微针刀浅筋膜松解术治疗腰椎间盘突出症早期临床疗效评价

发布时间：2018-03-07 03:33

本文选题：腰椎间盘突出症　切入点：微针刀　出处：《浙江中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：腰椎间盘突出症(LDH)是指由于腰椎间盘退变,腰椎骨质增生、纤维环变性,当椎间盘受力不均时,髓核膨出或突出,刺激或压迫了马尾神经或脊神经,导致神经根炎性水肿、微循环障碍,发生的以腰腿疼痛、感觉障碍为主的一种临床综合症候群。该病好发于30～60岁的体力劳动者或平时缺乏锻炼者,临床上以L4～L5、L5～S1椎间盘突出发病率最高。目前国内外临床上治疗LDH的方法可谓多种多样,但临床疗效都很难确定,而且都存在一定的复发率。LDH是临床常见病、多发病,对人类健康及正常的日常生活带来了极大的不便,因此寻求最佳治疗方法,提高患者的生活质量已成为医学界的重点课题。目的:对比研究微针刀浅筋膜松解术和传统针刺疗法治疗腰椎间盘突出症的临床治疗效果。方法:本课题根据随机分配原则,根据患者签定知情书时间依次编号后,将符合纳入标准的60例LDH患者进行随机对照观察,分为治疗组30例和对照组30例。治疗组给予微针刀在腰臀腿部位浅筋膜层松解治疗,每3天1次,4次为1个疗程,做1个疗程。对照组予毫针常规穴位针刺治疗,每日1次,每周5次,10次为1个疗程。共治疗1个疗程。采用疼痛视觉模拟评分法(Visual analogue scale,VAS)评估2组患者治疗前、治疗1次和治疗1疗程后腰腿疼痛情况,腰椎功能障碍指数(Oswestry disability index,ODI)评估2组患者治疗前、治疗1疗程后腰椎功能情况,对比2组临床疗效。结果:所有患者均治疗1疗程并随访。两组治疗后VAS和ODI评分与治疗前比较均有下降,差异有统计学意义(均P0.05)。治疗组评分下降更加明显(P0.05),在疗效方面:治疗组总有效率为94.3%,对照组有效率83.3%,微针刀优于针灸治疗。结论:微针刀浅筋膜松解术和传统针刺疗法都能有效缓解腰椎间盘突出症患者的腰腿疼痛症状,改善腰椎功能,两者比较,微针刀浅筋膜松解术疗法优于传统针刺疗法。
[Abstract]:Lumbar disc herniation (LDH) refers to the degeneration of lumbar intervertebral disc, the proliferation of lumbar vertebrae bone, and fiber ring degeneration. When the intervertebral disc is unevenly loaded, the nucleus pulposus bulges or protrudes and stimulates or compresses the cauda equina nerve or spinal nerve, resulting in inflammatory edema of nerve root. Microcirculation disorder, a clinical syndrome characterized by pain in the waist and leg, and sensory disorders. The disease is common in 30 to 60 year old manual workers or people who usually lack exercise. The incidence of disc herniation in L4 / L5 / L5 / S1 is the highest. At present, there are a variety of clinical methods to treat LDH at home and abroad, but the clinical efficacy is difficult to determine, and there is a certain recurrence rate. It brings great inconvenience to human health and normal daily life, so we seek the best treatment. To improve the quality of life of patients has become a key issue in the medical field. Objective: to compare and study the clinical effect of microneedle scalpel superficial fascia lysis and traditional acupuncture therapy in the treatment of lumbar disc herniation. Methods: according to the principle of random distribution, According to the number of love letters signed by the patients, 60 patients with LDH who met the inclusion criteria were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with microneedle knife in the superficial fasciolysis of waist and hip legs. Once every 3 days, 4 times as a course of treatment, 1 course of treatment. The control group was treated with routine acupuncture, once a day, Five times a week and 10 times a week as a course of treatment. Visual analogue scale scale score (VAS) was used to evaluate the pain of waist and leg before treatment once and after one course of treatment. The lumbar spine dysfunction index (Oswestry disability index ODI) was used to evaluate the lumbar function before and after treatment in two groups. Results: all the patients were treated for one course and followed up. The scores of VAS and ODI were decreased after treatment in both groups. The difference was statistically significant (P 0.05). The score of the treatment group decreased more obviously than that of the control group. The total effective rate of the treatment group was 94.34.The effective rate of the control group was 83.3%, and the micro-needle knife was superior to the acupuncture treatment. Conclusion: the treatment of superficial fascia lysis with microneedle knife and the traditional treatment are better than that of the control group. Acupuncture therapy can effectively relieve the pain symptoms of lumbar intervertebral disc herniation patients. To improve lumbar vertebrae function, microneedle scalpel superficial fascia lysis is superior to traditional acupuncture therapy.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R246.9

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