观察“子母补泻”理论的针灸处方对腰椎间盘突出症的临床疗效

Clinical Observation of Acupuncture Prescription on Lumbar Intervertebral Disc Protrusion Based on the Theory of“Zi-mu Bu-xie”

目的观察基于"子母补泻"理论的针灸处方对气滞血瘀型腰椎间盘突出症(Lumbar disc herniation,LDH)的临床疗效。方法选取2018年10月—2019年10月期间安徽中医药大学附属太和县中医院推拿二科收治的100例气滞血瘀型LDH病例,按随机数字表法分为对照组50例和研究组50例。对照组针灸处方单纯为足太阳膀胱经腧穴,行平补平泻法。研究组针灸处方在对照组基础上,根据实则泻其子原则,加足少阳胆经腧穴足临泣,行泻法,膀胱经腧穴仍行平补平泻法。针刺均以得气为度,留针30 min,1次/d,疗程(14±2)d。观察比较两组患者临床疗效、治疗前后疼痛视觉模拟评分(Visual analogue scale,VAS)、日本骨科协会腰腿疼评分(Japanese orthopaedic association scores,JOA)情况。结果治疗后对照组总有效率为82%(41/50),研究组总有效率为96%(48/50),两组比较,差异有统计学意义(P<0.05)。治疗后两组患者VAS评分均明显低于治疗前,JOA评分均明显高于治疗前,差异有统计学意义(P<0.05);且研究组治疗后VAS评分较对照组明显降低,JOA评分较对照组明显升高,两组比较,差异有统计学意义(P<0.05)。结论"子母补泻"理论指导的针灸处方可提高气滞血瘀型LDH疗效,改善患者腰腿疼症状。

Objective To observe the clinical effect of acupuncture prescription of"Zi-mu Bu-xie"theory on Lumbar intervertebral disc protrusion(LDH)with Qi stagnation and blood stasis.Methods A total of 100 cases of LDH of Qi stagnation and blood stasis type admitted to the Second Department of Tuina,Taihe County Hospital of Traditional Chinese Medicine from October 2018 to October 2019 were selected and divided into 50 cases in the control group and 50 cases in the study group according to the random number table.In the control group,the prescription of acupuncture and moxibustion was simply the acupoints of the full sun bladder meridian,and the method of leveling,reinforcing,and reducing.The acupuncture prescription of the study group was based on the control group,and according to the principle of reducing the child’s child in reality,the acupoints of the Gallbladder Meridian of Foot Shaoyang were added,and the acupoints of the bladder meridian were still treated with the method of flattening,replenishing and reducing.The acupuncture is based on the degree of getting qi,and the needle is retained for 30 minutes,1 time/d,and the course of treatment is(14±2)d.The clinical efficacy,visual analogue scale(VAS)of pain before and after treatment,and Japanese Orthopaedic Association Scores(JOA)of the two groups were analyzed.Results Fter treatment,the total effective rate of the control group was 82%(41/50),and the total effective rate of the study group was 96%(48/50).The difference between the two groups was statistically significant(P<0.05).After treatment,the VAS scores of the two groups of patients were significantly lower than before treatment,and the JOA scores were significantly higher than before treatment,the difference was statistically significant(P<0.05);and the VAS scores of the study group were significantly lower than those of the control group after treatment,and the JOA scores were significantly lower than those of the control group.The control group was significantly higher,and the difference between the two groups was statistically significant(P<0.05).Conclusion In terms of improving the symptoms of LDH waist and leg pain with stagnation of Qi and blood stasis,the acupuncture prescription guided by the theory of"Zimu Bu-xie"is better than the acupuncture prescription of single point selection of the full sun bladder meridian.