中医针灸联合推拿治疗腰椎间盘突出症的疗效及对疼痛消失时间的影响

Curative Effect of Acupuncture Combined with Massage on Lumbar Disc Herniation and Its Influence on the Time of Pain Disappearance

目的 探究与分析中医针灸联合推拿治疗腰椎间盘突出症的疗效及对疼痛消失时间的影响。方法 随机选取2020年3月—2022年5月中国人民解放军联勤保障部队第九〇〇医院仓山院区中医康复科收治的90例腰间盘突出症患者为研究对象,采用随机数表法分组,每组45例。两组均给予常规腰椎牵引方式治疗,在此基础上对照组给予针灸治疗,观察组加用推拿治疗,两组均连续治疗1个月,对比两组临床疗效、治疗前后视觉模拟评分法(Visual Analogue Scale, VAS)、改良Oswestry功能障碍指数(Oswestry Disability Index, ODI)、直腿抬高角度,同时对比两组治疗前后炎性因子水平。结果 观察组临床总有效率95.56%较对照组的77.78%高,差异有统计学意义(χ^(2)=6.154,P<0.05)。与治疗前相比,两组治疗后VAS和ODI评分较低,直腿抬高角度较高,且观察组VAS和ODI评分低于对照组,直腿抬高角度高于对照组,差异有统计学意义(P<0.05)。与治疗前相比,两组治疗后炎性因子水平均较低,且观察组血清肿瘤坏死因子-α、白细胞介素-1β、hs-CRP均低于对照组,差异有统计学意义(P<0.05)。结论 中医针灸联合推拿治疗腰椎间盘突出症的临床效果突出,降低患者疼痛度以及功能障碍程度,明显提高直腿抬高角度,明显降低炎性反应,患者的综合预后表现较好。

Objective To explore and analyze the curative effect of acupuncture combined with massage on lumbar disc herniation and the influence on the time of pain disappearance.Methods From March 2020 to May 2022,90 patients with lumbar disc herniation admitted to the Department of Traditional Chinese Medicine Rehabilitation,Cangshan District,900 Hospital of the Joint Logistics Support Force of the Chinese People´s Liberation Army were randomly selected as the research objects.They were divided into groups by random number table method,45 cases in each group.Both groups were treated with conventional lumbar traction.On this basis,the control group was treated with acupuncture and moxibustion,and the observation group was treated with massage.Both groups were treated continuously for 1 month.The clinical efficacy,Visual Analogue Scale(VAS),modified Oswestry Disability Index(ODI)and straight leg elevation angle before and after treatment were compared between the two groups.At the same time,the levels of inflammatory factors before and after treatment were compared between the two groups.Results The total clinical effective rate of the observation group was 95.56%higher than that of the control group(77.78%),and the difference was statistically significant(χ^(2)=6.154,P<0.05).Compared with before treatment,the VAS and ODI scores of the two groups were lower after treatment,and the straight leg elevation angle was higher.The VAS and ODI scores of the observation group were lower than those of the control group,and the straight leg elevation angle was higher than that of the control group,the difference was statistically significant(P<0.05).Compared with before treatment,the levels of inflammatory factors in the two groups were lower after treatment,and the levels of serum tumor necrosis factorα,interleukin-1βand hs-CRP in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion The clinical effect of TCM acupuncture combined with massage in the treatment of lumbar disc herniation is prominent,the degree of pain and dysfunction of patients is reduced,the angle of straight leg elevation is significantly improved,the inflammatory response is significantly reduced,and the comprehensive prognosis of patients is better.