中药熏蒸联合药盐包热敷改善腰椎间盘突出症急性期症状的疗效观察

The effect of external treatment of combined traditional Chinese medicine on improving acute symptoms of lumbar disc herniation

目的观察药盐包热熨敷联合中药熏蒸改善腰椎间盘突出症急性期疼痛、麻木症状的临床疗效.方法将45例符合纳入排除标准的腰椎间盘突出症患者随机分为对照组(21例)和观察组(24例).对照组采用常规治疗和中药熏蒸,观察组在常规治疗和中药熏蒸的基础上增加药盐包热熨敷.中药熏蒸和药盐包热熨敷均1次/d,7d为1个疗程,记录并比较治疗前和治疗1个疗程后的疗效.采用汉化版Oswestry功能障碍指数(ODI)和视觉模拟评分法(VAS)评分,伴随肢体麻木患者在治疗前后检查肌电图变化情况.结果两组ODI功能障碍指数、VAS评分及神经传导速度差异均有统计学意义(P<0.05).对照组中3例,观察组中1例,保守治疗期间症状加重,行选择神经根阻滞治疗.结论相对于单纯应用中药熏蒸,药盐包热熨敷联合中药熏蒸对改善腰椎间盘突出症急性期疼痛、麻木症状效果更明显.

Objective To obtain the clinical effects of medicinal salt pack combined herbal fumigation on the symptoms of pain and numbness in the acute stage of lumbar intervertebral disc herniation. Methods 45 patients with lumbar disc herniation were randomly divided into control group (21 cases)and observation group(24 cases).The control group was fumigated with conventional treatment and traditional Chinese medicine,and the observation group was fumigated with traditional Chinese medicine and added salt packet hot ironing on the basis of conventional treatment. Fumigation of traditional Chinese medicine and hot ironing of salt packets were performed once a day for 1d and a course of treatment for 7d,and the curative effects before and after treatment were recorded and compared. Oswestry Disability Index(ODI)and Visual Analogue Scale/Score(VAS)were used to evaluate the changes of electromyogram in patients with limb numbness before and after treatment. Results 45 patients,including 3 in the control group and 1 in the observation group,were treated with nerve root block when their symptoms worsened during conservative treatment. For the remaining patients,the differences in ODI dysfunction index,VAS score and nerve conduction velocity between the two groups were statistically significant (P<0.05).Conclusion Compared with the traditional Chinese medicine fumigation alone,the effect of salt package combined with Chinese medicine fumigation on improving the symptoms of acute pain and numbness of lumbar intervertebral disc herniation is more obvious.