【作者】 陈绮；

【导师】 江钢辉；

【作者基本信息】 广州中医药大学 ， 中医学， 2012， 硕士

【摘要】 目的坐骨神经痛是沿坐骨神经通路及其分布区的疼痛综合征,是临床常见病、多发病。本课题采用临床小样本随机对照研究,通过观察腰椎间盘突出症继发根性坐骨神经痛治疗前后疼痛和活动功能指标的变化,探讨耳穴埋针配合针刺治疗腰椎间盘突出症继发根性坐骨神经痛的可行性与有效性。方法本研究将符合纳入标准的坐骨神经痛的患者60例,随机分为两组：治疗组和对照组,每组30例。治疗组采用耳穴埋针配合常规针刺治疗,对照组采用常规针刺治疗。两组常规针刺每天治疗1次,每周连续治疗5天,休息2天,治疗2周(共10次)；耳穴埋针每3天治疗1次,每周2次,治疗2周(共4次)。在治疗前、治疗后对病情进行评估,以坐骨神经疗效标准表、行为疼痛测定表(BRS-6,behavioral rating scale)、McGill疼痛量表为观察指标,对评估结果进行分析,利用SPSS17.0软件包建立数据库并进行逻辑校对,为使两组间具有可比性,在两组间进行性别、年龄、病程等各方面进行均衡性比较及分析。两组计数资料采用卡方检验,计量资料采用t检验,等级资料采用秩和检验。结果治疗组和对照组对于腰椎间盘突出症继发根性坐骨神经痛都有明显的疗效(治疗组总有效率为93.3%,对照组总有效率为90.0%),但两种治疗方法在统计学无明显差异(P>0.05)。在改善患者疼痛方面治疗组及对照组均有确切的疗效,治疗组治疗后的PRI(疼痛分级指数的评定)总分、VAS(视觉模拟评分法)评分以及BRS-6(行为评分法)评分均比对照组的评分明显降低,两组治疗前后的PRI总分、VAS评分、BRS-6评分比较的P值均<0.01。另外以疼痛评分差值作比较,两组间治疗前后PRI总分差值比较P=0.021<0.05,VAS差值评分比较P=0.040<0.05,BRS-6差值评分比较P=0.012<0.05；说明治疗组在改善疼痛程度、行为能力方面优于对照组。结论治疗组与对照组对于腰椎间盘突出继发根性坐骨神经痛都有明显的疗效,但治疗组在改善患者疼痛程度、行为能力方而优于对照组,亦即耳穴埋针配合常规针刺在改善疼痛程度、行为能力方而比常规针刺治疗具有明显的疗效优势。更多还原

【Abstract】 ObjectiveSciatic nerve pain (SNP), also called Sciatica, a complex symptom, which is defined as pain in the passage and distribution region of the sciatic nerve. It is a common disease in clinic. The study intends to use small sample randomized controlled test methods, through the observation of the improvement of pain and functional activity index after the treatment. To evaluate the effect and feasibility of the ear points imbedding needle combined with acupuncture on sciatica caused by lumbar dice hernia.MethodWe collect the cases met the inclusion criteria60cases and divide the patients into the treatment group and control group randomly30cases in each group. The treatment group receives the therapy of ear points imbedding needle combined with acupuncture. The control group treats with acupuncture. The acupuncture is operated5times per week for2week,10times a treatment course. The therapy of ear points imbedding needle is operated2times per week for2week,4times a treatment course. We evaluate the disease in the initial treatment and a treatment after a course. We use the McGill Scale and the Behavioral Rating Scale (BRS-6) to estimate improvement of pain, analyze the results, compare clinical efficacy of two groupsResultsFor the sciatica caused by lumbar intervertebral dice hernia, each groups has significant effect (the total effective rate of the treatment group is93.3%and the total effective rate of the control group is90.0%), but the two treatment methods have no significant difference in outcomes(P>0.05). There is clear curative effect of two groups for improving the patlents pain (before and after the treatment, the P value of the PRI total score, the VAS score and the BRS-6score<0.01). In the treatment group the PRI total score, the VAS score and the BRS-6score is significantly lower than the scores in the control group, after the treatment. According the comparison between the two groups, the P value of the PRI total score=0.021<0.05, the VAS score=0.040<0.05and the P value of the BRS-6score=0.012<0.05. The difference of pain score derived from McGill pain questionnaire and the6-point Behavioral Rating Scale before and after treatment verified by t-test present a statistically significant relationshio between the variables (P<0.05). It indicates in improving the pain aspect the treatment group is significantly better than the control group.ConclusionThe treatment group and the control group for the sciatica caused by lumbar intervertebral disc hernia have obvious curative effect, but in improving the pain aspect the treatment group is significantly better than the control group. In other words, in improving pain aspect the therapy of ear points imbedding needle combined with acupuncture has obvious curative effect advantage, comparing the acupuncture therapy.更多还原