups were treated for once every other day,10 times as one course of treatment,rest for 2 days between treatments,and continuous treatment for 3 courses. The pain visual analog scale score( VAS) and Oswestry dysfunction index scores were compared before treatment and after treatment for 1 week,3 weeks,and in 1 month after the end of treatment. The clinical efficacy after the treatment was assessed. Results The pain VAS score and the Oswestry dysfunction index scores in the treatment group and the control group after treatment for 1 week,3 weeks,and in 1 month after the end of the treatment were significantly lower than those before treatment,and the scores in the treatment group after treatment for 1 week and in1 month after the end of the treatment were significantly lower than those in the control group at the same period( P <0. 05). The total effective rate of the treatment group was 96. 67%,which was significantly higher than that of the control group( 83. 33%) and the placebo group( 13. 3%)( P < 0. 05). Conclusion The treatment with ironing with medicine of Li nationality combined with electroacupuncture at Jiaji points can significantly improve the pain and clinical symptoms of patients with lumbar disc herniation. The curative effect is better than that of simple electroacupuncture at Jiaji points,and the analgesic effect is lasting. It is worthy of clinical application.
Objective It is to observe the clinical efficacy of the treatment on lumbar disc herniation between the combination of ironing with medicine of Li nationality combined with electroacupuncture at Jiaji points and simple electroacupuncture at Jiaji points. Methods 90 patients with lumbar disc herniation were randomly divided into treatment group,control group and placebo group,30 cases in each group. The control group was treated with electroacupuncture at Jiaji points.The treatment group was treated with the combination of local ironing with medicine of Li nationality combined with electroacupuncture at Jiaji points. The placebo group was treated with a set of flat-headed comforting needles on the Jiaji points,all the groups were treated for once every other day,10 times as one course of treatment,rest for 2 days between treatments,and continuous treatment for 3 courses. The pain visual analog scale score( VAS) and Oswestry dysfunction index scores were compared before treatment and after treatment for 1 week,3 weeks,and in 1 month after the end of treatment. The clinical efficacy after the treatment was assessed. Results The pain VAS score and the Oswestry dysfunction index scores in the treatment group and the control group after treatment for 1 week,3 weeks,and in 1 month after the end of the treatment were significantly lower than those before treatment,and the scores in the treatment group after treatment for 1 week and in1 month after the end of the treatment were significantly lower than those in the control group at the same period( P <0. 05). The total effective rate of the treatment group was 96. 67%,which was significantly higher than that of the control group( 83. 33%) and the placebo group( 13. 3%)( P < 0. 05). Conclusion The treatment with ironing with medicine of Li nationality combined with electroacupuncture at Jiaji points can significantly improve the pain and clinical symptoms of patients with lumbar disc herniation. The curative effect is better than that of simple electroacupuncture at Jiaji points,and the analgesic effect is lasting. It is worthy of clinical application.
引文
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[13]梁永瑛,郭艳明,顾钧青.电针深刺夹脊穴治疗腰椎间盘突出症临床疗效观察[J].中华中医药学刊,2012,30(6):1352-1353
[14]邹璟,黄国付,张琦,等.“夹脊”电针对兔退变腰椎间盘组织中基质金属蛋白酶13和基质金属蛋白酶组织抑制因子1表达的影响[J].针刺研究,2014,39(3):192-197
[15]赵长伟,李新建,冷向阳,等.中药外敷治疗腰椎间盘突出症的疗效分析[J].中医正骨,2010,22(12):21-22
[16]谢芳,黄锦军,廖桂华,等.中药涂擦后行烫熨疗法在腰椎间盘突出症中医综合保守治疗中应用效果观察[J].辽宁中医药大学学报,2016,18(4):151-154
[17]史万旭,安慧群,周福兴,等.腰椎间盘突出症中医证型与CR、CT影像学对照分析[J].中西医结合研究,2016,8(1):29-30
[18]印帅,吴楠,张志毅,等.基于MRI影像深刺夹脊穴对腰椎间盘突出症急性期患者临床疗效及生活质量影响研究[J].针灸临床杂志,2016,32(2):51-53
[2]陈章妹,王辉.“通脱法”针刺治疗腰椎间盘突出症90例[J].中国针灸,2016,36(1):69-70
[3]冯立来,徐艳艳.“冯氏一针”经络辨证治疗腰椎间盘突出症49例[J].中国针灸,2015,35(4):405-406
[4]冯新国,李小斌,易建良,等.腰椎间盘突出症患者温针治疗前后血清CGRP及IL-1α的变化及临床意义[J].国际检验医学杂志,2014,35(5):521-522
[5]杨鸫祥,王禹,姚啸生,等.中医熨法治疗腰椎间盘突出症Meta分析[J].辽宁中医药大学学报,2016,18(11):5-7
[6]胡有谷.腰椎间盘突出症[M].4版.北京:人民卫生出版社,2011:370
[7]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:201-202
[8]许能贵,符文彬.临床针灸学[M].北京:科学出版社,2014:187
[9]钟捷东.黎族医药[M].海口:海南出版社,2008:273-277
[10]Stubbs DF.Visual analogue scales[J].Br J Clin Pharmacol,1979,7(1):124
[11]Fairbank J.Use of Oswestry Disability Index(ODI)[J].Spine(Phila Pa 1976),1995,20(13):1535-1537
[12]谈建新,张艳艳,王世慧,等.散瘀止痛散联合针灸治疗腰椎间盘突出症疗效观察[J].四川中医,2016,34(10):78-80
[13]梁永瑛,郭艳明,顾钧青.电针深刺夹脊穴治疗腰椎间盘突出症临床疗效观察[J].中华中医药学刊,2012,30(6):1352-1353
[14]邹璟,黄国付,张琦,等.“夹脊”电针对兔退变腰椎间盘组织中基质金属蛋白酶13和基质金属蛋白酶组织抑制因子1表达的影响[J].针刺研究,2014,39(3):192-197
[15]赵长伟,李新建,冷向阳,等.中药外敷治疗腰椎间盘突出症的疗效分析[J].中医正骨,2010,22(12):21-22
[16]谢芳,黄锦军,廖桂华,等.中药涂擦后行烫熨疗法在腰椎间盘突出症中医综合保守治疗中应用效果观察[J].辽宁中医药大学学报,2016,18(4):151-154
[17]史万旭,安慧群,周福兴,等.腰椎间盘突出症中医证型与CR、CT影像学对照分析[J].中西医结合研究,2016,8(1):29-30
[18]印帅,吴楠,张志毅,等.基于MRI影像深刺夹脊穴对腰椎间盘突出症急性期患者临床疗效及生活质量影响研究[J].针灸临床杂志,2016,32(2):51-53