天麻注射液穴位注射治疗腰三横突综合征的疗效观察

Curative Effect Observation on Acupoint Injection of Tianma Injection in the Treatment of Third Lumbar Transverse Process Syndrome

目的:探讨天麻注射液穴位注射对腰三横突综合征的临床疗效。方法:选取2015年1月至2016年1月开封市中心医院收治的腰三横突综合征患者70例纳入研究时,随机分为对照组和观察组,每组35例,2组患者均予口服布洛芬缓释胶囊、磁振热、腰背肌功能锻炼及口服中药,观察组在对照组方案基础上加用天麻注射液穴位注射阿是穴,2 m L/穴,注射1次/3 d。2组均接以10次为1个疗程,均接受为期2疗程的治疗,疗程中间间隔3 d。观察治疗前后比较2组患者治疗前、治疗3 d、10 d后JOA评分系统(Japanese Orthopaedic Association Scores,JOA)、Oswestry功能障碍指数的变化、腰肌表面肌电图信号、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)评分、汉密尔顿抑郁量表(Hamilton Depression,HAMD)量表评分的变化。结果:1)2组治疗前JOA、Oswestry功能障碍指数比较,差异无统计学意义(P>0.05),治疗3 d后2组JOA评分均有所增加,Oswestry功能障碍指数有所减少,但此时2组均差异无统计学意义(P>0.05),直至治疗10 d后观察组JOA明显高于对照组,Oswestry功能障碍指数明显低于对照组,差异均有统计学意义(P<0.05)。2)2组治疗前竖脊肌、多裂肌AEMG、MF、MP F差异无统计学意义,治疗3 d后观察组竖脊肌、多裂肌AEMG值均大于对照组,MF、MPF小于对照组,差异均有统计学意义(P<0.05),直至治疗10 d时观察组改善的幅度进一步扩大。3)2组治疗前HAMA、HAMD评分数值相仿(P>0.05),治疗3 d后2组HAMA和HAMD负面情绪评分均较治疗前改善(P<0.05),但组间差异无统计学意义(P>0.05),治疗10 d后观察组HAMA、HAMD评分均明显低于对照组(P<0.05)。结论:天麻注射液穴位注射联合活血止痛胶囊可明显改善腰三横突综合征临床症状及腰肌功能,该法具有一定的时间依赖性。

Objective： To observe the clinical curative effect of acupoint injection of Tianma injection on third lumbar transverse process syndrome. Methods： A total of 70 cases of patients with third lumbar transverse process syndrome who received and cured in our hospital included in the study, were randomly divided into the control group and the observation group. Both of two groups had oral ibuprofen sustained release capsule and magneto-heat-cure, waist and back muscle function exercise and oral administration of traditional Chinese medicine. The observation group used acupoint injection of Tianma injection at Ashi acupionts on the basis of the control scheme, 2 mL/point, injections once every 3 days. Both group had 10 times for a course, with total two courses of treatment, and treatment interval of 3 days. JOA scoring system （Japanese Orthopaedic Association Scores, JOA）, the changes of Oswestry disability index, lumbar muscles surface EMG signal, the changes of Hamilton Anxiety Scale （HAMA） Scores and Hamilton Depression Scale （HAMD） at the time before treatment, and 3 days, 10 days after treatment of two groups were observed and compared. Results： 1） JOA, Oswestry disability index of the two groups has no obvious differences before treatment （ P 〉0.05）. 3 days after treatment, JOA scores of the two groups increased, and Oswestry disability index decreased. But at the moment, there was no statistically significant difference between the two groups （ P 〉0.05）. Until 10 days after treatment, JOA of the observation group was obviously higher than that of the control group, and Oswestry disability index significantly lower than the control group. The difference had statistical significance （ P 〈0.05）. 2） AEMG, MF, MPF of erector spinae and multifidus muscle in the two groups were with no statistical differences before treatment. 3 days after treatment, AEMG values of erector spinae and multifidus muscle were all greater than that of the control group. MF and MPF were less than the control group. The differences had statistical significance （ P 〈0.05）. Until 10 days after treatment, the magnitude of improvement in the observation group further expanded. 3） HAMA and HAMD scores of the two groups were similar before treatment （ P 〉0.05）. HAMA and HAMD negative emotions scores of the two groups improved 3 days after treatment than before treatment （ P 〈0.05）, but there were no statistically significant differences between the groups （ P 〉0.05）. 10 days after treatment, HAMA and HAMD scores of the observation group were significantly lower than the control group （ P 〈0.05）. Conclusion： Acupoint injection of Tianma injection combined Huoxue Zhitong Capsule can obviously improve the clinical symptoms and lumbar muscle function in third lumbar transverse process syndrome, and the method has certain time dependence.