针刀松解法对第三腰椎横突综合征临床疗效的研究

发布时间：2018-05-17 04:03

本文选题：第三腰椎横突综合征 + 电针治疗　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的探讨针刀松解疗法治疗第三腰椎横突综合征的临床疗效,以及其对第三腰椎横突局部软组织压痛的改善情况,为更规范的使用针刀松解法治疗第三腰椎横突综合征提供临床依据和数据支持。方法选取2015年2月-2017年1月到湖北省第三人民医院康复科门诊就诊的第三腰椎横突综合征患者。本次研究共68例患者,根据随机、对照原则,随机分为针刀松解治疗组和电针治疗对照组两组,每组34例。对照组采用L1-L3夹脊穴、局部阿是穴、气海俞、肾俞、腰阳关[1]进行电针治疗,治疗组采用局部阿是穴进行针刀松解法治疗。两组均1周为一个疗程,连续治疗3个疗程以后以临床疗效评定、VAS疼痛分值表、改良的日本骨科学会下腰痛评分[2]进行客观评价,观察疗效。结果1.在整体临床疗效的比较上,治疗结束后,针刀松解治疗组控制达13例,显效有10例,有效9例,总有效率94.11%;电针治疗对照组控制6例,显效有9例,有效15例,总有效率88.24%。数据差别存在统计学价值(P0.05),说明两组患者经治疗后均恢复良好;但是针刀治疗组的总有效率明显优于对照组,且治愈例数和显效例数均高于对照组,说明针刀松解法对于第三腰椎横突综合征的疗效更好,明显优于电针治疗组。2.治疗前两组的下腰痛评分(J0A评分)无显著性差异(P0.05),表明两组数据具有可比性。3个疗程结束后,两个组的下腰痛评分(J0A评分)较前相比都有显著性的增加,说明两组治疗方式均对该病有较好的疗效;治疗后电针治疗组平均(21.16±3.04)分,针刀松解治疗组平均(25.83±1.33)分,两组下腰痛评分(J0A评分)有显著差异(P0.05),针刀松解治疗组评分显著高于电针治疗组,表明针刀松解法对患者主观症状、临床体征和日常生活能力等的改善明显优于电针治疗。3.治疗前两组的VAS疼痛评分无显著性差异(P0.05),表明两组数据具有可比性。治疗后VAS疼痛分值比较:电针对照组平均(5.98±2.66)分,针刀松解治疗组平均(2.34±1.78)分;两组VAS评分均有显著差异(P0.05),针刀松解治疗组VAS疼痛评分显著高于电针治疗组,表明针刀松解法对患者横突尖部及其他压痛点的疼痛的缓解、改善明显优于电针治疗。结论针刀松解法对第三腰椎横突综合征的主观症状、临床体征和日常生活能力改善良好,镇痛效果明显,对横突尖部软组织具有良性的调节作用,且整体的综合疗效明显优于电针治疗组。针刀松解法治疗第三腰椎横突综合征疗效显著、简单易行、安全准确、成本低、性价比高、创伤及副作用小,值得临床广泛应用。
[Abstract]:Objective to investigate the clinical effect of acupuncture knife release therapy in the treatment of the third lumbar transverse process syndrome and the improvement of local soft tissue tenderness of the third lumbar transverse process. To provide clinical basis and data support for the treatment of the third lumbar transverse process syndrome with needle knife release. Methods the patients with transverse process syndrome of the third lumbar vertebrae were selected from February 2015 to January 2017 in the Department of Rehabilitation of the third people's Hospital of Hubei Province. In this study, 68 patients were randomly divided into two groups according to the principle of randomization and electroacupuncture treatment, 34 cases in each group. The control group was treated with L1-L3 Jiaji point, local Ashi point, Qi Haishu, Shenshu, Yaoyang Guan [1], and the treatment group was treated with local Ashi acupoint. The two groups were treated for one week. After 3 consecutive courses of treatment, the VAS pain score was evaluated by clinical efficacy, and the lower back pain score [2] of the modified Japanese Orthopaedic Society was evaluated objectively and the curative effect was observed. Result 1. After the treatment, 13 cases were controlled, 10 cases were markedly effective, 9 cases were effective, and the total effective rate was 94.11% in the treatment group, while in the electroacupuncture treatment group, 6 cases were controlled, 9 cases were effective, 15 cases were effective, and the total effective rate was 88.24%. The difference between the two groups showed that the two groups recovered well after treatment, but the total effective rate of the acupuncture knife treatment group was significantly better than that of the control group, and the number of cases of cure and significant effect were higher than that of the control group. The results showed that the treatment of the third lumbar vertebrae transverse process syndrome by needle knife loosening method was better than that of electroacupuncture treatment group. 2. There was no significant difference in the low back pain score and J0A score between the two groups before treatment, indicating that the data of the two groups were comparable. After three courses of treatment, the lower back pain score and the J0A score of the two groups increased significantly compared with the previous ones. The average score of electroacupuncture treatment group was 21.16 卤3.04, and that of acupuncture knife release treatment group was 25.83 卤1.33, and that of electroacupuncture treatment group was 21.16 卤3.04. There was significant difference between the two groups in the score of lower back pain (P 0.05), and the score in the treatment group was significantly higher than that in the electroacupuncture group, indicating that the improvement of subjective symptoms, clinical signs and daily life ability of the patients with acupuncture loosening was better than that of electroacupuncture. There was no significant difference in VAS pain score between the two groups before treatment (P 0.05), which indicated that the data of the two groups were comparable. Comparison of VAS pain scores after treatment: the average score of VAS was 5.98 卤2.66 in the electroacupuncture control group and 2.34 卤1.78 in the acupuncture treatment group, and there was a significant difference in VAS score between the two groups (P 0.05). The VAS pain score in the acupuncture treatment group was significantly higher than that in the electroacupuncture treatment group. The results showed that the relief of pain in the transverse process tip and other tenderness points by acupuncture was better than that by electroacupuncture. Conclusion the method of needle knife release can improve the subjective symptoms, clinical signs and daily living ability of the third lumbar vertebrae transverse process syndrome, and the analgesic effect is obvious, and it has a benign regulating effect on the transverse process tip soft tissue. The comprehensive curative effect of the whole group was better than that of the electroacupuncture group. The treatment of the third lumbar transverse process syndrome by needle-knife loosening is effective, simple, safe, accurate, low cost, high cost, low trauma and little side effects, so it is worthy of wide clinical application.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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