针刀对不同证型腰椎间盘突出症疗效的对比分析

Efficacy comparison of acupotomy therapy on lumbar disc herniation with different syndrome

目的:比较观察针刀对不同证型腰椎间盘突出症的疗效。方法:小针刀治疗297例患者,其中血瘀证107例,寒湿证63例,湿热证42例,肝肾亏虚证85例,应用视觉模拟指数(VAS)法评价疼痛程度,JOA下腰痛评分法评价临床疗效。结果:针刀对腰椎间盘突出症有良好的即时镇痛效果,各证型组间差异无统计学意义;针刀治疗腰椎间盘突出症的总有效率可达100%,优良率94.3%,各证型组间差异性比较,血瘀证组、寒湿证组、湿热证组3组间差异无统计学意义,肝肾亏虚组则差于其他3组,差异有统计学意义(P<0.05)。结论:针刀对不同证型腰椎间盘突出症均有良好的即时镇痛作用;针刀对血瘀证、寒湿证和湿热证等实证型患者疗效优良,而对虚证型患者疗效欠佳;精确选择治疗点是提高针刀治疗腰椎间盘突出症临床疗效的关键。

Objective： It is to compare and observe the curative effect of acupotomy therapy on lumbar disc herniation with different syndrome.Methods： 297 cases with lumbar disc herniation were treated with acupotomy therapy,including 107 cases of blood stasis,63 cases of cold and dampness,42 cases of dampness and heat,85 cases of deficiency of liver and kidney.The degree of pain was evaluated by VAS scores while the clinical effect was evaluated by the JOA scores.Results： The instantly analgesia effective of acupotomy therapy on lumbar disc herniation of different type of syndrome were all well.There was no statistic difference between the groups of different type of syndrome.The total therapeutic effect was 100%,and the good and excellent rate was 94.3%.Adopting Rank sum test and t test,we find that there were no significant differences among syndromes of blood stasis,cold and dampness,dampness and heat.While the syndrome of deficiency of liver and kidney was relatively ineffective（P0.05）.Conclusion： Acupotomy therapy has well instantly analgesia effect on lumbar disc herniation.And it is especially appropriate for syndromes of blood stasis,cold and dampness,dampness and heat.While the syndrome of deficiency of liver and kidney is not very good.And the key point to elevate the clinical curative effect is to choose the treatment point exactly.