中医推拿结合中药热敷对腰椎间盘突出症腰腿痛的影响

Tuina combined hot compress for low back pain due to lumbar disc herniation

目的探讨中医推拿结合中药热敷对腰椎间盘突出症(lumber disc herniation,LDH)腰腿痛的影响。方法将符合纳入标准的2019年1月-2020年6月石家庄市中医院LDH腰腿痛患者90例采用随机数字表法分为2组,每组45例。对照组口服醋氯芬酸缓释片与甲钴胺片治疗,观察组给予推拿手法结合中药热敷治疗。2组均治疗1个月,随访6个月。分别于治疗前后及随访6个月时采用VAS量表评估疼痛程度,Oswestry功能障碍指数(Oswestry Disability Index,ODI)评估功能障碍程度;采用肌电图检测仪测定胫神经传导速度(tibial nerve motor conduction velocity,TNMCV)、腓总神经传导速度(common peroneal nerve motor conduction velocity,CPNMCV),评价临床疗效。结果观察组优良率为51.1%(23/45)、对照组为28.9%(13/45),2组比较差异有统计学意义(χ^(2)=3.98,P=0.046)。观察组随访6个月VAS评分低于对照组(t=11.26,P<0.01);治疗后1个月、随访6个月ODI评分低于对照组(t值分别为7.19、18.30,P<0.01)。治疗后1个月、随访6个月,观察组CPNMCV(t值分别为2.08、1.99),NTMCV(t值分别为2.46、2.12)均高于对照组(P<0.05)。结论中医推拿结合中药热敷可有效改善LDH腰腿痛患者下肢神经传导速度,缓解腰腿痛症状。

Objective To explore the efficacy of Tuina combined hot compress in the treatment of lumbar disc herniation(LDH).Methods A total of 90 patients with LDH low back and leg pain in Shijiazhuang Traditional Chinese Medicine Hospital from January 2019 to June 2020 were divided into two groups,45 in each group.The control group was treated with Aceclofenac Sustained-release Tablets and Mecobalamin,and the observation group was treated with Tuina combined hot compress.Both groups were treated for 1 month and followed up 6 months.The Visual Analogue Scale(VAS)was used to evaluate the degree of pain.The Oswestry Dysfunction Index(ODI)was used to evaluate the recovery of lumbar function,and the improvement of daily activities of patients after treatment was evaluated.The conduction velocity of tibial nerve motor conduction velocity(TNMCV)and common peroneal nerve motor conduction velocity(CPNMCV)were measured by electromyography.The clinical effect was evaluated.Results After 6 months of follow-up,the response rate of the observation group was 51.1%(23/45)and that of the control group was 28.9%(13/45)(χ^(2)=3.98,P=0.046).The VAS score of the observation group was significantly lower than that of the control group(t=11.26,P<0.01).The ODI scores at 1 month after treatment and 6 months after follow-up were significantly lower than those in the control group(t values were 7.19,18.30,respectively,all Ps<0.001).The observation group 1 month after CPNMCV treatment and 6 months of follow-up(t=2.08,1.99),1 month after TNMCV treatment and 6 months of follow-up(t values were 2.46,2.12,respectively)were significantly higher than those in the control group(P<0.05).Conclusion Tuina combined with hot compress can improve the nerve conduction velocity of lower limbs,relieve the symptoms of low back and leg pain in patients after LDH operation.