丁桂散外敷联合推拿治疗腰椎间盘突出症的临床疗效观察

发布时间：2018-04-23 05:04

  本文选题：腰椎间盘突出症 + 丁桂散　； 参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:本研究通过运用丁桂散外敷联合推拿对寒湿型腰椎间盘突出症患者进行治疗,并与吡罗昔康贴片进行对照比较,观察患者治疗前后量表评分的变化,探讨丁桂散治疗腰椎间盘突出症在减轻疼痛、提高生活质量和恢复腰部活动方面的疗效及安全性,以期为临床治疗腰椎间盘突出症提供更多有效的手段和方法。方法:根据纳入标准从本院门诊选择80例寒湿型腰椎间盘突出症患者进行临床研究,用随机方法分为两组,试验组和对照组各40例。试验组患者予外敷丁桂散,对照组予外敷吡罗昔康贴片,两组均联合相同的推拿手法治疗。治疗前,两组均记录患者的基线参数如性别、年龄、病程、患肢等。观察治疗前、两周及随访两个月并记录治疗前后量表的VAS、0DI评分,测量SLR、Cobb角的数值,观察并记录药物的不良反应。收集数据后,用SPSS20.0软件进行统计,比较和分析两组治疗前后的临床疗效。结果:1.治疗前两组之间患者的一般资料如性别、年龄、病程、患肢等,以及VAS、0DI评分、SLR和Cobb角度统计(P0.05)均无显著性差异。2.治疗两周后,两组与治疗前相比较,有统计学差异,VAS、ODI、Cobb角比治疗前出现了显著下降,SLR明显高于治疗前。两组之间VAS评分比较,有统计学差异,且总体评分均数对照组低于试验组,显示对照组在短期内减轻疼痛的效果方面优于试验组。两组间的0DI评分、SLR、Cobb角及0DI改善率方面比较,无明显差异。3.治疗两个月后,两组与治疗前相比较,患者的VAS、ODI、Cobb比治疗前呈更显著下降,SLR提高较前面明显,有统计学差异。两组间的VAS、ODI、SLR角数值比较,无明显差异。Cobb方面对比,试验组低于对照组,有显著性的差异。0DI的改善率方面比较,两组变化相当,但均高于治疗前和治疗后两周。结论:1.丁桂散、吡罗昔康贴片外敷联合推拿,这两种方法治疗寒湿型LDH在短期和中期都能取得一定疗效。2.在治疗两周,吡罗昔康贴片较丁桂散外敷治疗寒湿型LDH在缓解疼痛的效果更明显;在提高生活质量、改善脊柱侧弯和恢复患侧下肢活动角度方面效果相当。3.在治疗两个月,丁桂散较吡罗昔康贴片外敷治疗寒湿型LDH在改善脊柱侧弯的疗效更理想,在减轻疼痛、提高生活质量和恢复患侧下肢活动角度方面效果相当。4.丁桂散外敷联合推拿治疗LDH具有安全有效、方便价廉的优势,在临床上值得推广和使用。
[Abstract]:Objective: the purpose of this study was to treat the patients with cold and wet lumbar intervertebral disc herniation by using Dinggui Powder and massage, and compare with Piroxicam patch to observe the change of scale before and after treatment. To explore the efficacy and safety of Ding Gui San in the treatment of lumbar disc herniation in alleviating pain, improving quality of life and restoring lumbar movement, in order to provide more effective means and methods for clinical treatment of lumbar disc herniation. Methods: 80 patients with cold and wet lumbar disc herniation were selected from our outpatient clinic according to the inclusion criteria. The patients were randomly divided into two groups: the experimental group (n = 40) and the control group (n = 40). The patients in the test group were treated with Dinggui Powder and the control group were treated with Piroxicam patch. The two groups were treated with the same massage manipulation. Before treatment, the baseline parameters such as gender, age, course of disease and affected limbs were recorded in both groups. Before treatment, two weeks and two months follow-up, VAS-0DI scores of the scale before and after treatment were recorded, the values of SLR Cobb angle were measured, and adverse drug reactions were observed and recorded. After collecting data, SPSS20.0 software was used to compare and analyze the clinical efficacy of the two groups before and after treatment. The result is 1: 1. There was no significant difference in general data between the two groups before treatment, such as sex, age, course of disease, affected limb, and VAS-0DI score and Cobb angle (P 0.05). After two weeks of treatment, there was a significant difference between the two groups and before treatment, there was a significant decrease in the angle of VASA ODI Cobb and the SLR was significantly higher than that before treatment. There was significant difference in VAS score between the two groups, and the average of total score in the control group was lower than that in the experimental group, which indicated that the control group was superior to the experimental group in alleviating pain in a short period of time. There was no significant difference between the two groups in the 0DI score and the improvement rate of 0DI. After two months of treatment, the VAS-ODI Cobb in the two groups was significantly lower than that before treatment, and the SLR was significantly higher than that before treatment, and there was significant difference between the two groups. There was no significant difference between the two groups in the value of VAS-ODII SLR, but there was no significant difference between the two groups. The improvement rate of the two groups was lower than that of the control group. There was a significant difference in the improvement rate of .0DI between the two groups. The changes in the two groups were similar, but both were higher than those before treatment and two weeks after treatment. Conclusion 1. Ding Gui San, Piroxicam patch combined with massage, these two methods in the treatment of cold and wet type LDH in the short and medium can achieve a certain curative effect. 2. In two weeks of treatment, Piroxicam patch was more effective than Dinggui Powder in relieving pain of cold and wet LDH, and had the same effect in improving quality of life, improving scoliosis and recovering lower extremity movement angle of affected side. After two months of treatment, Dinggui Powder was more effective than Piroxicam patch in improving scoliosis of cold and wet type of LDH, and had the same effect in relieving pain, improving quality of life and recovering lower extremity movement angle of affected side. Dinggui Powder combined with massage therapy has the advantages of safe, effective, convenient and cheap, and is worth popularizing and using in clinic.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9
，

本文编号：1790554