牵引联合针刺治疗腰椎间盘突出症随机平行对照研究

Traction combined with Acupuncture Treatment of Lumbar Disc Herniation Randomized Controlled Study

[目的]观察牵引联合针刺治疗腰椎间盘突出症疗效。[方法]使用随机平行对照方法,将120例住院及门诊患者按一般临床对照观察掷骰子法简单随机分为两组。对照组60例针刺,俯卧位或侧卧位,循经取穴,足太阳膀胱经和足少阳胆经穴为主,配华佗夹脊穴,据病情加双下肢取秩边、环跳、委中、承扶、承山、昆仑、太溪等穴,消毒,毫针（环跳穴、承扶穴3寸毫针,其余用1.5寸毫针）,快刺穴位浅层,慢深入穴位,中等强度提插捻转,直到产生酸麻胀痛感觉,30min/次,1次/d,并用TDP照射腰部和腿部。治疗组60例牵引,LYQ-02型牵引,据病情及耐受度设置牵引重量,一般从20-35kg开始,逐渐加至55-75kg,选择动态牵引,牵引重量间隔为5-l0kg,牵引时间为20-30min,休息片刻后针刺,隔日1次。针刺,取腰阳关、双肾俞,配以委中,承山,附阳、昆仑,2寸毫针用提、插、捻、转、平等手法,留针30min,1次/d,治疗后平卧硬板床休息1d。连续治疗10d为1疗程。观测临床症状、腰椎间盘突出病灶、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈16例,有效36例,无效8例,总有效率86.67%。对照组痊愈12例,有效20例,无效28例,总有效率53.33%。治疗组疗效优于对照组（P〈0.01）。[结论]牵引联合针刺治疗腰椎间盘突出症疗效满意,无严重不良反应,值得推广。

[Objective] To observe traction combined with acupuncture treatment of lumbar disc herniation. [Methods] randomized, parallel controlled method, 120 cases of inpatient and outpatient clinical controlled study as a general method is simple dice randomly divided into two groups. Acupuncture control group of 60 patients, prone position or lateral position, acupoints along meridians, bladder full sun and foot Gallbladder Meridian, with Jiaji Points, according to the disease to take rank lower limbs plus side, the ring jump, Venezuela, Cheng Fu, Cheng Shan, Kunlun, too River and other points, disinfection, needle（Huantiao, Cheng Fu hole 3-inch needle, and the remaining 1.5-inch needle）, fast barbed point shallow, slow-depth points, moderate lift and thrust twisting, until a tingling pain sensation, 30 min/times, 1 times/d, and irradiated with TDP waist and legs. Treatment group, 60 cases of traction, LYQ-02 type traction, according to the condition and tolerance settings traction weight, generally from 20-35kg and gradually increase to 55-75kg, select the dynamic traction, traction weight intervals of 5-l0kg, traction time is 20-30min, after a short break acupuncture every other day. Acupuncture, take Yaoyangguan, double Shenshu, together with the Commission, Cheng Shan, with Yang, Kunlun, 2-inch needle with a lift, insert, twist, turn, equal approach, the needle 30 min, 1 times/d, after treatment Banchuang supine rest 1d. 10 d for a course of continuous treatment. Observation of clinical symptoms of lumbar disc lesion, adverse reactions. One course of treatment, to determine efficacy. [Results] The cure 16 cases, effective 36 cases, 8 cases, the total efficiency of 86.67%. The control group cured 12 cases, effective in 20 cases, 28 cases, the total efficiency of 53.33%. Treatment group than the control group（P〈0.01）. [Conclusion]Traction combined with acupuncture treatment of lumbar disc herniation were satisfactory, no side effects, worthy of promotion.