经筋针刺联合腰部核心肌力训练治疗老年慢性腰腿痛的临床研究

Clinical Study on the Treatment of Chronic Lumbar and Leg Pain in the Elderly by Jingjin Acupuncture Combined with Lumbar Core Muscle Strength Training

目的:观察经筋针刺联合腰部核心肌力训练与单纯经筋针刺治疗老年慢性腰腿痛的疗效差异。方法:选取我院骨伤科2018年8月—2019年4月收治的老年慢性腰腿痛患者132例,按就诊顺序随机分为观察组和对照组,各66例。观察组予以经筋针刺联合腰部核心肌力训练治疗,对照组予以单纯经筋针刺治疗,两组患者均每天治疗1次,连续治疗2周,治疗后3个月和6个月随访。两组患者于治疗前、治疗2周后及治疗后3个月、6个月分别采用视觉模拟评分法(VAS)和Oswestry功能障碍指数问卷表(ODI)进行评分,参照《中医病证诊断疗效标准》于治疗2周后行临床疗效评定。结果:两组患者治疗前VAS、ODI评分比较均无显著差异(P>0.05);两组患者治疗2周后VAS、ODI评分较治疗前均有明显改善(P<0.05),但观察组的改善程度较为明显(P<0.05);两组患者在治疗后3个月及6个月随访时VAS、ODI评分较治疗后均有升高,但对照组升高幅度较为明显(P<0.05),而观察组升高幅度不明显(P>0.05);治疗2周后,观察组总有效率为96.97%,对照组为83.33%,观察组总有效率明显优于对照组(P<0.05)。结论:(1)两种治疗方法对老年慢性腰腿痛均具有临床疗效;(2)经筋针刺联合腰部核心肌力训练治疗老年性慢性腰腿痛疗效较单纯经筋针刺显著,远期疗效更佳。

Objective:To observe the difference of curative effect between Jingjin acupuncture combined with lumbar core muscle strength training and Jingjin acupuncture alone in treating senile chronic lumbar and leg pain.Methods:A total of 132 elderly patients with chronic lumbar and leg pain who were admitted to the department of orthopaedics and traumatology in our hospital from August 2018 to April 2019 were selected and randomly divided into an observation group and a control group(n=66).The observation group received Jingjin acupuncture combined with lumbar core muscle strength training,and the control group received meridian acupuncture alone.Both groups were treated once a day for 2 weeks,followed up at 3 and 6 months after treatment.The two groups of patients were scored by visual analogue scale(VAS)and oswestry disability index(ODI)before treatment,after 2 weeks of treatment,and 3 months and 6 months after treatment.Clinical efficacy was evaluated 2 weeks after treatment according to TCM Diagnostic Efficacy Criteria.Results:There were no significant differences in VAS and ODI scores between 2 groups before treatment(P>0.05);VAS and ODI scores of 2 groups were significantly improved after 2 weeks of treatment compared with before treatment(P<0.05),but the improvement degree of observation group was more significant(P<0.05);VAS and ODI scores of 2 groups at 3 and 6 months after treatment were higher than those after treatment,but the increase in the control group was more obvious(P<0.05),while the increase in the observation group was not obvious(P>0.05).After 2 weeks of treatment,the total effective rate was 96.97% in the observation group and 83.33% in the control group,and the total effective rate in the observation group was significantly better than that in the control group(P<0.05).Conclusion:(1)Both treatment methods have clinical effect on senile chronic lumbar and leg pain;(2)The effect of Jingjin acupuncture combined with lumbar core muscle strength training in the treatment of senile chronic lumbar and leg pain is more significant than that of Jingjin acupuncture alone,and the long-term effect is better.