动气针法治疗急性腰扭伤临床疗效及时效关系观察

Clinical efficacy and time-effect relationship of dynamic qi acupuncture for acute lumbar sprain

目的:观察动气针法治疗急性腰扭伤的临床疗效,探讨不同留针时间对疼痛、腰椎活动度及腰部功能障碍改善作用的差异。方法:将160例急性腰扭伤患者随机分为观察1组(40例,脱落4例)、观察2组(40例,脱落2例)、观察3组(40例,脱落4例)和西药组(40例,脱落6例)。观察1组、观察2组及观察3组予针刺“腰痛穴”和左侧三间,分别留针10、20、30 min,留针同时缓慢进行可耐受的腰部主动活动,每日1次;西药组予口服塞来昔布胶囊,每次0.2 g,每日2次,4组均治疗5 d。分别于治疗前后观察各组患者数字评分量表-11(NRS-11)、腰椎活动度(ROM)及改良Oswestry功能障碍指数(ODI)评分,并评定各组临床疗效。结果:治疗后,各组患者NRS-11、ROM及ODI评分均较治疗前降低(P<0.01);各观察组NRS-11、ROM和ODI评分降低幅度大于西药组(P<0.05),观察2组、观察3组ROM、ODI评分降低幅度大于观察1组(P<0.05)。观察1组、观察2组、观察3组总有效率分别为94.4%(34/36)、94.7%(36/38)和97.2%(35/36),均高于西药组的79.4%(27/34,P<0.05)。结论:留针10、20、30 min动气针法均可有效改善急性腰扭伤患者疼痛、腰椎活动度和腰部功能障碍,若患者腰部功能障碍明显,推荐留针20 min及以上。

Objective To observe the clinical efficacy of dynamic qi acupuncture for acute lumbar sprain,and to explore the differences of different needle retention time on the improvement of pain,lumbar mobility and lumbar dysfunction.Methods A total of 160 patients with acute lumbar sprain were randomly divided into an observation group A(40 cases,4 cases dropped off),an observation group B(40 cases,2 cases dropped off),an observation group C(40 cases,4 cases dropped off)and a medication group(40 cases,6 cases dropped off).The patients in the observation group A,the observation group B and the observation group C were treated with acupuncture at"lumbago point"and Sanjian(LI 3)on the left side,and during the needles were kept for 10,20 and 30 min respectively,the patients were required to take tolerable lumbar active activities,once a day;the patients in the medication group were treated with celecoxib capsules,0.2 g each time,twice a day.All the patients were treated for 5 d.Before and after treatment,the scores of numerical rating scale-11(NRS-11),lumbar range of motion(ROM)and modified Oswestry disability index(ODI)were observed,and the clinical efficacy of each group was evaluated.Results After treatment,the scores of NRS-11,ROM and ODI in each group were decreased compared before treatment(P<0.01).The decreased degree of NRS-11,ROM and ODI in each observation group was greater than that in the medication group(P<0.05),and the decreased degree of ROM and ODI in the observation group B and the observation group C was greater than that in the observation group A(P<0.05).The total effective rates were 94.4%(34/36)in the observation group A,94.7%(36/38)in the observation group B and 97.2%(35/36)in the observation group C,respectively,which were higher than 79.4%(27/34)in the medication group(P<0.05).Conclusion Dynamic qi acupuncture with needle retention for 10,20 and 30 min all could effectively improve the pain,lumbar mobility and lumbar dysfunction in patients with acute lumbar sprain.If the lumbar dysfunction is severe,needle retention for 20 min or more is recommended.