不同时间火龙灸治疗腰椎间盘突出症温度-时间规律及镇痛疗效研究

Study of the variation laws of temperature with time and analgesic effect of fire dragon moxibustion at different time in the treatment of lumbar disc herniation

目的探讨不同时间火龙灸治疗寒湿型腰椎间盘突出症的温度-时间变化规律及镇痛疗效,为提高临床火龙灸实施安全性提供依据。方法选择2019年3月~2020年3月本院门诊就医的符合纳入标准的72例寒湿型腰椎间盘突出症患者,按照完全随机法分为火龙灸治疗3个循环组、4个循环组和5个循环组。施灸过程中,采用高精度智能温控器进行监测,记录患者体表温度,分析温度-时间变化规律,记录不同组别患者热度评分、VAS评分和患者舒适度。结果每个循环施灸的温度最高点出现在灭火后,而整个施灸过程中最高温度出现在第2个循环;三组施灸热度评分5个循环组最高,且三组间差异有统计学意义(P<0.001);三组施灸后VAS评分比较,差异有统计学意义(P<0.001),且4个循环组和5个循环组优于3个循环组(P=0.013和P=0.001);4个循环组患者舒适度高于其他两组(P<0.001)。结论适当增加施灸时间可以提高临床疗效且不增加烧伤风险,但不意味着施灸时间越长越好,过度增加施灸时间并不提高临床疗效,反而降低患者舒适度,建议临床以4个循环施灸为宜。

Objective To explore the variation laws of temperature with time and analgesic effect of fire dragon moxibustion at different time in the treatment of cold-damp type lumbar disc herniation(LDH),so as to provide evidence for improving the safety of clinical application of dragon moxibustion.Methods From March 2019 to March 2020,a total of 72 patients with cold-damp type LDH treated by the outpatient service of our hospital who met the inclusion criteria were divided into the group of 3 circulations,4 circulations and 5 circulations of fire dragon moxibustion treatment according to complete random method.In the process of moxibustion,high-precision intelligent temperature controller was used to monitor and record the patients’surface temperature,analyze the variation laws of temperature with time and record the heat scores,VAS scores and comfort of the patients in different groups.Results The highest temperature of moxibustion in each circulation appeared after the fire was extinguished,while the highest temperature of the whole moxibustion process appeared in the 2nd circulation.In terms of the moxibustion heat scores,among the three groups those of the group of 5 circulations were the highest,and there were statistical differences among the three groups(P<0.001).The VAS scores of the three groups after moxibustion were statistically different(P<0.001),and those of the group of 4 circulations and the group of 5 circulations were better than those of the group of 3 circulations(P=0.013 and P=0.001).The comfort of the patients in the group of 4 circulations was higher than that in the other two groups(P<0.001).Conclusions Appropriately increasing moxibustion time can improve clinical efficacy without increasing the risk of burns,but it does not mean that the longer moxibustion time is better.Excessive increase in moxibustion time does not improve clinical efficacy,but reduces the comfort of the patients.It is suggested that 4 circulations of moxibustion should be used clinically.