耳针不同刺法对腰椎间盘突出症快速镇痛效应的比较研究

Study on the effects of the auricular acupuncture with different manipulations for rapid analgesia on the patients with lumbar disc hernia

目的:比较耳针沿皮透穴刺法与耳针直刺法对腰椎间盘突出症的快速镇痛效应,为本病找寻更佳的耳针刺法。方法:将92例患者按性别、年龄和疼痛程度3个预后因素一一配对,每对受试对象随机分到透刺组和直刺组,透刺组采用耳针沿皮透穴刺法,直刺组采用耳穴直刺法,均穴取双侧腰椎区,并随症配穴。全部病例通过简化McGill疼痛评分表(简化MPQ),在治疗前、针刺后5 min和30 min分别记录其疼痛积分,观察两组治疗前后的疗效差别。结果:序贯试验结果显示,透刺组在针刺后5 min男性患者的镇痛效应优于直刺组(P<0.05),而女性患者两组间差异无统计学意义(P>0.05);透刺组在针刺后30 min时的镇痛效应优于直刺组(P<0.05)。配对t检验结果显示,除轻度患者针刺后5 min疼痛积分两组比较差异无统计学意义(P>0.05)外,透刺组在针刺后5 min和30 min对腰椎间盘突出症的镇痛效应均优于直刺组(P<0.05,P<0.01)。结论:透刺对腰椎间盘突出症的快速镇痛效应优于直刺法。

Objective To compare the effects of the point-to-point needling and perpendicular needling of auricu- lar acupuncture for rapid analgesia on the patients with lumbar disc hernia, and find which method is better for this disease. Methods Ninety two patients were paired according to the three factors as sex, age and degree of pain, and then randomly divided into the point-to-point needling group and perpendicular needling group. The methods of point-to-point needling through the skin and perpendicular needling towards the skin were respectively applied at bi- lateral lumbar areas as auricular acupuncture, and added acupoints following the change of symptom. All patients accorded with the demands of McGill pain questionnaire （MPQ）, before treatment, 5 and 30 min after treatment, the accumulated score of pain was recorded respectively for observing the difference of the effects in both groups. Results After 5 min treatment, the effect of analgesia on the male patients in the point to-point needling group was better than that of in the perpendicular needling group （P〈0.05）, but there was no difference on the female pa- tients in both groups （P^0.05）. After 30 rain treatment, the effect of analgesia in the point-to-point needling group was better than that of the perpendicular needling group （P〈0.05）. Besides the patients with light degree pain, there was no significant difference between the two groups after 5 min treatment as score of pain （P〉0.05）, paired t-test showed that the effects of analgesia on the patients with lumbar disc hernia in the point-to-point nee- dling group was better than that of perpendicular needling group （P〈0.05）. Conclusion The point-to-point needling method can rapidly relieve patients~ lumbar disc hernia of pain, which is better than the perpendicular needling method.