毫火针结合新医正骨治疗腰椎椎管狭窄症的临床研究

Clinical study of filiform needle combined with bone setting in the treatment of lumbar spinal stenosis

目的观察毫火针结合新医正骨治疗腰椎椎管狭窄症的临床效果。方法选择2015年8月~2017年1月于河北省三河市医院中医科和三河市中医医院针灸科就诊的腰椎椎管狭窄症患者130例,按随机数字表法将其分成治疗组和对照组,每组各65例。治疗组采用毫火针结合新医正骨治疗法,毫火针隔日1次,10 d为1个疗程,共治疗2个疗程,正骨每隔2 d 1次,4次为1个疗程,共2个疗程。对照组采用针刺结合新医正骨治疗法,针刺每日1次,10 d为1个疗程,共2个疗程,正骨频次同治疗组。2个疗程后评定疗效,对有效患者随访3个月。采用视觉模拟评分法(VAS)评定腰、腿部的疼痛程度,观察两组不良反应情况。结果治疗组优良率(93.85%)高于对照组(70.77%),差异有统计学意义(P<0.05)。两组治疗后及3个月随访时VAS评分均较治疗前降低,且治疗组VAS评分低于对照组,差异均有统计学意义(均P<0.05)。两组治疗过程中均未见明显不良反应。结论毫火针结合新医正骨治疗腰椎椎管狭窄症的效果优于针刺结合新医正骨,可明显减轻患者疼痛,安全性高,是一种简单、有效、实用的治疗方案。

Objective To observe the clinical effect of filiform needle combined with bone setting in the treatment of lumbar spinal stenosis. Methods One hundred and thirty cases of patients with lumbar spinal stenosis treated in Department of Traditional Chinese Medicine, Sanhe Hospital of Hebei Province, and Department of Acupuncture, Sanhe Hospital of Traditional Chinese Medicine from August 2015 to January 2017 were randomly divided into treatment group and control group, with 65 cases in each group. The treatment group was given filiform needle combined bone setting, with iliform needle once daily, ten days in a course, total of two courses and bone setting once every two days, four times in a course, total of two courses. The control group was given acupuncture combined with bone setting, with acupuncture once daily, ten days in a course, total of two courses, with the same frequency of bone setting in treatment group. The curative effect was evaluated after treatment of two courses and the effective patients were followed up for 3 months. The degree of pain in the waist and legs was evaluated by the visual analogue scale （VAS）. The adverse reactions were observed between the two groups. Results The rate of excellent and good in the treatment group （93.85%） was higher than that of control group （70.77%）, with statistically significant difference （P 〈 0.05）. After treatment and at the end of follow-up, the scores of VAS in the two groups were lower than those before treatment, and the scores in the treatment group were lower than that of control group, with statistically significant differences （all P 〈 0.05）. No obvious adverse reactions were observed during treatment in the two groups. Conclusion The curative effect of filiform needle combined with bone setting is better than that of acupuncture combined with bone setting in the treatment of lumbar spinal stenosis. It can alleviate the pain and it is safe. Filiform needle combined with bone setting is a simple, effective and practical treatment.