电针配合麦粒灸治疗腰椎间盘突出症疗效观察

上海针灸杂志2014年2月第33卷第2期 ·157·文章编号:1005-0957(2014)02-0157-03 ·临床研究· 电针配合麦粒灸治疗腰椎间盘突出症疗效观察

刘燕

(厦门大学附属成功医院,厦门 361003)

【摘要】目的观察电针配合麦粒灸治疗腰椎间盘突出症的临床疗效。方法将60例腰椎间盘突出症患者按随机数字表法分为观察组和对照组,每组30例。观察组予电针配合麦粒灸治疗,对照组予单纯电针治疗。观察治疗前后的临床疗效、M-JOA 评分及SF-MPQ评分,并进行对比分析。结果观察组总有效率为93.3%,与对照组比较差异有统计学意义(P＜0.05);两组治疗后M-JOA评分均升高(P＜0.05),SF-MPQ评分均下降(P＜0.05),观察组改善更明显,差异有统计学意义(P＜0.05)。结论电针配合麦粒灸治疗腰椎间盘突出症疗效优于单纯电针治疗。

【关键词】椎间盘移位;腰椎间盘突出症;电针;直接灸;麦粒灸;M-JOA评分;SF-MPQ评分

【中图分类号】 R246.2 【文献标志码】 A

DOI:10.13460/j.issn.1005-0957.2014.02.0157

Therapeutic Observation of Electroacupuncture plus Wheat-grain Moxibustion for Lumbar Intervertebral Disc Herniation LIU Yan. Chenggong Hospital Affiliated to Xiamen University, Fujian Province,Xiamen 361003,China

[Abstract] Objective To observe the clinical efficacy of electroacupuncture plus wheat-grain moxibustion in treating lumbar intervertebral disc herniation (LIDH). Method Sixty LIDH patients were randomized into an observation group and a control group by the random number table, 30 in each group. The observation group was intervened by electroacupuncture plus wheat-grain moxibustion, and the control group was by electroacupuncture. The clinical efficacies, modified Japanese Orthopedic Association (M-JOA) scores, and short-form McGill pain questionnaire (SF-MPQ) scores were compared and analyzed. Result The total effective rate was 93.3% in the observation group, significantly different from that in the control group (P＜0.05); the M-JOA scores increased significantly in both groups (P＜0.05), the SF-MPQ scores dropped significantly in both groups (P＜0.05), and the improvements in the observation group were more statistically significant (P＜0.05). Conclusion Electroacupuncture plus wheat-grain moxibustion can produce better therapeutic efficacy than electroacupuncture alone in treating LIDH.

[Key words] Interverterbral disc displacement; Lumbar intervertebral disc herniation; Electroacupuncture; Direct moxibustion; Moxibustion with seed-sized moxa cone; Modified Japanese Orthopedic Association (M-JOA); Short-form McGill pain questionnaire (SF-MPQ)

腰椎间盘突出症是由于腰椎间盘的退变与损伤,导致脊柱内外力学平衡失调,椎间盘的髓核自破裂口突出,压迫腰脊神经根而引起腰腿痛的一种病症[1]。该病影响了患者的生活和工作,严重者可致瘫痪。针灸治疗本病疗效确切,并积累了丰富的经验[2-6],但电针配合麦粒灸治疗尚未见报道。2011年8月至2012年8月,笔者采用电针配合麦粒灸治疗本病30例,并与单纯电针治疗相比较,现将资料总结如下。

1 临床资料

1.1 一般资料

60例患者均来自本院中医康复科门诊,按随机数字表法分为两组。观察组30例,男17例,女13例;年龄18～63岁,平均(49±12)岁;病程最短5个月,最长8年,平均(31.64±9.52)个月;L4-5突出者18例,L5-S1突出者12例。对照组30例,男16例,女14例;年龄20～64岁,平均(49±12)岁;病程最短7个月,最长10年,平均(32.48±10.25)个月;L4-5突出者16例,L5-S1

1.2 诊断标准

突出者14例。两组患者性别、年龄、病程及发病部位比较差异无统计学意义(P＞0.05),具有可比性。

参照《中医病证诊断疗效标准》[7]

1.3 纳入标准

制定。①有腰部外伤、慢性劳损或受寒湿史。大部分患者在发病前有慢性腰痛史;②常发生于青壮年;③腰痛向臀部及下肢放射,腹压增加(如咳嗽、喷嚏)时疼痛加重;④脊柱侧弯,腰椎生理弧度消失,病变部位椎旁有压痛,并向下肢放射,腰部活动受限;⑤下肢受累神经支配区有感觉过敏或迟钝,病程长者可出现肌肉萎缩,直腿抬高或加强试验阳性,膝、跟腱反射减弱或消失,足拇趾背伸肌力减弱;⑥X线摄片检查示脊柱侧弯,腰生理前凸消失,病变椎间隙可能变窄,相邻边缘有骨赘增生。CT检查可显示椎间盘突出的部位和程度。

①符合诊断标准;②年龄18～65岁,性别不限;③知情同意。

作者简介:刘燕(1972 - ),女,主治医师