艾灸联合温经通络推拿手法治疗瘀血阻络型腰椎间盘突出症临床研究

Clinical Study on Moxibustion Combined with Warming and Activating Meridian Massage in Treatment of Blood Stasis Vessel Obstruction Type of Prolapse of Lumbar Intervertebral Disc

目的:探讨艾灸联合温经通络推拿手法治疗瘀血阻络型腰椎间盘突出症的效果,分析其作用机理。方法:选取2014年8月至2016年10月广州中医药大学番禺中医院收治的瘀血阻络型腰椎间盘突出症患者160例,按抽签方式随机分为观察组与对照组,每组80例。对照组接受温经通络推拿手法治疗,观察组在对照组基础上接受艾灸治疗。比较治疗前、后1个月2组中医症候积分、腰部JOA评分、视觉模拟疼痛评分(VAS)、Mc Gill疼痛问卷简表评分、日常生活能力ADL评分、SF-36健康调查量表评分的变化情况及不良反应发生情况,并评价2组临床疗效。结果:治疗后1个月,观察组和对照组的中医症候积分、VAS评分、Mc Gill评分较治疗前均明显下降,而腰部JOA评分、ADL评分、SF-36评分均明显上升,且观察组上述指标均优于对照组,差异有统计学意义(P<0.05);观察组临床疗效总有效率为96.25%(77/80),明显高于对照组的83.75%(67/80),差异有统计学意义(P<0.05);观察组的总不良反应发生率和对照组比较,差异无统计学意义(P>0.05)。结论 :采用艾灸联合温经通络推拿手法治疗瘀血阻络型腰椎间盘突出症,可显著提高疗效,缓解临床症状,减轻患者痛苦,提高生命质量,且不会增加不良反应的发生,是一种安全可靠的治疗方式,具有临床推广意义。

Objective： To investigate the effects of moxibustion combined with warming and activating meridian massage for treating blood stasis vessel obstruction type of prolapse of lumbar intervertebral disc,and to analyze its mechanism of action. Methods： A tatal of 160 patients with blood stasis vessel obstruction type of prolapse of lumbar intervertebral disc admitted into the hospital from August 2014 to October 2016 were divided into control group（ n = 80） and observation group（ n = 80） by drawing lots. Control group received warming and activating meridian massage and observation group received moxibustion on the basis of control group.The changes of scores of TCM symptom,lumbar JOA,VAS,McGill pain questionnaire,ADL,SF-36 questionnaire and the occurrence of adverse reactions of two groups were compared before and after 1-month treatment,and clinical efficacy of two groups were evaluated. Results： One month after treatment,the scores of TCM symptom,VAS,McGill of two groups significantly decreased,while scores of lumbar JOA,ADL,SF-36 significantly increased,and above-mentioned indexes of observation group were better than those of control group（ P〈0. 05）; The clinical total effective rate of observation group was 96. 25 %（ 77/80）,which was significantly higher than 83. 75 %（ 67/80）（ P〈0. 05）; There was not statistical difference in the total incidence of adverse reactions between the two groups（ P〉0. 05）. Conclusion： Moxibustion combined with warming and activating meridian massage in treatment of blood stasis vessel obstruction of prolapse of lumbar intervertebral disc can significantly improve efficacy,relieve clinical symptoms,decrease patients＇ pain,increase survival quality and not increase the occurrence of adverse actions. It is a kind of safe and reliable treatment method and worthy of clinical generalization.