摘要
目的观察银质针、毫针及消炎镇痛药物结合推拿多种干预因素治疗腰椎间盘突出症的疗效差异,初步探讨陆氏伤科治疗腰椎间盘突出症的针推结合优化方案。方法将120例腰椎间盘突出症患者随机分为3组,每组40例。分别采用银针温针灸、不锈钢毫针温针灸、非甾体消炎镇痛药治疗,每组中半数病例随机分为加推拿和不加推拿两个亚组,每个亚组20例。所有指标观测均在T0(治疗前基线点)、T1(第17±2天)、T2(第35±2天)、T3(60±2天)、T4(第90±2天)5个观察时相,T2时相为疗效判定的结局点,此时采集并统计各组观察指标。结果银质针组治疗后有效率为87.5%,毫针组为75.0%,药物组为57.5%,3种方法的临床疗效差异有统计学意义(P<0.05)。3组患者治疗后ODI值均较治疗前改变(P<0.05),3种治疗方法都有改善症状效应。治疗后银质针组和毫针组、药物组疼痛量表分值比较,差异有统计学意义(P<0.05),银质针组指标改善较多。单纯推拿治疗有独立效果,和其他治疗经析因分析未见交互作用。结论陆氏伤科温针灸疗法可缓解腰椎间盘疼痛和功能症状,其中银质针温针灸疗效较明显,结合推拿治疗疗效较好。
Objective To observe the differences in therapeutic effect of silver needle, filiform needle and anti-inflammatory and analgesic drugs combined with massage in the treatment of lumbar disc herniation(LDH) and to preliminarily explore the optimal combination of acupuncture and massage for treating LDH in Lu`s Traumatology Department. Methods 120 patients with LDH were randomly assigned into three groups, 40 patients in each group. The three groups were treated with needle warming moxibustion using silver needle and stainless-steel needle and non-steroidal anti-inflammatory analgesics, respectively. Half of the patients in each group were randomly treated with or without massage, 20 patients in each subgroup. All the indicators were observed at 5 time phases, namely T0(baseline point before treatment), T1(day 17±2), T2(day 35±2), T3(day 60±2) and T4(day 90±2), with T2 as the endpoint for determination of treatment effect. At T2, the observation indicators of each group were collected and statistics were obtained. Results The effective rate was 87.5%, 75.0% and 57.5% in the silver needle group, the filiform needle group and the drug group, respectively after treatment, with significant differences in clinical efficacy(P<0.05). The ODI scores of the three groups changed after treatment(P<0.05), and symptoms improved with the 3 treatment methods. After treatment, there were significant differences in the pain scale scores in the silver needle group,the filiform needle group and the drug group( P<0.05),with more improvements in the silver needle group.Effect was observed with massage alone, and there was no interaction with other therapies in post-hoc analysis. Conclusion Needle warming moxibustion in Lu`s Traumatology Department can alleviate the pain and functional symptoms of lumbar intervertebral disc. Needle warming moxibustion using silver needle shows remarkable effect and the effect is even better when combined with massage.
作者
李伟
徐洪亮
王慧芳
张天嵩
陆念祖
俞笑悦
江苏闽
侯彤
LI Wei;XU Hongliang;WANG Huifang;ZHANG Tiansong;LU Nianzu;YU Xiaoyue;JIANG Sumin;HOU Tong(Lu's Traumatology Department,Central Hospital of Shanghai Jing'an District(Jing'an Branch of Huashan Hospital Affiliated to Fudan University),Shanghai 200040,China;Jing,an District Centre Hospital Affiliated to Fudan University,Shanghai 200040,China)
出处
《上海中医药杂志》
2019年第10期65-68,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市卫计委面上项目(201540282)
上海市名老中医学术研究工作室项目(SHGZS-2017006)
上海市中医特色诊疗技术提升项目(Zyjx-2017059)
上海市静安区中医药临床重点专科项目(JA2016-Z002)
上海市静安区卫生计生系统学科带头人项目(2017年度)
第六批全国老中医药专家学术经验继承人项目
关键词
腰椎间盘突出症
针灸
银质针
推拿
优化方案
lumbar disc herniation
acupuncture and moxibustion
silver needle
massage
optimized regimen
作者简介
李伟,男,硕士,副主任医师,主要从事脊柱和骨关节疾病临床研究;通信作者:张天嵩,主任医师。E-mail:ztsdoctor@126.com。
