腰痹通胶囊联合浮针对腰椎间盘突出症患者腰椎活动度及腰背肌表面肌电信号的影响

Effect of Yaobitong Capsules Combined with Fu's Subcutaneous Needling on Lumbar Range of Motion and Surface Electromyography of Trunk Extensors in Patients with Lumbar Disc Herniation

【目的】探讨腰痹通胶囊联合浮针针刺治疗对腰椎间盘突出症(LDH)患者腰椎活动度及腰背肌表面肌电信号的影响。【方法】将80例LDH血瘀证患者随机分为研究组和对照组,每组各40例。对照组给予服用腰痹通胶囊治疗,研究组在对照组基础上给予浮针针刺治疗,疗程为2周。观察2组患者治疗前后腰椎活动度、疼痛程度视觉模拟量表(VAS)评分、改进汉化的Oswestry功能障碍指数(ODI)评分、Roland-Morris腰椎功能障碍问卷(RMDQ)评分及腰背肌表面肌电信号的变化情况,并评价2组患者的临床疗效。【结果】(1)疗效方面,治疗2周后,研究组的总有效率为97.50%(39/40),对照组为80.00%(32/40),组间比较(χ^(2)检验),研究组的临床疗效明显优于对照组(P<0.05)。(2)腰椎活动度方面,治疗后,2组患者的腰椎屈伸、旋转活动度均较治疗前明显改善(P<0.05),且研究组对腰椎屈伸、旋转活动度的改善幅度均明显优于对照组(P<0.05或P<0.01)。(3)腰椎功能评分方面,治疗后,2组患者的ODI评分和RMDQ评分均较治疗前明显下降(P<0.05),且研究组对ODI评分和RMDQ评分的下降幅度均明显优于对照组(P<0.01)。(4)疼痛程度评分方面,研究组治疗1周、2周和1个月后及对照组治疗2周和1个月后的疼痛程度VAS评分均较治疗前明显下降(P<0.05),且研究组在治疗1周、2周和1个月后对疼痛程度VAS评分的下降幅度均明显优于对照组(P<0.01)。(5)腰背肌表面肌电参数方面,治疗后,2组患者的腰背肌表面肌电信号积分肌电值(IEMG)和平均功率频率(MPF)均较治疗前明显升高(P<0.05),且研究组对腰背肌表面肌电信号MPF和IEMG的升高幅度均明显优于对照组(P<0.01)。【结论】腰痹通胶囊联合浮针针刺治疗可显著提升LDH患者的疗效,改善患者腰椎活动度,提高腰背肌群表面肌电信号,缓解肌肉疲劳和疼痛症状。

Objective To investigate the effect of Yaobitong Capsules combined with Fu's subcutaneous needling on lumbar range of motion and surface electromyography of trunk extensors in patients with lumbar disc herniation(LDH).Methods A total of 80 patients with LDH of blood stasis type were randomly divided into the study group and the control group,with 40 cases in each group.The control group was treated with Yaobitong Capsules orally,and the study group was given Fu's subcutaneous needling combined with Yaobitong Capsules orally.The course of treatment for the two groups covered 2 weeks.The changes of lumbar range of motion,pain visual analogue scale(VAS)score,improved Chinese Oswestry Disability Index(ODI)score,Roland-Morris Disability Questionnaire(RMDQ)score and surface electromyography of trunk extensors in the two groups before and after treatment were observed.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 2 weeks of treatment,the total effective rate of the study group was 97.50%(39/40),and that of the control group was 80.00%(32/40).The intergroup comparison(tested by chi-square test)showed that the clinical efficacy of the study group was significantly superior to that of the control group(P<0.05).(2)After treatment,the range of motion of lumbar flexion,extension and rotation in the two groups was significantly improved compared with that before treatment(P<0.05),and the improvement of lumbar range of motion in the study group was significantly superior to that in the control group(P<0.05 or P<0.01).(3)After treatment,the lumbar function scores of ODI score and RMDQ score in the two groups were significantly lower than those before treatment(P<0.05),and the decrease of ODI score and RMDQ score in the study group was significantly superior to that in the control group(P<0.01).(4)The pain VAS scores of the study group after one week,2 weeks and one month of treatment and the pain VAS scores of the control group after 2 weeks and one month of treatment were significantly lower than those before treatment(P<0.05),and the decrease of pain VAS scores of the study group after one week,2 weeks and one month of treatment was significantly superior to that of the control group(P<0.01).(5)After treatment,the parameters of surface electromyography of trunk extensors such as integrated electromyographic value(IEMG)and mean power frequency(MPF)in the two groups were obviously increased compared with those before treatment(P<0.05),and the increase of MPF and IEMG in the study group was significantly superior to that of the control group(P<0.01).Conclusion Yaobitong Capsules combined with Fu's subcutaneous needling can significantly enhance the curative effect of LDH patients,alleviate the lumbar range of motion,improve the surface electromyography of trunk extensors,and relieve muscle fatigue and pain symptoms.