理筋整复推拿结合腰三针治疗腰椎间盘突出症的疗效及安全性

Efficacy and safety of tendon restoring massage combined with three-needle lumbar acupuncture in the treatment of lumbar intervertebral disc herniation

目的探讨理筋整复推拿结合腰三针治疗腰椎间盘突出症(LDH)的疗效及安全性。方法回顾性分析2021年1~6月深圳市大鹏新区葵涌人民医院中医科门诊收治的200例LDH患者的临床资料,根据治疗方式不同分为四组,每组50例。对照组1给予理筋整复推拿治疗,对照组2给予腰三针治疗,对照组3给予电脑中频理疗,观察组给予理筋整复推拿结合腰三针治疗。治疗1个月,比较四组患者的治疗效果,治疗前后的临床症状评分[腰痛评分、下肢放射痛评分、腰背肌后伸活动度(ROM)、等长肌力(IMS)]、视觉模拟(VAS)评分、Oswestry功能障碍指数(OSW)评分和并发症发生情况。结果观察组患者的治疗总有效率为96.00%,明显高于对照组1的76.00%、对照组2的78.00%及对照组3的80.00%,差异均有统计学意义(P<0.05);治疗后,四组患者的腰痛及下肢放射痛评分均明显降低,且观察组的两项评分分别为(2.19±0.31)分、(2.23±0.45)分,明显低于对照组1[(5.87±0.87)分、(4.61±0.54)分]、对照组2[(5.69±0.91)分、(4.59±0.62)分]及对照组3[(5.77±1.21)分、(4.62±0.73)分],而ROM、IMS升高,且观察组的ROM、IMS分别为(25.42±3.13)°、(812.14±102.13)N,明显高于对照组1[(21.41±4.09)°、(699.31±98.65)N]、对照组2[(20.98±5.22)°、(698.31±99.13)N]及对照组3[(21.65±4.09)°、(701.43±101.34)N],差异均有统计学意义(P<0.05);治疗后,四组患者的VAS评分、OSW评分均明显降低,且观察组的两项评分分别为(2.17±0.37)分、(2.87±0.31)分,均明显低于对照组1[(4.09±1.01)分、(4.12±0.41)分]、对照组2[(4.21±0.98)分、(4.09±0.51)分]及对照组3[(3.98±0.76)分、(4.21±0.44)分],差异均有统计学意义(P<0.05);观察组、对照组1、对照组2和对照组3的并发症发生率分别为4.00%、8.00%、10.00%、14.00%,差异无统计学意义(P>0.05)。结论理筋整复推拿结合腰三针治疗LDH可显著改善患者的临床症状,缓解疼痛,促进功能恢复,临床应用效果好且安全性高。

Objective To investigate the efficacy and safety of tendon restoring massage combined with three-needle lumbar acupuncture in the treatment of lumbar intervertebral disc herniation(LDH).Methods A total of200 patients with LDH treated in Department of Traditional Chinese Medicine,Shenzhen Dapeng New District Kuiyong People’s Hospital from January to June 2021 were analyzed retrospectively.According to different treatment methods,they were divided into four groups(control group 1,control group 2,control group 3,observation group),with 50 cases in each group.The control group 1 was treated with tendon restoring massage,the control group B was given three-needle lumbar acupuncture,the control group C received computer medium frequency physiotherapy,and the observation group received tendon restoring massage combined with three-needle lumbar acupuncture.After one month of treatment,the treatment effects,clinical symptom scores[low back pain score,lower limb radiation pain score,low back muscle extension activity(ROM),isometric muscle strength(IMS)],Visual Analogue Scale(VAS),Oswestry dysfunction index(OSW)score,and complications before and after treatment were compared among the four groups.Results The total effective rate of the observation group was 96.00%,which was significantly higher than 76.00%of the control group 1,78.00%of the control group 2,and 80.00%of the control group 3(P<0.05).After treatment,the scores of low back pain and lower limb radiating pain of the four groups were significantly reduced,and the two scores of the observation group were(2.19±0.31)points and(2.23±0.45)points,which were significantly lower than(5.87±0.87)points,(4.61±0.54)points of the control group 1,(5.69±0.91)points,(4.59±0.62)points of the control group 2,and(5.77±1.21)points,(4.62±0.73)points of the control group 3.The ROM and IMS increased after treatment;and the ROM and IMS of the observation group were(25.42±3.13)°and(812.14±102.13)N,respectively,which were significantly higher than(21.41±4.09)°,(699.31±98.65)N of the control group 1,(20.98±5.22)°,(698.31±99.13)N of the control group 2,and(21.65±4.09)°,(701.43±101.34)N of the control group 3(P<0.05).After treatment,the score of VAS and OSW of the four groups were significantly reduced,and the two scores of the observation group were(2.17±0.37)points and(2.87±0.31)points,which were significantly lower than(4.09±1.01)points,(4.12±0.41)points of the control group 1,(4.21±0.98)points,(4.09±0.51)points of the control group 2,and(3.98±0.76)points,(4.21±0.44)points of the control group 3(P<0.05).The complication rates of observation group,control group 1,control group 2,and control group 3 were 4.00%,8.00%,10.00%,and 14.00%,respectively,with no statistically significant differences(P>0.05).Conclusion Tendon restoring massage combined with three-needle lumbar acupuncture in the treatment of LDH can significantly improve the patient’s clinical symptoms,relieve pain,and promote functional recovery,with good clinical application effect and high safety.