针推结合治疗腰椎间盘突出症的临床研究

发布时间：2018-06-20 16:46

本文选题：腰椎间盘突出症 + 针刺　；参考：《广州中医药大学》2016年博士论文

【摘要】：背景：近年来腰椎间盘突出已经成为我国最为主要的疾病之一,其根源在于腰间盘退变,日常生活中急性扭伤、慢性劳损等都是腰间盘突出的主要诱因。这些原因会导致人体纤维环破裂,髓核会逐渐从纤维环破裂的地方溢出,逐渐在腰间盘和神经根之间扩散。大量的骨核蛋白以及P蛋白会在很大程度上对人体神经产生刺激作用,再加上组织胺的作用,最终会导致化学性神经根炎的发生,对患者的生活、工作和劳动均可造成很大的影响。如何选用更有效的治疗方法,减轻病人的痛苦和社会负担,已成为当前国内外的研究热点。目的：本文在相关理论、文献的支持下,运用中医治疗方法结合的理念和原则,采用临床实验设计的方法对腰间盘突出的治疗效果进行研究,观察针推五步法治疗腰推间盘突出症的临床分期和总体疗效,并与单独针刺治疗和单独推拿治疗腰椎间盘突出症的疗效进行比较,以验证最佳治疗方案,为临床治疗方法的选择提供依据和参考。方法：将符合要求的90例患者随机分为试验组30例和两对照组各30例,试验组组患者给予针推结合治疗,对照组患者给予常规针刺、常规推拿治疗,三组各治疗两个疗程共一个月。疗程完毕后进行疗效评价。观测指标：以日本下腰痛JOA量表、生活质量QOL量表、McGill疼痛量表,分别在治疗前、治疗1周、治疗2周、治疗3周、治疗4周和一个月后进行评分。结果：1、治疗前,试验组与两对照组在患者年龄、性别和病程,治疗前各项指标评分分别进行统计学检验,结果无明显差异(P0.05),具有可比性。2、试验组和两对照组治疗后自身前后对比,观察指标JOA、QOL, McGill各项程度和积分均获得明显改善,经统计学处理有显着性差异,三组两两比较有统计学差异,其中试验组针推结合组最为显著,改善最大。结论：针推结合与常规针刺和常规推拿三种治疗方式,均能有效的改善腰椎间盘突出症,生活质量亦有效改善。本研究经过三种的治疗观察,针推结合治疗效果优于常规针刺、推拿治疗,具有明显的优势,是一种安全有效的疗法,值得在临床实践中应用。
[Abstract]:Background: in recent years, lumbar disc herniation has become one of the most important diseases in China, its root is lumbar disc degeneration, daily life acute sprain, chronic strain are the main causes of lumbar disc herniation. These causes lead to the rupture of the human fibrous ring and the gradual spillover of the nucleus pulposus from the site of the rupture of the fibrous ring, gradually spreading between the lumbar disc and the nerve root. A large number of bone nucleoproteins and P proteins can stimulate the nerves of the human body to a large extent, plus the role of histamine, which will eventually lead to the occurrence of chemical radiculitis and the life of the patients. Both work and labor have a great impact. How to select more effective treatment methods to alleviate the pain and social burden of patients has become a hot spot at home and abroad. Objective: to study the therapeutic effect of lumbar disc herniation with the support of relevant theory and literature, using the idea and principle of combination of traditional Chinese medicine treatment method and clinical experimental design. To observe the clinical stage and overall curative effect of acupuncture and five steps method in treating lumbar intervertebral disc herniation, and to compare the effect of acupuncture alone and massage alone in the treatment of lumbar intervertebral disc herniation, in order to verify the best treatment scheme. To provide the basis and reference for the selection of clinical treatment methods. Methods: 90 patients were randomly divided into the experimental group (n = 30) and the control group (n = 30). The patients in the experimental group were treated with acupuncture combined with massage, while the patients in the control group were treated with routine acupuncture and massage. Each group had two courses of treatment for one month. The curative effect was evaluated after the course of treatment. Outcome measures: JOA scale for low back pain and McGill pain scale for quality of life (QOL) were evaluated before treatment, 1 week, 2 weeks, 3 weeks, 4 weeks and 1 month after treatment, respectively. Results before treatment, the patients' age, sex, course of disease, and the scores of each index before treatment were statistically examined in the trial group and the two control groups. Results there was no significant difference between the two groups (P 0.05, P 0.05), and there was a significant difference between the experimental group and the two control groups before and after treatment. The observed indexes of JOAA QOLand McGill were improved obviously, and there was significant difference between the two groups. There were statistical differences among the three groups, among which the acupuncture and push combined group was the most significant and the improvement was the most significant in the experimental group. Conclusion: acupuncture combined with conventional acupuncture and conventional massage can effectively improve lumbar disc herniation and quality of life. After three kinds of treatment observation, the effect of acupuncture combined with massage therapy is superior to that of conventional acupuncture and massage therapy. It has obvious advantages and is a safe and effective therapy, which is worthy of application in clinical practice.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R246.9

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