艾灸治疗不同灸感腰椎间盘突出症急性期患者60例疗效观察

Therapeutic Effect of Moxibustion in Treating 60 Cases of Acute Stage Lumbar Disc Herniation Patients with Different Moxibustion Sensations

目的观察艾灸治疗腰椎间盘突出症急性期不同灸感患者的疗效差异。方法艾灸探查131例腰椎间盘突出症急性期患者大肠俞、阿是穴、委中的灸感,根据患者灸感的不同,分为热敏灸感(6种特殊的热敏灸感)与温热灸感(仅有局部温热感)。运用倾向性评分匹配法对不同灸感患者进行匹配,得到组间协变量均衡的样本,共30对,热敏灸感患者为试验组,温热灸感患者为对照组。两组患者均采用艾灸治疗,前4天每日2次,第5天开始每日1次再治疗10天,共18次,疗程共2周。分别于治疗前、治疗2周后、治疗后6个月观察两组患者改良日本骨科学会下腰痛评分量表(M-JOA)评分及疼痛视觉模拟评分法(VAS)评分。结果治疗2周及治疗后6个月,两组患者M-JOA评分及VAS评分均较治疗前显著下降(P<0.05或P<0.01)。治疗2周试验组M-JOA(8.63±2.57)分,对照组(11.12±3.21)分,治疗后6个月试验组M-JOA(12.65±2.97)分,对照组(14.87±3.08)分;治疗2周试验组VAS(2.56±0.62)分,对照组(3.94±0.95)分,治疗后6个月试验组VAS(4.02±0.80)分,对照组(5.06±1.02)分,试验组均显著低于对照组(P<0.05或P<0.01)。结论艾灸治疗腰椎间盘突出症急性期患者,产生热敏灸感者临床疗效优于温热灸感者,且热敏灸感患者疗效更为稳定。

Objective To observe the difference of therapeutic effect of moxibustion in treating acute stage lumbar disc herniation（ LDH） patients of different moxibustion sensations. Method Explore moxibustion sensations at Dachangshu（ BL25）,Ashi points and Weizhong（ BL40） of 131 acute stage LDH patients. According to patients＇ different feelings,moxibustion sensations were divided into heat-sensitive moxibustion sensations（ 6 types of special heat-sensitive moxibustion sensations） and warm moxibustion sensations（ only local area warm feeling）.Matched patients of different moxibustion sensations adopting Propensity Score Matching（ PSM） method and gained samples with balanced covariant between groups. There were 30 pairs in total. Patients with heat-sensitive moxibustion sensations was in the test group; patients with warm moxibustion sensations was in the control group. Patients in both groups were all treated by moxibustion twice every day in the first 4 days. From the 5th day,treat once every day for 10 days and treated 18 times totally. The course was 2 weeks. Observed the scores of Modified Japanese Orthopaedic Association Low Back Pain Score Scale（ M-JOA） and Visual Analogue Score（ VAS） before treatment,after treating for 2 weeks and 6 months after treatment respectively. Results After treating for 2 weeks and 6 months after treatment,scores of M-JOA and VAS in both groups were much lower than those before treatment（ P〈0. 05 or P〈0. 01）. After treating for 2 weeks,scores of M-JOA in the test group was 8. 63 ± 2. 57,11. 12 ± 3. 21 in the control group. Six months after treatment,scores of M-JOA in the test group was 12. 65 ± 2. 97,14. 87 ± 3. 08 in the control group. After treating for 2 weeks,scores of VAS in the test group was 2. 56 ± 0. 62,3. 94 ± 0. 95 in the control group. Six months after treatment,scores of VAS in the test group was 4. 02 ± 0. 80,5. 06 ± 1. 02 in the control group. Scores in the test group were much lower than those in the control group（ P〈0. 05 or P〈0. 01）. Conclusion When treated with moxibustion,the clinical effect of acute stage LDH patients with heat-sensitive moxibustion sensations was better than that of patients with warm moxibustion sensations,and the therapeutic effect on heat-sensitive moxibustion sensations patients was steadier.