针刀松解术缓解骨质疏松性脊柱骨折急性期疼痛的临床研究

发布时间：2018-05-13 05:02

本文选题：针刀 + 松解术　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：通过针刀松解术缓解骨质疏松性脊柱骨折急性期疼痛,并设立电针组作为对照,观察患者治疗前后疼痛和腰背功能变化,并评价其疗效,为临床提供一种新的治疗方法。方法：将纳入的64例患者随机分为针刀组和电针组各32例。两组均给予静滴甘露醇脱水、血塞通改善微循环及口服钙尔奇D抗骨质疏松作为基础治疗。针刀组在此基础上使用针刀松解术治疗,1次/日,3次/第1周,1次/第2周,1周为1个疗程,共2个疗程；电针组使用电针治疗,1次/日,5次/周,1周为1个疗程,共2个疗程。于治疗前、治疗第7天和第14天记录患者的VAS疼痛评分和卧床时腰背功能评分,在治疗结束后1个月后行电话随访。结果：1、基线：两组患者性别、年龄、发病时间、压缩椎体分布、治疗前VAS评分及卧床时腰背功能评分比较,差异无统计学意义(P0.05),具有可比性。2、疗效观察指标：两组治疗后的VAS评分和卧床时腰背功能评分均较治疗前明显降低,差异具有统计学意义(P0.05)；针刀组治疗后的VAS评分和卧床时腰背功能评分均低于电针组,差异具有统计学意义(P0.05),且针刀组治疗后的VAS评分和卧床时腰背功能评分下降幅度均大于电针组,差异具有统计学意义(P0.05),综合分析,针刀组优于电针组。3、临床疗效评价：针刀组：治愈率0,显效率68%,有效率32%,无效率0,总有效率100%；电针组：治愈率0,显效率36%,有效率58%,无效率6%,总有效率94%。两组总有效率组间比较,差异具有统计学意义(P0.05),针刀组优于电针组。4、不良事件：治疗期间,两组患者均未发生意外情况及不良事件。5、随访情况：治疗结束后1个月随访,针刀组复发1例,电针组复发3例,两组复发情况比较,差异无统计学意义(P0.05)。结论：1、针刀松解术和电针疗法都可有效地缓解骨质疏松性脊柱急性期疼痛,改善患者卧床时腰背功能,但在缓解疼痛和改善患者腰背功能方面,针刀松解术均优于电针疗法。2、针刀松解术具有定点容易、操作简便,治疗时间短和频次较少,取效快、疗效好、安全性高等优点,患者易于接受,值得临床推广。
[Abstract]:Objective: to relieve the acute pain of osteoporotic spine fracture by acupotomy, and to establish an electroacupuncture group as a control group, to observe the changes of pain and back function before and after treatment, and to evaluate its curative effect, and to provide a new method of treatment. Methods: 64 patients were randomly divided into Acupotomy group and electroacupuncture group (32 cases each). Two The group was treated with dehydrated mannitol, blood Seton ameliorating microcirculation and oral calcium D anti osteoporosis as basic treatment. Needle knife group was treated with Acupotomy on this basis, 1 times / day, 3 / first weeks, 1 / second weeks, 1 weeks for 2 courses, electroacupuncture group using electroacupuncture treatment, 1 times per day, 5 / Zhou, 1 weeks for 1 courses. 2 courses of treatment. Before the treatment, the patients' VAS pain score and the bed back function score were recorded on the seventh and fourteenth days. After the treatment, the telephone followed up 1 months after the treatment. Results: 1, baseline: two groups of patients' sex, age, onset time, compression vertebral distribution, pre treatment VAS score and bed time waist back function score, the difference was no unified Study significance (P0.05), with comparability.2, effect observation index: two groups after treatment, the VAS score and the bed back function score were significantly lower than before the treatment, the difference was statistically significant (P0.05). The VAS score and the bed back function score of the needle knife group were lower than those in the electroacupuncture group, and the difference was statistically significant (P0.05). The VAS score and the lower back function score of the needle group after treatment were all greater than that in the electroacupuncture group (P0.05), and the difference was statistically significant (P0.05). The needle knife group was superior to the electroacupuncture group.3, and the clinical efficacy was evaluated: the cure rate was 0, the effective rate was 68%, the effective rate was 32%, the ineffective rate was 0, the total effective rate was 100%, the curative rate was 0 and the effective rate was 3. 6%, the effective rate was 58%, the invalid rate was 6%, the total effective rate of the total effective 94%. two groups was compared, the difference was statistically significant (P0.05), the needle knife group was better than the electroacupuncture group.4, the adverse events were not occurred in the two groups of patients and adverse events.5, followed up: 1 months after the end of the treatment, 1 cases in the needle knife group, and the recurrence 3 in the electroacupuncture group. There was no significant difference in the recurrence of the two groups (P0.05). Conclusion: 1, acupotomy and electroacupuncture can effectively relieve the acute pain of the osteoporotic spine and improve the back and back function of the patients in bed, but in alleviating pain and improving the function of the waist and back, Acupotomy is superior to the electroacupuncture therapy.2 and needle knife loosening. It is easy to operate, easy to operate, short in treatment time and frequency, quick in efficacy, good in efficacy and high in safety. It is easy for patients to accept and is worthy of clinical promotion.

【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

【参考文献】