电针与双氯灭痛治疗腰椎间盘突出症的疗效观察(英文)

Therapeutic effects of electro acupuncture and diclofenic on herniation of lumbar intervertebral disc

背景:研究表明针刺对治疗坐骨神经痛有较高的有效率,非类固醇类药物,如双氯灭痛也被广泛用于治疗坐骨神经痛,但针刺和双氯灭痛分别治疗坐骨神经痛的疗效对比如何亟待研究。目的:比较电针刺与双氯灭痛治疗腰椎间盘突出症引起的坐骨神经痛的疗效。设计:随机对照研究。地点和对象:本研究在巴基斯坦伊斯兰堡中国针灸中心完成,对象为2001-02/2002-10该中心门诊治疗的腰椎间盘突出症患者40例。方法:随机分为电针组23例,电针刺25min/d,治疗7d。药物组17例,口服双氯灭痛片50mg/次,3次/d,治疗7d。主要观察指标:两组治疗前后直腿抬高实验(SLR),臀部、大腿后侧及小腿压痛、麻木感。结果:治疗后电针组直腿抬高角度明显大于药物组(t=2.179,P<0.05);电针组臀部压痛减轻的VSA分数明显小于药物组(t=2.224,P<0.05)。但压痛的减轻在大腿后和小腿部在两组间没有区别(大腿:t=1.912,小腿:t=1.580,P>0.05)。在电针组SLR增加20°以上的患者数多于药物组(χ2=4.817,P<0.05)。同样,电针组臀部压痛减轻在20分以上的患者数多于药物组(χ2=5.028,P<0.05)。但大腿后和小腿部压痛的减轻在20分以上的患者数两组间没有明显区别(大腿:χ2=0.583;小腿χ2=1.081,P>0.05)。足部麻木感的减轻两组间没有明显区别(χ2=0.680,P>0.05)。结论:对于?

BACKGROUND: Acupuncture studies frequently claim high success rates of pain relief in sciatica and non steroid anti inflammatory drugs(NSAIDs) such as diclofenac, are commonly used in treatment of sciatica. However, the therapeutic effects of acupuncture and diclofenac on sciatica remain to be compared. OBJECTIVE:To compare the effect of electro acupuncture and that of diclofenac treatment on the sciatica caused by herniation of intervertebral disc. DESIGN:A randomized controlled basic research was conducted. SETTING and PARTICIPANTS:Forty patients of Pakistani nationality with intervertebral disc herniation were selected from China Acupuncture Center, Islamabad, Pakistan, during the period from February of 2001 to October of 2002. METHODS:The 40 patients were randomly divided into 2 groups: acupuncture group with 23 cases, treated with electro acupuncture 25 minutes daily for 7 days, and medication group with 17 case, treated with 50 mg diclofenac post cibum tid for 7 days. MAIN OUTCOME MEASURES:Laséque’s sign, and tenderness and numbness of the buttock, posterior side of the thigh, and the leg. RESULTS:After the treatment, the angle of Laséque’s sign of the acupuncture group was significantly bigger than that of the medication group (P< 0.05,t=2.179); The mean VSA score of buttock tenderness relief was significantly lower in the acupuncture group than in the medication group (P< 0.05,t=2.224). However, the mean scores of tenderness relief in the posterior side of the thigh and of the leg were not significantly different between the two groups(t=1.912 and t=1.580, both P >0.05).The number of the patients with an increase of the Laséque’s sign angle >20°was significantly higher in the acupuncture group than in the medication group (χ2=4.817,P< 0.05). Similarly, the number of the patients with the buttock tenderness relief by more than 20 scores in the acupuncture group was significantly higher than that in the medication group (χ2=5.028,P< 0.05). But there were not significant differences between the two groups in tenderness relief in the posterior side of the thigh and in the leg by more than 20 scores (χ2=0.583 and χ2=1.081, P >0.05). There was no significant difference in alleviation of numbness at the feet between the two groups (χ2=0.680,P >0.05). CONCLUSION:Electro acupuncture is more effective than diclofenac treatment in increasing the Laséque’s sign angles and relieving tenderness in the punctured area. However, there is no significant difference in the effect on tenderness relief in the areas far from the punctured area.