【作者】 温家隆；

【导师】 庄礼兴；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2010， 博士

【摘要】 研究目的通过随机对照临床研究,对针刀结合针刺疗法治疗坐骨神经痛的有效性进行评价。研究方法选取台中向上中医诊所符合纳入标准的60例坐骨神经痛患者,采用简单随机法分为治疗组和对照组,每组30例。治疗组施以针刀疗法和针刺疗法,针刺选穴肾俞、气海俞、腰3-5夹脊、秩边、环跳、阿是穴；针刀治疗：根据解剖学结构,于臀中肌髂骨附着处点按找寻压痛点、硬结或条索状物,以甲紫在压痛区做标记点。般取3-5点,据病情和患者体质而定。以碘伏消毒标记区2-3遍。以右手持1号或2号针刀,左手以消毒纱布夹持刀体,刀口线与臀中肌肌纤维平行,刀体与皮肤垂直,快速刺入皮肤,直达髂骨骨面。让针刀自然“浮”起,再行纵行疏通,横行剥离,刀下有松动感即可出刀。如有硬结或条索状物,行“十”字切割2-3刀,然后用力按压5-10min。每周治疗1次,3次为1个疗程。对照组口服布洛芬和泼尼松。两组患者治疗1个疗程评价疗效。采用健康状况调查问卷量表(MOS SF-36)、简化McGill疼痛询问量表评价疗效,并对针刺治疗进行安全性评价,采用盲法评估。结果1.治疗组患者针刺治疗前后血常规、尿常规、肝功能及心电图安全性指标经统计学处理,差异无统计学意义(P>0.05)。2.两组治疗后,患者疼痛分级指数(PRI)总分、目测类比定级法计分(VAS)及现有疼痛强度(PPI)比较,差异有显著性意义(P<0.05)。3.疗程结束时,治疗组痊愈10例,显效11例,有效9例,无效0例,总有效率100%,对照组痊愈5例,显效7例,有效13例,无效5例,总有效率83.3%,两组的总体疗效经统计学处理,差异有统计学意义(P<0.05)。4.疗效相关性分析：疗效与性别无显著性差异(P>0.05),与年龄及病程有显著性差异(P<0.05)。结论针刀结合针刺治疗坐骨神经痛的总体疗效优于常规西药疗法,能有效减轻疼痛症状,提高患者的生存质量,且无任何毒副作用。更多还原

【Abstract】 ObjectiveTo evaluated the effect of acupotomy combined with acupucture on sciatica by a randomized controlled trial.MethodsAccording to the inclusive criteria,60 cases were chosen from Xiang Shang TCM clinic in Tai Zhong.60 cases were randomly divided into a treatment group (n=30) and a control group(n=30). The treatment group was treated with acupotomy combined with acupucture, the acupuncture at lumbar paravertebral points (L3-5), Zhibian (BL54), Huangtiao, Qihaishu, Shenshu, and Ashi points. The control group was treated with ibuprofen and prednisone. After receiving a course of treatment, the clinical effect was evaluated according to the Health Questionnaire (MOS SF-36) and Simplify the McGill Pain Questionnaire, and the safety of acupuncture therapy was evaluated, too. All evaluations were used blind method.Results1. In the treatment group, there were no statistically significant differences between pre and post treatment on the safety indexes, such as blood routine, urine routine, liver function and electrocardiograph (P>0.05)2. After treatment, there were statistically significant differences between the two groups in pain rating index score(PRI), visual analog scale scores(VAS) and pain intensity (PI) (P<0.05)3. After treatment, in the treatment group,10 cases were cured,11 cases were remarkably effective,9 cases were effective,0 cases were ineffective and the total effective rate was 100%. While in the control group,5 cases were cured,7 cases were remarkably effective,13 cases were effective,5 cases were ineffective and the total effective rate was 83.3%. There were statistically significant differences between the two groups in the clinical effect (P＜0.05)4.There were no statistically significant differences between sexuality and effectiveness (P>0.05), whereas there were statistically significant differences between the age, course and effectiveness (P<0.05) ConclusionThe total clinical effect of acupotomy combined with acupucture were superior to the routine western medicine therapy. Acupuncture therapy could effectively relieve pain, improve the survival quality and without any side effect.更多还原