定点正骨复位结合针刺治疗腰椎间盘突出症的临床观察

Curative Effect of Fixed-Point Hammering Combined with Acupuncture Therapy for Lumbar Disc Herniation

目的:探讨基于骨筋脉三联疗法应用定点正骨复位结合针刺治疗腰椎间盘突出症(LDH)的临床疗效。方法:将60例LDH患者随机分为治疗组和对照组各30例,治疗组应用定点正骨复位结合针刺治疗,均每周治疗1次;对照组给予单纯针刺治疗,每周治疗2次;共治疗4周。采用日本骨科协会制定的改良后下腰痛评分(modified anese Orthopaedic Association, m-JOA)判定LDH临床症状的严重程度,分别于治疗前1天、治疗2周后、治疗4周后行m-JOA下腰痛评分进行疗效评估,并在治疗后半年观察复发情况。结果:(1)治疗4周后,治疗组总有效率为93.33%,高于对照组的83.33%(P<0.05)。(2)两组治疗2周后、治疗4周后m-JOA评分呈逐渐降低趋势(P<0.05),治疗组在观察周期中,m-JOA评分中“总分”“主观症状”“客观体征”“日常工作能力”评分降低情况均优于对照组(P<0.05)。(3)治疗结束半年后,可见治疗组复发率低于对照组(P<0.05)。结论:基于骨筋脉三联疗法应用定点正骨复位结合针刺治疗LDH临床疗效优于单纯针刺,能减少针刺治疗频次和复发情况,值得进一步扩大样本持续研究。

ObjectiveObjective:To investigate the curative effect of fixed-point hammering combined with acupuncture therapy in treatment of lumbar disc her‐niation(LDH)based on triple technique of"bone-tendon-vein".MethodsMethods:Sixty patients with LDH were randomly divided into treatment group(n=30)and control group(n=30),and the treatment group was treated with fixed-point hammering combined with acupuncture therapy,both of which were treated once a week;the control group was given acupuncture treatment alone,which was treated twice a week;a total of 4 weeks of treatment was given.The modified anese Orthopaedic Association(m-JOA)was used to determine the severity of clinical symptoms of LDH,and the m-JOA was performed 1 day before treatment,2 weeks after treatment,and 4 weeks after treatment to assess the efficacy of LDH and to observe the recur‐rence situation half a year after treatment.ResultsResults:(1)After 4 weeks of treatment,the total effective rate of the treatment group was 93.33%,which was higher than 83.3%that of the control group(P<0.05).(2)The m-JOA scores of the two groups showed a trend of gradual decrease after 2 weeks and 4 weeks of treatment(P<0.05),and the scores of the m-JOA scores of the treatment group in the observation cycle,including the scores of"total score","subjective symptoms","objective signs"and"daily work ability",were lower than those of the control group.In the m-JOA score,the reduc‐tion of"total score","subjective symptoms","objective symptoms"and"daily work ability"in the treatment group was better than that in the control group(P<0.05).(3)Six months after the end of treatment,the relapse rate of the treatment group was lower than that of the control group(P<0.05).ConclusionConclusion:Based on the fact that the curative effect of the application of fixed-point hammering combined with acupuncture therapy in the treat‐ment of LDH by osteosynovial triple therapy is better than that of acupuncture alone,and that it can reduce the frequency of acupuncture treatment and recurrence,which is worthwhile to further expand the sample for continuous research.