腰三针治疗腰椎间盘突出症的临床观察及影像学变化

Clinical Observation on Lumbar Three Needles in the Treatment of Lumbar Disc Protrusion and Imaging Changes

目的:观察腰三针治疗腰椎间盘突出症的临床疗效,并研究和分析其与螺旋CT各指标的关系。方法:选取2016年1月与2017年1月南阳市中心医院收治的腰椎间盘突出症患者78例,根据随机数字表法随机分为对照组和观察组,每组39例,对照组予普通针刺加电针治疗,观察组加以腰三针治疗,观察2组治疗前后功能障碍指数(ODI)、下腰痛评分(JOA),并在治疗前后对CT影像学的变化进行观测,分析其相关性。结果:治疗8周后,1)2组患者的ODI积分明显降低,JOA评分明显升高(P<0.05),且观察组优于对照组(P<0.05);2)2组患者在治疗后硬膜囊前后径、神经根受压程度比均较治疗前减小,矢状径较治疗前增大(P<0.05),且观察组在治疗后的改善程度优于对照组(P<0.05);3)CT的前后径、神经根受压比与ODI(r=0.820,P<0.01)、(r=0.854,P<0.01)呈正相关,CT的矢状径与ODI评分呈负相关(r=-0.811,P<0.01)。结论:结合使用腰三针治疗腰椎间盘突出症,可有效改善患者的神经根压迫,显著提高腰椎间盘突出症的临床疗效,值得推广应用。

Abstract analyze its relationship with the various indicators of spiral CT. Methods ：A total of 78 eases of lumbar disc herniation were collected between January 2016 and January 2017 in our hospital, and the patients were randomly divided into control group and observation group, with 39 eases in each group. The control group was treated with eomnlon acupuncture plus eleetroaeupune-ture treatment, and the observation group was treated with three lumbar needle therapy. The dysfunction index （ODI）, low back pain score （JOA） of two groups before and after treatment were observed. Tile changes of CT image before and after treatment were observed, and the correlation was analyzed. Results ：After 8 weeks of treatment, 1） the ODI scores of two groups of patients de-creased significantly, and JOA score increased significantly （P 〈 0. 05 ）. The observation group was better than the control group （P 〈 0. 05 ） ; 2） in the patients of the two groups before and after treatment, the dural sac diameter, the degree of compression of the nerve root ratio was reduced significantly, and the sagittai diameter increased compared with before treatment （P 〈 0. 05 ）. The observation group after treatment improved more than the control group （ P 〈 0. 05 ） ; 3 ） CT anteroposterior diameter, nerve root compression ratio and ODI （ r = 0. 820, P 〈 0. 01 ）, （ r = 0. 854, P 〈 0. 01 ） was positively related. The sagittal diameter of the CT was negatively correlated with the ODI score （ r = - 0. 811, P 〈 0. 01）. Conclusion： Combined with lumbar three needles in the treatment of lumbar disc herniation, it can effectively improve the nerve root compression of patients, significantly improve the clin-ical efficacy of lumbar disc herniation, and it is worthy of popularization and application.