恢刺夹脊穴结合SET训练治疗腰椎间盘突出症的临床观察
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摘要
目的:通过观察和评价恢刺夹脊穴结合SET训练对腰椎间盘突出症的治疗效果,并与常规针刺治疗进行比较,寻求一种将现代康复理念与中医特色理论有机结合形成治疗腰椎间盘突出症的特色中医康复技术。方法:选取2016年5月至2018年5月湖南中医药大学附一院收治的腰椎间盘突出症患者60例作为研究对象,按照随机数字表法随机分为观察组和对照组,每组30例。观察组运用恢刺夹脊穴结合SET训练进行治疗1次/d,6次/周,连续治疗2周,对照组运用常规针刺进行治疗,30 min/次,1次/d,6次/周,连续治疗2周。采用VAS疼痛评分、腰痛症状积分表、表面肌电图对治疗前后的情况进行比较。结果:1) 2组VAS计分、腰痛症状积分治疗前与治疗后比较,均不同程度降低(P <0. 05,P <0. 01),且观察组优于对照组; 2) 2组治疗前后表面肌电在A、B、C、D电极RMS值比较,差异均无统计学意义(p> 0. 05),2组治疗前后自身比较表面肌电在E、F电极RMS值均有升高(P <0. 01),且观察组优于对照组(P <0. 01); 3)整体临床疗效比较:观察组优于对照组(P <0. 01)。结论:恢刺夹脊穴结合SET训练能明显减轻腰突症患者疼痛及症状积分,提高临床疗效。激活并强化腰腹部核心肌群肌力,加强脊柱稳定性。
Objective: To observe and evaluate the therapeutic effects of lateral needling Jiaji( EX-B 2) combined with SET training on lumbar intervertebral disc herniation,and to compare it with the effects of conventional acupuncture treatment,so as to seek a characteristic Chinese medicine rehabilitation technology for lumbar intervertebral disc herniation,which combines modern rehabilitation concept technology with traditional Chinese medicine characteristic theory and technology. Methods: A total of 60 patients with lumbar intervertebral disc herniation were included from the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from May 2016 to May 2018,and randomly divided into the observation group and the control group,with 30 cases in each group. The observation group was treated once a day,6 times a week,for 2 weeks with lateral needling Jiaji( EX-B 2) combined with SET training. The control group was treated with routine acupuncture for 30 minutes,once a day,6 times a week,for 2 weeks. VAS pain score,low back pain symptom score table and surface electromyography( SEMG) were used to compare the situation before and after treatment. Results: 1) The VAS score,low back pain symptom score of the 2 groups were lower than before( P < 0. 05,P < 0. 01),and the observation group was better than that in the control group. 2) There was no statistically significant difference in RMS value of A,B,C and D electrodes in SEMG between the 2 groups before and after treatment( P > 0. 05). The RMS value of E and F electrodes in SEMG of the 2 groups was higher than before( P < 0. 01),and the value in the observation group was better than that in the control group( P < 0. 01). 3) Comparison of the overall clinical efficacy: the treatment group was better than the control group( P < 0. 01). Conclusion: Lateral needling Jiaji( EX-B 2) combined with SET training can significantly reduce the pain and symptom scores of patients with lumbar protrusion,improve the clinical efficacy,activate and strengthen the muscle strength of the lumbar and abdominal core muscles and enhance the stability of the spine.
Objective: To observe and evaluate the therapeutic effects of lateral needling Jiaji( EX-B 2) combined with SET training on lumbar intervertebral disc herniation,and to compare it with the effects of conventional acupuncture treatment,so as to seek a characteristic Chinese medicine rehabilitation technology for lumbar intervertebral disc herniation,which combines modern rehabilitation concept technology with traditional Chinese medicine characteristic theory and technology. Methods: A total of 60 patients with lumbar intervertebral disc herniation were included from the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from May 2016 to May 2018,and randomly divided into the observation group and the control group,with 30 cases in each group. The observation group was treated once a day,6 times a week,for 2 weeks with lateral needling Jiaji( EX-B 2) combined with SET training. The control group was treated with routine acupuncture for 30 minutes,once a day,6 times a week,for 2 weeks. VAS pain score,low back pain symptom score table and surface electromyography( SEMG) were used to compare the situation before and after treatment. Results: 1) The VAS score,low back pain symptom score of the 2 groups were lower than before( P < 0. 05,P < 0. 01),and the observation group was better than that in the control group. 2) There was no statistically significant difference in RMS value of A,B,C and D electrodes in SEMG between the 2 groups before and after treatment( P > 0. 05). The RMS value of E and F electrodes in SEMG of the 2 groups was higher than before( P < 0. 01),and the value in the observation group was better than that in the control group( P < 0. 01). 3) Comparison of the overall clinical efficacy: the treatment group was better than the control group( P < 0. 01). Conclusion: Lateral needling Jiaji( EX-B 2) combined with SET training can significantly reduce the pain and symptom scores of patients with lumbar protrusion,improve the clinical efficacy,activate and strengthen the muscle strength of the lumbar and abdominal core muscles and enhance the stability of the spine.
引文
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[2]郑灿磊,焦杨,郑桂芝.徐疾补泻手法针刺腰夹脊穴治疗腰椎间盘突出症的临床研究[J].针刺研究,2017,40(3):242-246.
[3]林定坤,郭玉海,杨伟铭.规范化手法治疗腰椎间盘突出症的临床疗效[J].中国医药,2013,8(7):984-985.
[4]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.
[5]孙敬龙,李丽.悬吊运动训练治疗腰椎间盘突出症的疗效观察[J].中国康复医学杂志,2014,29(4):374-376.
[6]李丽,冯梓芸,孙敬龙.悬吊循经弹拨法治疗腰椎间盘突出症临床观察[J].康复学报,2015,25(4):10-13.
[7]李祖虹,刘琦,章志超.悬吊运动疗法治疗腰椎间盘突出症患者的疗效观察[J].中华物理医学与康复杂志,2013,35(5):393-395.
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[13]曾朝辉,全韩,赵金亮,等.湖南省株洲市腰椎间盘突出症流行病学调查报告[J].湖南中医杂志,2015,31(12):141-143.
[14]周升新,王英振.肥胖与腰椎间盘突出症术后腰腿痛的相关性研究[J].颈腰痛杂志,2018,39(1):41-43.
[15]欧正龙,曾祥永.中医针灸推拿加牵引治疗老年血瘀型腰椎间盘突出症的临床疗效观察[J].世界中医药,2017,12(7):1652-1655.
[16]袁志刚,符文彬.符文彬教授三步阶梯疗法治疗肩周炎经验介绍[J].新中医,2012,44(2):144-145.
[17]陈朝明,张彩荣.粗银针恢剌治疗脊柱过敏症临床研究[J].河南中医学院学报,2008,23(3):27-28.
[18]Lee CW,Hwangbo K,Lee IS.The effects of combination patterns of proprioceptive neuromuscular facilitation and ball exercise on pain and muscle activity of chronic low back pain patients[J].J Phys T-her Sci,2014,26(1):93-96.
[19]钱月芳,金敏娟,方昊,等.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.
[20]Cormie P,Deane RS,Triplett NT,et al.Acute effects of whole-body vibration on muscle activity,strength,and power[J].Journal of Strength and Conditioning Research,2006,20(2):257-261.
[21]Moezy A,Olyaei G,Hadian M,et al.A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction[J].British Journal of Sports Medicine,2008,42(5):373-378.
[2]郑灿磊,焦杨,郑桂芝.徐疾补泻手法针刺腰夹脊穴治疗腰椎间盘突出症的临床研究[J].针刺研究,2017,40(3):242-246.
[3]林定坤,郭玉海,杨伟铭.规范化手法治疗腰椎间盘突出症的临床疗效[J].中国医药,2013,8(7):984-985.
[4]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.
[5]孙敬龙,李丽.悬吊运动训练治疗腰椎间盘突出症的疗效观察[J].中国康复医学杂志,2014,29(4):374-376.
[6]李丽,冯梓芸,孙敬龙.悬吊循经弹拨法治疗腰椎间盘突出症临床观察[J].康复学报,2015,25(4):10-13.
[7]李祖虹,刘琦,章志超.悬吊运动疗法治疗腰椎间盘突出症患者的疗效观察[J].中华物理医学与康复杂志,2013,35(5):393-395.
[8]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,1995:201-202.
[9]王启才.针灸治疗学[M].7版.北京:中国中医药出版社,2003:60.
[10]徐卫东,刘乡,朱兵,等.电针对三叉神经脊束尾侧核会聚神经元镇痛作用的穴位特异性和广泛性[J].针刺研究,1995,20(1):24-30.
[11]Faerbank jc l,et al,Arthroscopic microdiscectomy and selective fragmcntcctomy[J].Clin Orthop,1998,34(7):150-167.
[12]国家食品药品监督管理局.中药新药临床研究指导原则(试行)[S].1版.北京:中国医药科技出版社,2002:30.
[13]曾朝辉,全韩,赵金亮,等.湖南省株洲市腰椎间盘突出症流行病学调查报告[J].湖南中医杂志,2015,31(12):141-143.
[14]周升新,王英振.肥胖与腰椎间盘突出症术后腰腿痛的相关性研究[J].颈腰痛杂志,2018,39(1):41-43.
[15]欧正龙,曾祥永.中医针灸推拿加牵引治疗老年血瘀型腰椎间盘突出症的临床疗效观察[J].世界中医药,2017,12(7):1652-1655.
[16]袁志刚,符文彬.符文彬教授三步阶梯疗法治疗肩周炎经验介绍[J].新中医,2012,44(2):144-145.
[17]陈朝明,张彩荣.粗银针恢剌治疗脊柱过敏症临床研究[J].河南中医学院学报,2008,23(3):27-28.
[18]Lee CW,Hwangbo K,Lee IS.The effects of combination patterns of proprioceptive neuromuscular facilitation and ball exercise on pain and muscle activity of chronic low back pain patients[J].J Phys T-her Sci,2014,26(1):93-96.
[19]钱月芳,金敏娟,方昊,等.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.
[20]Cormie P,Deane RS,Triplett NT,et al.Acute effects of whole-body vibration on muscle activity,strength,and power[J].Journal of Strength and Conditioning Research,2006,20(2):257-261.
[21]Moezy A,Olyaei G,Hadian M,et al.A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction[J].British Journal of Sports Medicine,2008,42(5):373-378.