中医针刺结合骨伤护理对腰椎间盘突出症患者预后的影响

Effect of Chinese medicine acupuncture combined with bone injury nursing on prognosis of patients with lumbar disc herniation

目的研究中医针刺结合骨伤护理对腰椎间盘突出症患者的证候改善及预后的影响。方法选取2017年1月至2018年12月陕西中医药大学附属医院接诊的100例腰椎间盘突出症患者进行研究。根据随机数表法将患者均分为对照组和观察组各50例,对照组采取单纯的中医针刺治疗,观察组在对照组的治疗基础上,加以骨伤护理。比较两组患者治疗3个月后的临床效果,治疗前和治疗3个月后的中医症候评分、腰椎功能障碍评分、疼痛评分(VAS)及腰腿痛评分(JOA),以及治疗后的不良反应情况。结果治疗后,观察组患者的治疗总有效率为96.0%,明显高于对照组的84.0%,差异有统计学意义(P<0.05);治疗前,两组患者的中医症候评分、腰椎功能障碍评分比较差异均无统计学意义(P>0.05);治疗3个月后,观察组患者的中医症候评分、腰椎功能障碍评分分别为(13.4±1.5)分和(22.8±2.7)分,明显低于对照组的(18.2±2.3)分和(27.5±3.6)分,两组比较差异均有统计学意义(P<0.05);治疗前,两组患者的VAS、JOA评分差异无统计学意义(P>0.05),但治疗3个月后,观察组患者的VAS评分为(3.0±1.1)分,明显低于对照组的(3.7±0.9)分,IOA评分为(24.8±5.3)分,明显高于对照组的(22.0±4.7)分,两组比较差异均有统计学意义(P<0.05);观察组患者的不良反应发生率为6.0%,明显低于对照组的18.0%,差异有统计学意义(P<0.05)。结论中医针刺结合骨伤护理治疗腰椎间盘突出症的疗效显著,其能够改善患者的中医症候评分,减少腰椎功能障碍,缓解疼痛和腰腿痛,预后良好,值得临床推广应用。

Objective To study the effect of acupuncture combined with bone injury nursing on the improvement of symptoms and prognosis of patients with lumbar disc herniation.Methods A total of 100 patients of lumbar disc herniation treated in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2017 to December 2018 were studied.According to the random number table method,the patients were divided into control group and observation group,each with 50 patients.The control group was treated with simple Chinese medicine acupuncture,while the observation group was treated with bone injury nursing on the basis of the treatment of the control group.The clinical effects of the two groups after 3 months of treatment were compared and analyzed.The scores of TCM symptoms,lumbar dysfunction,Visual Analogue Scale (VAS),Japanese Orthopaedic Association (JOA) scores, and adverse reactions after treatment were compared and analyzed before and after 3 months of treatment.Results After treatment,the total effective rate of the observation group (96.0%) was significantly higher than that of the control group (84.0%),with a significant difference between the two groups (P<0.05).Before treatment,there was no significant difference in the scores of TCM symptoms and lumbar dysfunction between the two groups (P>0.05).After 3 months of treatment,the scores of TCM symptoms and lumbar dysfunction in the observation group were 13.4±1.5,22.8±2.7,significantly lower than 18.2±2.3,27.5±3.6 in the control group (P<0.05).Before treatment,there was no significant difference in VAS and JOA scores between the two groups (P>0.05).After 3 months of treatment,the VAS scores of the observation group was 3.0±1.1,significantly lower than 3.7±0.9 of the control group,and the JOA scores was 24.8±5.3,significantly higher than 22.0±4.7 of the control group.The differences between the two groups were statistically significant (P<0.05).The incidence of adverse reactions in the observation group (6.0%) were significantly lower than that in the control group (18.0%),P<0.05.Conclusion Chinese medicine acupuncture combined with bone injury nursing in the treatment of lumbar intervertebral disc herniation has a remarkable effect.It can improve the scores of patients' TCM symptoms,reduce lumbar dysfunction,relieve pain and lumbar and leg pain,and result in a good prognosis,which is worthy of application and promotion.