[1]谢晓亮,BISSOMBOLO MAKELE Robert(刚果共和国),樊天佑,等.电针华佗夹脊穴与椎间孔镜治疗腰椎间盘突出症对比研究[J].陕西中医杂志,2022,(6):789-792.[doi:DOI:10.3969/j.issn.1000-7369.2022.06.028]
　XIE Xiaoliang,BISSOMBOLO MAKELE Robert,FAN Tianyou,et al.Comparative study of electro-acupuncture at Huatuo Jiaji points and percutaneous endoscopic lumbar discectomy in treatment of lumbar disc herniation[J].,2022,(6):789-792.[doi:DOI:10.3969/j.issn.1000-7369.2022.06.028]
点击复制

电针华佗夹脊穴与椎间孔镜治疗腰椎间盘突出症对比研究
分享到：

《陕西中医》杂志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年6期
页码:
789-792
栏目:
出版日期:
2022-06-05

文章信息/Info

Title:
Comparative study of electro-acupuncture at Huatuo Jiaji points and percutaneous endoscopic lumbar discectomy in treatment of lumbar disc herniation
作者:
谢晓亮; BISSOMBOLO MAKELE Robert(刚果共和国); 樊天佑; 李玉梅; 顾晶亮; 裘敏蕾
(上海中医药大学附属市中医医院,上海 200071)
Author(s):
XIE Xiaoliang; BISSOMBOLO MAKELE Robert; FAN Tianyou; LI Yumei; GU Jingliang; QIU Minlei
(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)
关键词:
腰椎间盘突出症;  电针;  华佗夹脊穴;  经皮内镜下腰椎间盘切除术;  生活质量
Keywords:
Lumbar disc herniation;  Electro-acupuncture;  Huatuo Jiaji points;  Percutaneous endoscopic lumbar discectomy;  Quality of life
分类号:
R 68
DOI:
DOI:10.3969/j.issn.1000-7369.2022.06.028
文献标志码:
A
摘要:
目的:观察电针腰椎华佗夹脊穴与椎间孔镜手术治疗腰椎间盘突出症(LDH)临床疗效。方法:收集187例LDH患者,根据患者意愿分为电针组(n=95)和椎间孔镜组(n=92)。电针组在病变节段患侧选取华佗夹脊穴施以电针治疗,椎间孔镜组则在椎间孔镜系统下行病变节段突出髓核摘除术。比较两组患者VAS、ODI、SF-36量表评分及直腿抬高角度、疗效。结果:治疗后,两组患者VAS、ODI、SF-36评分和直腿抬高角度较治疗前改善(均P<0.05)。治疗后1个月、治疗后3个月,椎间孔镜组VAS、ODI、SF-36评分及直腿抬高角度改善优于电针组(均P<0.05)。治疗后6个月,两组患者VAS、ODI评分比较,差异无统计学意义(均P>0.05),椎间孔镜组直腿抬高角度、SF-36评分改善优于电针组(均P<0.05)。治疗后12个月,两组患者VAS、ODI、SF-36评分及直腿抬高试验比较,无统计学意义(均P>0.05)。治疗后1个月,椎间孔镜组优良率高于电针组(P<0.05); 治疗后12个月,椎间孔镜组优良率与电针组比较,差异无统计学意义(P>0.05)。结论:电针腰椎华佗夹脊穴与椎间孔镜手术治疗腰椎间盘突出症均有效,可改善临床症状,提高生活质量。椎间孔镜组近期疗效优于电针治疗组,两组远期疗效相近。
Abstract:
Objective:To observe clinical efficacy of electro-acupuncture at Huatuo Jiaji points and percutaneous endoscopic lumbar discectomy in the treatment of patients with lumbar disc herniation(LDH).Methods:187 patients with LDH were divided into electro-acupuncture group 95 cases and percutaneous endoscopic lumbar discectomy(PELD)group 92 cases.Patients in the electro-acupuncture group was treated with electro-acupuncture at Huatuo Jiaji points on the diseased segment of affected side,while the PELD group protruding nucleus pulposus removed by PELD system.The VAS score,ODI score,SF-36 score,straight leg elevation angle and efficacy were compared between the two groups.Results: After treatment,VAS score,ODI score,SF-36 score and straight leg elevation angle of the two groups were improved compared with before treatment(all P<0.05).One and three months after treatment,VAS score,ODI score,SF-36 score and straight leg elevation angle improvement in the PELD group were better than those in the electro-acupuncture group(all P<0.05).Six months after treatment,there were no significant differences in VAS and ODI scores between two groups(all P>0.05).The improvement of straight leg elevation angle and SF-36 score in the PELD group were better than those in the electro-acupuncture group(all P<0.05).Twelve months after treatment,there were no statistically significant differences in VAS score,ODI score,SF-36 score and straight leg elevation test between the two groups(all P>0.05).One month after treatment,the excellent and good rate of the PELD group was higher than that of electro-acupuncture group(P<0.05).Twelve months after treatment,there was no significant difference in the excellent and good rate between the two groups(P>0.05).Conclusion:Electro-acupuncture at Huatuo Jiaji points and PELD are effective in the treatment of lumbar disc herniation,which can improve the clinical symptoms and improve the quality of life.The short-term treatment of PELD group was better than that of electro-acupuncture group,and the long-term efficacy of the two groups was similar.

参考文献/References:

[1] 牛朝阳,李鹏超,孟庆良.腰椎间盘突出症的中医诊疗思路探析[J].辽宁中医杂志,2020,47(9):37-40.
[2] 樊天佑.腰椎病中西医结合治疗[M].北京:科学出版社,2017:54-65.
[3] 张丽霞,黄上晏,金 玮,等.内热针针刺腰夹脊穴治疗92例腰椎间盘突出症患者的疗效观察[J].时珍国医国药,2018,29(6):1380-1381.
[4] 邵 萍,杜 震,忻志平,等.电针夹脊穴治疗腰椎间盘突出症:随机对照研究[J].世界针灸杂志,2018,28(3):167-173,231.
[5] 张王华,王 峰,金诚久,等.刺腰夹脊联合四指推脊柱调整手法对腰椎间盘突出症患者腰椎功能及疼痛程度的影响[J].陕西中医,2021,42(1):109-110.
[6] 胡安文,吴博文.靶点靶线体表投影穿刺法在侧路椎间孔镜技术中的应用[J].中国微创外科杂志,2020,20(3):245-249.
[7] 苏 萌,曾腾辉,陈 扬,等.椎间孔镜TESSYS技术与开放手术治疗单节段腰椎间盘突出症疗效比较[J].中国骨与关节损伤杂志,2019,34(1):79-81.
[8] 陈天良,练子荣,陈博来,等.针灸治疗经皮椎间孔镜治疗腰椎间盘突出症术后残余症状临床研究[J].陕西中医,2019,40(8):1138-1140.
[9] 赵晓东,邓立明,王建波,等.椎间孔镜与椎间盘镜治疗腰椎间盘突出症5年疗效比较[J].中国微创外科杂志,2019,19(8):684-687,701.
[10] 董永强,何鑫东,张伟伟,等.经皮椎间孔镜髓核摘除术联合McKenzie疗法治疗腰椎间盘突出症的临床研究[J].中医正骨,2016,28(7):38-41.
[11] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:201-202.
[12] 郭 扬,孙卓然,周思宇,等.术前相邻节段退变对腰椎融合术后相邻节段退变及临床疗效的影响[J].中国脊柱脊髓杂志,2020,30(2):103-110.
[13] 何洪艳,王卫红,刘铭成.中医治疗腰椎间盘突出症研究进展[J].中国实用医药,2014,9(2):249-250.
[14] 袁 帅,蒋 毅.腰椎间盘突出症的临床诊治[J].中国临床医生杂志,2018,46(12):1387-1389.
[15] 杜 震,邵 萍,何永淮,等.电针华佗夹脊穴与药物治疗腰椎间盘突出症比较分析[J].辽宁中医杂志,2009,36(9):1566-1569.
[16] 翟楠楠,戴琪萍,孙亚楠,等.电针夹脊穴结合Tergumed系统训练治疗腰椎间盘突出症临床观察[J].上海中医药大学学报,2016,30(1):36-39.
[17] 汤 俊,吴文虎,倪卫祖.电针不同取穴治疗腰椎间盘突出症60例临床研究[J].中医临床研究,2014,6(10):42-43.
[18] 文 强,张联太,柳玉琴,等.电针华佗夹脊穴治疗腰椎间盘突出症108例临床观察[J].针灸临床杂志,2001,17(5):35-36.
[19] 赵晓明,刘 亮,袁启令,等.椎间孔镜与椎间盘镜治疗腰椎间盘突出症后复发率及翻修率比较的Meta分析[J].中国内镜杂志,2019,25(12):1-8.
[20] Peul WC,Houwelingen HC,Van WB,et al.Surgery versus prolonged conservative treatment for sciatica[J].N Engl Journal Med,2007,356(22):2245-2256.
[21] Weinstein JN,Lurie JD,Tosteson TD,et al.Surgical vs nonoperative treatment for lumbar disk herniationthe spine patient outcomes research trial observational cohort[J].JAMA,2006,296(20):2451-2459.
[22] 刘力源,张建斌,金传阳,等.华佗夹脊穴的归经探索:督脉[J].针刺研究,2018,43(11):744-746.

相似文献/References:

[1]王权亮,高根建,杨 勇.搓飞针刺手法治疗急性腰椎间盘突出症疗效评价及机制研究*[J].陕西中医杂志,2019,(1):116.
[2]肖 伟,龚明发,向文海,等.肌筋膜松弛术结合针灸治疗腰椎间盘突出症临床研究*[J].陕西中医杂志,2019,(7):902.
[3]李道通,毛书歌.手法整骨复位结合中医定向透药疗法治疗腰椎间盘突出症疗效研究*[J].陕西中医杂志,2019,(8):1077.
　LI Daotong,MAO Shuge..Therapeutic effect of manual orthopedic reduction combined with traditional Chinese medicine directed drug therapy for lumbar disc herniation[J].,2019,(6):1077.
[4]陈天良,练子荣,陈博来△,等.针灸治疗经皮椎间孔镜治疗腰椎间盘突出症术后残余症状临床研究[J].陕西中医杂志,2019,(8):1138.
[5]李俊龙,周 景,刘斯文,等.中医外治法在腰椎间盘突出症急性期的应用进展*[J].陕西中医杂志,2019,(8):1145.
　LI Junlong,ZHOU Jing,LIU Siwen,et al.Clinical research progress of external therapy of TCM for acute lumbar disc herniation[J].,2019,(6):1145.
[6]王 雷,郭运岭,王 壮,等.“柔筋调脊”针法治疗腰椎间盘突出症所致慢性腰腿痛疗效研究*[J].陕西中医杂志,2019,(10):1464.
　WANG Lei,GUO Yunling,WANG Zhuang,et al.Observation of the clinical effects on chronic lumbar and leg pain caused by lumbar disc herniation treated with soft muscle and adjust spine acupuncture[J].,2019,(6):1464.
[7]周锡奎,高璟△,徐东华.针刺联合麻黄附子细辛汤加味治疗腰椎间盘突出症临床研究[J].陕西中医杂志,2019,(11):1627.
　ZHOU Xikui,GAO Jing,XU Donghua..Clinical study on treatment of lumbar intervertebral disc herniation with acupuncture combined with Mahuang Fuzi Xixin decoction[J].,2019,(6):1627.
[8]王智群,刘汝专△,张 磊,等.桃红四物汤联合经皮椎间孔镜治疗腰椎间盘突出症疗效研究*[J].陕西中医杂志,2019,(12):1676.
　WANG Zhiqun,LIU Ruzhuan,ZHANG Lei,et al.Clinical study on the treatment of lumbar disc herniation with Taohong Siwu decoction combined with percutaneous endoscopic transluminal discectomy[J].,2019,(6):1676.
[9]刘晶晶,许晓爽,赵 婧,等.独活续断汤辅助治疗老年腰椎间盘突出症疗效〖JZ〗及对患者血清代谢组学的影响*[J].陕西中医杂志,2020,(1):76.
[10]贺韵涵,李晓峰,符 涛,等.针刺干预对肌萎缩侧索硬化症模型小鼠脑及脊髓中IBA-1和TNF-α表达的影响*[J].陕西中医杂志,2020,(3):292.
　HE Yunhan,LI Xiaofeng,FU Tao,et al.Effects of acupuncture on the expression of IBA-1 and TNF-α in the brain and spinal cord in mice with smyotrophic lateral sclerosis disease[J].,2020,(6):292.

备注/Memo

备注/Memo:
基金项目:上海申康发展中心促进市级医院临床技能与临床创新三年行动计划重大临床研究项目(SHDC2020CR1051B)
更新日期/Last Update: 2022-06-09