郭程湘畅气通络治疗腰椎间盘突出症随机平行对照研究

GUO Chengxiang Changqitongluo(郭程湘畅气通络) Treatment Lumbar disc Herniation Randomized Controlled Study

[目的]观察郭程湘畅气通络治疗腰椎间盘突出症疗效。[方法]使用随机平行对照方法,将60例住院及门诊患者按抛硬币法简单随机分为两组。对照组30例中频理疗联合牵引,腰椎自动牵引床,平躺,固定胸廓和盆骨,间断牵引,5min/次,休息2min,连续治疗30min,1次/d;电脑理疗仪,电极块12cm×18cm,置于腰骶部疼痛区域,电流强度以耐受为宜,20min/次,1次/d。治疗组30例郭程湘畅气通络,放松：？、揉、按手法按摩疼痛区,腰部为重点,5~8min/次;点穴：循经取肝俞、肾俞、大肠俞、委中等,点穴;治疗：推分棘突,从第1胸椎棘突开始向骶部推动,由上向下,重复3遍,每遍稍加用力,1~2min/次。将压痛部位棘突间隙分开并行颤动手法2min;俯卧扳腿,俯卧后,一只手放于疼痛棘突间隙处,另一手置于同侧大腿根部,轻托腿部,尽量后伸下肢,后伸角度0~15°,同时从上往下推腰椎,持续4s,左右各行一次,1min/次,重复3次,每次力道逐渐加重。连续治疗12d为1疗程。观测临床症状、VAS评分、JOA评分、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组痊愈11例,显效9例,有效8例,无效2例,总有效率93.33%;对照组痊愈6例,显效5例,有效9例,无效10例,总有效率66.67%;治疗组疗效优于对照组（P〈0.05）。评分指标两组均有改善（P〈0.01）,治疗组改善优于对照组（P〈0.01）。[结论]郭程湘畅气通络法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 GUO Chengxiang Changqitongluo Treatment of lumbar disc herniation. [Methods] random parallel control method, 60 patients hospitalized and outpatients by a coin toss method is simple randomized into two groups. 30 patients IF physiotherapy combined with traction, automatic lumbar traction bed, lying down, fixed thorax and pelvis, intermittent traction, 5 min/times, rest 2min, continuous treatment 30min, 1 times/d; computer physiotherapy, electrode block 12cm x 18cm, placed lumbosacral pain area, the current strength to withstand appropriate, 20 min/times, 1 times/d. Treatment group of 30 patients Guo Chengxiang qi meridians massage, relaxation： roiling, kneading, pressing pain massage area, focusing on the waist, 5-8 min/times; acupuncture： the liver meridian Yu, Shenshu, colon Yu, appointed moderate, acupuncture; treatment： push spinous points, sacral began to push from the first thoracic spinous process~ from top to bottom, repeated three times, each time a little hard, 1-2 min/times. The site spinous gap tenderness separate parallel fibrillation technique 2min; prone leg pull, after prone, put a hand on pain spinous gap, one hand placed on the same side of the thigh, leg Torr light as possible extension of lower extremity, after extension angle 0-15 o , while pushing down from the lumbar spine, sustained 4s, so each row once, lmin/times, repeated three times, each time gradually increased strength. 12d for a course of continuous treatment. Observation of clinical symptoms, VAS score, JOA score, adverse reactions. Continuous treatment 2 courses, to determine efficacy. [Results] The cure in 11 cases, 9 cases, 8 cases, 2 cases, the total efficiency of 93.33%. Group 6 cases were cured, 5 cases markedly effective in 9 cases, 10 cases, the total efficiency 66.67%. Treatment group than the control group （P〈0.05）. Rating indicators improved in both groups （P〈0.01）, the treatment group than the control group improved （P 〈0.01）. [Conclusion] GUO Chengxiang Treatment qi meridians satisfactory method of lumbar disc herniation, no serious adverse reactions, should be promoted.