中药热奄包+电针联合双氯芬酸钠治疗腰椎间盘突出症(风寒湿痹)随机平行对照研究

Randomized Parallel Controlled Study on the Treatment of Lumbar Intervertebral Disc Herniation(Fenghan Shibi/风寒湿痹) with Traditional Chinese Medicine Rehuangbao plus Electroacupuncture combined with Diclofenac Sodium

[目的]观察中药热奄包+电针联合双氯芬酸钠治疗腰椎间盘突出症(风寒湿痹)效。[方法]使用随机平行对照方法,将120例门诊患者按就诊顺序号抽签法随机分为三组。A组40例双氯芬酸钠,1粒/次,1次/d。B组电针,主穴:气海俞、大肠俞、关元俞、环跳,大腿后侧疼痛加殷门、委中;下肢外侧疼痛加风市、阳陵泉、昆仑等,皮肤常规消毒,选择40mm针,避开血管与神经,夹持法进针,环跳针刺方向朝外生殖器,深度2.5寸,余各穴均直刺,深度1.5寸,大幅度提插捻转,1min/穴·次^(-1),环跳针感要求有麻电感向下肢放射,得气后接电针治疗仪,TDP电磁波治疗仪照射,30min/次,1次/d,避免烫伤;双氯芬酸钠治疗同对照组。C组中药热奄方:红花、赤芍、川芎、当归、牛膝、巴戟天、地龙、羌活、细辛、桂枝、宽筋藤、威灵仙、独活、草乌~制、川乌~制、伸筋草、透骨草、川芎、薄荷各20g,冰片15g,以上药物打成药粉装入透气布药袋,把药粉湿润不滴水为宜,用气锅加热至60～70℃,取出后先在病痛部位快速来回推烫(先快后慢),待药包降温至40℃(或患者能耐受)固定在疼痛处热敷,盖上大毛巾,30min/次,1次/d;双氯芬酸钠、电针治疗同对照组。连续治疗10d为1疗程。观测临床表现、不良反应。治疗1疗程(10d),判定疗效。[结果]A组临床痊愈17例,显效7例,有效8例,无效8例,总有效率80.00%;B组临床痊愈20例,显效7例,有效6例,无效7例,总有效率82.50%;C组临床痊愈31例,显效4例,有效3例,无效2例,总有效率95.00%,临床疗效A组与B组无显著差异(P>0.05),C组优于A组、B组(P<0.05)。[结论]中药热奄包+电针联合双氯芬酸钠治疗腰椎间盘突出症(风寒湿痹),疗效满意,无严重不良反应,值得推广。

[Objective] To observe the therapeutic effect of traditional Chinese medicine rehuangbao +electroacupuncture combined with diclofenac sodium on lumbar intervertebral disc herniation(Fenghan Shibi). [Method] 120 outpatients were randomly divided into three groups by drawing lots according to the order of visiting. In group A, 40 cases were diclofenac sodium, 1 tablets/times, 1 times/d. Group B: electroacupuncture at main points: Qihaishu, Dachangshu, Guanyuanyu, Huanjuan, back thigh pain plus Yinmen, Weizhong;lower extremity pain plus Fengshi, Yanglingquan, Kunlun and so on, skin routine disinfection, choose 40 mm needle, avoid blood vessels and nerves, clip needling method, loop-jump needling direction towards external genitals, depth of 2.5 inches, the rest. Acupoints are straight punctured, depth 1.5 inches, large-scale lifting and twisting, 1 min/acupoint times-1, ring jumping needle sensation requires anesthesia inductance to radiate to lower limbs, after getting breath, electro-acupuncture therapeutic apparatus, TDP electromagnetic wave therapeutic apparatus, 30 min/time, once a day, to avoid scald;diclofenac sodium treatment with the control group. Group C: Red Flower, Radix Paeoniae Rubra, Chuanxiong, Angelica, Achyranthes bidentata, Morinda officinalis, Dilong, Qianghuo, Asarum, Cinnamomum ramulus, Willingham, Duhuo, Radix Aconiti Root, Radix Euphorbiae, Radix Euphorbiae, Radix Euphorbiae, Radix Chuanxiong, Mint each 20 g, Borneol 15 g. The above medicines were beaten into breathable cloth bags and the powder was not moist. Dropping water is appropriate, heating to 60~70 ℃ with an air cooker, then quickly pushing and scalding(fast and slow) in the pain area after removal, and then fixing the package to 40 ℃(or the patient can tolerate) at the pain place for hot compress, covered with a large towel, 30 minutes/time, once a day;diclofenac sodium and electro-acupuncture treatment are the same as the control group. Continuous treatment of 10 d for 1 courses. Clinical manifestations and adverse reactions were observed. 1 course of treatment(10), determine the curative effect. [Result] In group A, 17 cases were cured, 7 cases were markedly effective, 8 cases were effective, fective rate was 82.50%. In group C, 31 cases were cured, 4 cases were markedly effective, 3 cases were effective, 2 cases were ineffective, and the total effective rate was 95.00%. There was no significant difference in clinical efficacy between group A and group B(P>0.05), C group was better than group A and group B(P<0.05). [Conclusion] The treatment of lumbar intervertebral disc herniation(Fenghan Shibi) with Chinese herbal medicine Rehuangbao + electro-acupuncture combined with diclofenac sodium has satisfactory curative effect and no serious adverse reactions, which is worthy of p 8 cases were ineffective, and the total effective rate was 80.00%. In group B, 20 cases were cured, 7 cases were markedly effective, 6 cases were effective, 7 cases were ineffective, and the total efromotion.