针刺夹脊穴配合多裂肌训练治疗腰椎间盘突出症疗效观察

Clinical Effects of Acupuncture at Jiaji(EX-B 2)Combined with Multifidus Muscle Training Therapy on Lumbar Disc Herniation

目的观察针刺夹脊穴配合多裂肌训练治疗腰椎间盘突出症(LDH)的临床疗效。方法采用随机数字表法将63例腰椎间盘突出症患者分为观察组32例和对照组31例。观察组有2例因治疗1周后未见好转,要求停止治疗而退出试验;对照组有1例因依从性差,违背研究方案,自动退出试验。对照组予健康宣传、多裂肌训练和抗炎止痛治疗,观察组在对照组治疗基础上联合针刺夹脊穴治疗,2组均连续治疗2周。观察2组治疗前后的视觉模拟评分(VAS)、日本骨科学会(JOA)下腰痛评分、腰椎前屈和后伸角度和多裂肌稳定躯干能力评分,并比较2组腰痛复发率。结果与治疗前比较,2组治疗后腰椎前屈、后伸角度均明显增加(P<0.05),左、右两侧多裂肌稳定躯干能力评分和JOA评分均明显升高(P<0.05),VAS评分明显降低(P<0.05);与对照组比较,观察组治疗后腰椎前屈、后伸角度均明显增加(P<0.05),左、右两侧多裂肌稳定躯干能力评分和JOA评分均明显升高(P<0.05),VAS评分明显降低(P<0.05)。2组治疗后1、3、6个月复发率比较,差异无统计学意义(P>0.05)。结论针刺夹脊穴配合多裂肌训练可改善LDH患者腰椎活动度和疼痛程度,提高双侧多裂肌稳定躯干能力,提高腰椎功能。

Objective:To observe the clinical effects of acupuncture at Jiaji(EX-B 2)combined with multifidus muscle training in the treatment of lumbar disc herniation.Methods:A total of 63 patients with lumbar disc herniation were randomly divided into observation group(n=32)and control group(n=31).Two cases in the observation group withdrew from the trial because they did not get better after one week of treatment and asked to stop the treatment;one case in the control group automatically withdrew from the trial due to poor compliance and violation of the trial scheme.The control group was treated with health education,multifidus muscle training,and oral treatment of analgesic and anti-inflammatory.The observation group was treated with acupuncture at Jiaji(EX-B 2)on the basis of the control group.Both groups were treated continuously for 2 weeks.The visual analogue scale(VAS),the Japanese Orthopedic Association(JOA)low back pain score,the flexion and extension angles of lumbar vertebrae,and the score of trunk stabilizing ability of multifidus muscles were observed before and after treatment in the two groups,and the recurrence rate of low back pain in both groups was compared.Results:Compared with those before treatment,the flexion and extension angles of lumbar vertebrae,the scores of trunk stabilizing ability of left and right multifidus muscles,and the JOA scores of both groups increased significantly after treatment(P<0.05),while the VAS scores decreased significantly(P<0.05).Compared with the control group,the flexion and extension angles of lumbar vertebrae,the scores of trunk stabilizing ability of left and right multifidus muscles,and the JOA scores in the observation group increased significantly after treatment(P<0.05),while the VAS scores decreased significantly(P<0.05).There was no significant differences between the two groups in the recurrence rate at 1,3 and 6 months after treatment(P>0.05).Conclusion:Acupuncture of Jiaji acupoint combined with multifidus muscle training can improve the activity and pain degree of lumbar vertebrae,the ability of bilateral multifidus muscles to stabilize the trunk,and the functional function of lumbar vertebrae in patients with LDH.