穴位埋线综合治疗腰椎间盘突出症(气滞血瘀)随机平行对照研究

Randomized Parallel Controlled Study of Acupoint Catgut Embedding in Treating Lumbar Disc Herniation Due(Qizhi Xueyu/气滞血瘀)

[目的]观察穴位埋线综合治疗腰椎间盘突出症(气滞血瘀)疗效。[方法]使用随机平行对照方法,将40例住院患者按病志号抽签方法随机分为两组,急性期严格卧硬板床,恢复期佩戴腰围保护及支撑,腰部保暖;饮食控制、加强腰背部肌功能锻炼,心理干预。对照组20例针刺病应穴配委中,L_3~S_1椎间隙正中为病应穴(上一椎间隙正中,下一椎间隙正中,挟上、中、下三个椎间隙正中左右旁开1~1.5寸,共八穴),一次性针灸针(0.25×40mm^0.25×75mm)先直刺一针,然后在上一椎间隙正中,下一椎间隙正中,挟上、中、下三个椎间隙正中左右旁开1~1.5寸处,八个方位各刺一针,1次/d;委中平补平泻,深度1~2寸;连电针,连续波,频率1~2Hz,输出电流强度患者能耐受为度,留针30min,1次/d;TDP照射。治疗组20例穴位埋线:膈俞(双侧)、肝俞(双侧)、肾俞(双侧)、大肠俞(双侧)、腰眼(双侧),气海、关元、血海(双侧)、足三里(双侧);胶原蛋白线"4-0",左手拇指、食指绷紧或捏起进针部位皮肤,右手握住埋线针,据皮下脂肪情况选进针深度埋入穴位,4~5d施行1次。连续治疗30d为1疗程。观测临床症状、腰部疼痛评分、焦虑评分、不良反应。治疗1疗程(30d),判定疗效。随访2年,观测复发人数、埋线处皮损情况。[结果]治疗组临床痊愈8例,显效8例,有效3例,无效1例,总有效率95.00%;对照组临床痊愈6例,显效5例,有效5例,无效4例,总有效率80.00%;临床疗效两组无显著差异(P>0.05)。腰部疼痛评分、焦虑评分两组均有改善(P<0.05,P<0.01),治疗组改善优于对照组(P<0.05)。随访2年,1疗程后对照组12例腰部刺痛感仍未缓解,劳累及行走时疼痛明显,3个疗程后明显缓解;1年后腰部疼痛不适对照组12例,治疗组0例;1~2年治疗组3例偶有腰部疼痛不适;两组皮损恢复良好,均未出现疤痕及色素沉着。[结论]穴位埋线综合治疗腰椎间盘突出症(气滞血瘀),疗效满意,无严重不良反应,起效快,远期疗效更稳定,值得推广。

[Objective] To observe the clinical effect of acupoint catgut embedding in treating lumbar disc herniation due to Qizhi Xueyu. [Method] Using parallel randomized controlled clinical trial, randomly divide 40 patients into two groups by using the simple way of dice cast. The control group of 20 patients are treated by Comprehensive treatment of acupuncture and acupoint acupuncture. The treatment group of 20 patients are treated by acupoint catgut embedding and the acupuncture points are： Phrenic acupoint （bilateral）, Ganshu （bilateral）, Shenshu （bilateral）, large intestine acupoint （bilateral）, Yaoyan （bilateral）, Qihai, Guan yuan, Blood Sea （bilateral）, Zusanli （bilateral）. After 30 days of the treatment, compare the control group with the treatment group, review, summarize and analyze the them. [Results] In the treatment group, 8 cases were cured, 8 cases were markedly effective, 3 cases were effective, 1 cases were invalid, the total effective rate was 95%, 6 cases in the control group, 5 cases, 5 effective, 4 ineffective, total effective 80%, there were no significant difference in clinical efficacy （P〉0.05）. The waist pain score and anxiety score were improved in the two groups （P 〈0.05, P〈0.01）, and the improvement in the treatment group was better than that in the control group （P 〈0.05）. After 2 years of follow-up, 12 cases of low back pain in the control group remained unrelieved after the 1 course of treatment, the pain of tired and walking was obvious, and after 3 courses of treatment, 12 cases in the low back pain control group, 0 cases in the treatment group, 3 in the 1-2 year treatment group, 3 cases of occasional waist pain discomfort, and two groups of skin lesions recovered well, no scar and pigmentation were found.[Conclusion] Acupoint catgut embedding therapy is effective in treating lumbar intervertebral disc herniation due to Qizhi Xueyu. It is simple and safe to operate. It has little pain and its effect can last a long time. It is worth promoting.