踝三针治疗腰椎间盘突出症根性痛临床观察

Clinical observation on ankle-three-needle for treatment of nerve root pain of prolapse of lumbar intervertebral disc

目的:观察踝三针对腰椎间盘突出症根性痛镇痛作用。方法:380例患者随机分为踝三针组、常规针刺组、药物组。踝三针组依据不同的突出节段分别取根痛1、根痛2、根痛3,采用提捏进针法,沿皮刺入;常规针刺组取肾俞、气海俞、突出相应节段的夹脊穴、次等穴,采用平补平泻手法;药物组采用来比林针0·9g加生理盐水2mL常规臀部肌肉注射。结果:踝三针、常规针刺、药物来比林3种治疗方法起效时间分别为6分钟、27分钟、18分钟;3组患者镇痛的维持时间分别是24·48小时、8·93小时、6·36小时,踝三针较其他两种治疗方法差异有显著性意义,而常规针刺组与药物组比无显著差异。3组治疗后各时间点镇痛的评分变化趋势比较差异均有非常显著性意义(P<0·01)。3种治疗方法对0·5、1、24、48小时时点直腿抬高试验测量值的影响差异有极显著性意义(P<0·001)。结论:踝三针对腰椎间盘突出引起的根性痛有显著镇痛效果。

Objective To observe the analgesic effect of ankle-three-needle on nerve root pain of prolapse of lumbar intervertebral disc. Methods Three hundred and eighty cases were randomly divided into an ankle-three-needle group, a routine acupuncture group and a medication group. The ankle-three-needle group were treated with ankle-three-needle therapy, i.e. according to different prolapse segments, points Gentong No. 1, 2 and 3 were selected with lifting-kneading needle insertion method used and the needle was inserted along the skin; the routine acupunc- ture group were treated with acupuncture at Shenshu （BL 23）, Qihaishu （BL 24） and Jiaji （EX-B 2） of the prolapse corresponding segment, and Ciliao （BL 32）, etc. with uniform reinforcing-reducing manipulation; the medication group were treated with routine buttock intramuscular injection of aspirin-DL-lysine plus saline. Results The time inducing analgesia was 6 minin the ankle-three-needle group, 27 rain in the routine acupuncture group and 18 rain in the medication group. The effect-lasting time was 24.48 h in the ankle-three-needle group, 8. 93 h in the routine acupuncture group and 6.36 h in the medication group, with a significant difference as the ankle-three-needle group compared with both the routine acupuncture group and the medication group, but with no significant difference between the routine acupuncture group and the medication group. After treatment, there were very significant differences in change tendency of the analgesic score among the three groups at all the time points （P〈0.01）. And there was very significant differences in the changing tendency of straight-leg raising test among the three groups at 0.5 b, 1 h,24 h and 48 h （P〈0. 001）. Conclusion Ankle-three-needle has obvious therapeutic effect on nerve root pain induced by prolapse of lumbar intervertebral disc.