【作者】 王淑杰；

【导师】 高维滨；

【作者基本信息】 黑龙江中医药大学 ， 针灸推拿学， 2009， 硕士

【摘要】 [目的]观察电针夹脊穴疗法与普通毫针疗法在治疗腰椎间盘突出症(Lumbarintervertebraldiseprotrusion,LIDP)中临床疗效差异,探讨其治疗LIDP的机理,旨在通过观察电针夹脊穴对治疗LIDP的临床疗效和疼痛的改善,以期对临床治疗起一定的指导作用。[方法]选择2007年-2008年间在我院门诊就诊的63例LIDP患者随机分为治疗组32例和对照组31例进行比较。治疗组选取病变椎体(如有多个椎体病变以最重者为中心)及上下各1个椎体间两侧的夹脊穴共3对,用华佗牌2.5-3寸不锈钢毫针直刺进针,针刺时针尖方向斜向脊柱侧,得气后,将3组导线左右连接,选用疏波,电流以局部肌肉出现节律跳动,患者能耐受为度。每次治疗30分钟,10次为1疗程,休息3日,共观察两个疗程。对照组参照《针灸学》选取患侧肾俞、大肠俞、秩边、环跳、承扶、殷门、委中、阳陵泉,疗程同治疗组。治疗期间主要观察患者的症状、体征、生活及工作能力。临床疗效根据中药新药治疗LIDP的临床指导原则和《常见疾病的诊断与疗效判定(标准)》制定,疼痛综合评定采用腰腿痛评价量表对两组病人症状、生活、工作能力、体征评分,综合评价治疗前后改善情况,作出准确的评估并行两组间的比较。[结果]电针治疗组(A)临床疗效:治愈率53.1%,愈显率81.3%,总有效率93.8%。毫针对照组(B)临床疗效:治愈率32.3%,愈显率58.1%,总有效率87.1%。两组间治愈率比较:A比B(P<0.01),电针治疗组明显优于毫针对照组,统计学处理有极显著差异。愈显率比较:A比B(P<0.0 1),电针治疗组明显优于毫针对照组,统计学处理有极显著差异。总有效率比较:A比B(P<0.05),电针治疗组优于毫针对照组,统计学处理有显著差异。电针治疗组(A)治疗前后疼痛综合积分差值:症状积分差值:7.53±2.07,体征积分差值:7.75±2.14。毫针对照组(B)治疗前后疼痛综合积分差值:症状积分差值:5.93±2.40,体征积分差值:6.03±2.45。两组间症状积分差值比较:A比B(P<0.01),电针治疗组明显优于毫针对照组,统计学处理有极显著差异。体征积分差值比较:A比B(P<0.01),电针治疗组明显优于毫针对照组,统计学处理有极显著差异。、[结论]①电针治疗LIDP在改善患者症状、体征及恢复其功能方面均明显优于传统针刺法。②电针夹脊穴治疗LIDP以膨出型、突出型患者为主要适应症。更多还原

【Abstract】 [Objective]To observe the electro-acupuncture therapy Jiaji ordinary filiform needle therapy in the treatment of lumbar disc herniation (Lumbarintervertebraldiseprotrusion,LIDP ) differences in clinical efficacy,to explore its therapeutic mechanism LIDP designed by observing the electro-acupuncture treatment Jiaji LIDP clinical efficacy and the improvement of pain,with a view to a certain extent on the clinical treatment of the guiding role.[Methods]years 2007 -2008 in our hospital out-patient treatment of 63 cases of LIDP treatment group were randomly divided into 32 cases and 31 cases of the control group for comparison.The treatment group selected vertebral lesion(if multiple vertebral lesions were the most re-center) and up and down both sides of the vertebral body of a total of three pairs of Jiaji with licensing Huatuo 2.5-3 inch stainless steel needle into the acupuncture needle,acupuncture needle at the spine side oblique direction,a gas will be about 3 wire connection,selection of sparse wave,current local muscle appeared to beat rhythm,the patient can tolerate for the degree.30 minutes each treatment,10 times for 1 course,rest on the 3rd,two courses of treatment were observed.Control group with reference to "acupuncture" select Shenshu xue,Da chang shu,Zhi bian,Huan tiao,Cheng fu,Yin men, Wei zhong,Yang ling quan,treatment with the treatment group.The main observation during treatment of patients with signs and symptoms and function,clinical efficacy.According to Chinese medicine treatment LIDP clinical guidelines and "common diseases to determine the diagnosis and efficacy of(standard)," Comprehensive Assessment of the use of pain rating scale based on low back pain patients in two groups of symptoms,life,work capacity,signs score,integrated evaluation before and after treatment to improve the situation,to make an accurate assessment of the comparison between the two groups in parallel.[Results]Electro-acupuncture treatment group(A) Clinical Efficacy:53.1% cure rate,markedly effective rate of 81.3 percent,the total effective rate 93.8%.Cents for the control group(B) clinical efficacy:32.3%cure rate, markedly effective rate of 58.1%,the total effective rate 87.1%.The cure rate comparison between the two groups:A than B(P < 0.01), electro-acupuncture treatment group was significantly better than for the control group cents,statistically significant differences.Markedly effective rate:A more than B(P<0.01),electro-acupuncture treatment group was significantly better than for the control group cents,statistically significant differences.Comparison of the total effective rate:A more than B(P < 0.05),Electroacupuncture for the treatment group cents better than the control group,statistically significant differences.Electro-acupuncture treatment group(A) Comprehensive pain points before and after treatment difference:symptom score difference:7.53±2.07,signs point difference: 7.75±2.14.Cents for the control group(B) the comprehensive integration of pain before and after treatment difference:symptom score difference:5.93±2.40,signs point difference:6.03±2.45.Symptom score difference between the two groups compared:A than B(P <0.01),electro-acupuncture treatment group was significantly better than for the control group cents, statistically significant differences.Comparison of signs points difference:A than B(P <0.01),electro-acupuncture treatment group was significantly better than for the control group cents,statistically significant differences.[Conclusion]①LIDP electro-acupuncture in improving the treatment of patients with symptoms and signs and restore its function was significantly better than traditional acupuncture needle.②Jiaji Electro-acupuncture treatment of bulging LIDP to highlight the type of patients as the main indication.更多还原