腰椎间盘突出症中医治疗优化方案的临床研究

Clinical study on treatment optimization of lumbar intervertebral disc herniation

目的观察分期综合康复治疗腰椎间盘突出症的临床疗效，明确牵引、针刺、整脊等中医治疗方法干预的时间窗，优化腰椎间盘突出症的中医治疗方案。方法选取符合诊断标准和纳入标准，且同意参加本临床试验并签署了知情同意书的住院患者200名，采用随机数字分组法分为对照1组、对照2组、对照3组和治疗组，每组50例。对照1组：牵引治疗；对照2组，针刺治疗；对照3组，整脊治疗；治疗组：第1周牵引治疗，第2周针刺治疗，第3周整脊治疗。治疗3周后，做JOA（日本骨科协会）下腰痛疾患疗效评定及总有效率评价。结果治疗后对照1组、对照2组、对照3组和治疗组JOA改善率分别为59．38％、61．35％、58．60％和76_31％；总有效率分别为80．00％、78．00％、76．00％、92．00％，提示治疗组的治疗效果显著，且优于对照1、2、3组。结论牵引、针刺、整脊分期综合康复治疗腰椎间盘突出症疗效显著；牵引、针刺、整脊等疗法的分期干预能优化腰椎间盘突出症的中医治疗方案。

Objective To observe the clinical effect of phased comprehensive rehabilitation treatment for lumbar disc herniation, clarify the time window for the intervention of traditional Chinese medicine such as traction, acupuncture, and chiropractic, and optimize the traditional Chinese medicine treatment plan for lumbar disc herniation. Methods 200 hospitalized patients who conformed to the diagnostic criteria and inclusion criteria, agreed to participate in this clinical trial, and signed the informed consent, were selected and were divided into control group 1, control group 2, control group 3, and treatment group with the random number table method, 50 cases in each group. Control group 1 received traction treatment, control group 2 received acupuncture treatment, control group 3 received chiropractic treatment, and treatment group received traction treatment during the first week, acupuncture treatment during the second week, chiropractic treatment during the third week. After 3 weeks of treatment, JOA （Japanese orthopaedic association） was used to evaluate lower back pain and the treatment effect was evaluated. Results After treatment, the improvement rate of JOA was 59.38%, 61.35%, 58.60%, and 76.31% in control group 1, control group 2, control group 3, and treatment group respectively, the total effective rate was 80.00%, 78.00%, 76.00%, and 92.00% respectively, which suggested that the therapeutic effect of the treatment group was significant, better than those of control group 1, control group 2, and control group 3. Conclusions Phased comprehensive rehabilitation treatment including traction, acupuncture, and chiropractic has remarkable clinical effect for lumbar disc herniation; phased intervention of traction, acupuncture, and chiropractic can optimize the TCM treatment plan of lumbar disc herniation.