电针治疗腰椎间盘突出症椎间孔镜术后残余痛的疗效观察

发布时间：2018-05-18 09:35

本文选题：电针 + 腰椎间盘突出症　；参考：《福建中医药大学》2017年硕士论文

【摘要】：目的:观察电针治疗腰椎间盘突出症(Lumbar Disc Herniation,LDH)椎间孔镜术后残余痛的临床疗效,初步探讨电针治疗的可能机制,为传统中医方法治疗椎间孔镜术后残余痛提供新的可能。方法:选择于2015年6月至2016年12月我院骨科诊断明确,并在符合手术指征及征得患者同意的前提下于本院顺利行"椎间孔镜下髓核摘除术"并术后出现残余痛的患者,利用随机数字分组法对各观察对象随机分组为试验组和对照组。在相同一般处理的基础下,试验组术后第1天开始采用电针针刺夹脊穴、肾俞、环跳、委中、环跳阳陵泉治疗,治疗频率一天一次,连续六天为一个疗程,两疗程间休息一天,共治疗两个疗程;对照组术后第1天开始予口服艾瑞昔布治疗至术后第14天。所有患者至少随访3个月,对比两组患者术后第1天、7天、14天、3个月的视觉模拟疼痛评分(Visual Analogue Scale,VAS)、腰椎功能障碍评分(Oswestry Dability Index,ODI)、日本骨科协会(Japanese Orthopaedic Association Scores,JOA)下腰痛疾患疗效评定表及临床疗效评估治疗分数,进行统计学分析,比较两组治疗方式的治疗效果。结果:1.两组在性别、年龄、病程、脱落病例、病变节段、病变部位分布等方面无显著性差异(P0.05),具有可比性。2.VAS评分比较:两组组内对比:治疗干预后,两组VAS评分均呈下降趋势,分别将两组术后第1天与术后第7天、术后第7天与术后第14天VAS、术后第14天与术后第3个月VAS评分比较,差异具有统计学意义(P=0.000,P0.05)。两组组间对比:术后第1天两组差异不具有统计学意义(P=0.772,P0.05);术后第7天两组差异具有统计学意义(P=0.028、P0.05);术后第14天两组差异具有统计学意义(P=0.022、P0.05);术后3个月两组差异具有统计学意义(P=0.004、P0.05)。两组间VAS评分下降幅度使用重复测量方差分析,试验组较对照组下降幅度较大,说明其治疗作用由于对照组。3.ODI评分比较:两组组内对比:治疗干预后,两组ODI评分均呈下降趋势,两组术后第1天与术后第7天、术后第7天与术后第14天、术后第14天与术后第3个月差异具有统计学意义(P=0.000,P0.05)。两组组间对比:术后第1天组间差异不具有统计学差异(P=0.797,P0.05);术后第7天两组差异具有统计学意义(P=0.028、P0.05);术后第14天两组差异具有统计学意义(P=0.001、P0.05);术后第3个月两组差异具有统计学意义(P=0.000、P0.05)。两组间ODI评分下降幅度使用重复测量方差分析,试验组较对照组下降幅度较大,说明其治疗作用由于对照组。4.JOA评分比较:两组组内对比:治疗干预后,两组JOA评分均呈上升趋势,两组术后第1天与术后第7天、第7天与术后第14天、术后第7天与术后第14天差异具有统计学意义(P=0.000,P0.05)。两组组间对比:术后第1天组间差异不具有统计学差异(P=0.632,P0.05);术后第7天两组差异具有统计学意义(P=0.021、P0.05)术后第14天两组差异具有统计学意义(P=0.000、P0.05);术后第3个月两组差异具有统计学意义(P=0.000、P0.05)。两组间JOA评分上升幅度使用重复测量方差分析,试验组较对照组上升幅度较大,说明其治疗作用由于对照组。5.治疗后两组总体临床疗效:试验组总优良率为84.62%,对照组总优良率为68.97%,试验组临床疗效明显优于对照组(P=0.029,P0.05),差异具有统计学意义。结论:电针及艾瑞昔布口服对腰椎间盘突出症椎间孔镜术后残余痛均具有显著疗效,且电针疗法优于艾瑞昔布,值得临床推广。
[Abstract]:Objective: To observe the clinical efficacy of electroacupuncture in the treatment of residual pain after lumbar intervertebral disc herniation (Lumbar Disc Herniation, LDH), and to discuss the possible mechanism of electroacupuncture treatment, and provide a new possibility for the treatment of residual pain after intervertebral foraminoscopy in traditional Chinese medicine. Method: selected from June 2015 to December 2016, our hospital department of orthopedics diagnosis is clear, On the basis of the same general treatment, electroacupuncture was used first days after the operation on the basis of the same general treatment. Acupuncture at Jiaji acupoint, Shenshu, ring jump, in the committee, the ring jump Yang Mausoleum treatment, the treatment frequency one day, six days as a course of treatment, two courses rest one day, a total of two courses of treatment; the control group began first days after the operation to take oral erixib to fourteenth days after the operation. The patients were followed up for at least 3 months, compared to two groups of patients first days after the operation, 7 14 days, 14 days, 3 months of visual analogue pain score (Visual Analogue Scale, VAS), lumbar dysfunction score (Oswestry Dability Index, ODI), Japan Department of orthopedics Association (Japanese Orthopaedic Association Scores,) low back pain disease efficacy assessment table and clinical efficacy assessment of treatment scores, statistical analysis, compare the two groups of treatment methods Results: 1. in the two groups, there were no significant differences in sex, age, course of disease, diseased cases, segmental lesions, and the distribution of lesion sites (P0.05). Compared with the comparable.2.VAS score, the two groups were compared: after the treatment, the two groups of VAS scores showed a downward trend, and the two groups were first days after the operation and seventh days after the operation, and seventh days after the operation, respectively. Fourteenth days after the operation, VAS, fourteenth days after the operation and third months after the VAS score, the difference was statistically significant (P=0.000, P0.05). The two groups were compared: first days after the operation, the two groups were not statistically significant (P=0.772, P0.05); seventh days after the operation, two groups were statistically significant (P=0.028, P0.05); two groups of differences were statistically significant on the fourteenth day after the operation. Meaning (P=0.022, P0.05), 3 months after the operation, the two groups were statistically significant (P=0.004, P0.05). The decrease of VAS score between the two groups was analyzed by repeated measurement of variance, and the experimental group was significantly lower than the control group, indicating that the therapeutic effect of the control group was compared with that of the control group: the comparison of the two groups: the two groups of ODI scores were all below the treatment intervention. Descending trend, two groups first days after operation and seventh days after operation, seventh days after operation and fourteenth days after operation, fourteenth days after operation and third months after the operation have statistical significance (P=0.000, P0.05). Two groups on the first day after group difference was not statistically significant difference (P=0.797, P0.05), seventh days after operation, two group differences were statistically significant (P=0.028, P0.05); The difference between the two groups was statistically significant (P=0.001, P0.05) fourteenth days after the operation, and the difference between the two groups was statistically significant (P=0.000, P0.05) third months after the operation. The decrease of the ODI score between the two groups was analyzed by repeated measurement of variance, and the experimental group was significantly lower than the control group, indicating that the therapeutic effect of the control group was compared with the.4.JOA score in the control group: the two groups were in the same group. Ratio: after the treatment, the two groups of JOA scores increased, the two groups first days after the operation and seventh days after the operation, seventh days and fourteenth days after the operation, seventh days after the operation and fourteenth days difference was statistically significant (P=0.000, P0.05). The two groups were compared: first days after the operation, the difference was not statistically significant (P=0.632, P0.05); seventh day postoperative two group differences after the operation The difference between the two groups was statistically significant (P=0.000, P0.05) fourteenth days after the operation (P=0.000, P0.05). The difference between the two groups was statistically significant (P=0.000, P0.05) third months after the operation (P=0.000, P0.05). The increase amplitude of the JOA score between the two groups was analyzed by the repeated measurement of variance, and the experimental group was higher than the control group, indicating that the therapeutic effect of the test group was compared with the control group. Group.5. after treatment, the total clinical efficacy of the two groups: the total excellent rate in the experimental group was 84.62%, the total excellent rate in the control group was 68.97%. The clinical effect of the test group was obviously superior to the control group (P=0.029, P0.05), and the difference was statistically significant. Electroacupuncture is superior to erixib and is worthy of clinical promotion.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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