自制新型中药水凝胶膏联合经皮神经电刺激辅助治疗盘源性下腰痛的临床疗效观察

Clinical effect of self-made new Chinese medicine hydrogel ointment combined with transcutaneous electrical nerve stimulation in the treatment of discogenic low back pain

目的观察新型中药水凝胶膏联合TENS辅助治疗盘源性下腰痛的临床疗效。方法选取2017年5月—2019年6月在浙江中医药大学附属江南医院治疗的盘源性下腰痛患者46例,按随机数字表法分为冲击波组(23例)和联合治疗组(23例),分别采用冲击波和在冲击波基础上加用中药水凝胶膏联合TENS治疗。治疗前、4周后记录并对比分析2组间VAS评分、Tampa评分、JOA评分、ODI评分差异,腰椎活动度及临床疗效。结果2组治疗8次后与同组治疗前各评分比较,差异均有统计学意义(均P<0.05);治疗8次后,联合治疗组各评分优于冲击波组,差异均有统计学意义(均P<0.05)。治疗8次后,联合治疗组前屈和后伸活动度优于冲击波组,差异均有统计学意义(t=-7.693、-5.274,均P<0.05)。2组患者末次随访的疗效比较,联合治疗组总有效率高于冲击波组,但无统计学差异(t=1.000,P>0.05);且联合治疗组疗效优于冲击波组,差异有统计学意义(Z=-2.008,P<0.05)。结论新型中药水凝胶膏联合经皮神经电刺激辅助治疗盘源性下腰痛可有效缓解腰部疼痛,减轻恐动程度,改善腰椎活动功能,提高患者生活质量。

Objective To observe the clinical effect of a self-made new Chinese medicine hydrogel ointment combined with transcutaneous electrical nerve stimulation(TENS)in the treatment of discogenic low back pain.Methods Total 46 patients with discogenic low back pain in Jiangnan Hospital Affiliated to ZheJiang University of Traditional Chinese Medicine from May 2017 to June 2019 were selected and divided into shock wave group(23 cases)and combined treatment group(23 cases)according to the random number table method.Shock wave and shock wave combined with Chinese medicine hydrogel ointment and TENS were respectively treated.The VAS score,Tampa score,JOA score,ODI score,range of motion and clinical efficacy were recorded and compared between the two groups at the time of pre-treatment and 4 weeks after treatment.Results After 4 weeks of treatment,the scores of the two groups were statistically significant compared with those of the same group before treatment(all P<0.05),and the scores of the combined treatment group were all better than those of the shock wave group at the same time(all P<0.05).After 4 weeks of treatment,the anterior flexion and posterior extension mobility of the combined treatment group were better than that of the shock wave group,with statistically significant differences(t=-7.693,-5.274,all P<0.05).Two groups of patients compared the efficacy of the last follow-up,the combined treatment group total effective rate was higher than the shock wave group,but no statistical difference(t=1.000,P>0.05),and the proportion of"excellent"in the combined treatment group was better than that in the shock wave group(Z=-2.008,P<0.05).Conclusion The new Chinese medicine hydrogel ointment combined with TENS can effectively relieve the lower back pain,reduce the fear of movement,improve the lumbar mobility and improve the quality of life of patients.