屈曲位整脊手法配合苗药鸡胚地龙膏治疗对腰椎管狭窄症患者微循环的影响

Effect of spine-massage at flexed positions combined with Jipei ointment on microcirculation of patients with lumbar spinal stenosis

目的观察屈曲位整脊手法配合鸡胚地龙膏治疗对风寒痹痛型腰椎管狭窄症患者腰部和下肢微循环的影响,并初步探讨其微循环效应机制。方法采用随机、药物双盲、手法单盲对照方法,选取120例腰椎管狭窄症患者,随机分为三组,每组40例。治疗Ⅰ组采用屈曲位整脊手法加安慰剂治疗、治疗Ⅱ组采用屈曲位整脊手法加鸡胚地龙膏治疗、治疗Ⅲ组采用鸡胚地龙膏加模拟屈曲位整脊手法治疗。治疗后观察各组治疗前后症状体征积分及腰部、下肢微循环各位点的变化情况。结果①中医症状改善情况:治疗Ⅱ组中医症状疼痛、肢体麻木、畏寒肢冷评分改善情况分别与治疗Ⅰ组、治疗Ⅲ组比较,差异均有统计学意义(P<0.01)。②腰部及下肢微循环测定值比较:治疗后,三组腰部及下肢微循环患侧各位点测定值均较治疗前降低(P<0.01);治疗Ⅱ组各位点测定值分别与治疗Ⅰ组、治疗Ⅲ组比较,差异有统计学意义(P<0.01)。结论屈曲位整脊手法配合鸡胚地龙膏对风寒痹痛型腰椎管狭窄症患者腰部和下肢微循环有显著改善作用,其微循环的改善与临床症状体征的变化有关。

Objective To observe the effect of spine-massage at flexed positions combined with Jipei ointment on the microcirculation of waist and lower limbs of patients with lumbar spinal stenosis characterized by symp toms such as coM and arthralgia,so as to explore the mechanism of microcirculation effect.Methods By Adop ring randomized, double-blinded medicine and single-blinded manipulation controlled methods, 120 patients with lumbar spinal stenosis were divided into 3 groups in random with 40 cases in each group. Group I were treated with spine-massage at flexed positions plus placebo.Group II were treated with spine-massage at flexed positions plus Jipei ointment.Group III were treated with Jipei ointment plus mock spine-massage at flexed positions.Then, changes of symptom and sign scores as well as the microcirculation at various positions of waist and lower limbs were observed before and after treatment.Results ① Comparison of TCM symptom improvement：Compared with Group I and the GroupIII ,Group III improved much more greatly in scores about pain of TCM symptoms, numbness of lower limbs as well as intolerance of coldness and chilly limbs, so the differences were statistically significant（ P 〈0.01）. ②Comparison of mesured values of microcirculation at waist and lower limbs： All pa tients had lower measured values of microcirculation at all positions of waist and lower limbs after treatment（ P 〈0. 01）.But GroupII had the lowest measured values, so the differences from other groups were statistically significant（ P 〈0.01）.Conclusion Spine-massage at flexed positions combined with Jipei ointment can remarkably improve the microcirculation at waist and lower limbs of patients with lumbar spinal stenosis characterized with symptoms of cold and arthralgia.The improvement of microcirculation is correlated with the changes of clinical symptoms and signs.