基于“内热法理论”运用内热针治疗风寒痹阻型腰椎间盘突出症40例临床观察

Clinical Observation on 40 Cases of Lumbar Disc Herniation of Wind-cold Obstruction Type Treated by Internal Heat Acupuncture Based on the Theory of Internal Heat Therapy

目的:观察内热针疗法治疗风寒痹阻型腰椎间盘突出症的有效性及安全性,为"内热法理论"提供临床依据。方法:采用随机对照的设计方案,将80例风寒痹阻型腰椎间盘突出症患者随机分为治疗组和对照组,每组40例。治疗组基于内热法采用内热针治疗,对照组采用温针灸治疗。观察2组临床疗效,以及治疗前后中医症状、体征积分,日本骨科协会(JOA)评分,视觉模拟评分法(VAS)评分;同时观察治疗组治疗过程中各时间点生命体征变化情况。结果:治疗组完成39例,其中治愈33例,好转5例,无效1例,总有效率为97.43%;对照组完成37例,其中治愈24例,好转8例,无效5例,总有效率为86.49%。2组比较,差异有统计学意义(P < 0.05)。治疗后,2组腰痛症状、体征积分,JOA评分和VAS评分较治疗前均有改善(P < 0.05),且治疗组优于对照组(P < 0.05)。治疗过程中血氧饱和度监测值比较,差异无统计学意义(P ﹥ 0.05);麻醉时患者脉率、呼吸频率和血压较前短暂性升高,治疗结束后各指标恢复正常范围;针刺后与治疗前、针刺中比较,差异有统计学意义(P < 0.05)。结论:基于"内热法理论"运用内热针疗法治疗风寒痹阻型腰椎间盘突出症近期疗效肯定,能明显缓解疼痛症状,具有更加便捷、有效的特点,临床应用安全,值得推广。

Objective:To observe the efficacy and safety of internal heat acupuncture in the treatment of lumbar disc herniation(LDH)of wind-cold obstruction type,and to provide clinical basis for the theory of internal heat therapy.Methods:Eighty cases of LDH of wind-cold obstruction type were randomly divided into a treatment group and a control group,40 cases in each group.The treatment group was treated with internal heat acupuncture based on internal heat method,and the control group was treated with warm acupuncture,observing the clinical effect of the two groups,as well as the scores of symptoms and signs of traditional Chinese medicine before and after treatment,JOA score,and VAS score;and at the same time,observing the changes of vital signs in the treatment group at all time points.Results:Thirty-nine cases were completed in the treatment group,among which 33 cases were recovered,5 cases were improved,1 case was ineffective,and the total effective rate was 97.43%;while in the control group,37 cases were completed,among which 24 cases were recovered,8 cases were improved,5 cases were ineffective,and the total effective rate was 86.49%.The difference between the two groups was statistically significant(P<0.05).After treatment,the scores of symptoms and signs,JOA scores and VAS of the two groups were improved(P<0.05),and the treatment group was better than the control group(P<0.05).There was no significant difference in the monitoring value of blood oxygen saturation during the treatment(P﹥0.05).During anesthesia,the pulse rate,respiratory frequency and blood pressure of the patients were temporarily higher than before and returned to the normal range after treatment.The difference was statistically significant after the acupuncture compared with before and during the treatment(P<0.05).Conclusion:Based on the theory of internal heat therapy,the internal heat acupuncture in the treatment of LDH of wind-cold obstruction type has a positive short-term effect,can significantly alleviate the pain symptoms,more convenient,effective and safe,worthy of promotion.