激痛点针刺联合神经松动术治疗干性坐骨神经痛的临床研究
发布时间：2018-10-30 09:45
【摘要】：目的:本研究拟采用激痛点针刺联合神经松动术治疗干性坐骨神经痛,观察治疗前后及随访两个月患者的简化McGill疼痛问卷积分(SF-MPQ评分,包括PRI、VAS及PPI评分)与Oswestry功能障碍指数(CODI评分)的变化及其临床疗效,分析其具体的作用原理,以期缩短患者的治疗时间,提高干性坐骨神经痛的远期疗效,为本病的诊治提供新思路、新方法。方法:选取2015年6月至2016年12月在十堰市太和医院东院区骨科康复3病区住院的且符合纳入标准的患者60例,按照就诊先后时间顺序进行随机分组(采用随机数字表法),将其分为治疗组和对照组,每组各30例。两组患者均接受常规康复治疗(磁疗、超短波、经皮电刺激),治疗组加用激痛点针刺联合神经松动术进行治疗,对照组加用普通针刺联合传统推拿术进行治疗,每天1次,7天为一个疗程,治疗组共治疗2个疗程,对照组治疗3个疗程,每个疗程期间休息一天。观察两组患者治疗前后及随访2个月的SF-MPQ评分及CODI评分,并将两组的疗效进行对比。结果:(1)治疗前,两组研究对象的疼痛分级指数(PRI评分)、视觉模拟评估(VAS评分)、现时疼痛强度(PPI评分)、SF-MPQ总评分及CODI评分的对比结果显示,两组间差异无统计学意义(P0.05),表明组间具有可比性。(2)治疗后,两组研究对象的PRI评分、VAS评分、PPI评分、SF-MPQ总评分及CODI评分较治疗前均有降低,差异均具有统计学意义(P0.01或P0.05);同时,治疗组研究对象的上述评分较治疗前降低程度更加明显,差异有统计学意义(P0.01);由此说明,治疗组在改善研究对象的疼痛及功能障碍方面更有优势。(3)2个月随访时,治疗组与对照组的CODI评分及SF-MPQ总评分比较,治疗组均低于对照组,差异仍具有统计学意义,说明治疗组在远期仍能更加有效地改善研究对象的疼痛及功能障碍。(4)治疗结束后,治疗组的总有效率(93.3%)明显高于对照组(83.3%),二者差异无统计学意义(P0.05),说明治疗后两组总有效率基本相当;2个月随访时,治疗组总有效率(92.9%)明显高于对照组(66.7%),且二者差异具有统计学意义(P0.05),说明治疗组的远期总有效率优于对照组。结论:(1)治疗组与对照组采用的方法能有效减轻干性坐骨神经痛患者的疼痛程度,且治疗组采用的激痛点针刺联合坐骨神经松动术效果更加明显,且这种效果远期仍具有优势。(2)治疗组与对照组采用的方法都能有效的改善干性坐骨神经痛患者的功能障碍,且治疗组采用的激痛点针刺联合坐骨神经松动术效果更加明显,且这种效果远期仍具有优势。(3)治疗组与对照组采用的方法对干性坐骨神经痛都具有显著疗效,且治疗组采用的激痛点针刺联合坐骨神经松动术的远期疗效更加明显。
[Abstract]:Objective: the purpose of this study was to treat dry sciatica with excitatory pain point acupuncture combined with nerve loosening, and to observe the simplified McGill pain questionnaire score (SF-MPQ score, including PRI,) before and after treatment and follow-up for two months. The changes of VAS and PPI scores and Oswestry dysfunction index (CODI score) and their clinical efficacy were analyzed, and the mechanism of their action was analyzed in order to shorten the treatment time and improve the long-term effect of dry sciatica. To provide new ideas and methods for the diagnosis and treatment of this disease. Methods: from June 2015 to December 2016, 60 patients who were hospitalized in the orthopaedic rehabilitation area of Taihe Hospital, Shiyan City, were randomly divided according to the order of visiting time (using random digital table method). They were divided into treatment group and control group with 30 cases in each group. The patients in both groups were treated with routine rehabilitation therapy (magnetic therapy, ultrashort wave, percutaneous electric stimulation), the treatment group was treated with excitatory pain point acupuncture combined with nerve loosening, and the control group was treated with common acupuncture combined with traditional massage once a day. 7 days as a course of treatment, treatment group 2 courses of treatment, control group 3 courses of treatment, each course of rest during one day. The SF-MPQ score and CODI score of the two groups were observed before and after treatment and 2 months follow-up, and the efficacy of the two groups was compared. Results: (1) before treatment, the pain grading index (PRI), visual analogue assessment (VAS), current pain intensity (PPI), total SF-MPQ score and CODI score were compared between the two groups. There was no significant difference between the two groups (P0.05), indicating comparability between the two groups. (2) after treatment, the PRI score, VAS score, PPI score, SF-MPQ total score and CODI score of the two groups were lower than those before treatment. The differences were statistically significant (P0.01 or P0.05). At the same time, the above scores of the treatment group were significantly lower than those before treatment (P0.01). The results showed that the treatment group had more advantages in improving pain and dysfunction. (3) after 2 months follow-up, the CODI score and the total SF-MPQ score of the treatment group and the control group were lower than those of the control group. The difference is still statistically significant, indicating that the treatment group can improve pain and dysfunction more effectively in the long term. (4) after treatment, The total effective rate of the treatment group (93.3%) was significantly higher than that of the control group (83.3%). There was no significant difference between the two groups (P0.05). After 2 months follow-up, the total effective rate in the treatment group (92.9%) was significantly higher than that in the control group (66.7%), and the difference between the two groups was statistically significant (P0.05), which indicated that the total long-term effective rate of the treatment group was better than that of the control group. Conclusion: (1) the treatment group and the control group can effectively reduce the pain degree of the patients with dry sciatica, and the effect of the treatment group is more obvious. Both the treatment group and the control group can effectively improve the dysfunction of patients with dry sciatica. The effect of acupuncture combined with sciatic nerve loosening was more obvious in the treatment group than in the control group. (3) both the treatment group and the control group had significant curative effects on dry sciatica. In the treatment group, the long-term effect of acupuncture combined with sciatic nerve loosening was more obvious.
【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】：R246.6
本文编号：2299646
[Abstract]:Objective: the purpose of this study was to treat dry sciatica with excitatory pain point acupuncture combined with nerve loosening, and to observe the simplified McGill pain questionnaire score (SF-MPQ score, including PRI,) before and after treatment and follow-up for two months. The changes of VAS and PPI scores and Oswestry dysfunction index (CODI score) and their clinical efficacy were analyzed, and the mechanism of their action was analyzed in order to shorten the treatment time and improve the long-term effect of dry sciatica. To provide new ideas and methods for the diagnosis and treatment of this disease. Methods: from June 2015 to December 2016, 60 patients who were hospitalized in the orthopaedic rehabilitation area of Taihe Hospital, Shiyan City, were randomly divided according to the order of visiting time (using random digital table method). They were divided into treatment group and control group with 30 cases in each group. The patients in both groups were treated with routine rehabilitation therapy (magnetic therapy, ultrashort wave, percutaneous electric stimulation), the treatment group was treated with excitatory pain point acupuncture combined with nerve loosening, and the control group was treated with common acupuncture combined with traditional massage once a day. 7 days as a course of treatment, treatment group 2 courses of treatment, control group 3 courses of treatment, each course of rest during one day. The SF-MPQ score and CODI score of the two groups were observed before and after treatment and 2 months follow-up, and the efficacy of the two groups was compared. Results: (1) before treatment, the pain grading index (PRI), visual analogue assessment (VAS), current pain intensity (PPI), total SF-MPQ score and CODI score were compared between the two groups. There was no significant difference between the two groups (P0.05), indicating comparability between the two groups. (2) after treatment, the PRI score, VAS score, PPI score, SF-MPQ total score and CODI score of the two groups were lower than those before treatment. The differences were statistically significant (P0.01 or P0.05). At the same time, the above scores of the treatment group were significantly lower than those before treatment (P0.01). The results showed that the treatment group had more advantages in improving pain and dysfunction. (3) after 2 months follow-up, the CODI score and the total SF-MPQ score of the treatment group and the control group were lower than those of the control group. The difference is still statistically significant, indicating that the treatment group can improve pain and dysfunction more effectively in the long term. (4) after treatment, The total effective rate of the treatment group (93.3%) was significantly higher than that of the control group (83.3%). There was no significant difference between the two groups (P0.05). After 2 months follow-up, the total effective rate in the treatment group (92.9%) was significantly higher than that in the control group (66.7%), and the difference between the two groups was statistically significant (P0.05), which indicated that the total long-term effective rate of the treatment group was better than that of the control group. Conclusion: (1) the treatment group and the control group can effectively reduce the pain degree of the patients with dry sciatica, and the effect of the treatment group is more obvious. Both the treatment group and the control group can effectively improve the dysfunction of patients with dry sciatica. The effect of acupuncture combined with sciatic nerve loosening was more obvious in the treatment group than in the control group. (3) both the treatment group and the control group had significant curative effects on dry sciatica. In the treatment group, the long-term effect of acupuncture combined with sciatic nerve loosening was more obvious.
【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】：R246.6
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