针刺推拿结合治疗腰椎间盘突出症疗效观察

Curativ Observation of Using Acupuncture Combined with Chinese Massage to Treat Lumbar Disc Herniation

目的:观察针刺推拿结合治疗腰椎间盘突出症的临床疗效。方法:将120例腰椎间盘突出症患者随机分为针推组和针刺组各60例,分别采用针刺推拿结合疗法和单纯针刺法,以临床疗效、疼痛视觉模拟评分VAS、Oswestry功能障碍指数ODI及JOA腰痛评分为观察指标。结果:两组均取得明显的临床疗效,且针推组明显优于针刺组(P<0.001);两种疗法均能明显降低VAS评分及ODI功能障碍指数、提高JOA评分,与针刺组相比,VAS、JOA评分及ODI功能障碍指数均有显著性差异(P<0.001)。结论:针刺、推拿疗法治疗腰椎间盘突出症疗效确切,针刺推拿结合法的疗效明显优于单纯针刺法,尤其在矫正腰椎的生理弧度、使突出的椎间盘部分或彻底复位、松解神经根粘连、改善腰椎功能等方面具有明显的优势,值得推广应用。

Objective： To observe the efficacy of acupuncture combined with Chinese massage in the treatment of Lumbar Disc Herniation （LDH）. Methods： In total, 120 outpatients with LDH were randomly assigned to be treated by acupuncture and Chinese massage or only by acupuncture, 5 times a week, for 4 weeks. The co-primary outcome measures were the changes in VAS, Japanese Orthopaedic Association （JOA） score and the Oswestry Disability Index （ODI） questionnaire and clinical efficacy at the 4^th week. Results： 58 patients by acupuncture with Chinese massage and 57 patients by acupuncture completed the study. Both groups achieved obvious clinical efficacy, and improvement in clinical efficacy by acupuncture with Chinese massage was greater than by acupuncture （ P 〈 0. 001 ）. The endpoint from baseline was significantly decreased in VAS and ODI, while increased in JOA score for both therapy, and improvements were significantly greater for acupuncture with Chinese massage than acupuncture for change in VAS, JOA score and OD1 （P 〈 0. 001）. Conclusion： Acupuncture or Chinese massage is effective in the treatment of LDFI, and effect of acupuncture combined with Chinese massage is superior to acupuncture obviously, particularly with more advantage in correcting lumber vertebra physical radian, promoting restoration of intervertebral disc, releasing the adhesion of spinal nerve root and promoting the function of lumber vertebra, especially worth promoting and applying.