【作者】 赵桂英；

【导师】 庄礼兴；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2014， 博士

【摘要】 目的：本研究采用临床前瞻性随机对照研究方法,综合比较头针运动疗法结合电针治疗腰椎间盘突出症与单用电针治疗该病的疗效差异,为腰椎间盘突出症的优化治疗方案提供科学证据。方法：本研究目标人群来自2013.07-2014.03在台湾温崇凯中医诊所就诊的患者,选出符合纳入标准的腰椎间盘突出症患者共60例,按照1：1的比例随机分为两组——试验组、对照组,每组各30例。试验组予以头针运动疗法结合电针治疗,对照组仅仅予以电针治疗,电针操作、疗程均同试验组。两组患者均为每周治疗3次,定于每周一、三、五治疗,周六、日休息,1周为1个疗程,共治疗2个疗程。1个疗程结束后和2个疗程结束后,均从视觉模拟评分(VAS评分表)、Oswestry功能障碍指数评分、JOA腰痛评分三方面对两组患者进行治疗前、治疗后组内和组间评分比较,客观评价疗效差异。结果：1.治疗前两组一般资料和各项指标基线比较,差异无统计学意义(P>0.05),组间具有可比性。2.VAS评分比较：第一个疗程后与治疗前两组组内比较,VAS评分均降低,且差异具有统计学意义(P<0.05),第一个疗程后两组组间比较,试验组VAS评分低于对照组,差异具有统计学意义(P<0.05)；第二个疗程后与治疗前两组组内比较,VAS评分均降低,且差异具有统计学意义(P<0.05),第二个疗程后两组组间比较,试验组VAS评分低于对照组,差异具有统计学意义(P<0.05)。3.JOA腰痛评分比较:第一个疗程后与治疗前两组组内比较,JOA评分均升高,且差异具有统计学意义(P<0.05),第一个疗程后两组组间比较,JOA评分差异不具有统计学意义(P>0.05)；第二个疗程后与治疗前两组组内比较,JOA评分均升高,且差异具有统计学意义(P<0.05),第二个疗程后两组组间比较,试验组JOA评分高于对照组,差异具有统计学意义(P<0.05)。4. Oswestry功能障碍指数评分比较：第一个疗程后与治疗前两组组内比较,Oswestry评分均降低,且差异具有统计学意义(P<0.05),第一个疗程后两组组间比较,Oswestry评分差异不具有统计学意义(P>0.05)；第二个疗程后与治疗前两组组内比较,Oswestry评分均降低,且差异具有统计学意义(P<0.05),第二个疗程后两组组间比较,试验组Oswestry评分低于对照组,差异具有统计学意义(P<0.05)。5.总体疗效比较：试验组总有效率93.33%,对照组总有效率86.67%,试验组优于对照组(P<0.05)。结论：1.头针运动疗法结合电针以及单纯电针治疗腰椎间盘突出症均有效,能改善患者疼痛、整体症状、体征以及改善肢体功能。2.短期内,头针运动疗法结合电针较单纯电针对疼痛的改善效果更好,对整体症状、体征以及肢体功能的改善效果两种疗法没有差异。3.治疗结束后,头针运动疗法结合电针疗法对疼痛、整体症状、体征及肢体功能的改善均优于单用电针治疗。4.头针运动疗法结合电针治疗总体疗效优于单用电针治疗。更多还原

【Abstract】 Object i veEvaluate objectively the clincical efficacy on lumbar disc herniation (LDH) patients Treated with Scalp acupuncture movement therapy Combined with electroacupuncture by RCT. Compare the therapy of Scalp acupuncture movement with electroacupuncture treatment group with only electroacupuncture control group at the clinical efficacy, so as to comfirm its effectiveness of treating the LDH patients.MethodsThe target population come from the patients who treated at the oriental medicine clinic in WenTsungKai of Taiwai from2013.07to2014.03. According to randomized controlled way of study,60patients with LDH who met the standards of disease diagnosis were divided into two groups averagely:The Scalp acupuncture movement with electroacupuncture was research group while the only electroacupuncture was control group. The same points and the same method of operation were selected in the acupuncture part. The both groups were treated three times each week, which scheduled to treat at Monday、 Wednesday and Friday, rest at Saturday and Sunday, and two weeks for the total treatment duration. After the first treatment duration and the second, separately observe the treatment effects of changes between the two groups of patients from the standard for scoring the score of VAS, the score of JOA as well as the score of Oswestry.Results1.There were no statistically significant differences in the general information and pre-treatment evaluation parameters of the patients (P>0.05),which showed the two groups had comparability. 2. Comparison of the VAS score:After the first treatment, compare the comparison of the two groups and comparison between the two groups, the score of VAS was decreased in both groups, and there was significant difference between the two groups (P<0.05). After the second treatment, compare the Comparison of the two groups and comparison between the two groups, the score of VAS was decreased in both groups, and there was significant difference between the two groups (P<0.05).3.Comparison of JOA score:After the first treatment,compare the comparison of the two groups, the score of JOA was increased in both groups, and there was significant difference between the two groups (P<0.05), and compare the comparison between the two groups, there was no significant difference between the two groups (P>0.05). After the second treatment, compare the comparison of the two groups and comparison between the two groups, the score of JOA was increased in both groups, and there was significant difference between the two groups (P<0.05).4.Comparison of Oswestry score:After the first treatment, compare the comparison of the two groups, the score of Oswestry was increased in both groups, and there was significant difference between the two groups (P<0.05), and compare the comparison between the two groups, there was no significant difference between the two groups (P>0.05). After the second treatment, compare the comparison of the two groups and comparison between the two groups, the score of Oswestry was increased in both groups, and there was significant difference between the two groups (P<0.05).5.The comparison of overall effectiveness:the total effective rate was93.33%in test group and86.67%in control group with statistically significant differences (P<0.05).Conclusion1.The Scalp acupuncture movement with electroacupuncture treatment and the only electroacupuncture treatment both have effect. They both can improve pain, overall symptoms, sign and limb function.2. The Scalp acupuncture movement with electroacupuncture treatment has better effect than the only electroacupuncture treatment in the relief of pain in a short time, but no difference to improve overall symptoms, sign and limb function.3. After the end of treatment, the Scalp acupuncture movement with electroacupuncture treatment has better effect in both improving pain, overall symptoms, sign and limb function than the only electroacupuncture treatment.4. The overall effect of the Scalp acupuncture movement with electroacupuncture treatment is better than the only electroacupuncture treatment.更多还原