首页|针刺联合点扳抖手法治疗腰椎间盘突出症缓解期50例随机对照试验

针刺联合点扳抖手法治疗腰椎间盘突出症缓解期50例随机对照试验

扫码查看
目的 评价针刺联合点扳抖手法治疗腰椎间盘突出症缓解期的临床疗效与安全性.方法 104例腰椎间盘突出症缓解期患者随机分为治疗组和对照组各52例.治疗组采用针刺联合点扳抖手法治疗,针刺选取腰部夹脊穴(双侧)、阿是穴、肾俞穴(双侧)、环跳穴(双侧)、委中穴(患肢对侧)、承山穴(患肢对侧);对照组采用腰椎牵引联合穴位超声脉冲透入治疗(穴位同治疗组针刺穴位),每次20min,两组均每周3次,共3周.主要结局指标为腰椎间盘突出症症状与体征的评分改善率,分别于治疗1周、治疗3周、1个月随访时、3个月随访时计算;次要结局指标为日本整形外科学会(JOA)评分、视觉模拟评分法(VAS)评分和Oswestry功能障碍指数问卷表(ODI)评分(包括ODI总积分、坐位评分和站立评分),分别于治疗前、治疗1周、治疗3周、1个月随访时、3个月随访时各评价1次;3个月随访时评定临床疗效;记录患者不良事件发生情况,以及治疗前后血常规、尿常规、大便常规及心电图情况,评价安全性.结果 两组患者各脱落2例,最终纳入分析各50例.治疗1周、治疗3周、1个月随访时及3个月随访时,治疗组腰椎间盘突出症症状与体征的评分改善率均高于对照组(P<0.01).治疗1周、治疗3周、1个月随访时及3个月随访时两组患者JOA评分均较本组治疗前升高,VAS评分、ODI总积分、ODI坐位评分与站立评分均较本组治疗前明显降低(P<0.05),且治疗组各时间点JOA评分均高于对照组,VAS评分、ODI总积分、ODI坐位评分与站立评分均低于对照组(P<0.05).3个月随访时,治疗组优良率为70.00%(35/50)优于对照组的50.00%(25/50)(P<0.05).两组患者治疗前后血常规、尿常规、大便常规及心电图均未见异常,未出现不良事件.结论 针刺联合点扳抖手法治疗腰椎间盘突出症缓解期患者在减轻疼痛、提高生活质量方面有较好疗效及安全性,且疗效优于腰椎牵引联合穴位超声脉冲透入治疗.
Acupuncture with Manipulation for Lumbar Disc Herniation in Remission of 50 Cases:A Randomized Controlled Trial
Objective To evaluate the clinical effectiveness and safety of acupuncture with manipulation for lumbar disc herniation in remission period.Methods One hundred and four patients with lumbar disc herniation in remission were randomly divided into a treatment group and a control group,with 52 cases in each group.Treatment group applied acupuncture with manipulation of pointing,pulling,and shaking.Acupoints were selected as lumbar Jiaji(EX-B2,bilateral),Ashi point,Shenshu(BL 23,bilateral),Huantiao(GB 30,bilateral),Weizhong(BL 40,opposite side of the affected area),Chengshan(BL 57,opposite side of the affected area).The control group applied lumbar traction plus acupoint ultrasonic pulse penetration therapy(acupoints selection same as the treatment group);20 minutes each time,3 times a week,a total of 3 weeks for both groups.The primary outcome was the improvement rate of lumbar disc herniation symptoms and signs,which was calculated at 1 week of treatment,3 weeks of treat-ment,1 month follow-up,and 3 months follow-up,respectively;the secondary outcome were the Japanese Orthopae-dic Association(JOA)scores,Visual Analogue Scale(VAS)scores,and Oswestry Disability Index(ODI)scores(including ODI total scores,sitting scores and standing scores),which were evaluated before treatment,1 week of treatment,3 weeks of treatment,1 month follow-up,and 3 months follow-up;clinical effectiveness was assessed at 3 months follow-up;and the occurrence of adverse events in the participants,as well as blood routine,urine routine,stool routine,and electrocardiograms before and after the treatment were recorded to evaluate safety.Results Two patients from each group fell out,and 50 patients of each group were included in the outcome analysis ultimately.The scores of lumbar disc herniation symptoms and signs improved more in the treatment group than in the control group at 1 week of treatment,3 weeks of treatment,1 month follow-up and 3 months follow-up(P<0.01).The JOA scores of participants in both groups at 1 week of treatment,3 weeks of treatment,1 month follow-up and 3 months follow-up were higher than those before treatment in the same group,and the VAS scores,ODI total scores,ODI sitting scores and standing scores were significantly lower than those before treatment in the same group(P<0.05),and the JOA scores of patients in the treatment group were higher than those of the control group at all time points,and the VAS scores,ODI total scores,ODI sitting scores and standing score were lower than those of the control group(P<0.05).At the 3 months follow-up,the excellent rate of the treatment group was 70.00%(35/50)better than that of the control group,which was 50.00%(25/50)(P<0.05).There were no abnormalities in blood,urine,stool routines and electrocardiograms before and after treatment in both groups,and no adverse events occurred.Conclusion Acupuncture with manipulation of pointing,pulling,and shaking for treating patients with lumbar disc herniation in remission has a better safety on pain relief and improving quality of life,and the effectiveness is better than lumbar traction plus acupoint ultrasonic pulse penetration therapy.

lumbar disc herniationremission periodacupuncturemassagerandomized controlled trial

陈春、靳蛟、莫靖煊、林海、时福东、王国军、吴冠男、张世民

展开 >

中国中医科学院望京医院,北京市朝阳区望京中环南路6号,100102

腰椎间盘突出症 缓解期 针刺 推拿 随机对照试验

中国中医科学院科技创新工程重大攻关项目北京市中医药科技发展资金项目

CI2021A02006JJ-2020-75

2024

中医杂志
中华中医药学会 中国中医科学院

中医杂志

CSTPCD北大核心
影响因子:1.464
ISSN:1001-1668
年,卷(期):2024.65(10)
  • 26