解剖点斜刺结合推拿疗法治疗骶髂关节损伤的临床疗效观察

Clinical Therapeutic Effect of Oblique Needling with Tuina in Relieving Sacroiliac Joint Injury

目的:比较解剖点斜刺结合推拿疗法与常规推拿疗法治疗骶髂关节损伤的疗效差异,探讨治疗骶髂关节损伤的较好方法。方法:将120例骶髂关节损伤患者随机分为两组,观察组60例,采用解剖点斜刺结合常规推拿治疗;对照组60例,单纯采用常规推拿治疗。两组均每日治疗1次,疗程均为20d。比较两组治疗后的临床疗效及治疗前后疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数的差异。结果:观察组总有效率为95%(57/60),优于对照组的80%(48/60,P<0.05)。治疗后两组均可降低VAS及功能障碍指数(P<0.01),且观察组的改善程度均优于对照组(P<0.01)。结论:解剖点斜刺结合推拿疗法治疗骶髂关节损伤的疗效优于单纯常规推拿疗法,可有效缓解疼痛,改善功能障碍。

Objective To observe the therapeutic effect of oblique needling in combination with Tuina at the sacroiliac joint for patients experiencing sacroiliac joint injury.Methods One hundred and twenty patients with sacroiliac joint injury were randomized into routine Tuina group and oblique needling combined with Tuina（Acu＋Tuina）group（n=60in each group）.For patients of the Tuina group,routine Tuina as rotating,pressing-rubbing,digital pressing,articular moving,etc.was manipulated at Shangliao（BL 31）,Ciliao（BL 32）,Zhongliao（BL 31）,Xialiao（BL 30）,Huantiao（GB 30）,Zhibian（BL 54）,Weizhong（BL40）and sacroiliac joint area.For patients of the Acu＋Tuina group,the anatomical points between the bilateral iliac crests and the sacral joints were punctured obliquely with disposable acupuncture needles.The treatment was conducted for 30 min every time,once daily for 3weeks except weekends.The Visual Analogue Scale（VAS）and Oswestry Disability Index（ODI,concerning intensity of pain,lifting,ability to care for oneself,ability to walk,ability to sit,sexual function,ability to stand,social life,sleep quality,and ability to travel）were employed to evaluate the patients＇ reactions and functional activity changes before and after the treatment.Results Following the treatment,of the two 60 patients in the Tuina and Acu ＋Tuina groups,12 and 26cases were cured,20 and 20experienced marked improvement,16 and 11were effective,12 and 3invalid,with the effective rates being 80% and 95%,respectively.The effective rate of the Acu＋Tuina group was significantly superior to that of the Tuina group（P0.05）.The VAS scores and ODI were considerably decreased in both groups after the treatment and were significantly lower in the Acu＋Tuina group than in the Tuina group（P0.01）.Conclusion Oblique needling the anatomical points in the sacroiliac joint region combined with Tuina manipulation is evidently better than simple Tuina in reducing pain and in improving functional activity and life quality in sacroiliac joint injury patients.