【作者】 陈伟坤；

【导师】 赖新生；

【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,对针刺疗法治疗坐骨神经痛的有效性进行评价。研究方法选取2009年4月至2010年3月在台北汉坤中医诊所就诊的60例坐骨神经痛患者,按照随机数字法分为治疗组和对照组,每组30例。治疗组选穴腰夹脊(L2-4)、秩边、环跳、殷门、委中、承山、昆仑、悬钟、阿是穴；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.疗程结束时,治疗组痊愈9例,显效10例,有效11例,无效0例,总有效率100%,对照组痊愈5例,显效6例,有效14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)。2.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)。3.治疗组中轻度疼痛患者痊愈5例,显效1例,有效及无效均0例；中度疼痛患者痊愈11例,显效例,有效3例,无效0例；重度疼痛患者痊愈0例,显效3例,有效1例,无效1例。三组经统计学处理,差异具有显著性(P＜0.05)。4.两组治疗后,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)。5.两组治疗前与治疗后比较,MOS SF-36量表各维度(生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康)积分均增加显著,经统计学处理,差异具有显著性(P<0.01),治疗后一般健康状况、精力、社会功能、情感职能、精神健康两组间比较差异具有显著性(P＜0.05)。结论针刺治疗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 acupucture on sciatica by a randomized controlled trial.MethodsAccording to the inclusive criteria,60 cases were chosen from Taibei Hankun Chinese clinic.60 cases were randomly divided into a treatment group (n=30) and a control group(n=30). The treatment group was treated with acupuncture at lumbar paravertebral points (L2-4), Zhibian (BL54), Huangtiao, Yinmen, Weizhong, Chengshan, Kunlun, Xuanzhong 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. After treatment, in the treatment group,9 cases were cured,10 cases were remarkably effective,11 cases were effective,0 cases were ineffective and the total effective rate was 100%. While in the control group,5 cases were cured,6 cases were remarkably effective,14 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).2. 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).3. In the treatment group, mild pain patients,5 cases were cured,1 case was remarkably effective, and no case was effective or ineffective, moderate pain patients,19 cases were cured,1 case was remarkably effective,11 case were remarkably effective,5 cases were effective, and 3 case was ineffective, severe pain patients, no cases were cured,3 case was remarkably effective, 1 cases were effective, and no case was ineffective. There were statistically significant differences between the two groups (P<0.05).4. 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).5. Various indexes of MOS SF-36 were significantly improved in both groups after the treatment(P< 0.01). There were statistically significant differences between the two groups in general health, energy, social function, emotional function and mental health (P< 0.05).ConclusionThe total clinical effect of acupuncture therapy was 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