目的: 探索温阳通络针法联合穴位按摩（acupoint massage,AM）对寒湿阻络型老年腰椎间盘突出（lumbar disc herniation,LDH）患者的疗效及治疗后患者的疼痛程度、腰椎活动度（lumbar activity,LA）的影响。方法: 选取2023年1月—2024年1月在本院康复科接受治疗的寒湿阻络型老年LDH患者84例,采用随机数字表法分为研究组和对照组各42例。对照组给予常规保守治疗,研究组在常规保守治疗 的基础上联合温阳通络针法以及AM治疗,两组均连续治疗6周。比较两组LDH患者的中医证候积分、疗效、疼痛程度[视觉模拟评分表（visual analogue scale,VAS）]、腰椎活动度（lumbar activity,LA）[腰椎前屈度（lumbar flexion,LFD）和腰椎后伸度（lumbar posterior extension,LPE）]的变化和不良反应发生率。结果: 治疗6周后,两组患者的中医证候积分均降低,且研究组的中医证候积分显著低于对照组;治疗6周后,研究组患者的总有效率高于对照组;治疗2周、6周后两组VAS分数均较治疗前降低,且研究组VAS分数显著低于对照组;治疗6周后,两组的LFD和LPE均增加,且研究组的LFD和LPE增加幅度高于对照组;两组不良反应发生率无显著差异。结论: 温阳通络针法联合AM对LDH患者的疗效显著,能有效缓解患者疼痛感,改善LA,安全且有效。
Abstract
Objective To explore the efficacy of Wenyang Tongluo acupuncture combined with acupoint massage (AM) on elderly patients with cold-dampness blocking collaterals type of lumbar disc herniation (LDH) and the influence on pain degree and lumbar activity (LA) after treatment. Methods 84 elderly patients with LDH who received treatment in department of rehabilitation of the hospital from January 2023 to January 2024 were selected and divided into study group and control group, with 42 cases in each group. The control group was given conventional conservative treatment, while the study group was combined with Wenyang Tongluo acupuncture and AM treatment on the basis of conventional conservative treatment. Both groups were given continuous medication for 6 weeks. TCM symptoms scores, efficacy, pain degree [Visual Analogue Scale (VAS)], lumbar activity (LA) [lumbar flexion (LFD), lumbar posterior extension (LPE)] and incidence of adverse reactions were compared between groups of patients with LDH. Results After 6 weeks of treatment, the scores of TCM symptoms in the two groups were reduced, and the symptoms scores in study group were significantly lower than those in control group. The total effective rate after 6 weeks of treatment was higher in study group than that in control group. After 2 weeks and 6 weeks of treatment, the VAS score in both groups was declined than that before treatment, and the VAS score in study group was significantly lower compared with those in control group. After 6 weeks of treatment, LFD and LPE were increased in both groups, and LFD and the increase was greater in the study group than in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Wenyang Tongluo acupuncture combined with AM has a significant efficacy on LDH patients, which can effectively relieve pain and improve LA. It is safe and effective.
关键词
温阳通络针法 /
穴位按摩 /
腰椎间盘突出 /
疗效 /
疼痛程度 /
腰椎活动度
Key words
Wenyang Tongluo acupuncture /
acupoint massage /
lumbar disc herniation /
efficacy /
pain degree /
lumbar activity
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基金
安徽省中医药传承创新科研项目“南少林理筋整脊手法联合桂葛舒颈方治疗神经根型颈椎病（风寒阻络证）的疗效及对相关炎性因子水平的影响”（2024CCCX010）
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