“松、正、理”三步推拿法联合电热针疗法在腰椎间盘突出症患者康复治疗中的应用分析

Application of loosing-bonesetting-conditioning tendons three-step massage combined with electrothermal needle therapy in the rehabilitation treatment of patients with lumbar disc herniation

目的:对“松、正、理”三步推拿法联合电热针疗法在治疗腰椎间盘突出症(LDH)患者的康复效果进行观察。方法:回顾性分析2019年1月~2021年3月期间在本院收治的180例LDH患者,根据患者所用治疗方案分为单一电热针疗组(简称单一组,采用电热针疗法,n=88)和推拿针灸联合组(简称联合组,采用“松、正、理”三步推拿法联合电热针疗法,n=92),两组患者均完成2个疗程(4周)的治疗。观察两组患者的临床疗效、中医症状积分、腰椎功能[腰椎Oswestry功能障碍指数(ODI)、腰腿视觉疼痛评分(VAS)、下腰痛日本骨科协会评估治疗分数(JOA)、腰椎关节活动度(前屈和后伸)、下肢Fugl-Meyer运动功能评定量表(FMA)]、血清学指标水平[白介素-6(IL-6)、肿瘤坏死因子(TNF)-α、β-内啡肽(EP)]的变化情况。记录两组不良反应事件。结果:临床疗效:联合组优于单一组(P<0.05);中医症状积分:治疗后,联合组均低于单一组(P<0.05);腰椎功能:治疗后,联合组ODI、JOA、腰椎关节活动度、下肢FMA评分均高于单一组,VAS评分低于单一组(P<0.05);血清指标:治疗后,联合组IL-6、TNF-α水平低于单一组,β-EP高于单一组(P<0.05);不良反应:两组比较无差异(P>0.05)。结论:三步推拿联合电针疗法可有效抑制LDH患者炎症反应、缓解腰椎疼痛、改善腰椎功能,进一步提高临床疗效。

Objective:To observe the curative effect of loosing-bonesetting-conditioning tendons three-step massage combined with electrothermal needle therapy on patients with lumbar disc herniation(LDH).Methods:A total of 180patients with LDH admitted to the hospital were enrolled between January 2019and March 2021.According to different treatment methods,they were divided into single electrothermal needle therapy group(single group,electrothermal needle therapy,n=88)and massage combined with needle group(combination group,loosing-bonesetting-conditioning tendons three-step massage combined with electrothermal needle therapy,n=92).All were treated for 2courses(4weeks).The clinical curative effect,changes in scores of TCM symptoms,lumbar function and serological indexes in the two groups were observed.The occurrence of adverse events was recorded.Results:The clinical response rate of combination group was better than that of single group(95.65%vs 84.09%,P<0.05).After treatment,scores of TCM symptoms in combination group were lower than those in single group(P<0.05).After treatment,scores of ODI,JOA,lumbar range of motion and lower limb FMA in combination group were higher than those in single group,and VAS score was lower than that in single group(P<0.05).After treatment,levels of IL-6and TNF-αin combination group were lower than those in single group,whileβ-EP was higher than that in single group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(3.26%vs 1.14%,P>0.05).Conclusion:Three-step massage combined with electrothermal needle therapy can effectively inhibit inflammatory response,relieve lumbar pain and improve lumbar function LDH patients,and further improve clinical curative effect.