火针为主治疗腰椎间盘突出症继发根性坐骨神经痛的临床观察

发布时间：2018-01-19 12:18

本文关键词： 坐骨神经痛夹脊穴火针针刺　出处：《广州中医药大学》2016年博士论文　论文类型：学位论文

【摘要】：目的：为治疗腰椎间盘突出症继发的根性坐骨神经痛探索出最佳疗效且简单易行的方案,故在众多疗法中,以具备简便、安全、效果明显而副作用少等优势的中医针灸为方向,并以其中具有驱寒逐湿、温通经络作用的火针疗法为对象,探讨火针与体针结合治疗,对坐骨神经痛的止痛疗效,在临床中进行对比研究,期望进一步提高中医治疗坐骨神经痛的针对性,为临床治疗本病提供有用的参考。方法：将诊断为腰椎间盘突出症继发根性坐骨神经痛病人,并自愿参加本研究的患者共90例,采随机对照的研究方法,将患者分为治疗组(火针结合常规针刺组)30例,对照一组(单纯火针组)30例,对照二组(常规针刺组)30例。在相同治疗次数的情况下,观察患者治疗前后的改善情况。结果：1.治疗组治疗前、后疼痛评分(VAS)比较有显着性差异(P0.01);Oswestry功能障碍指数比较有显着性差异(P0.01)；腰痛疾患治疗成绩判定基准(JOA)比较有显着性差异(P0.01)。2.治疗组治疗后疼痛评分(VAS)分别与对照一组和对照二组比较,有显着性差异(P0.01)。3.治疗组治疗后疼痛评分(VAS)总有效率分别与对照一组和对照二组比较,有显着性差异(P0.01)。4.治疗组治疗后Oswestry功能障碍指数分别与对照一组和对照二组比较,有显着性差异(P0.01)。5.治疗组治疗后腰痛疾患治疗成绩判定基准(JOA)分别与对照一组和对照二组比较,有显着性差异(P0.01)。6.治疗组治疗后腰痛疾患治疗成绩判定基准(JOA)总有效率分别与对照一组和对照二组比较,有显着性差异(P0.01)。7.治疗组治疗寒湿型和肾虚失养型的疗效,分别与对照一组和对照二组比较,有显着性差异(P0.01),表明治疗组疗效明显优于两对照组；对照一组与对照二组比较无显着性差异(P0.05),表明两对照组的疗效相当。三组对湿热型和瘀血内阻型的疗效比较,三组比较均无显着性差异(P0.05),表明三组的疗效相当。结论：火针夹脊穴配合常规针刺治疗腰椎间盘突出症继发根性坐骨神经痛,可明显改善根性坐骨神经痛的疼痛程度、对日常生活的影响及腰椎功能等情况,治疗后均未见不良反应,有较好的临床作用。
[Abstract]:Objective: to explore the best curative effect and simple and easy scheme for the treatment of sciatica secondary to lumbar disc herniation. Acupuncture and moxibustion with obvious effect and less side effect is the direction of acupuncture and moxibustion, which has the function of driving away cold and removing dampness and warming the meridian as the object, and discusses the combination of fire acupuncture and body acupuncture. In order to improve the pertinence of traditional Chinese medicine treatment of sciatica, the curative effect of sciatica was compared in clinic. Methods: 90 patients who were diagnosed as secondary radical sciatica of lumbar intervertebral disc herniation and volunteered to participate in this study were selected as randomized controlled study. The patients were divided into treatment group (30 cases in fire acupuncture combined with routine acupuncture group), control group (30 cases in simple fire acupuncture group and 30 cases in control group) (30 cases in routine acupuncture group). Results: before and after treatment, the pain scores of the treatment group were significantly different (P 0.01). There was significant difference in Oswestry dysfunction index (P 0.01). There was a significant difference between the two groups (P < 0.01). The pain scores of the treatment group were compared with those of the control group and the control group. The total effective rate of pain score after treatment in the treatment group was compared with that of the control group and the control group. There was significant difference (P 0.01). 4. The Oswestry dysfunction index of the treatment group was compared with that of the control group and the control group. There was a significant difference (P 0.01) .5.The treatment group after treatment of low back pain disease treatment results judging standard (JOA) were compared with the control group and control group two groups. There was significant difference (P 0.01). 6. The total effective rate of the treatment group was compared with that of the control group and the control group. There was significant difference (P 0.01). There was significant difference between the treatment group and the control group (P 0.01) in the treatment of cold dampness type and kidney deficiency loss of nourishment type, compared with the control group and the control group two groups, respectively. The results showed that the curative effect of treatment group was better than that of two control groups. There was no significant difference between the control group and the control group, which indicated that the two control groups had the same curative effect, and the three groups had the same curative effect on the damp-heat type and the blood stasis type. There was no significant difference among the three groups (P 0.05), which indicated that the curative effect of the three groups was equal. Conclusion: the treatment of sciatica secondary to lumbar disc herniation by fire needle Jiaji point combined with routine acupuncture. It can obviously improve the pain degree of radical sciatica, the influence of daily life and lumbar vertebrae function, etc. There is no adverse reaction after treatment, so it has good clinical effect.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R246.9

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