温针灸与低频脉冲电联合维生素B_1与腺苷钴胺治疗腓总神经损伤随机平行对照研究

Warm Acupuncture and Low Frequency Pulse combined with Vitamin B_1 and Adenosine Cobalamin Treatment of Peroneal Nerve Injury Parallel Randomized Controlled Study

[目的]观察温针灸与低频脉冲电联合维生素B1与腺苷钴胺治疗腓总神经损伤疗效。[方法]使用随机平行对照方法,将90例门诊及住院患者按就诊顺序编号简单随机分为两组。对照组45例维生素B1 20mg/次,3次/d;腺苷钴胺500μg/次,3次/d。治疗组45例温针灸,取穴：足三里、阳陵泉、三阴交、太溪、血海、髀关;操作：采用30号40mm毫针,穴位局部行75%酒精常规消毒,针刺得气后留针于穴位,将清艾条剪成1cm长短,置于足三里穴位针柄上,温灸3次;温针治疗结束5min,采用KT-90A型低频脉冲神经损伤治疗仪,选取患侧下肢腓骨长、短肌、胫骨前肌等肌群,脉冲波形为双向不对称方波（矩形波）,频率0.5～5Hz,电流50m A,输出幅度以患者受刺激的神经干所支配区域的肌肉有节律收缩或能耐受为宜;维生素B1与腺苷钴胺治疗同对照组。连续治疗4周为1疗程。观测临床症状、下肢功能与肌力、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组治愈13例,显效29例,无效3例,总有效率93.33%。对照组治愈6例,显效26例,无效13例,总有效率71.11%。治疗组疗效优于对照组（P〈0.01）。[结论]温针灸与低频脉冲电联合维生素B1与腺苷钴胺治疗腓总神经损伤疗效显著,无严重不良反应,值得推广。

[ Objective ] To observe the low-frequency pulse and temperature acupuncture combined with vitamin B1 and adenosine cobalamin treatment of peroneal nerve injury randomized parallel-group efficacy study. [ Method ] randomized parallel-group method using the 90 cases of outpatient and inpatient treatment are numbered sequentially by simple random into two groups. The control group 45 cases of vitamin B1 20mg / time, 3 times / d; adenosylcobalamin 500 μ g / time, 3 times / d. Treated 45 cases of acupoints： Zusanli Yanglingquan, Sanyinjiao, too Creek, a sea of blood, thigh clearance. Operation： Using the 30th 40mm needles, acupuncture partial line 75% alcohol disinfection routine, after the gas needle on acupuncture points, will cut into lcm lengths clear moxa placed on Zusanli needle handle, moxa three times. After warm acupuncture 5min, chosen using KT-90A type low-frequency pulse therapy instrument to continue treatment of nerve injury, choose lower limb peroneus longus, brevis, tibialis anterior muscle and other muscles, the pulse waveform is a bidirectional asymmetric square wave （rectangular wave ）, the frequency of 0.5 - 5Hz, current 50mA, the output amplitude of muscle stimulation to a patient＇s neural stem region dominated rhythmic contractions or can tolerate appropriate; vitamin B1 and adenosine cobalamin treatment with the control group. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms, the function of the lower limbs and muscle strength, adverse reactions. Continuous treatment for 3 courses, to determine efficacy. [ Results ] Treatment group were cured 13 cases, effective in 29 cases, 3 cases, the total efficiency of 93.33%. 6 cases in the control group were cured, effective in 26 cases, 13 cases ineffective, the total efficiency of 71.11%. Treatment group than in the control group （P〈0.01）. [ Conclusion ] Acupuncture low frequency pulse and temperature combined with vitamin B1 and adenosine cobalamin treatment of peroneal nerve injury effect is significant, it is worth promoting.