中药内服联合中医手法、针灸治疗腰椎间盘突出症的临床疗效

Clinical Curative Effect of Treating Lumbar Disc Herniation by Herbal Oral Administration Combining with Traditional Chinese Manual Therapy and Acupuncture

目的：探讨研究中药内服联合中医骨伤手法按摩、针灸治疗腰椎间盘突出症的临床疗效,观察其对治疗后患者相关指标的改善影响。方法：65例腰椎间盘突出症患者,按照数字表法将所有患者随机分为两组,A组33例,行中医骨伤手法、活血通络汤方联合温针灸进行治疗。B组32例,行中医骨伤按摩手法联合活血通络汤方治疗。观察并评估两组患者治疗后的VAS（视觉模拟评分）评分、JOA评分、临床疗效及相关免疫指标水平变化。结果：A组治疗后的JOA评分明显高于B组,差异具有统计学意义（P〈0.05）;A、B两组治疗前的VAS评分无显著差异（P〉0.05）,治疗后A组患者的VAS评分显著低于B组,比较差异具有统计学意义（P〈0.05）。A组治疗后临床疗效有效率明显高于B组,比较差异具有统计学意义（P〈0.05）;所有患者治疗后的IL-1、TNF-α指标水平均较治疗前明显改善,且A组治疗后的IL-1、TNF-α指标水平显著低于B组,差异具有统计学意义（P〈0.05）。结论：中药内服、骨伤手法按摩联合温针灸治疗腰椎间盘突出症后,可明显改善患者的临床症状,显著降低疼痛感,整体疗效更好,适合临床医师选择应用。

Objectives： To discuss the clinical curative effect of treating lumbar disc herniation by herbal oral administration combining with traditional Chinese bone injury manual massage,acupuncture and observe the influence on relevant indexes of patients after treatment. Methods： Sixty-five patients with lumbar disc herniation were divided into two groups using number table method by the treatment physician. There were 33 cases in group A,receiving traditional Chinese bone injury manual therapy. Huoxue Tongluo Decoction combining with warm acupuncture. There were 32 cases in group B,receiving traditional Chinese bone injury massage method combining with Huoxue Tongluo Decoction. VAS（ visual analogue scale） score,JOA score,clinical curative effect and relevant immune index level change of patients from two groups after treatment were observed and assessed. Results： JOA score of two groups before treatment had no evident difference. After treatment,JOA score of group was evidently higher than that of group B and the difference had statistical significance（ P 0. 05）. VAS score of group A and group B before treatment had no significant difference（ P 0. 05）.After treatment,VAS score of patients from group A was significantly lower than that of group B and the difference between them had statistical significance（ P 0. 05）. The clinical curative efficiency of group A after treatment was evidently higher than that of group and the difference had statistical significance（ P 0. 05）. IL-1 and TNF-α of all patients after treatment were all improved comparing with that before treatment and IL-1 and TNF-α of group A aftertreatment was significantly lower than that of group B. The difference had statistical significance（ P 0. 05）.Conclusions： After treating lumbar disc herniation by herbal oral administration,bone injury manual massage combining with warm acupuncture can evidently improve patients＇ clinical symptoms and significantly decrease the pain feeling. The combination of these treatment methods has a good systematic curative effect,so it is suitable for application by clinical physicians.