身痛逐瘀汤离子导入联合常规疗法治疗非特异性下腰痛的疗效分析与护理体会
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摘要
目的:观察在常规疗法基础上加用身痛逐瘀汤离子导入治疗非特异性下腰痛(NLBP)的疗效。方法:将80例NLBP瘀血阻络证患者随机分为对照组和观察组各40例。对照组服用布洛芬分散片,痛处涂抹双氯芬酸钠凝胶,并以牵引、微波理疗进行治疗,观察组药物使用与牵引措施同对照组,并加用身痛逐瘀汤离子导入治疗。2组均视情况进行情志、饮食、生活起居和中药离子导入等方面的常规护理,连续治疗4周。治疗前后评定2组患者的疼痛视觉模拟法(VAS)评分、腰部压痛评分、日本骨科协会(JOA)下腰痛评价表评分,治疗后进行总体感觉评价。结果:治疗后,观察组下腰痛改善情况优于对照组,差异有统计学意义(P <0.05)。2组VAS评分和腰部压痛评分均较治疗前下降(P <0.01),观察组VAS评分和腰部压痛评分均低于对照组(P <0.01)。2组JOA评价表症状、体征、ADL评分和总分均较治疗前升高(P <0.01),观察组4项分值均高于对照组(P <0.01)。观察组总体感觉优于对照组,差异有统计学意义(P <0.05)。结论:在常规疗法基础上加用身痛逐瘀汤离子导入,可有效减轻NLBP患者的疼痛,改善下腰痛症状,促进腰部功能的恢复,提高患者的生活活动能力,患者总体感觉良好。
Objective: To observe the curative effect of the additional application of iontophoresis of Shentong Zhuyu tang for nonspecific lower back pain(NLBP) based on routine therapy. Methods: Divided 80 cases of patients with NLBP with syndrome of collateral retardation due to blood stasis randomly into the control group and the observation group,40 cases in each group. The control group was given ibuprofen dispersible tablets, with diclofenac sodium gel applied to the painful spot and traction and microwave physical treatment for treatment. The drug application and traction measures given in the observation group were the same as those in the control group, and the iontophoresis of Shentong Zhuyu tang was additionally given. Depending on different circumstances, the two groups were treated with routine nursing measures such as emotion,diet,daily life and iontophoresis of Chinese medicine for 4 weeks.Assessed the visual analogue scale(VAS) scores, lumbar tenderness scores, and the lower back pain scores of Japanese orthopaedic association(JOA) evaluation table before and after treatment in two groups,and evaluated the overall sensory evaluation after treatment.Results: After treatment, the improvement of low back pain in the observation group was better than that in the control group,difference being significant(P < 0.05). The VAS scores and lumbar tenderness scores of the two groups were decreased when compared with those before treatment(P < 0.01),the VAS scores and lumbar tenderness scores of the observation group were lower than those of the control group(P < 0.01). The scores of symptoms, signs, ADL and total scores of the two groups were increased when compared with those before treatment(P < 0.01),the four scores in the observation group were higher than those in the control group(P< 0.01). The overall perception of the observation group was better than that of the control group, difference being significant(P < 0.05).Conclusion:The additional application of the iontophoresis of Shentong Zhuyu tang based on routine therapy can effectively alleviate the pain of NLBP patients, improve the symptoms of lower back pain,promote the recovery of lumbar function, and increase the living ability of patients. The overall feeling of patients is good.
Objective: To observe the curative effect of the additional application of iontophoresis of Shentong Zhuyu tang for nonspecific lower back pain(NLBP) based on routine therapy. Methods: Divided 80 cases of patients with NLBP with syndrome of collateral retardation due to blood stasis randomly into the control group and the observation group,40 cases in each group. The control group was given ibuprofen dispersible tablets, with diclofenac sodium gel applied to the painful spot and traction and microwave physical treatment for treatment. The drug application and traction measures given in the observation group were the same as those in the control group, and the iontophoresis of Shentong Zhuyu tang was additionally given. Depending on different circumstances, the two groups were treated with routine nursing measures such as emotion,diet,daily life and iontophoresis of Chinese medicine for 4 weeks.Assessed the visual analogue scale(VAS) scores, lumbar tenderness scores, and the lower back pain scores of Japanese orthopaedic association(JOA) evaluation table before and after treatment in two groups,and evaluated the overall sensory evaluation after treatment.Results: After treatment, the improvement of low back pain in the observation group was better than that in the control group,difference being significant(P < 0.05). The VAS scores and lumbar tenderness scores of the two groups were decreased when compared with those before treatment(P < 0.01),the VAS scores and lumbar tenderness scores of the observation group were lower than those of the control group(P < 0.01). The scores of symptoms, signs, ADL and total scores of the two groups were increased when compared with those before treatment(P < 0.01),the four scores in the observation group were higher than those in the control group(P< 0.01). The overall perception of the observation group was better than that of the control group, difference being significant(P < 0.05).Conclusion:The additional application of the iontophoresis of Shentong Zhuyu tang based on routine therapy can effectively alleviate the pain of NLBP patients, improve the symptoms of lower back pain,promote the recovery of lumbar function, and increase the living ability of patients. The overall feeling of patients is good.
引文
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[9]魏莉瑛,刘连幸,武蕾,等.浅谈中药离子导入疗法[J].中国中医药现代远程教育,2015,13(17):134-135.
[10]徐桂华,胡慧.中医护理学基础[M].北京:中国中医药出版社,2016:485-489.
[2]张继伟,陈东煜.非特异性下腰痛的保守治疗现状[J].中医药临床杂志,2015,27(12):1668-1670.
[3]李树祝,李冉,白岚.中药离子导入技术应用进展[J].中国疗养医学,2012,21(11):996-997.
[4]中国康复医学会脊柱脊髓专业委员会专家组.中国急/慢性非特异性腰背痛诊疗专家共识[J].中国脊柱脊髓杂志,2016,26(12):1134-1138.
[5]国家中医药管理局.ZY/T001.1~001.9-94中医病证诊断疗效标准[S].南京:南京大学出版社,1994:201.
[6]范振华,胡永善.骨科康复医学[M].上海:上海医科大学出版社,1999:219.
[7]张惠珍,王诗忠.身痛逐瘀汤治疗椎间盘退行性下腰痛的机制研究[J].湖南中医杂志,2014,30(10):122-123.
[8]陈靖,吴成举.身痛逐瘀汤镇痛作用实验研究[J].实用中医药杂志,2013,29(6):422.
[9]魏莉瑛,刘连幸,武蕾,等.浅谈中药离子导入疗法[J].中国中医药现代远程教育,2015,13(17):134-135.
[10]徐桂华,胡慧.中医护理学基础[M].北京:中国中医药出版社,2016:485-489.