循经远取动法治疗腰扭伤的临床疗效观察

发布时间：2018-07-25 12:09

【摘要】：目的：观察循经远取动法治疗腰扭伤的临床疗效,为腰扭伤的针刺治疗寻求更有效、更方便的方法。方法：选取60例符合本研究要求的腰扭伤患者随机分为治疗组和对照组各30例,两组均给予基础治疗。治疗组采用循经远取动法,膀胱经型腰扭伤选取患侧攒竹穴、后溪穴,督脉型腰扭伤选取水沟穴,同时结合腰部主动或被动运动,针刺后留针30分钟,每10分钟行针1次,7天为1个疗程,治疗1个疗程。对照组采用常规针刺法,取局部穴位及膀胱经穴为主,针刺肾俞、大肠俞、阿是穴、委中穴,留针30分钟,每10分钟行针1次,7天为1个疗程,治疗1个疗程。观察两组患者首次治疗后的视觉模拟评分(VAS)、腰椎活动度评分(ROM),和治疗1个疗程后的VAS评分ROM评分和腰部功能障碍指数评分(JOA)的变化。所得数据采用SPSS17.0统计软件处理,计量资料采用t检验,用均数±标准差(x±s)表示,计数资料采用卡方检验,等级资料采用秩和检验,P0.05表示具有显著性差异,P0.01表示具有极显著性差异,P0.05表示差异无统计学意义。将两组进行治疗前、首次治疗后和治疗1个疗程后的组内对比和组间比较,观察其临床疗效差异。结果：60例患者均完成本次临床观察研究,无脱落、中止病例,无针刺不良反应发生。1、临床疗效评价：治疗组30例患者中,治愈18例,显效8例,有效3例,无效1例,治愈率60%,总有效率96.7%。对照组30例患者中,治愈12例,显效7例,有效4例,无效7例,治愈率40%,总有效率76.7%,治疗组的治愈率高于对照组。治疗组总有效率与对照组比较,经秩和检验,Z=-2.054,P=0.04,P0.05,差异具有统计学意义,提示总有效率治疗组优于对照组。2、VAS评分比较：两组患者首次治疗后VAS评分较同组治疗前评分有所下降,差异具有统计学意义(P0.01),说明两组患者治疗1次后疼痛感均有不同程度的减轻。首次治疗后治疗组的VAS评分与对照组比较,P0.01,具有极显著性差异,说明首次治疗后治疗组在缓解疼痛方面优于对照组。两组治疗1个疗程后VAS评分与同组治疗前比较,差异具有统计学意义,P0.01,提示两种方法治疗腰扭伤可以缓解患者的腰部疼痛。治疗1个疗程后,治疗组的VAS评分与对照组比较差异具有统计学意义,P0.05,说明治疗组对疼痛的改善程度优于对照组。3、JOA综合评分比较：两组患者治疗1个疗程后JOA综合评分较治疗前均有所降低,(P0.01),说明治疗后的两组患者在自觉症状、日常生活活动功能等方面都有所改善,两种治疗方法均有效。治疗组治疗1个疗程后JOA评分的改善程度优于对照组,治疗1个疗程后两组患者的JOA评分比较差异具有统计学意义P0.01,说明治疗组对腰部功能障碍的改善优于对照组。4、ROM评分比较：两组患者首次治疗后ROM评分较同组治疗前评分均有所下降,比较差异具有统计学意义(P0.01),提示经过1次治疗,治疗组和对照组均可以使腰部活动范围增大。首次治疗后治疗组的ROM评分与对照组比较,P0.05,差异具有统计学意义,提示治疗组对腰椎范围的改善程度更大。治疗1个疗程后两组患者的ROM评分较同组治疗前,比较差异具有统计学意义(P0.01),治疗1个疗程后治疗组的ROM评分与对照组相比,P0.05,具有显著性差异,说明两种方法对腰扭伤的腰椎活动度改善均有效,治疗组优于对照组。结论：1、循经远取动法与常规针刺法治疗腰扭伤均有明显疗效,循经远取动法组疗效更为显著,优于常规针刺法组。2、首次治疗后两组患者的VAS评分、ROM评分较治疗前均有所改善,循经远取动法组疼痛的缓解程度、腰椎活动范围的改善均优于常规针刺法组。3、治疗1个疗程后两组患者的VAS评分、JOA评分和ROM评分较治疗前均下降明显,两种方法均有效,循经远取动法组在缓解患者腰部疼痛、改善腰椎活动范围、提高生活质量等方面均优于常规针刺法组。
[Abstract]:Objective: To observe the clinical effect of the treatment of lumbar sprain in the treatment of lumbar sprain, and to seek more effective and convenient methods for the acupuncture treatment of lumbar sprain. Method: 60 cases of lumbar sprain were randomly divided into treatment group and control group of 30 cases, two groups were given basic treatment. The type of lumbar sprain was selected from the side of the suffering side bamboo point, the posterior stream point, the vein type waist sprain to select the water groove point, combined with the active or passive movement of the waist. After acupuncture, the needle was retained for 30 minutes, 1 times every 10 minutes, 7 days for 1 courses and 1 courses of treatment. The control group adopted the local acupuncture point and the bladder meridian points, and the acupuncture of the Shenshu, the large intestine Shu and the acupoint. To observe the changes of the visual analogue score (VAS) for the first treatment of the two groups of patients (VAS), the lumbar activity score (ROM), the VAS score and the function barrier index score (JOA) after the 1 course of treatment. The results of the data were measured by SPSS17.0 software, and the changes in the VAS score and the function barrier index score (JOA) after the 1 courses of treatment were observed. The data were treated with t test and mean number + standard deviation (x + s). Counting data were checked by chi square test, rank data were tested with rank sum test, P0.05 showed significant difference. P0.01 showed significant difference, P0.05 showed no statistical difference. Two groups were treated before treatment, after first treatment and after 1 courses of treatment. Results: 60 cases completed this clinical observation and study, 60 cases complete this clinical observation, no shedding, discontinuation of cases, no adverse effects of acupuncture,.1, clinical efficacy evaluation: 30 cases in the treatment group, 18 cases, 8 cases, effective 3 cases, 1 cases, cure rate 60%, total effective rate of 96.7%. control group 30 cases. In the patients, 12 cases were cured, 7 cases were markedly effective, 4 cases were effective, 7 cases were invalid, the cure rate was 40%, the total effective rate was 76.7%, the cure rate of the treatment group was higher than the control group. The total effective rate of the treatment group was compared with the control group. The difference had statistical significance through the rank sum test, Z=-2.054, P=0.04, P0.05, suggesting that the total effective treatment group was superior to the control group.2, VAS score comparison: two groups: two groups comparison: two groups comparison: two groups comparison: two groups comparison comparison: two groups comparison: two groups comparison: two groups comparison: two groups comparison: two groups comparison: two groups After the first treatment of the patients, the VAS score was lower than the same group before treatment, the difference was statistically significant (P0.01), indicating that two groups of patients were relieved of pain in different degrees after 1 times of treatment. After the first treatment, the VAS score of the treatment group was compared with the control group, with a significant difference, indicating that the treatment group after the first treatment was relieving pain after the first treatment. The pain was better than the control group. After 1 courses of treatment, the VAS score was compared with the same group before treatment, the difference was statistically significant, P0.01, suggesting that the two methods of treatment of lumbar sprain can relieve the pain of the waist. After the treatment of the 1 courses, the VAS score of the treatment group was statistically significant compared with the control group, P0.05, indicating the pain in the treatment group. The improvement of pain was better than that of the control group.3, and the JOA comprehensive score was compared: the JOA comprehensive score of the two groups was lower after 1 courses of treatment than before the treatment, (P0.01), indicating that the two groups of patients after the treatment were improved in the conscious symptoms, the daily living function and so on, and the two treatment methods were all effective. The treatment group was treated with JOA after 1 courses of treatment. The improvement of the score was better than that of the control group. The difference of JOA score in the two groups after 1 courses of treatment was statistically significant P0.01, indicating that the improvement of the waist dysfunction in the treatment group was better than that of the control group.4, and the ROM score was compared: the ROM score of the two groups was lower than that of the same group after the first treatment, and the difference was statistically significant. Learning significance (P0.01), suggesting that after 1 times of treatment, both the treatment group and the control group could increase the range of the waist activity. After the first treatment, the ROM score of the treatment group was compared with the control group, P0.05, the difference was statistically significant, suggesting that the treatment group improved the extent of the lumbar vertebra greater. After the treatment of the 1 courses, the two groups of patients were compared with the same group treatment. Before 1 courses of treatment, the difference was statistically significant (P0.01). Compared with the control group, the ROM score of the treatment group was significantly different from the control group. It showed that the two methods were effective in improving the lumbar activity of lumbar sprain, and the treatment group was superior to the control group. Conclusion: 1, there was a significant treatment in the treatment of Lumbar Sprain with the method of far fetching and conventional acupuncture. The effect was more significant than the conventional acupuncture group, which was better than the conventional acupuncture group.2. The VAS score of the two groups of patients after the first treatment was improved. The improvement of the ROM score was better than that before the treatment. The improvement of the range of activity of the lumbar vertebra was better than that of the conventional acupuncture group.3, and the VAS score of the two groups after the 1 course of treatment, and JOA evaluation. The score and ROM score were obviously lower than those before the treatment. The two methods were all effective. The group was better than the conventional acupuncture group in alleviating the pain of the waist, improving the range of lumbar activity and improving the quality of life.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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