摘要
目的 探讨针灸结合散寒活血止痛方外敷治疗腰椎间盘突出症患者的效果.方法 126例腰椎间盘突出症患者,按随机数字表法分成对照组和研究组,各 63 例.对照组施行常规腰椎牵引治疗,研究组在常规腰椎牵引治疗基础上采取针灸联合散寒活血止痛方外敷治疗.对比两组临床疗效,腰椎活动度、腰椎功能评分,症状评分,舒适度、心理、睡眠质量评分,生活质量评分.结果 经治疗后,研究组总有效率 98.41%比对照组的 87.30%高(P<0.05).对照组治疗前前屈、后伸、侧屈、旋转腰椎活动度及腰椎功能评分分别为(47.29±4.16)°、(12.51±1.14)°、(14.19±1.06)°、(13.29±1.17)°、(16.58±2.19)分,治疗后分别为(52.37±4.94)°、(14.69±1.58)°、(16.43±1.87)°、(15.07±1.46)°、(19.37±2.65)分;研究组治疗前前屈、后伸、侧屈、旋转腰椎活动度及腰椎功能评分分别为(47.53±4.08)°、(12.63±1.06)°、(14.30±1.03)°、(13.39±1.12)°、(16.74±2.03)分,治疗后分别为(60.46±5.32)°、(17.05±1.97)°、(18.97±2.14)°、(17.12±1.85)°、(22.09±2.71)分.治疗后,两组的前屈、后伸、侧屈、旋转腰椎活动度及腰椎功能评分与治疗前相比均显著增高,而研究组的前屈、后伸、侧屈、旋转腰椎活动度及腰椎功能评分均比对照组高(P<0.05).对照组治疗前腰背疼痛、下肢放射痛、大小便障碍评分分别为(2.13±0.42)、(2.05±0.40)、(2.19±0.47)分,治疗后分别为(1.58±0.43)、(1.52±0.48)、(1.61±0.45)分;研究组治疗前腰背疼痛、下肢放射痛、大小便障碍评分分别为(2.15±0.45)、(2.03±0.44)、(2.21±0.54)分,治疗后分别为(1.17±0.39)、(1.06±0.31)、(1.16±0.40)分.治疗后,两组腰背疼痛、下肢放射痛、大小便障碍评分相比于治疗前均明显降低,而研究组腰背疼痛、下肢放射痛、大小便障碍评分均比对照组低(P<0.05).对照组治疗前舒适度、焦虑、抑郁、睡眠质量评分分别为(81.42±5.97)、(54.38±4.45)、(56.27±5.10)、(15.20±2.15)分,治疗后分别为(93.25±6.30)、(45.61±3.96)、(46.98±4.37)、(12.56±1.58)分;研究组治疗前舒适度、焦虑、抑郁、睡眠质量评分分别为(81.67±6.15)、(54.19±4.58)、(56.03±5.24)、(15.07±2.29)分,治疗后分别为(102.59±6.57)、(40.90±3.74)、(41.85±3.81)、(10.80±1.31)分.治疗后,两组舒适度、焦虑、抑郁、睡眠质量评分与治疗前对比均显著改善,而研究组舒适度评分比对照组高,焦虑、抑郁、睡眠质量评分均比对照组低(P<0.05).对照组治疗前生理、心理、环境、社会关系评分分别为(74.21±5.30)、(73.64±5.27)、(74.52±5.19)、(74.39±5.02)分,治疗后分别为(82.93±6.85)、(82.40±6.13)、(83.27±6.30)、(83.14±6.54)分;研究组治疗前生理、心理、环境、社会关系评分分别为(74.68±5.12)、(73.91±5.19)、(74.80±5.24)、(74.75±5.08)分,治疗后分别为(89.75±6.48)、(89.07±6.02)、(90.14±6.15)、(89.96±6.27)分.治疗后,两组生理、心理、环境、社会关系评分较之于治疗前均显著增高,而研究组比对照组高(P<0.05).结论 在腰椎间盘突出症患者治疗中,将针灸与散寒活血止痛方外敷联合应用可增强患者疗效,对于患者腰椎功能、腰椎活动度、腰椎疼痛等症状可起到更好的改善作用,有利于提升患者舒适度,改善其心理、睡眠及生活质量.
Abstract
Objective To explore the effect of acupuncture combined with external application of Sanhan Huoxue Zhitong recipe on patients with lumbar disc herniation.Methods 126 patients with lumbar disc herniation were divided into a control group and a study group by random number table method,with 63 cases in each group.The control group was treated with conventional lumbar traction,and the study group was treated with acupuncture and external application of Sanhan Huoxue Zhitong recipe on the basis of conventional lumbar traction.The clinical efficacy,lumbar range of motion,lumbar function score,symptom score,comfort score,psychological score,sleep quality score and quality of life score were compared between the two groups.Results After treatment,the total effective rate of the study group was 98.41%,which was higher than 87.30%of the control group(P<0.05).In the control group,the antexion,extension,lateral flexion,rotational lumbar range of motion and lumbar function score were(47.29±4.16)°,(12.51±1.14)°,(14.19±1.06)°,(13.29±1.17)° and(16.58±2.19)points before treatment,and those were(52.37±4.94)°,(14.69±1.58)°,(16.43±1.87)°,(15.07±1.46)° and(19.37±2.65)points after treatment.In the study group,the antexion,extension,lateral flexion,rotational lumbar range of motion and lumbar function score were(47.53±4.08)°,(12.63±1.06)°,(14.30±1.03)°,(13.39±1.12)°and(16.74±2.03)points before treatment,and those were(60.46±5.32)°,(17.05±1.97)°,(18.97±2.14)°,(17.12±1.85)° and(22.09±2.71)points after treatment.After treatment,the antexion,extension,lateral flexion,rotational lumbar range of motion and lumbar function score in both groups were significantly higher than those before treatment,while the antexion,extension,lateral flexion,rotational lumbar range of motion and lumbar function score in the study group were higher than those in the control group(P<0.05).In the control group,the scores of low back pain,lower extremity radiation pain and defecation disorder were(2.13±0.42),(2.05±0.40)and(2.19±0.47)points before treatment,and those were(1.58±0.43),(1.52±0.48)and(1.61±0.45)points after treatment.In the study group,the scores of low back pain,lower extremity radiating pain and defecation disorder were(2.15±0.45),(2.03±0.44)and(2.21±0.54)points before treatment,and those were(1.17±0.39),(1.06±0.31)and(1.16±0.40)points after treatment.After treatment,the scores of low back pain,lower extremity radiation pain and defecation disorder in both groups were significantly lower than those before treatment,while the scores of low back pain,lower extremity radiation pain and defecation disorder in the study group were lower than those in the control group(P<0.05).In the control group,the scores of comfort,anxiety,depression and sleep quality were(81.42±5.97),(54.38±4.45),(56.27±5.10)and(15.20±2.15)points before treatment,and those were(93.25±6.30),(45.61±3.96),(46.98±4.37)and(12.56±1.58)points after treatment.In the study group,the scores of comfort,anxiety,depression and sleep quality before treatment were(81.67±6.15),(54.19±4.58),(56.03±5.24)and(15.07±2.29)points before treatment,and those were(102.59±6.57),(40.90±3.74),(41.85±3.81)and(10.80±1.31)points after treatment.After treatment,the scores of comfort,anxiety,depression and sleep quality in both groups were significantly improved compared with those before treatment,while the score of comfort in the study group were higher than that in the control group,and the scores of anxiety,depression and sleep quality were lower than those in the control group(P<0.05).In the control group,the scores of physiology,psychology,environment and social relations were(74.21±5.30),(73.64±5.27),(74.52±5.19)and(74.39±5.02)points before treatment,and those were(82.93±6.85),(82.40±6.13),(83.27±6.30)and(83.14±6.54)points after treatment.In the study group,the scores of physiology,psychology,environment and social relations were(74.68±5.12),(73.91±5.19),(74.80±5.24)and(74.75±5.08)points before treatment,and those were(89.75±6.48),(89.07±6.02),(90.14±6.15)and(89.96±6.27)points after treatment.After treatment,the scores of physiology,psychology,environment and social relations in both groups were significantly higher than those before treatment,but the study group was higher than the control group(P<0.05).Conclusion In the treatment of patients with lumbar disc herniation,the combined application of acupuncture and external application of Sanhan Huoxue Zhitong recipe can enhance the curative effect of patients,and play a better role in improving the lumbar function,lumbar range of motion,lumbar pain and other symptoms,which is conducive to improving the comfort level of patients,and improving their psychology,sleep and quality of life.
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