中医综合方案干预退行性腰椎管狭窄症的临床研究  

A Clinical Study on the Intervention of a Comprehensive Program of Traditional Chinese Medicine on Degenerative Lumbar Spinal Stenosis

作　　者：周彦吉 安易 雷园[3] 张洋[3] 杨晓明[3] 邵辉 章乃文 翁志文[3] 刘长信[3] 王锡友[3] 于长禾[3] Zhou Yanji;An Yi;Lei Yuan;Zhang Yang;Yang Xiaoming;Shao Hui;Zhang Naiwen;Weng Zhiwen;Liu Changxin;Wang Xiyou;Yu Changhe(Aerospace Center Hospital,Beijing 100049,China;First Clinical School of Beijing University of Chinese Medicine,Beijing 100700,China;Beijing University of Chinese Medicine,Dongzhimen Hospital,Beijing 100700,China)

机构地区：[1]航天中心医院,北京100049 [2]北京中医药大学第一临床医学院,北京100700 [3]北京中医药大学东直门医院,北京100700

出　　处：《世界科学技术-中医药现代化》2023年第6期2188-2195,共8页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：北京市卫生健康委员会首都卫生发展科研专项青年优才(2020-4-4195):退行性腰椎管狭窄症中医综合诊疗方案的规范化研究,负责人:于长禾。

摘　　要：目的初步验证中医综合方案干预退行性腰椎管狭窄症的有效性、安全性,并探索影响中医方案治疗DLSS疗效的预后因素。方法连续纳入64例退行性腰椎管狭窄症患者,采用针刀松解、刺络放血联合药物竹罐和推拿按摩干预,穴位选用与治疗腰椎范围等长的督脉,膀胱经第1、2侧线及阿是穴,每周2次,每疗程8次,连续治疗2疗程。观察治疗前、治疗后、随访1个月时患者腰椎管狭窄症特异性量表评分(SSM)、改良Oswestry功能障碍指数(ODI)、12项健康调查简表评分(SF-12)的变化。以SSM症状或功能评分任一≥0.5进行判效标准分组进行单因素分析,采用Logistic回归分析该疗法影响患者的预后因素。结果治疗2个疗程后,患者SSM症状评分(2.25±0.56)、SSM功能评分(2.06±0.67)、ODI指数(15.49±8.72)、SF-12生理评分(36.31±7.35),较治疗前明显好转,差异具有统计学意义(P<0.05),SF-12心理评分(49.70±9.47),较治疗前差异无统计学意义(P>0.05);随访1个月患者SSM症状评分(2.22±0.54)、SSM功能评分(2.09±0.66)、ODI指数(15.53±8.23)、SF-12生理评分(36.55±7.25)、SF-12心理评分(50.62±9.17),较治疗前明显好转,差异具有统计学意义(P<0.05),较治疗2个疗程后,差异无统计学意义(P>0.05)。各影响因素的单因素Logistic回归分析显示:BMI、基线症状维度、基线功能维度、椎间孔狭窄、侧隐窝狭窄、两节段狭窄在有效组、无效组之间差异有统计学意义(P<0.05)。结论刺络放血联合药物竹罐治疗退行性腰椎管狭窄具有一定临床疗效。Objective To preliminarily verify the effectiveness and safety of bloodletting combined with drug bamboo cups in intervention of degenerative lumbar spinal stenosis,and to explore the prognostic factors that affect the efficacy of TCM regimens in the treatment of DLSS.Methods 64 consecutive patients with degenerative lumbar spinal stenosis were enrolled.Bloodletting combined with drug bamboo cup intervention was used.Acupoints were selected and treated with the same length of the governor channel of the lumbar spine,the first and second side lines of the bladder meridian and Ashi point,weekly 2 times,8 times per course,2 consecutive courses of treatment.Before treatment,after treatment,and 1 month follow-up,the changes of the patient's lumbar spinal stenosis specific scale(SSM),modified Oswestry dysfunction index(ODI),and 12 health survey summary scores(SF-12)were observed.Using SSM symptom or function score≥0.5,the criteria for grouping were first single-factor analysis,and then logistic regression was used to analyze the prognostic factors of the treatment.Results After 2 courses of treatment,the patient's SSM symptom score(2.25±0.56),SSM function score(2.06±0.67),ODI index(15.49±8.72),and SF-12 physiological score(36.31±7.35)were more significant than before treatment Improved,the difference was statistically significant(P<0.05),the SF-12 psychological score(49.70±9.47),the difference was not statistically significant compared with before treatment(P>0.05);the patient's SSM symptom score(2.22±0.54)was followed up for one month,SSM function score(2.09±0.66),ODI index(15.53±8.23),SF-12 physiological score(36.55±7.25),SF-12 psychological score(50.62±9.17),which are significantly better than before treatment,and the difference is statistically significant(P<0.05),the difference was not statistically significant(P>0.05)after 2 courses of treatment.The univariate logistic regression analysis of each influencing factor showed that:BMI,baseline symptom dimension,baseline functional dimension,foraminal sten

关 键 词：腰椎管狭窄症 刺络放血 药物竹罐 病例系列研究 

分 类 号：R274.34[医药卫生—中医骨伤科学]