调神健脾法针灸结合治疗慢性非特异性腰痛临床研究

Clinical Study on Combined Therapy of Acupuncture and Moxibustion with Tiaoshen Jianpi Method for Chronic Nonspecific Low Back Pain

目的:观察调神健脾法针灸结合治疗慢性非特异性腰痛的临床疗效。方法:选取90例慢性非特异性腰痛患者,采用随机数字表法分为调神健脾组、电针组、西药组,每组30例。调神健脾组采用调神健脾法针灸结合治疗,电针组给予腰骶部电针治疗,西药组口服尼美舒利联合盐酸雷尼替丁胶囊。3组均连续治疗2周,6个月后随访。于治疗前、治疗2次、1周、2周以及6个月后随访时观察3组患者疼痛视觉模拟评分法(VAS)和日本骨科学会(JOA)下腰痛评分,并评价临床疗效。结果:治疗2周后,调神健脾组总有效率为90.0%,高于电针组76.7%和西药组70.0%(P<0.05);6个月后随访,调神健脾组总有效率为93.3%,高于电针组的63.3%和西药组的56.7%(P<0.05)。治疗后各时间点、6个月后随访时,3组VAS评分均较治疗前降低(P<0.05);治疗1周时,调神健脾组和电针组VAS评分均低于西药组(P<0.05);治疗2周、6个月后随访时,调神健脾组VAS评分低于同时期电针组和西药组(P<0.05)。治疗后各时间点、6个月后随访时,3组JOA评分均较治疗前升高(P<0.05);治疗1周,调神健脾组和电针组JOA评分高于西药组(P<0.05);治疗2周、6个月后随访时,调神健脾组JOA评分高于同时期电针组和西药组(P<0.05)。结论:调神健脾法针灸结合治疗慢性非特异性腰痛能减轻患者腰痛症状,改善腰椎功能,近、远期临床疗效优于常规电针和西药。

Objective:To observe the clinical effect of combined therapy of acupuncture and moxibustion with Tiaoshen Jianpi method for chronic nonspecific low back pain. Methods:A total of 90 cases of patients with chronic nonspecific low back pain were selected and divided into the Tiaoshen Jianpi group, the electroacupuncture group, and the western medicine group,with 30 cases in each group. The Tiaoshen Jianpi group was treated with combined therapy of acupuncture and moxibustion with Tiaoshen Jianpi method;the electroacupuncture group was treated with electroacupuncture at lumbosacral portion, and the western medicine group was given the oral administration with nimesulide and ranitidine hydrochloride capsules. All groups were continuously treated for two weeks and followed up after six months. Scores of low back pain in Japanese Orthopaedic Association(JOA) and Visual Analogue Scale(VAS) for pain were observed in the three groups before treatment, after two treatments, after one-week treatment, after two-week treatment and during the follow-up. Clinical effects were evaluated. Results:After two-week treatment,the total effective rate was 90.0% in the Tiaoshen Jianpi group,higher than that of 76.7% in the electroacupuncture group and that of 70.0% in the western medicine group(P<0.05). During the follow-up after six months, the total effective rate was 93.3% in the Tiaoshen Jianpi group,higher than that of 63.3% in the electroacupuncture group and that of 56.7% in the western medicine group(P<0.05). VAS scores at different time points after treatment and during the follow-up in the three groups were decreased when compared with those before treatment(P<0.05);after one-week treatment, VAS scores in the Tiaoshen Jianpi group and the electroacupuncture group were lower than that in the western medicine group(P<0.05);after two-week treatment and during the follow-up,VAS score in the Tiaoshen Jianpi group was lower than those in the electroacupuncture group and the western medicine group in the same period(P<0.05). JOA scores at different time points after treatment and during the follow-up in the three groups were increased when compared with those before treatment(P<0.05);after one-week treatment,JOA scores in the Tiaoshen Jianpi group and the electroacupuncture group were higher than that in the western medicine group(P<0.05);after two-week treatment and during the follow-up,JOA score in the Tiaoshen Jianpi group was higher than those in the other two groups in the same period(P<0.05). Conclusion:The combined therapy of acupuncture and moxibustion with Tiaoshen Jianpi method can relieve symptoms of low back pain of patients with chronic nonspecific low back pain, and improve their lumbar function. It has a better short-term and long-term clinical effect than routine electroacupuncture and western medicine.