恢刺法结合舒筋弹拨法治疗梨状肌综合征临床疗效观察

Clinical Obversation of Relaxing Needling Combined with Flicking and Plucking Manipulation for Patients with Pyriformis Syndrome

目的:观察恢刺针法结合舒筋弹拨法治疗梨状肌综合征的临床疗效。方法:将符合诊断标准和纳入标准的患者,按照随机数字表法分为对照组和治疗组,其中对照组(n=38)采用常规针刺治疗,治疗组(n=42)采用恢刺针法结合舒筋弹拨法治疗,两组疗程均为4周。分别观察两组患者治疗前、后临床疗效、疼痛视觉模拟评分(AVS)、数字疼痛评分(NRS)、胫神经H反射及随访复发率。结果:对照组总有效率86.8%,治疗组总有效率95.2%,两组比较差异具有统计学意义(P=0.031);治疗组第1次治疗后VAS、NRS评分较治疗前均降低(P<0.05),与同时期对照组比较差异均具有统计学意义(P<0.05);两组疗程结束时VAS、NRS评分较治疗前均降低(P<0.01),与同时期对照组比较差异均具有显著统计学意义(P<0.01);治疗组治疗后H反射潜伏期明显缩短(P<0.01),对照组治疗后潜伏期缩短(P<0.05),治疗组明显优于对照组(P<0.01);治疗组随访复发1例,复发率2.3%,对照组随访复发3例,复发率7.9%,两组比较差异具有统计学意义(P<0.05)。结论:恢刺针法结合舒筋弹拨法治疗梨状肌综合征能够减轻患者疼痛症状,缩短胫神经H反射潜伏期,改善患者临床症状,疗效显著。

Objective： To observe the clinical effect of relaxing needling combined with flicking and plucking manipulation on patiens with piriformis syndrome. Methods： Patients who met the diagnostic criteria and inclusion criteria were divided randomly into a control group and a treatment group. 38 patients in the control group were treated by conventional acupuncture therapy,while 42 patients in the treatment group received relaxing needling combined with flicking and plucking manipulation. Patients in both groups were treated for 4 weeks.The clinical efficacy,visual analogue scale（ AVS）,numeric rating scale（ NRS）,tibial nerve H reflex and recurrence rate were observed before and after treatment. Results： The total effective rate in the control group was86. 8% and it was 95. 2% in the treatment group. The difference between two groups was statistically significant（ P = 0. 031）; VAS and NRS scores were decreased significantly compared with those before treatment in the treatment group after the first treatment（ P〈0. 05）,and differences were statistically significant compared with those in the control group during the same period（ P〈0. 05）; VAS and NRS scores were decreased significantly compared with those before treatment at the end of the course in both groups（ P〈0. 01）,and differences were statistically significant compared with those in the control group（ P〈0. 01）. After treatment,the latency of H reflex was significantly shorter in the treatment group（ P〈0. 01）,and the latency of H reflex in the control group was shortened（ P〈0. 05）. The treatment group was significantly superior to the control group（ P〈0. 01）. One case was recrudescent in the treatment group and the recurrence rate was 2. 3%; three cases were recrudescent in the control group and the recurrence rate was 7. 9%,with a significant difference between two groups（ P〈0. 05）. Conclusion： Relaxing needling combined with flicking and plucking manipulation can reduce the pain symptoms of patients,shorten the tibial nerve H reflex latency and improve clinical symptoms,with a curative effect.