摘要
目的:比较气街干预合脊柱调衡与常规针刺推拿治疗腰椎间盘突出症的疗效差异,并探讨其镇痛作用机制。方法:将71例患者随机分为综合组(36例)和常规组(35例)。综合组取腹气街部穴位,行双手同刺法,配合脊柱调衡治疗;常规组穴取肾俞、大肠俞及患侧环跳、承扶等,采用常规针刺法和常规推拿治疗。治疗前后两组均采用视觉模拟量表(VAS)评分、功能障碍指数Os-westry问卷调查表、健康相关生活质量评分(SF-36)问卷和检测血清肿瘤坏死因子α(TNF-α)水平评定镇痛效应和临床疗效。结果:综合组愈显率为91.7%(33/36),明显优于常规组的77.1%(27/35,P<0.05);治疗前10次的镇痛效应综合组明显优于常规组(P<0.05);两组治疗后Os-westry功能障碍指数均显著改善(均P<0.05),且综合组优于常规组(P<0.05);治疗后SF-36总体健康、身体疼痛、生理功能、社会功能、情感职能维度值综合组优于常规组(均P<0.05);治疗15次后综合组血清TNF-α水平较治疗前降低,且明显低于常规组(P<0.05),治疗30次后综合组亦低于常规组(P<0.05)。结论:气街理论指导针刺合脊柱调衡干预比常规针刺推拿治疗腰椎间盘突出症起效快、疗效好,在一定程度上提高了患者的生活质量。其镇痛效应与降低血清TNF-α水平有关。
Objective To compare the efficacy difference in the treatment of lumbar disc herniation （LDH） between the comprehensive therapy of qi pathway intervention and the spinal adjustment and the conventional therapy of acupuncture and Tuina and explore the analgesic mechanism. Methods Seventy-one cases were randomized into a comprehensive therapy group （36 cases） and a conventional therapy group （35 cases）. In the comprehensive therapy group, the acupoints in the region of abdominal qi pathway were selected and stimulated manually with both hands. In combination, the spinal adjustment therapy was applied. In the conventional therapy group, Shenshu （BL 23）, Dachangshu （BL 25）, Huantiao （GB 30） and Chengfu （BL 36） on the affected side were selected and stimulated with the conventional needling technique. Additionally, the routine Tuina therapy was applied. Before and after treatment, the visual analogue scale （VAS）, Oswestry disability index （ODI） questionnaire, the health related quality of life （SF-36） questionnaire and the＇level of serum tumor necrosis factor （TNF-a） were adopted to determine analgesic effect and clinical efficacy. Results In the comprehensive therapy group, the curative and effective rate was 91.7% （33/36）, which was apparently superior to 77.1% （27/35） in the conventional therapy group （P〈0.05）. The analgesic effect in the first 10 treatments in the comprehensive therapy group was apparently superior to that in the conventional therapy group （P〈0.05）. ODI after treatment was improved significantly in both groups （both P〉0.05）, in which the result in the comprehensive therapy group was superior to that in the conventional therapy group （P（0.05）. After treatment, the SF-36 values of general health, bodily pain, physiologicalfunctioning, social functioning and emotional functioning in the comprehensive therapy group were superior to that in the conventional therapy group （all P〈0.05）. After 15 treatments, the level of serum TNF-a in the comprehensive therapy group was lowered as compared with that before treatment and lower apparently than that in the conventional therapy group （P〈0. 05） ; after 30 treatments, it was also lower than that in conventional therapy group （P〈0.05）. Conclusion In the guide of the theory of qi pathway, the comprehensive therapy of acupuncture and spinal adjustment intervention achieves the quick and good efficacy on LDH as compared with the conventional acupuncture and Tuina and improves the quality of life for the patients to certain extent. The analgesic effect of this therapy is relevant with the decrease of serum TNF-a.
出处
《中国针灸》
CAS
CSCD
北大核心
2013年第4期289-293,共5页
Chinese Acupuncture & Moxibustion
基金
高等学校博士学科点专项科研基金项目:20101210110005
铜仁市科研计划项目:2010018
关键词
椎间盘移位
腰椎
气街
针刺疗法
推拿疗法
随机对照试验
intervertebral disc displacement, lumbar vertebrae
pathway of qiacupuncture therapy Tuinarandomized controlled trial（RCT）
