深层肌康复锻炼联合揿针对经皮椎间孔镜下髓核摘除术后腰间盘突出症患者腰痛及日常生活的影响

Effect of deep muscle rehabilitation exercise combined with thumb-tack needle for subcutaneous embedding on lumbago and daily life of patients after minimally invasive lumbar surgery

目的探究深层肌康复锻炼联合揿针对经皮椎间孔镜下髓核摘除术后腰间盘突出症患者腰痛及日常生活的影响。方法将90例2018年1月至2021年4月在江苏省南通市中医院确诊为腰椎间盘突出症并行经皮椎间孔镜下髓核摘除术的患者选为研究对象,采用随机数字表法将其分为观察组(45例)和对照组(45例)。对照组术后采用深层肌康复锻炼(1个月)联合常规针灸(2 d)治疗,观察组术后采用深层肌康复锻炼(1个月)加用揿针留针(2 d)治疗。比较两组在手术前后视觉模拟评分法(VAS)、日本骨科协会(JOA)、中医症状评分及Oswestry功能障碍指数(ODI)的差异。结果治疗后,两组VAS、中医症状评分均低于治疗前,JOA评分高于治疗前,且观察组VAS、中医症状评分低于对照组,JOA评分高于对照组(P<0.05)。治疗后,两组疼痛强度、生活自理能力、提物、行走、站立、睡眠、社交活动、旅行及总分均低于治疗前,且观察组低于对照组(P<0.05)。结论深层肌康复锻炼联合揿针能明显减轻腰椎间盘突出症术后患者的腰部疼痛,提高其腰椎活动度及日常生活能力,可在临床推广应用。

Objective To explore the effect of deep muscle rehabilitation exercise combined with thumb-tack needle for subcutaneous embedding on lumbago and daily life of patients with lumbar disc herniation after percutaneous transforaminal endoscopic discectomy.Methods Ninety patients diagnosed with lumbar disc herniation(LDH)and underwent percutaneous foraminal endoscopic discectomy in Nantong Hospital of Traditional Chinese Medicine,Jiangsu Province from January 2018 to April 2021 were selected as subjects.They were divided into observation group(45 case)and control group(45 case)by random number table method.The control group was treated with deep muscle rehabilitation exercise(one month)combined with conventional acupuncture(two days),and the observation group was treated with deep muscle rehabilitation exercise(one month)combined with thumb-tack needle for subcutaneaus embedding(two days).The differences of visual analog scale(VAS),Japanese Orthopaedic Association(JOA),traditional Chinese medicine symptom score,and Oswestry disability index(ODI)before and after surgery were compared between the two groups.Results After treatment,VAS and traditional Chinese medicine symptom scores in two groups were lower than those before treatment,while JOA score was higher than that before treatment,VAS and traditional Chinese medicine symptom scores in observation group were lower than those in control group,while JOA score was higher than that in control group(P<0.05).After treatment,pain intensity,self-care ability,extract,walking,standing,sleep,social activity,travel,and total score in two groups were lower than those before treatment,and observation group was lower than that in control group(P<0.05).Conclusion Deep muscle rehabilitation exercise combined with thumb-tack needle for subcutaneaus embedding can significantly reduce the lumbago of patients after lumbar disc herniation,improve the range of motion of lumbar spine and the ability of daily living,which can be popularized in clinical application.