针刀触激术治疗梨状肌综合征的临床研究

发布时间：2018-04-05 18:13

本文选题：梨状肌综合征　切入点：针刀触激术　出处：《南京中医药大学》2017年硕士论文

【摘要】：研究背景:梨状肌综合征(Piriformis syndrome,PS)是指梨状肌因急慢性损伤导致的梨状肌紧张痉挛、水肿肥厚等刺激或卡压坐骨神经或其他骶丛神经而产生一系列症状的综合征。目前临床上中西医治疗方式较多,主要分为非手术疗法和手术疗法,非手术疗法存在着疗效较慢、复发率较高的缺点,手术虽可以直接解除卡压,但存在着麻醉意外风险和手术费用高等缺点。针刀疗法治疗梨状肌综合征方法相对简便、临床疗效显著,本课题采用针刀触激术治疗梨状肌综合征,意在为针刀治疗该病提供临床依据、优化临床方案。研究目的:观察针刀触激术对梨状肌综合征患者的临床疗效情况、视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)的影响,探讨针刀触激术的安全性和有效性,分析针刀触激术治疗梨状肌综合征的原理。以丰富临床治疗梨状肌综合征的手段,提高患者的生活质量。研究方法:招募2016年1月至2016年12月间在南京市中西医结合医院疼痛科门诊、江苏省中西医结合医院针刀科门诊、南京中医药大学国医堂针灸门诊确诊为梨状肌综合征的78名患者。预编序号1-78,用随机数字表的方法并按随机数字升序将1-78号进行分组,分2个平行组进行,分别为针刀治疗组、针刺对照组,每组各39例。针刀组患者3次为一疗程,每次间隔5天;针灸组每两日1次,5次为1疗程,记录两组治疗结束后的疗效。疗效观察及评价标准选用视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI),用SPASS 20.0软件进行统计分析。研究结果:1.针刀治疗梨状肌综合征,能明显改善梨状肌综合征患者的临床症状及体征,差异具有统计学意义(P0.05),疗效明显优于针刺组。2.通过VAS视觉模拟评分法,治疗后针刀组的评分改善优于针刺组,差异具有统计学意义(P㩳0.05)。3.通过Owestry功能障碍指数问卷表,治疗后针刀组的功能障碍改善优于针刺组,差异具有统计学意义(P0.05)。研究结论:1.针刀触激术治疗梨状肌综合征的疗效优于传统针刺方法。2.在临床治疗过程中,两组患者治疗过程中未出现神经损伤、血肿等不良反应,说明针刺与针刀触激术在临床应用中安全可靠。3.对于以梨状肌综合征为代表的软组织损伤并以神经卡压为表现的疾病,在临床上适宜选用针刀触激术。
[Abstract]:Background: piriformis syndrome (Piriformis syndrome) refers to a series of symptoms of piriformis syndrome caused by acute and chronic injury of piriformis caused by spasm of piriformis muscle, edema and hypertrophy, or compression of sciatic nerve or other sacral plexus nerves.At present, there are many clinical treatments of traditional Chinese and western medicine, which are mainly divided into non-operative therapy and surgical therapy. Non-operative therapy has the disadvantages of slow curative effect and high recurrence rate. Although the operation can relieve compression directly,However, there are some disadvantages such as the risk of anaesthesia accident and the high cost of operation.The treatment of piriformis syndrome by needle knife therapy is relatively simple, and the clinical effect is remarkable. The purpose of this paper is to provide clinical basis for needle knife therapy of piriformis syndrome, and to optimize the clinical scheme.Objective: to observe the clinical curative effect and the visual analogue score of visual analogue score (VAS) and Oswestry dysfunction index (Oswestry) in patients with piriformis syndrome, and to explore the safety and effectiveness of needle touching.To analyze the principle of needle-knife touch-excitation in the treatment of piriformis syndrome.To enrich the clinical treatment of piriformis syndrome, improve the quality of life of patients.Methods: from January 2016 to December 2016, we recruited an outpatient from the pain Department of Nanjing Integrated Chinese and Western Medicine Hospital and the needle-knife department of Jiangsu Provincial Integrated Chinese and Western Medicine Hospital.A total of 78 patients with piriformis syndrome were diagnosed as piriformis syndrome in the clinic of National Medical College of Nanjing University of traditional Chinese Medicine.The number 1-78 was precompiled and divided into two parallel groups by random number table and ascending order of random numbers. Each group was divided into two groups: acupuncture treatment group (n = 39) and acupuncture control group (n = 39), each group was divided into two groups: acupuncture treatment group (n = 39) and acupuncture control group (n = 39).The patients in the acupuncture and knife group were treated for a course of treatment with an interval of 5 days, and the acupuncture and moxibustion group received 5 times every two days for a course of treatment. The curative effect of the two groups was recorded after the end of the treatment.The visual analogue scoring method was used to evaluate the curative effect and the SPASS 20.0 software was used for statistical analysis.The result of the study was: 1.Needle knife treatment of piriformis syndrome can significantly improve the clinical symptoms and signs of patients with piriformis syndrome, the difference is statistically significant (P 0.05), the curative effect is obviously better than acupuncture group. 2.The score of acupuncture group after treatment was better than that of acupuncture group by VAS visual analogue scoring method, and the difference was statistically significant.According to the questionnaire of Owestry dysfunction index, the improvement of functional disorder in the acupuncture group was better than that in the acupuncture group after treatment, and the difference was statistically significant (P 0.05).Conclusion: 1.The curative effect of needle knife touch stimulation in the treatment of piriformis syndrome is better than that of traditional acupuncture method.In the course of clinical treatment, there were no adverse reactions such as nerve injury and hematoma in the two groups, indicating that acupuncture and needle-knife touch stimulation were safe and reliable in clinical application.For the soft tissue injury represented by piriformis syndrome and the disease represented by nerve entrapment, needle-knife touch stimulation is suitable for clinical use.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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