不同针具、不同操作方法对恢刺法治疗腰椎间盘突出症的疗效差异及其机制

An exploration on the eff ect diff erence and mechanism of diff erent needles and manipulation methods in the treatment of herniation of cervical disc with the relaxing needling therapy

目的探究不同针具、不同操作方法运用恢刺法治疗腰椎间盘突出症的疗效差异及其机制。方法收集本院针灸推拿科疗区腰椎间盘突出症患者144例作为研究对象,根据随机对照法将其分为A组、B组、C组、D组,各36例。A组实施撬拔法联合粗针、B组实施撬拔法联合细针、C组实施提插捻转法联合细针、D组实施提插捻转法联合粗针。观察4组患者治疗后简式McGill疼痛问卷、腰椎JOA评分、压敏点痛阈测定值,并应用SF-36生活质量量表评估4组患者治疗前后生活质量。结果A组在简式McGill疼痛问卷、腰椎JOA评分、压敏点痛阈测定值级、SF-36生活质量、治疗疗程方面明显优于其余各组,差异具有统计学意义(P<0.05);D组简式McGill疼痛问卷、腰椎JOA评分、压敏点痛阈测定值级SF-36生活质量方面明显优于B组、C组,差异具有统计学意义(P<0.05);而B组与C组比较差异无统计学意义(P>0.05)。结论撬拔法联合粗针组合的恢刺法在治疗腰椎间盘突出症方面效果显著,进一步证明粗针明显优于细针,撬拔法明显优于提插捻转法;其作用机制可能与缓解肌筋膜痉挛,纠正错位腰椎关节相关。

Objective To explore the effect difference and mechanism of different needles and manipulation methods in the treatment of herniation of cervical disc with the relaxing needling therapy(Huici).Methods A total of 144 patients with herniation of cervical disc in the acupuncture and massage department of our hospital were enrolled as the research subjects and randomly divided into 4 groups,with 36 cases in each group.Group A was treated with the prying-pulling manipulation combined with thick needles,while group B was treated with the prying-pulling manipulation combined with thin needles,and group C with the lifting-thrusting-twirling manipulation combined with thin needles,while group D with the lifting-thrusting-twirling manipulation combined with thick needles.After treatment,the simplified McGill Pain Questionnaire score,lumbar JOA score and pressure-sensitive point pain threshold value were observed,and the life quality of the four groups was evaluated by the SF-36 life quality scale before and after treatment.Results Group A was signifi cantly better than the other groups in the simplifi ed McGill Pain Questionnaire score,lumbar JOA score,level of the pressure-sensitive point pain threshold value,SF-36 life quality score and treatment course(P<0.05).Group D was signifi cantly better than group B and group C in the simplifi ed McGill Pain Questionnaire score,lumbar JOA score,level of the pressure-sensitive point pain threshold value,SF-36 life quality score(P<0.05),while there was no significant difference between group B and group C(P>0.05).Conclusion The prying-pulling manipulation combined with thick needles is remarkably eff ective in the treatment of herniation of cervical disc with the relaxing needling therapy,which further proves that thick needles are obviously superior to thin needles,and the prying-pulling manipulation is obviously better than the lifting-thrusting-twirling manipulation,while its mechanism may be related to relieving the myofascial spasm and correcting the misplaced lumbar joints.