电针加穴位注射治疗腰椎间盘突出症疗效观察

Observations on the Efficacy of Electroacupuncture plus Point Injection in Treating Lumbar Intervertebral Disc Protrusion

目的对电针、穴位注射、电针加穴位注射三种疗法治疗腰椎间盘突出症进行较系统的临床观察。方法选择90例患者,采用简单随机方法,分为电针加穴位注射组(电注组)、电针组(电针组)、穴位注射组(穴注组)三组,每组30例。运用疗效标准和量化标准(JOA和VAS量化评分),分别进行治疗前后的自身比较和组间比较。结果三组治疗前后量化评分自身对比,差异均有统计学意义(P<0.01)。量化评分组间比较显示,电注组明显优于电针组或穴注组(P<0.05);且电注组治愈率比电针组高(P<0.05)。在第1疗程电针疗法优于穴位注射疗法(VAS评分两组比较P<0.05);在第2疗程穴位注射疗法优于电针疗法(VAS评分两组比较P<0.05)。三组病程>12个月病例的治愈率低于病程≤12个月病例的治愈率(P<0.05)。各组肝肾亏虚证的治愈率均低于其他三个中医证型的治愈率(P<0.05)。结论电针加穴位注射治疗腰椎间盘突出症有良好的临床协同效果,但病程大于1年及肝肾亏虚证治愈率较低。

Objective To investigate the efficacies of three therapies,electroacupuncture,point injection and electroacupuncture plus point injection,in treating lumbar intervertebral disc protrusion.Methods Ninety patients were selected and allocated by simple randomization to three groups,electroacupuncture plus point injection,electroacupuncture and point injection,30 cases each.The criteria of therapeutic effects and a quantitative criterion（JOA and VAS） were used.A comparison was made between pretreatment and posttreatment within one group and between different groups.Results There was a statistically significant difference in the score between pretreatment and posttreatment in all the three groups（P〈0.01）.Scoring showed that the effect was significantly better in the electroacupuncture plus point injection group than in the electroacupuncture group or the point injection group（P〈0.05）.The cure rate was significantly higher in the electroacupuncture plus point injection group than in the electroacupuncture group（P〈0.05）.In the first course of treatment, the effect of electroacupuncture was superior to that of point injection（P〈0.05 by VAS analysis）;in the second course of treatment,the effect of point injection was superior to that of electroacupuncture（P〈0.05 by VAS analysis）.In the three groups,the cure rate was significantly lower in the patients with the duration of disease 〉 twelve months than in those ≤ twelve months（P〈0.05）.The cure rate was significantly lower for liver-kidney depletion than for the other three types of syndromes.Conclusion Electroacupuncture plus point injection has clinically a good synergic effect in treating lumbar intervertebral disc protrusion,but the cure rate is lower in the patients with the duration of disease over twelve months and those with liver-kidney depletion.