基于肌电生物反馈仪观察的电针治疗腰椎间盘突出症的临床研究

Clinical study of electroacupuncture in the treatment of lumbar disc herniation based on electromyographic biofeedback instrument

目的 :探讨基于肌电生物反馈仪观察的电针治疗腰椎间盘突出症的临床疗效。方法 :收集2016年12月至2018年5月收治的304例腰椎间盘突出症患者,随机分为治疗组153和对照组151例。两组均固定电针仪的波型和频率,治疗组用基于肌电生物反馈仪观察的电针法,采用神经干最大动作电位幅值时的最小电流强度;对照组采用普通电针疗法,电流强度固定为2 mA,两组均以10 d为1个疗程。观察两组患者治疗前后的日本骨科学会下腰痛评分(JOA)、腰痛部位红外热像变化情况和临床疗效。结果 :治疗组总有效率为88.2%(135/153),对照组为86.1%(130/151),组间差异无统计学意义(P> 0.05)。治疗组治愈率为52.3%(80/153),对照组治愈率为41.7%(61/151),组间差异有统计学意义(P <0.05)。与治疗前比较,治疗组与对照组治疗后JOA评分均提高(P <0.01),但组间比较差异无统计学意义(P> 0.05)。与治疗前比较,两组治疗后腰痛部位红外热像图温度值均升高(P <0.01),且治疗组优于对照组(P <0.01)。结论 :基于肌电生物反馈仪观察的电针治疗腰椎间盘突出症总有效率等同于普通电针疗法,而治愈率则优于后者。

Objective:To investigate the clinical effect of electroacupuncture in the treatment of lumbar disc herniation based on the electromyographic biofeedback instrument.Methods:A total of 304 patients with lumbar disc herniation admitted from December 2016 to May 2018 were collected and randomly divided into a treatment group with 153 and a control group with 151 cases.The waveform and frequency of the electroacupuncture instrument were fixed in both groups.The treatment group used the electroacupuncture method based on the electromyography biofeedback instrument and the minimum current intensity was used when the maximum action potential of nerve trunk was amplitude.The control group was treated with conventional electroacupuncture and the current intensity was fixed at 2 mA.Both groups took 10 days as a course of treatment.The JOA scoring criteria of lower back pain,changes in infrared thermal image of low back pain and clinical efficacy of the two groups were observed before and after treatment.Results:The total effective rates were 88.2%(135/153)in the treatment group and 86.1%(130/151)in the control group and there was no significant difference between the two groups(P >0.05).The cure rate was 52.3%(80/153)in the treatment group and 41.7%(61/151)in the control group,and there was significant difference between the two groups(P<0.05).Compared with those before treatment,JOA scores in the treatment group and the control group were improved after treatment(P<0.01),but there was no significant difference between the two groups(P >0.05).Compared with those before treatment,infrared thermogram temperature value of low back pain in both groups increased after treatment(P<0.01),and the treatment group was superior to the control group(P<0.01).Conclusion:The total effective rate of electroacupuncture in the treatment of lumbar disc herniation based on electromyographic biofeedback instrument is equal to that of common electroacupuncture therapy,and the cure rate is better than that of the latter.