电针夹脊穴配合推拿手法治疗腰椎间盘突出症的临床研究

【作者】 郑文进；

【导师】 许能贵；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2011， 博士

【摘要】 1目的通过临床随机对照试验,探讨电针夹脊穴结合推拿手法治疗腰椎间盘突出症的临床疗效,为临床运用针灸推拿治疗本病提供依据。2方法将符合纳入标准的100例腰椎间盘突出症的患者随机分成治疗组和对照组各50例。治疗组患者采用电针夹脊穴结合推拿手法治疗；对照组则采取电针常规穴位配合推拿手法治疗。以简式疼痛问卷表(MPQ)、症状积分量表、生存质量表(SF-36)以及血清P物质测定为疗效评价指标,观察电针夹脊穴结合推拿手法治疗腰椎盘突出症的临床疗效,及对患者生存质量的影响。3结果本研究通过对比电针夹脊穴结合推拿手法治疗与电针常规穴位配合推拿手法治疗腰椎间盘突出的临床效果,结果提示,①经简式痛疼量表评分量表(MPQ)评定,两组治疗后(经t检验)较治疗前S、A、T、VAS、PPI均有显着改善(p<0.05)；S、A、T、VAS的改善程度治疗组较对照组明显(p<0.05),而PPI的改善两组间无显着差别(p>0.05)。②两组治疗前症状积分总记分无显著差异(p>0.05),表明两组样本来自同一总体,可以进行同步研究；两组治疗前后总分均有显著改善(p<0.05)；两组治疗后症状总积分和改善率比较均有显著差异(p<0.05),说明治疗组总体疗效明显优于对照组。③经卡方检验,两组总有效率比较无显著性差异(p>0.05),显愈率比较有显著差异(p<0.05),表明治疗组方法优于对照组。④治疗前两组患者外周血浆P物质含量比较差异无统计学意义(P>0.05)；治疗后两组P物质含量均有下降,治疗组下降较对照组明显,差异有统计学意义(P<0.05)。⑤生存质量评价,经过干预后,治疗组的GH维度校正后得分高于对照组且差异有统计学意义(P=0.008),故可认为经治疗后治疗组GH维度的生存质量比对照组好。4结论电针夹脊穴配合推拿手法治疗腰椎间盘突出症疗法是较为理想的治疗方法,本研究中治疗组临床疗效及生存质量改善均优于对照组,电针夹脊穴配合推拿手法治疗腰椎间盘突出症共同起到解除神经根压迫、消除神经根炎症、调节免疫、纠正腰椎小关节紊乱、调节椎旁肌肉张力增加脊柱稳定性,活血化瘀,改善微循环等治疗作用,具有简便实用,值得临床推广。更多还原

【Abstract】 ObjectTo discuss the clinical efficacy of lumbar disc herniation through randomized controlled clinical trial of electrical acupuncture analgesia combined with manipulation therapy and it also provides a reliable clinical evidence for the clinical application.MethodsThe 100 patients met the inclusion criteria of TCM diagnosis by lumbar disc hernia ion were randomly divided into treatment group and 50 patients in control group. The Treatment groups were treated with electric acupuncture analgesia combined with massage therapy.The control group taking regular acupuncture points with massage therapy. The short form pain questionnaire, symptom score scale, quality of life table and the serum substance P index are used to determinate the efficacy. The clinical efficacy and the quality of life for patients are observed at end.ResultsAfter the two different ways, we found that①After being assessed by MPQ form (by t test),the two groups’S, A, T, VAS, PPI were significantly improved than before (p<0.05); S, A, T, VAS were better improved in treatment Group (p<0.05), While the improvement of PPI was no significant difference between the two groups (p>0.05).②There is no significant difference in total scores (p>0.05) in the two groups before treatment,, showed that two samples can be synchronized; The two groups scores were both significantly improved than before (p<0.05);The improvement rate were significantly different between the two groups (p<0.05). The treatment group’s effect is better than the control group.③The total effective rate was no significant difference (p> 0.05) between the two groups by the The chi-square test, while the more significant differences rates were significantly (p <0.05),it shows that the method of the treatment group is better than the control group.④Before the treatment, the substance P content of peripheral blood plasma difference was not statistically significant (P>0.05);While after the treatment, the two groups’ substance P content were decreased significantly (P<0.05.) ⑤The treatment group’s GH score is significantly higher than the control group after the dimension being corrected (P=0.008). The quality of life in treatment group is better improved than in the control group.ConclusionsElectric acupuncture analgesia with massage therapy is a complete treatment for the lumbar disc protrusion. The clinical efficacy and the quality of life are both significantly improved in the treatment group. This way can relieve nerve root compression, eliminate the nerve root inflammation, correct lumbar facet joint disorders and increase spinal stability Para spinal muscle tension, blood circulation, improve the microcirculation.So it has a high practical value and is worthy of promotion.更多还原