中西医结合治疗腰椎间盘突出症临床研究

Clinical Study on Treatment of Lumbar Intervertebral Disc Herniation with Integrative Medicine

目的:观察椎间孔神经根阻滞+手法整复+骨盆牵引+艾灸综合方案治疗腰椎间盘突出症近期和远期的临床疗效。方法:将402例患者随机分为两组,对照组采用椎间孔神经根阻滞+骨盆牵引;治疗组在对照组的基础上加用手法整复和艾灸,疗程均为2周。疼痛程度采用简化Mc Gill疼痛问卷(short-form Mc Gill pain questionnaire,SF-MPQ)评估,功能障碍程度采用Oswestry功能障碍指数(Oswestry disability index,ODI)评估,并测量腰椎前屈与后伸活动范围,以上指标治疗前后各评价1次。在治疗结束后1个月、3个月和6个月对患者进行SF-MPQ和ODI问卷评价。结果:治疗组近期疗效愈显率为86.50%,对照组为77.23%,治疗组优于对照组(χ2=5.813,P<0.05);治疗后治疗组疼痛分级指数(pain rating index,PRI)、视觉疼痛评分(visual analogue scale,VAS)和现在疼痛状况(present pain intensity,PPI)及SF-MPQ总分均低于对照组(P<0.01);治疗后治疗组疼痛、单项功能、个人综合能力和ODI量表总分均低于对照组(P<0.01);治疗后治疗组腰椎前屈与后伸活动度均优于对照组(P<0.01);治疗后1个月、3个月、6个月,治疗组SF-MPQ总分和ODI总分均低于同期对照组(P<0.01)。结论:采用椎间孔神经根阻滞+手法整复+骨盆牵引+艾灸综合方案治疗腰椎间盘突出症有较好的近期和远期疗效。

Objective ：To observe the short-term and long-term clinical efficacy of intervertebral foramen nerve root block ＋ manipu- lation ＋ pelvic traction ＋ moxibustion comprehensive regimen in treatment of lumbar intervertebral disc herniation. Methods ： 402 patients were randomly divided into two groups. The control group was treated with intervertebral nerve root ganglion ＋ pelvic trac- tion. The treatment group was treated with manipulation and moxibustion in addition to that of the control group. The course of treatment was 2 weeks. The degree of pain was measured with short-form mcGill pain questionnaire （SF-MPQ）, and the degree of dysfunction was measured with the Oswestry disability index （ODI） by measuring the range of lumbar flexion and extension,The above indicators were evaluated before and after treatment. SF-MPQ and ODI questionnaires were evaluated for patients at 1 month ,3 months, and 6 months after treatment. Results：The effective rate of the treatment group was 86.50% and that of the con- trol group was 77.23 %, which means that the effective rate of the treatment group was superior to that of the control group （X2 = 5.813, P 〈 0.05 ）. After treatment, the pain rating index （ PRI）, the visual analogue scale （ VAS）, the current pain intensity （PPI） and SF-MPQ of the treatment group were significantly lower than those in the control group respectively （ P 〈 0.01 ）. After treatment, the pain, individual function, individual comprehensive ability of the treatment group were significantly lower than those of the control group （P 〈 0.01 ）. After treatment, the lumbar flexion and posterior extension of the treatment group were better than those in the control group respectively （P 〈 0.01 ）. One month,3 months and 6 Month after treatment, the total score of SF-MPQ and ODI of the treatment group were lower than those of the control group respectively （P 〈 0.01 ）. Conclusion ： The combining therapy of intervertebral nerve root block ＋ manipulation ＋ pelvic traction ＋ moxibustion has good short-term and long-term effect in treatment of lumbar intervertebral disc herniation.