药物罐联合夹脊穴深刺治疗腰椎间盘突出症疗效及对M-JOA评分、ODI指数、生活质量的影响
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摘要
目的观察药物罐联合夹脊穴深刺治疗腰椎间盘突出症(LDH)疗效及对M-JOA评分、ODI指数和生活质量的影响。方法将101例LDH患者随机分为观察组(50例)及对照组(51例),2组均首先接受常规西医基础治疗,对照组在其基础上给予药物罐治疗,观察组在对照组基础上加用夹脊穴深刺治疗,疗程均为2个月。记录2组临床疗效,观察2组治疗前后疼痛、腰背肌后伸活动度(ROM)和等长肌力(IMS)、肌电图、M-JOA腰痛评分表、ODI指数和生活质量的变化。结果观察组治疗总有效率明显高于对照组(P <0. 05)。2组治疗后疼痛视觉模拟评分(VAS)分级和平均分值均明显降低(P均<0. 05),观察组治疗后以上指标均明显低于对照组(P均<0. 05); 2组治疗后腰背肌ROM、IMS,股神经感觉传导速度(SCV)、运动传导速度(MCV),M-JOA评分,ODI指数均显著改善(P均<0. 05),动作电位潜伏期显著缩短(P均<0. 05),观察组治疗后以上指标改善情况均明显优于对照组(P均<0. 05); 2组治疗后世界卫生组织(WHO)生活质量评分量表(WHOQOL)中生理健康、心理健康、独立性、环境因素及社会关系评分均显著提高(P均<0. 05),观察组治疗后以上维度评分均明显高于对照组(P均<0. 05)。结论药物罐联合夹脊穴深刺治疗LDH疗效确定,能够显著缓解患者腰腿疼痛,提高腰背肌肌力和活动度,促进肌电图恢复,改善腰椎功能,提高生活质量。
Objective It is to observe the effect of drug cupping combined with with deep puncture on Jiaji point on lumbar disc herniation( LDH) and its effect on M-JOA score,ODI and quality of life. Methods 101 patients with LDH were randomly divided into observation group( 50 cases) and control group( 51 cases). Both groups were treated with conventional western medicine. Additionally,the control group was treated with drug cupping,the observation group was treated with drug cupping combined with deep puncture on Jiaji point. Both the courses of treatment were 2 months. The clinical efficacy of the two groups was recorded. The changes of pain,posterior lumbar muscle extension( ROM) and isometric muscle strength( IMS),electromyography,M-JOA low back pain score,ODI and quality of life were observed before and after treatment. Results The total effective rate of the observation group was higher than that of the control group( P <0. 05). The visual analogue scale( VAS) scores and mean scores of the two groups were significantly decreased after treatment,the decrease of the above indexes were lower in the observation group than those in the control group( P < 0. 05).After treatment,the ROM and IMS of posterior lumbar muscle,the sensory conduction velocity( SCV) and motor conduction velocity( MCV) of the femoral nerve,the latency of the action potential,M-JOA score and ODI index were significantly improved after treatment in both groups( P < 0. 05),the improvements of above indexes were better in the observation group than those in the control group( P < 0. 05). The scores of physical health,mental health,independence,environmental factors,and social relationship in WHOQOL were significantly increased after treatment in both groups( P < 0. 05),and the increase of the observation group was more significant than that of the control group( P < 0. 05). Conclusion Drug cupping combined with deep puncture on Jiaji point can which could significantly relieve the pain of the waist and leg,improve the muscle strength and activity of the back muscles,promote the recovery of EMG,improve the lumbar function and improve the quality of life is effective in the treatment of LDH.
Objective It is to observe the effect of drug cupping combined with with deep puncture on Jiaji point on lumbar disc herniation( LDH) and its effect on M-JOA score,ODI and quality of life. Methods 101 patients with LDH were randomly divided into observation group( 50 cases) and control group( 51 cases). Both groups were treated with conventional western medicine. Additionally,the control group was treated with drug cupping,the observation group was treated with drug cupping combined with deep puncture on Jiaji point. Both the courses of treatment were 2 months. The clinical efficacy of the two groups was recorded. The changes of pain,posterior lumbar muscle extension( ROM) and isometric muscle strength( IMS),electromyography,M-JOA low back pain score,ODI and quality of life were observed before and after treatment. Results The total effective rate of the observation group was higher than that of the control group( P <0. 05). The visual analogue scale( VAS) scores and mean scores of the two groups were significantly decreased after treatment,the decrease of the above indexes were lower in the observation group than those in the control group( P < 0. 05).After treatment,the ROM and IMS of posterior lumbar muscle,the sensory conduction velocity( SCV) and motor conduction velocity( MCV) of the femoral nerve,the latency of the action potential,M-JOA score and ODI index were significantly improved after treatment in both groups( P < 0. 05),the improvements of above indexes were better in the observation group than those in the control group( P < 0. 05). The scores of physical health,mental health,independence,environmental factors,and social relationship in WHOQOL were significantly increased after treatment in both groups( P < 0. 05),and the increase of the observation group was more significant than that of the control group( P < 0. 05). Conclusion Drug cupping combined with deep puncture on Jiaji point can which could significantly relieve the pain of the waist and leg,improve the muscle strength and activity of the back muscles,promote the recovery of EMG,improve the lumbar function and improve the quality of life is effective in the treatment of LDH.
引文
[1]姚晓红.个性化护理对腰椎间盘突出症患者生活质量及心理状态的影响[J].中国卫生标准管理,2016,7(16):205-206
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[4]胡有谷.腰椎间盘突出症[M].4版.北京:人民卫生出版社,2011:25-26
[5]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,1994:234
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[10]钱月芳,金敏娟,方昊.腰部核心肌力训练联合悬吊训练治疗腰椎间盘突出症的疗效观察[J].中华物理医学与康复杂志,2016,38(9):704-706
[11]史鹏博,李沛,张仲博,等.平乐郭氏正骨理筋手法改善腰椎间盘突出症患者腰背肌生物力学性能研究[J].上海中医药大学学报,2017,31(5):51-55
[12]黄开梅,刘兵,赵中.60例腰椎间盘突出症患者的肌电图分析[J].现代电生理学杂志,2016,23(2):84-86
[13]周谋望,岳寿伟,何成奇,等.腰椎间盘突出症的康复治疗中国专家共识[J].中国康复医学杂志,2017,32(2):129-135
[14]蔡建彬.初步探讨药罐疗法临床应用[J].临床医药文献电子杂志,2017,4(47):9296-9297
[15]卢轩,陈泽林,郭义.罐疗之药罐研究-药罐疗法临床应用探要[J].中国针灸,2011,31(1):79-81
[16]黄秋玲.平衡针与芒针刺夹脊穴治疗腰椎间盘突出症的对比研究[D].北京:北京中医药大学,2015:20-22
[17]王振国,李和.电针深刺夹脊穴治疗腰椎间盘突出症163例疗效观察及对血浆β-内啡肽的影响[J].颈腰痛杂志,2015,36(1):49-51
[18]伍永灼,郑文诺,张福顺.针刺夹脊穴结合龙氏手法治疗脊柱相关疾病临床观察[J].临床医学,2016,36(12):116-117
[19]邓玉金.针刺夹脊穴联合运动疗法为主治疗中风后偏瘫痉挛状态的效果观察[J].针灸临床杂志,2015,31(12):13-16
[20]陈荣良,杜伟斌,全仁夫,等.针刺夹脊穴及督脉穴对急性脊髓损伤神经传导通路影响的研究[J].中国中医急症,2016,25(4):619-622
[2]Sik BJ,Kang KH,Hyun PJ,et al.Postoperative Clinical Outcome and Risk Factors for Poor Outcome of Foraminal and Extraforaminal Lumbar Disc Herniation[J].J Korean Neurosurg Soc,2016,59(2):143-148
[3]Gugliotta M,Da CB,Dabis E,et al.Surgical versus conservative treatment for lumbar disc herniation:a prospective cohort study[J].BMJ Open,2016,6(12):e012938
[4]胡有谷.腰椎间盘突出症[M].4版.北京:人民卫生出版社,2011:25-26
[5]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,1994:234
[6]谭冠先.疼痛诊疗学[M].2版.北京:人民卫生出版社,2005:12-13
[7]王雪强,郑依莉,胡浩宇,等.常用腰痛功能障碍评估量表的研究进展[J].中国康复理论与实践,2017,23(6):672-676
[8]程继伟,王振林,刘伟,等.Oswestry功能障碍指数的改良及信度和效度检验[J].中国脊柱脊髓杂志,2017,27(3):235-241
[9]郝元涛,方积乾,李彩霞,等.世界卫生组织生命质量量表及其中文版[J].国外医学社会医学分册,1999,16(3):118-122
[10]钱月芳,金敏娟,方昊.腰部核心肌力训练联合悬吊训练治疗腰椎间盘突出症的疗效观察[J].中华物理医学与康复杂志,2016,38(9):704-706
[11]史鹏博,李沛,张仲博,等.平乐郭氏正骨理筋手法改善腰椎间盘突出症患者腰背肌生物力学性能研究[J].上海中医药大学学报,2017,31(5):51-55
[12]黄开梅,刘兵,赵中.60例腰椎间盘突出症患者的肌电图分析[J].现代电生理学杂志,2016,23(2):84-86
[13]周谋望,岳寿伟,何成奇,等.腰椎间盘突出症的康复治疗中国专家共识[J].中国康复医学杂志,2017,32(2):129-135
[14]蔡建彬.初步探讨药罐疗法临床应用[J].临床医药文献电子杂志,2017,4(47):9296-9297
[15]卢轩,陈泽林,郭义.罐疗之药罐研究-药罐疗法临床应用探要[J].中国针灸,2011,31(1):79-81
[16]黄秋玲.平衡针与芒针刺夹脊穴治疗腰椎间盘突出症的对比研究[D].北京:北京中医药大学,2015:20-22
[17]王振国,李和.电针深刺夹脊穴治疗腰椎间盘突出症163例疗效观察及对血浆β-内啡肽的影响[J].颈腰痛杂志,2015,36(1):49-51
[18]伍永灼,郑文诺,张福顺.针刺夹脊穴结合龙氏手法治疗脊柱相关疾病临床观察[J].临床医学,2016,36(12):116-117
[19]邓玉金.针刺夹脊穴联合运动疗法为主治疗中风后偏瘫痉挛状态的效果观察[J].针灸临床杂志,2015,31(12):13-16
[20]陈荣良,杜伟斌,全仁夫,等.针刺夹脊穴及督脉穴对急性脊髓损伤神经传导通路影响的研究[J].中国中医急症,2016,25(4):619-622