[1]陶 龙,蒋 涛,孙培养,等.针刺联合关节错缝复位术治疗腰椎间盘突出症急性期疗效及对患者疼痛和腰椎功能康复的影响[J].陕西中医,2024,(1):124-127.[doi:DOI:10.3969/j.issn.1000-7369.2024.01.029]
　TAO Long,JIANG Tao,SUN Peiyang,et al.Curative effect of acupuncture combined with joint dislocation reduction and its influences on pain and recovery of lumbar function in patients with acute lumbar disc herniation[J].,2024,(1):124-127.[doi:DOI:10.3969/j.issn.1000-7369.2024.01.029]
点击复制

针刺联合关节错缝复位术治疗腰椎间盘突出症急性期疗效及对患者疼痛和腰椎功能康复的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年1期
页码:
124-127
栏目:
针灸经络
出版日期:
2024-01-05

文章信息/Info

Title:
Curative effect of acupuncture combined with joint dislocation reduction and its influences on pain and recovery of lumbar function in patients with acute lumbar disc herniation
作者:
陶 龙; 蒋 涛; 孙培养; 倪 璐; 陈 飞; 郭庆军; 吴志东; 王 坤; 桂美琳; 何雨霞
(安徽中药大学第二附属医院,安徽 合肥 230061)
Author(s):
TAO Long; JIANG Tao; SUN Peiyang; NI Lu; CHEN Fei; GUO Qingjun; WU Zhidong; WANG Kun; GUI Meilin; HE Yuxia
(Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230061,China)
关键词:
腰椎间盘突出症;  关节错缝复位术;  针刺;  急性期;  疼痛;  腰椎功能
Keywords:
Lumbar disc herniation;  Joint dislocation reduction;  Acupuncture;  Acute stage;  Pain;  Lumbar function
分类号:
R 658.53
DOI:
DOI:10.3969/j.issn.1000-7369.2024.01.029
文献标志码:
A
摘要:
目的:探究针刺联合关节错缝复位术治疗腰椎间盘突出症(LDH)急性期患者的治疗效果。方法:选取84例LDH急性期患者,随机分为观察组和对照组,两组各42例。对照组行关节错缝复位术,观察组在此基础上联合针刺法治疗。观察两组治疗后的疗效和住院时间、治疗前后疼痛(VAS)和腰椎功能评分、中医证候、腰部活动度、疼痛介质[5-羟色胺(5-HT)、前列腺素E2(PGE2)和P物质(SP)]水平和不良反应发生情况。结果:治疗后,与对照组比较,观察组VAS评分较低、JOA评分较高(P<0.05); 治疗后,与对照组比较,观察组胸腹胀满、腰膝无力两项积分较低(P<0.05); 治疗后,两组患者腰部屈曲、伸展和侧屈活动范围比较均有所升高,观察组高于对照组(P<0.05); 两组患者疼痛介质5-HT、PGE2和SP水平比较均有所降低,观察组低于对照组(P<0.05); 观察组住院时间短于对照组(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:采用针刺联合关节错缝复位术治疗LDH急性期患者,其疗效良好,能提高患者腰椎功能,减轻患者疼痛程度和中医证候,缩短患者住院时间,且安全性良好。
Abstract:
Objective:To explore the curative effect of acupuncture combined with joint dislocation reduction and its influences on pain and recovery of lumbar function in patients with acute lumbar disc herniation(LDH).Methods:A total of 84 patients with acute LDH were enrolled and randomly divided into observation group(42 cases,joint dislocation reduction + acupuncture)and control group(42 cases,joint dislocation reduction).The curative effect and hospitalization time after treatment,scores of visual analogue scale(VAS),lumbar function and TCM syndromes before and after treatment,lumbar range of motion,levels of pain mediators(5-hydroxytryptamine [5-HT],prostaglandin E2 [PGE2],substance P [SP])and the occurrence of adverse reactions in the two groups were observed.Results:After treatment,VAS score was decreased in both groups,which was lower in observation group than control group,while JOA score was increased,which was higher in observation group than control group(P<0.05).After treatment,scores of TCM syndromes(abdominal distension,waist-leg weakness)were decreased in both groups,which were lower in observation group than control group(P<0.05).After treatment,range of motion values(lumbar flexion,extension,lateral flexion)were increased in both groups,which were greater in observation group than control group(P<0.05).After treatment,levels of 5-HT,PGE2 and SP were decreased in both groups,which were lower in observation group than control group(P<0.05).The hospitalization time was shorter in observation group than control group(P<0.05),but the difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion: Acupuncture combined with joint dislocation reduction has good curative effect in patients with acute LDH,which can improve lumbar function,relieve pain and TCM syndromes,and shorten hospitalization time,with good safety.

参考文献/References:

[1] 葛郁龙,康银辉.术前坐骨神经传导速度与腰椎间盘突出症经皮椎间孔镜下椎间盘切除治疗效果相关性研究[J].陕西医学杂志,2022,51(10):1253-1255.
[2] 包士雷,王彤,刘守国,等.不同牵引方式应用于非急性期腰椎间盘突出患者的疗效观察[J].中国伤残医学,2020,28(13):25-28.
[3] 罗刚,钟卓泰,李丽霞.关节错缝术配合针刺治疗老年腰椎间盘突出症的疗效观察[J].广州中医药大学学报,2020,37(9):1707-1711.
[4] 王晓明,李民,谭婕,等.针刺结合痧点放血治疗腰椎间盘突出症急性期疗效观察[J].中华中医药杂志,2020,35(9):4753-4757.
[5] 谢碧玉,曾密,李玮儒.针灸联合中医定向透药疗法对腰椎间盘突出症急性期的疗效及对CRP的影响[J].岭南急诊医学杂志,2021,26(5):534-535.
[6] 胥少汀,葛宝丰.实用骨科学[M].3版.北京:人民军医出版社,2005:1678-1679.
[7] 国家中医药管理局.中医病证诊断疗效标准[J].湖北中医杂志,2002,10(2):57-58.
[8] 国家中医药管理局医政司.中医骨伤科病证诊断疗效标准[M].南京:南京大学出版社,1994:6-28.
[9] 高万露,汪小海.视觉模拟疼痛评分研究的进展[J].医学研究杂志,2013,42(12):144-146.
[10] KATO S,OSHIMA Y,MATSUBAYASHI Y,et al.Minimum clinically important difference and patient acceptable symptom state of japanese orthopaedic association score in degenerative cervical myelopathy patients[J].Spine,2019,44(10):691-697.
[11] 越雷,陈浩,李淳德,等.脊柱矢状位动态平衡的研究和应用进展[J].中国脊柱脊髓杂志,2021,31(11):1034-1038.
[12] 洪秋阳,杨惠民,王桂玲,等.针刺骨法配合委中放血治疗腰椎间盘突出症疗效观察[J].世界中西医结合杂志,2018,13(2):153-156.
[13] 陈晓.针刺配合腰椎稳定肌群训练治疗腰椎间盘突出症临床观察及对NRS、JOA评分的分析[J].中医临床研究,2019,11(20):114-116.
[14] 王楠,钱宇章,谢林.不同针刺方法治疗腰椎间盘突出症的网状Meta分析[J].中国组织工程研究,2022,26(5):813-820.
[15] 蒿飞,杨晓梅,范文海,等.针刺夹脊穴结合腰椎牵引治疗腰椎间盘突出症疗效及对腰椎功能、炎性因子的影响[J].中医学报,2022,37(7):1535-1540.
[16] 梅求安,周仲瑜,王刚,等.激痛点针刺联合益气活血方治疗腰椎间盘突出症急性期的疗效观察[J].中国中医急症,2022,31(10):1825-1828.
[17] 潘昊天,李璟,冯晨晨,等.燔针劫刺针法对椎间盘源性坐骨神经痛疗效的影响:随机对照试验[J].中国针灸,2022,42(3):261-266.
[18] 黄建,汪洪,徐文博.激痛点针刺联合脊柱平衡法治疗腰椎间盘突出症急性期的疗效观察[J].中国中医急症,2022,31(12):2197-2199.
[19] 黎强.针刺、艾灸联合身痛逐瘀汤加减治疗腰椎间盘突出症的疗效及对血清生化指标的影响[J].贵州医药,2022,46(1):114-115.
[20] 吕小龙,张聪伟,杨莉.夹脊穴针刺联合腰部“桥式”运动疗法对腰椎间盘突出症患者的治疗效果观察[J].贵州医药,2022,46(3):399-401.
[21] 王婷婷,张向云.温针灸联合中医定向透药治疗虚寒型膝关节骨性关节炎30例总结[J].湖南中医杂志,2020,36(8):84-85.
[22] 李明辉,朱小虎,程宇核,等.激痛点针刺联合神经松动术治疗腰椎间盘突出症所致坐骨神经痛的疗效研究[J].中国中医急症,2019,28(6):992-995.
[23] 莫冬梅,王岱稳,张晓强,等.针刺对腰椎间盘突出症患者下肢运动功能障碍及感觉功能的影响[J].西部中医药,2022,35(5):140-143.
[24] 曹凤,彭志杰,冯勇伟,等.头针运动疗法治疗急性期腰椎间盘突出症的随机对照研究[J].中国中医急症,2022,31(3):469-472.
[25] 蒋晨浩,蔡靓羽,张建楠,等.循经体外冲击波联合针刺补泻“五输穴”治疗血瘀型腰椎间盘突出症的疗效观察[J].实用临床医药杂志,2022,26(4):46-49,72.

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,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,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,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,(1):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,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,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,(1):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,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,(1):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,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,(1):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,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,(1):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,2020,(1):76.
[10]王远庆,吴耀持.超微针刀网点状松解法对腰椎间盘突出症患者VAS评分和JOA腰椎疾患评分的影响[J].陕西中医,2020,(4):541.
　WANG Yuanqing,WU Yaochi..The effect of ultra fine needle knife on VAS score and JOA lumbar disease score in patients with lumbar disc herniation[J].,2020,(1):541.

备注/Memo

备注/Memo:
基金项目:第七批全国老中医药专家学术经验继承工作项目[国中医药人教函(2022)76号]; 安徽省“十四五”省级中医优势特色专科—推拿科项目[皖中医药服务秘(2021)71号]; 第五批全国中医临床优秀人才研修项目[国中医药人教函(2022)1号]
更新日期/Last Update: 2024-01-09