针刺配合推拿治疗腰椎间盘突出症的临床研究

Clinical Observation on Acupuncture Combined with Massage for Treatment of Lumbar Intervertebral Disc Protrusion

【目的】遵循DME原则设计方案,科学评价针刺配合推拿治疗腰椎间盘突出症的有效性,为临床提供循证医学依据。【方法】将180例患者随机分配到治疗组和对照组。治疗组给予针刺配合推拿治疗,对照组仅给予针刺治疗。2组均治疗12 d后进行疗效评价。采用改良日本骨科学会下腰痛评分法(M-JOA)和国际公认的描述与测量疼痛的简化Mcgill评定表(MPQ)对2组进行评分,观察2组的病情程度分级、病情改善率和不良反应情况。【结果】2组治疗前后病情程度分级比较及病情改善率比较,差异均有显著性意义(P<0.01)。治疗后2组疼痛分级指数(PRI)、目测类比定级法(VAS)、现有痛苦强度(PPI)等各项评分均较治疗前显著降低(P<0.01),而治疗组与对照组在治疗后各项评分的组间比较,差异均有显著性意义(P<0.05)。2组病例均未发生不良反应及安全性问题。【结论】针刺和推拿均能较好地改善症状,但针刺与推拿联合应用能提高疗效。

Objective To evaluate the effectiveness of acupuncture combined with massage for the treatment of lumbar intervertebral disc protrusion on the basis of design,measurement and evaluation of clinical trials.Methods One hundred and eighty qualified patients were randomized into two groups： the treatment group（N=81） received acupuncture combined with massage,and the control group（N=79） received acupuncture alone.The treatment lasted 12 days.The classification and improvement of illness state as well as side effects were evaluated by Modified Japanese Orthopedic Association（M-JOA） and short-form of McGill pain questionnaire（SF-MPQ）.Results The difference of classification and improvement of illness state was significant between the two groups（P〈0.01）.After treatment,the scores of pain rating index（PRI）,visual analog scale（VAS） and present pain intensity（PPI） were decreased in both groups（P〈0.01 compared with those before treatment）,and the differences were significant between the two groups（P〈0.05）.No side effect was found in both groups.Conclusion Both acupuncture and massage can relieve the symptoms of lumbar intervertebral disc protrusion,but the combination of acupuncture and massage has better effect.