梅花针循经叩刺对腰椎间盘突出症术后下肢感觉障碍的疗效分析

Analysis of therapeutic effect of lower limb sensation disorder after lumbar disc herniation operation treated with plum-blossom needle along meridians

目的:比较梅花针循经叩刺与口服甲钴胺治疗腰椎间盘突出症术后下肢感觉障碍的疗效差异,同时探讨梅花针干预的最佳时机。方法:将80例腰椎间盘突出症髓核摘除术后遗留下肢感觉障碍的患者随机分为梅花针组(40例)和西药组(40例)。梅花针组接受梅花针循经叩刺治疗,取相应手术节段神经根支配感觉区域的经络:L3/L4取足太阴脾经下肢段,L4/L5取足少阳胆经下肢段,L5/S1取足太阳膀胱经下肢段,每3天治疗1次,共治疗20次;西药组接受口服甲钴胺片500μg,每日3次。2个月后采用肢体神经感觉功能综合评价方法评估比较两组治疗后下肢感觉障碍恢复情况。结果:梅花针组总有效率为90.0%(36/40),优于西药组60.0%(24/40)(P<0.05)。梅花针组中,术后1个月内采用梅花针治疗优于术后1～3个月开始治疗者(P<0.05),而术后1～3个月与术后3个月以上治疗效果无明显差异(P>0.05)。结论:梅花针循经叩刺治疗腰椎间盘突出症术后下肢感觉障碍效果优于口服甲钴胺,术后1个月内梅花针干预治疗效果最佳。

Objective To compare the differences of therapeutic effect in lower limb sensation disorder after lumbar disc herniation operation treated with plum-blossom needle along meridians and Methylcobalamin with oral administration,and explore the best time for plum-blossom needle intervention.Methods Eighty cases of lower limb sensation disorder caused by nucleus pulposus discectomy of lumbar disc herniation were randomly divided into a plum-blossom needle group（40 cases） and a western medication group（40 cases）.In plum-blossom needle group,tapping with plum-blossom needle along meridians was received,the meridians located at sensation areas which were dominated by relevant segmental nerve root in operation were selected： the lower limb section of the Spleen Meridian of Foot-Taiyin was selected for operation at L3/L4;the lower limb section of the Gall Bladder Meridian of Foot-Shaoyang was selected for operation at L4/L5;the lower limb section of the Bladder Meridian of Foot-Taiyang was selected for operation at L5/S1;once treatment was applied every 3 days,and 20 times treatments were applied totally.In western medication group,Methylcobalamin was orally taken for 500 μg,3 times a day.The recovery of lower limb sensation disorder was evaluated and compared by the comprehensive evaluation method of sensory function of body nerve after 2 months in both groups.Results The total effective rate was 90.0%（36/40） in plum-blossom needle group,superior to that of 60.0%（24/40） in western medication group（P0.05）.In plum-blossom needle group,the effect for the cases which received treatment within one month after operation was superior to that received treatment du-ring 1-3 months after operation（P0.05）;and there was no significant differences between the cases which received the treatment during 1-3 months after operation and more than 3 months after operation（P0.05）.Conclusion The therapeutic effect of lower limb sensation disorder after lumbar disc herniation operation treated with plum-blossom needle along meridians is superior to that of Methylcobalamin with oral administration;the plum-blossom needle intervention within one month after operation can receive the best effect.