宫廷正骨手法联合腰脊神经后内侧支阻滞治疗腰椎小关节综合征60例疗效观察

Observation of Curative Effect on 60 Cases of Lumbar Facet Joint Syndrome by Palace Bone-setting Therapeutic Combined with Lumbar Medial Branch Nerve Block

目的:观察宫廷正骨手法联合腰脊神经后内侧支阻滞治疗腰椎小关节综合征的治疗效果及临床意义。方法:选取2014年6月至2015年10月北京中医药大学附属护国寺中医医院收治的腰椎小关节综合征患者60例,采用随机数字表方法随机分为观察组和对照组,每组30例。观察组以腰脊神经后内侧支阻滞联合宫廷正骨手法治疗,1次/周,3次为1个疗程;对照组采用单纯腰脊神经后内侧支阻滞治疗,1次/周,3次为1个疗程。对2组患者进行VAS评分、JOA评分及疗效观察比较。结果:观察组治疗后当天与治疗后1个月VAS评分与治疗前比较差异有统计学意义(P<0.01),与对照组比较差异无统计学意义(P>0.05);观察组治疗后当天、治疗后1个月与治疗前比较,JOA评分增长明显,与治疗前比较差异有统计学意义(P<0.01);观察组治疗后1个月时评分高于对照组(P<0.05);治疗后1个月,观察组优22例,良6例,可2例,差0例,优良率93.3%,总有效率100%,对照组优13例,良8例,可6例,差3例,优良率70%,总有效率90%,观察组优良率和总有效率与对照组比较差异均有统计学意义(P<0.05)。结论:应用腰脊神经后内侧支阻滞联合宫廷正骨手法治疗腰椎小关节综合征能够显著改善患者VAS评分、JOA评分,具有疗效确切,操作简单的优势,其远期疗效也要优于单纯腰脊神经后内侧支阻滞。

Objective：To investigate the effect and clinical significance of palace bone-setting therapeutic in treating the lumbar facet joint syndrome by lumbar medial branch nerve block combined with.Methods：All patients of the study were from HuGuosi Hospital Affiliated to Beijing University of Traditional Chinese Medicine.A total of 60 cases were observed and 30 cases were divided into treatment group and 30 cases were in the control group.Treatment group was treated with lumbar medial branch nerve block combined with palace bone-setting treatment, once a week, for 3 weeks.The control group was treated by the medial branch nerve block, once a week, for 3 weeks.VAS score, JOA score and efficacy were observed between two groups.Results：There was a statistically significant difference of VAS between pretreatment and after treatment, also and a month after treatment group （P〈0.01）, but there was no statistically significant difference compared with the control group （P〉0.05）.JOA score increased significantly and there was a statistically significant difference between pretreatment and after treatment, also and a month after treatment group （P〈0.01）, and the score was higher than that in the control group a month after the treatment （P〈0.05）.A month after treatment, the treatment group had excellent improvement in 22 patients, good in 6 patients, ordinary 2 patients and poor in 0 patients, and the effective rate was 93.3% while the total efficiency was 100%.In the control group, excellent improvement was in 13 patients, good in 8 patients, ordinary in 6 patients and poor in 3 patients, and excellent rate was 70% while the total efficiency was 90%.The excellent rate and the efficiency of the treatment group was better than those of the control group （P〈0.05）.Conclusion：VAS score, JOA score, and efficacy of patients with lumbar facet joint syndrome can be significantly improved with lumbar medial branch nerve block combined with palace bone-setting treatment.It has a significant effect with simply operation, and its long-term effect is also superior to lumbar nerve medial branch block.