电针联合无极桩功法治疗腰椎间盘突出症患者的临床疗效观察

Clinical Efficacy of Electroacupuncture and Wujizhuang(无极桩)Exercise in the Treatment of Lumbar Disc Herniation

目的观察调脊电针法联合无极桩功法治疗腰椎间盘突出症的临床疗效。方法选取2020年1月—2021年10月期间在秦皇岛市中医医院针灸科门诊就诊的180例腰椎间盘突出症患者作为研究对象,按随机数字表法分为联合组、调脊电针组和常规电针组,每组各60例。常规电针组在常规针刺的基础上,选取患侧腰夹脊穴、环跳与阳陵泉或环跳与委中,连接两组电针;调脊电针组选取健侧调脊穴连电针,其余选穴及下肢电针治疗同常规电针组;联合组在调脊电针组的基础上,指导患者每天练习无极桩功法30 min。3组电针治疗均30 min/次,1次/d,每周5次。治疗2周后,观察比较3组患者临床疗效,治疗前后疼痛视觉模拟评分(Visual analogue scale,VAS)、改良日本骨科学会的下腰痛评分表(Modified Japanese Orthopaedic Association,M-JOA)积分、改良Oswestry功能障碍指数(Modified Oswestry dysfunction index,M-ODI)的变化。结果治疗后3组患者VAS评分均较治疗前降低,差异有统计学意义(P<0.05)。调脊电针组与常规电针组治疗1周时VAS评分比较,差异无统计学意义(P>0.05);调脊电针组治疗2周时VAS评分低于常规电针组,差异有统计学意义(P<0.05)。联合组治疗1周、2周时VAS评分均低于调脊电针组与常规电针组,差异有统计学意义(P<0.05)。治疗后3组患者M-JOA评分均较治疗前降低,差异有统计学意义(P<0.05)。调脊电针组治疗1周时M-JOA评分与常规电针组比较,差异无统计学意义(P>0.05);调脊电针组治疗2周时M-JOA评分明显低于常规电针组,差异有统计学意义(P<0.05)。联合组治疗1周、2周时M-JOA评分均低于调脊电针组与常规电针组,差异有统计学意义(P<0.05)。治疗后3组患者M-ODI评分均较治疗前降低,差异有统计学意义(P<0.05);调脊电针组M-ODI评分均低于常规电针组,差异有统计学意义(P<0.05);联合组M-ODI评分均低于调脊电针组与常规电针组,差异有统计学意义(P<0.05)。治疗2周后,联合组临床痊愈率23.21%(13/56)高于调脊电针组1.89%(1/53)和常规电针组,差异有统计学意义(P<0.05);在愈显率方面,调脊电针组与联合组均高于常规电针组,差异有统计学意义(P<0.05),而联合组与调脊电针组比较,差异无统计学意义(P>0.05)。结论调脊电针法联合无极桩功法治疗腰椎间盘突出症疗效显著,可明显减轻患者临床症状、体征,改善患者日常活动能力,值得临床中推广应用。

Objective To observe the clinical efficacy of spinal adjustment electroacupuncture combined with Wujizhuang exercise in the treatment of lumbar disc herniation.Methods A total of 180 patients with lumbar disc herniation who visited the Department of Acupuncture and Moxibustion,Qinhuangdao Hospital of Traditional Chinese Medicine from January 2020 to October 2021 were selected and randomly divided into three groups:a combination group,a spinal adjustment electroacupuncture group,and a conventional electroacupuncture group,with 60 patients in each group.The conventional electroacupuncture group received acupuncture treatment according to routine procedures,and additional electroacupuncture was applied at the Jiaji(EX-B 2)on the affected side,as well as Huantiao(GB 30)and Yanglingquan(GB 34)or Huantiao(GB 30)and Weizhong(BL 40).The spinal adjustment electroacupuncture group received electroacupuncture at Jiaji(EX-B 2)on the healthy side,while the remaining acupoints and lower limb electroacupuncture treat-ment were the same as those in the conventional electroacupuncture group.In the combination group,patients were instructed to practice the Wujizhuang exercise for 30 min every day in addition to the spinal adjustment electroacupuncture.The duration of each electroacupuncture treatment session for all three groups was 30 min,once a day,five times a week.After two weeks of treatment,the clinical efficacy of the three groups was observed and compared.The changes in visual analog scale(VAS)scores,Modified Japanese Orthopaedic Association(M-JOA)scores,and Modified Oswestry Dysfunction Index(M-ODI)scores before and after treatment were also evaluated.Results After treatment,the VAS scores in all three groups were significantly lower than before treatment(P<0.05).There was no significant difference in VAS scores between the spinal adjustment electroacupuncture group and the conventional electroacupuncture group after one week of treatment(P>0.05),but after two weeks of treatment,the VAS scores in the spinal adjustment electroacupuncture group were lower than those in the conventional electroacupuncture group(P<0.05).The VAS scores in the combination group after one and two weeks of treatment were lower than those in the spinal adjustment electroacupuncture group and the conventional electroacupuncture group(P<0.05).After treatment,the M-JOA scores in all three groups were significantly lower than those before treatment(P<0.05).There was no significant difference in M-JOA scores between the spinal adjustment electroacupuncture group and the conventional electroacupuncture group after one week of treatment(P>0.05),but after two weeks of treatment,the M-JOA scores in the spinal adjustment electroacupuncture group were significantly lower than those in the conventional electroacupuncture group(P<0.05).The M-JOA scores in the combination group after one and two weeks of treatment were lower than those in the spinal adjustment electroacupuncture group and the conventional electroacupuncture group(P<0.05).After treatment,the M-ODI scores in all three groups were significantly lower than those before treatment(P<0.05).The M-ODI scores in the spinal adjustment electroacupuncture group were significantly lower than those in the conventional electroacupuncture group(P<0.05),and the M-ODI scores in the combination group were significantly lower than those in the spinal adjustment electroacupuncture group and the conventional electroacupuncture group(P<0.05).After two weeks of treatment,the clinical curative rate in the combination group was 23.21%(13/56),which was higher than 1.89%(1/53)in the spinal adjustment electroacupuncture group and the conventional electroacupuncture group(P<0.05).In terms of curative and markedly effective rate,both the spinal adjustment electroacupuncture group and the combination group were higher than the conventional electroacupuncture group(P<0.05),while there was no significant difference between the combination group and the spinal adjustment electroacupuncture group(P>0.05).Conclusion The combination of spinal adjustment electroacupuncture and Wujizhuang exercise has significant efficacy in the treatment of lumbar disc herniation,and it can significantly alleviate clinical symptoms and signs,improve patients'daily activity ability,and is worthy of clinical promotion and application.