基于经筋理论针刺治疗非特异性腰痛的疗效评价

Evaluation of Therapeutic Effect of Acupuncture on nonspecific Low Back Pain Based on Tendon Theory

目的观察针刺结筋病灶点对比推拿治疗非特异性腰痛的临床疗效。方法选取2019年7月-2019年11月就诊于辽宁中医药大学附属医院、附属第二医院、北方战区总医院的非特异性腰痛患者72例,按照随机数字表法分为经筋针刺组和推拿组各36例。经筋针刺组基于经筋理论采用经筋刺法,对患者触诊评估选点后,每次选择8~12个治疗选点进行治疗,针刺得气后,留针30 min。5次/周,1周为1个疗程,共治疗4个疗程;推拿组采用?、按、揉、点等推拿手法,按摩肾俞、大肠俞、命门、腰阳关、委中、腰部阿是穴等穴位治疗。每次30 min。5次/周,1周为1个疗程,共治疗4个疗程。运用VAS量表、ODI量表对治疗前、后患者疼痛程度、腰部功能障碍进行评估,并评价其临床疗效。结果针刺组疗效明显优于推拿组(P <0. 05),差异具有统计学意义;与治疗前相比,治疗后两组VAS评分均较治疗前明显降低(P <0. 01),且针刺组VAS评分明显低于推拿组,差异具有统计学意义(P <0. 05)。治疗后两组患者ODI评分均较治疗前明显降低(P <0. 01),且针刺组ODI评分明显低于推拿组,差异具有统计学意义(P <0. 05)。结论基于经筋理论指导下针刺治疗非特异性腰痛的疗效明显优于推拿疗法,能够有效缓解患者疼痛、改善患者腰部功能障碍,在一定程度上提高患者的生活质量,值得临床推广。

Objective To observe the clinical effect of acupuncture and tendon lesions versus Tuina for nonspecific low back pain. Method A total of 72 patients with nonspecific low back pain who were admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,the Second Affiliated Hospital and the General Hospital of the Northern Theater from July 2019 to November 2019 were collected. According to the random number table method,the patients were divided into the tendon acupuncture group and the Tuina group (n = 36). The tendon acupuncture group was treated with the tendon-needling method based on tendon theory. After the patient was evaluated for palpation,8 to 12 acupoints were selected for treatment. After the acupuncture was obtained,the needle was left for 30 minutes,5 times/week,7 days for a course of treatment,totally 4 courses of treatment. The Tuina group used rolling,pressing,kneading and other Tuina techniques to Tuina acupoints such as Shenshu (BL23),Dachangshu (BL25),Mingmen (DU4),Yaoyangguan (DU3),Weizhong (BL40) and Yao Ashi,30 min/time,once a week,7 days for a course of treatment,totally 4 courses of treatment. The VAS scale and ODI scale were used to evaluate the pain level and lumbar dysfunction before and after treatmentand the clinical efficacy was evaluated. Results The tendon acupuncture group was significantly better than the Tuina group (P < 0. 05),and the difference was statistically significant. Compared with those before treatment,the VAS scores of the two groups were significantly lower after treatment (P <0. 01),and the VAS score of the tendon acupuncture group was significantly lower than that of the Tuina group (P < 0. 05).After treatment,the ODI scores of the two groups were significantly lower than those before treatment (P < 0. 01),and the ODI score of the tendon acupuncture group was significantly lower than that of the Tuina group (P < 0. 05). Conclusion The therapeutic effect of acupuncture on nonspecific low back pain is better than that of Tuina therapy under the guidance of the tendon theory. It can effectively alleviate the painand improve the waist dysfunction of patients,and improve the quality of life of patients to a certain extent,which is worthy of clinical promotion.