摘要
目的:探讨水针刀疗法松解椎管外小关节外侧囊区及椎间孔外口区治疗腰椎间盘突出症的疗效。方法:将40例腰椎间盘突出症(L4/L5)患者随机分为观察组和对照组各20例,对照组采用水针刀松解小关节外侧囊区(棘突间旁开1.5~2cm)以解除脊神经后内支压迫,观察组则松解椎间孔外口区(棘突间旁开约3.5cm)以解除脊神经前支的压迫,均治疗1次,采用JOA、ODI评分量表及视觉模拟评分法(VAS)评价功能障碍及疼痛情况。结果:治疗后1周,两组JOA、ODI、VAS评分均得到显著改善(P<0.05),但组间比较差异无统计学意义(P>0.05);随访6个月后,观察组JOA、ODI、VAS评分改善程度均显著优于对照组(P<0.05);两组患者均未出现严重不良事件。结论:椎管外水针刀松解腰脊神经调衡法治疗腰椎间盘突出症,通过小关节外侧囊区、椎间孔外口区行针刺、松解治疗,均能在早期有效地缓解患者的临床症状,重新调整脊柱平衡,改善腰腿功能情况,提高患者的生活质量;而在远期疗效方面,椎间孔外口区优于小关节外侧囊区。
Objective： To investigate the efficacy of releasing lateral capsule area of small joints and intervertebral foramen area with injection needle scalpel for lumbar disc herniation. Methods： 40 cases of patients with lumbar disc herniation （L4/L5） were randomly divided into observation group （20 cases） and control group （20 cases）, the control group released lateral capsule area of small joints （1.5-2cm beside interspinous process） to re- move the stress by posterior internal branch of spinal nerve, the observation group released the intervertebral foramen area （3.5cm beside interspi- nous process） to remove the stress by anterior spinal nerve branch, and evaluated the functional disorder and pain with JOA, OD! scores and visual analogue scale （VAS） after 1 time of treatment. Results： 1 week after treatment, the JOA, ODI and VAS scores were significantly improved （P〈0.05）, but there was no statistical difference between the two groups （P〉0.05）; after 6 months of follow-up, the improvement of JOA, ODI and VAS scores of observation group were significantly better than those of control group （P〈0.05）; there was no severe adverse events in both groups. Conclusion： Releasing lumbar spinal nerves by extraspinal balancing therapy with injection needle scalpel in treatment of lumbar disc herniation which punctures and releases at lateral capsule area of small joints and intervertebral foramen area can early and effectively relieve the symptoms, readjust the spinal balance, improve the lumbar vertebral function and patients＇ quality of life; while in terms of long-term effect, intervertebral foramen area is better than lateral capsule area of small joints.
作者
郭俊彪
冯思仪
王慧敏
吴树旭
GUO Jun-biao;FENG Si-yi;WANG Hui-min;WU Shu-xu(Guangdong Provincial TCM Hospital, Guangzhou, Guangdong 510120)
出处
《按摩与康复医学》
2018年第7期66-70,共5页
Chinese Manipulation and Rehabilitation Medicine
关键词
腰椎间盘突出症
水针刀
椎管外
调衡疗法
椎间孔外口
小关节外侧囊
疗效
lumbar disc herniation
injection needle scalpel
extraspinal
balancing therapy
intervertebral foramen
lateral capsule of small joints
ef-ficacy
