温针灸联合三维牵引对腰椎间盘突出症的临床疗效评价研究

Research on the clinical efficacy evaluation of warming acupuncture and moxibustion combined with three-dimensional traction on lumbar disc herniation

目的观察温针灸联合三维牵引对腰椎间盘突出症患者疼痛及临床症状的改善情况。方法选取2020年6月至2021年5月北京中医药大学房山医院针灸科门诊就诊的腰椎间盘突出症患者共70例,按照随机数字表法分为对照组和研究组,每组各35例。对照组给予三维牵引治疗,研究组给予温针灸联合三维牵引治疗。温针灸治疗包括针刺肾俞、大肠俞、腰夹脊、秩边、环跳、委中、阳陵泉、昆仑穴位。针刺操作后在患侧肾俞、秩边穴的针柄部位应用百笑灸实施温针灸操作。每日治疗1次,治疗时间为30 min,治疗5 d为1个疗程。连续休息2 d后继续治疗,共治疗4个疗程。对两组患者的视觉模拟评分(VAS)、腰椎功能障碍指数(ODI)、日本骨科协会评估评分(JOA)以及临床治疗有效率进行比较。结果研究组患者VAS、ODI评分在第2、4个疗程后及随访时的评分低于对照组(P<0.05);JOA评分在第2、4个疗程后及随访时评分高于对照组(P<0.05);研究组治疗总有效率高于对照组(P<0.05)。结论温针灸联合三维牵引治疗腰椎间盘突出症可以有效缓解疼痛,改善患者的生活质量,临床值得推广。

Objective To observe the improvements in pain and clinical symptoms of patients with lumbar disc herniation by warming acupuncture and moxibustion combined with three-dimensional traction.Methods A total of 70 patients with lumbar disc herniation admitted to the Clinic of Department of Acupuncture and Moxibustion in Fangshan Hospital,Beijing University of Traditional Chinese Medicine from June 2020 to May 2021 were divided into the control group(n=35)and the study group(n=35)according to the random number table method.The control group was treated with three-dimensional traction therapy,while the study group was treated with warming acupuncture and moxibustion combined with three-dimensional traction therapy.For the warming acupuncture and moxibustion therapy,acupoints of Shenshu(BL23),Dachangshu(BL25),Yaojiaji(EX-B2),Zhibian(BL54),Huantiao(GB30),Weizhong(BL40),Yanglingquan(GB34)and Kunlun(BL 60)were acupunctured.After the acupuncture operation,Baixiao moxibustion was applied to the needle handle of acupoints of Shenshu(BL23)and Zhibian(BL54)on the affected side to perform warming acupuncture and moxibustion therapy.The patients were treated for 30 min once a day and 5 days as a course of treatment.After consecutive rest for 2 days,the treatment was continued for totally 4 courses.The visual analogue scale(VAS)scores,lumbar oswestry disability index(ODI),Japanese Orthopedic Association(JOA)scores and the clinical effective rate of treatment were compared between the two groups.Results After 2 and 4 courses of treatment and at follow-up,the scores of VAS and ODI of patients in the study group were lower than those in the control group(P<0.05).After 2 and 4 courses of treatment and at follow-up,JOA scores in the study group were higher than those in the control group(P<0.05).The total effective rate of treatment in the study group was higher than that in the control group(P<0.05).Conclusion Warming acupuncture and moxibustion combined with threedimensional traction therapy can effectively relieve pain and improve the quality of life of patients with lumbar disc herniation.Therefore,it is worthy of clinical promotion.