腰三针为主配合康复训练治疗腰椎间盘突出症的临床研究

发布时间：2018-05-16 16:13

  本文选题：腰三针疗法 + 康复训练　； 参考：《广州中医药大学》2017年硕士论文

【摘要】：腰椎间盘突出症(Lumbar disc herniation,LDH)是一种以腰痛、下肢放射痛为主要表现的临床常见病,目前治疗的方法可基本分为手术治疗与非手术治疗两大类,针灸康复在LDH的非手术治疗中占有重要地位。本文主要将通过概述LDH的现代针灸治疗进展,展示近年来针灸治疗的研究方向与思路,并提出本病在临床研究中尚且存在的问题,为进一步研究针灸康复治疗LDH提供参考。目的:观察腰三针为主单独电针及与康复训练配合治疗的效应对腰椎间盘突出症的临床疗效,发掘两者的配合优势,为非手术治疗LDH的方法提供进一步参考。方法:采用简单随机对照法,选取符合纳入标准的病例62例,按1:1的比例随机分入腰三针组与联合治疗组,其中腰三针组予以腰三针为主的辨证取穴电针治疗,联合治疗组予以腰三针为主的辨证取穴电针治疗配合康复训练。每天治疗1次,每周治疗5日,10次治疗为一个疗程。治疗前后分别进行JOA下腰痛评价表及0DI问卷表的观察评分,并在完成全部疗程后根据《中医病证诊断疗效标准》中的内容进行疗效评价。统计分析处理采用SPSS 19.0统计软件包,分别进行组内与组间的相关统计学比较。成果:两组患者的一般情况及临床基线资料分别进行对比分析后得出其均无统计学意义(P0.05),说明两组的基线水平一致,研究资料具有可比性。经过一个疗程的治疗后,联合治疗组总有效率为96.7%,腰三针组总有效率为90.3%,两者比较结果具有统计学意义(P0.05)。治疗后两组患者的JOA量表评分均较前提高(P0.05),其中联合治疗组评分的提高更显著,且组间比较具有明显差异(P0.01),故认为联合治疗组疗效优于腰三针组;治疗后两组患者的ODI问卷表评分均较前下降(P0.05),其中联合治疗组评分下降更显著,且组间比较具有明显差异(P0.01),故认为联合治疗组疗效优于腰三针组。结论:腰三针为主的针刺疗法与其配合康复训练的疗法对LDH都有着不错的疗效,能较为明显地改善患者的临床症状及活动功能障碍。相比而言,在腰三针理念指导之下配合康复训练的治疗对改善患者腰腿痛症状及活动功能、日常工作和生活等方面的效果更为显著,联合治疗比单独运用针刺治疗的临床疗效更佳。
[Abstract]:Lumbar disc herniation (LDH) is a common clinical disease characterized by low back pain and radiation pain of lower extremity. The current treatment methods can be divided into two categories: surgical treatment and non-operative treatment. Acupuncture rehabilitation plays an important role in non-operative treatment of LDH. This article will summarize the progress of modern acupuncture and moxibustion therapy of LDH, show the research direction and train of thought of acupuncture treatment in recent years, and put forward the existing problems of this disease in clinical research, which will provide a reference for further research on acupuncture rehabilitation therapy LDH. Objective: to observe the clinical effect of the treatment of lumbar intervertebral disc herniation with three lumbar acupuncture and rehabilitation training, explore the advantages of the two, and provide a further reference for the non-operative treatment of LDH. Methods: 62 cases were randomly divided into three lumbar acupuncture group and combined treatment group according to the 1:1 ratio, in which the lumbar three acupuncture group was treated with the syndrome differentiation and acupoint electroacupuncture of the lumbar three acupuncture group, and 62 patients who met the inclusion criteria were randomly divided into the lumbar three acupuncture group and the combined treatment group. The combined treatment group was treated with syndrome differentiation and acupoint electroacupuncture combined with rehabilitation training. Once a day, 5 days a week, 10 times a course of treatment. The JOA low back pain evaluation table and the 0DI questionnaire were observed before and after the treatment, and the curative effect was evaluated according to the content of TCM disease syndrome diagnosis curative effect standard after the completion of the whole course of treatment. The statistical analysis was carried out by SPSS 19.0 software package, and the correlation between the two groups was compared. Results: the general situation and clinical baseline data of the two groups were compared and analyzed respectively. The results showed that there was no statistical significance between the two groups, indicating that the baseline level of the two groups was the same, and the research data were comparable. After a course of treatment, the total effective rate of the combined treatment group was 96.7g and the total effective rate of the lumbar three-needle group was 90.30.The comparison between the two groups was statistically significant (P 0.05). After treatment, the scores of JOA scale in both groups were higher than those in the previous group, and the scores of the combined treatment group were significantly higher than those of the former group, and there was a significant difference between the two groups. Therefore, the therapeutic effect of the combined treatment group was better than that of the lumbar three-needle group. After treatment, the scores of ODI questionnaire in the two groups were lower than those in the former group (P 0.05), and the scores of the combined treatment group were significantly lower than those of the control group, and there was a significant difference between the two groups. It was concluded that the therapeutic effect of the combined treatment group was better than that of the lumbar three needle group. Conclusion: the acupuncture therapy combined with rehabilitation training has a good effect on LDH and can obviously improve the clinical symptoms and motor dysfunction of the patients. In contrast, the treatment with rehabilitation training under the guidance of the idea of three lumbar needles is more effective in improving the symptoms and activities of low back pain, daily work and life, etc. The clinical effect of combined therapy is better than that of acupuncture alone.
【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】：R246.9
，

本文编号：1897540