电针联合美洛昔康治疗急性腰椎间盘突出症临床研究  

Clinical Study of Electroacupuncture Combined with Meloxicam in Treatment of Acute Lumbar Intervertebral Disc Herniation

作　　者：宓轶群[1] 唐银娟 张李琼[1] 吴耀持[1] 

机构地区：[1]上海交通大学附属第六人民医院,上海200233 [2]上海市长宁区天山中医医院,上海200051

出　　处：《中国中医急症》2010年第3期412-413,445,共3页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市卫生局科研项目(No.2005S001A)

摘　　要：目的比较电针联合美洛昔康、电针联合地塞米松对急性腰椎间盘突出症疼痛症状、体征、患者满意度、健康调查简表(SF-36)结果的影响,以寻找快速、有效的治疗急性腰椎间盘突出症的中西医结合疗法。方法将120例急性腰椎间盘突出症患者随机分为电针组(穴取十七椎、腰阳关、环跳、阳陵泉)、电针美洛昔康组(电针结合口服美洛昔康);电针激素组(电针结合静滴地塞米松、甘露醇)。在不同时点进行各组镇痛效果(VAS评分)、体征改善(JOA评分)、满意度(PSS评分)、SF-36评分比较。结果3组治疗结束后VAS和JOA评分均较治疗前有所下降,电针美洛昔康组效果最好;3组疗程结束后PSS评分较治疗前相比满意度明显增加,电针美洛昔康组和电针激素组均比电针组更佳,其中电针美洛昔康组最佳;3组治疗后SF-36评分均上升,电针激素组疼痛指数、总体健康感觉和社会功能恢复较好,电针美洛昔康组躯体功能、精力和情绪角色功能等方面恢复较好,电针激素组不良反应占20.00%。结论电针结合美洛昔康治疗急性腰椎间盘突出症镇痛效果满意,能显著提高生活质量,且无激素类药物诸多禁忌,可作为临床首选方案之一。Objective： To investigate the effect of electroacupuncture combined with meloxicam or dexamethasone on the visual analogue score （VAS）, JOA, patient satisfaction score （PSS） and short forum-36 （SF-36） score in the treatment of acute lumbar intervertebral disc herniation. Methods： 120 patients were randomly allocated into three groups： group A （received eleetroacupuncture, 17 zhni acupoiuts, waist-Yang Guan, HuantiaoGB30, YanglingquauGB36）, group B （electroaeupuncture combined with melexicam） and group C （electroacupuncture combined with dexamethasone） . The changes of VAS, JOA, PSS, SF-36 score were investigated before and after the treatment. Results： The VAS, JOA and PSS in all groups were improved significantly after treatment. The VAS, JOA and PSS in group B were significantly better than those of group A and C after the treatment. The SF-36 score in all groups were increased after treatment. The physical functioning, the vitality and the role emotional in group B were significantly higher than those in group A and C, whereas pain index, general health perceptions and social functioning in group C after treatment were higher than those in group A and B. The adverse reaction rate of group C was 20.00%. Conclusion： The electroacupuncture combined with meloxicam could effectively improve VAS, JOA, PSS and part of SF-36 score, and has no contraindication compare with dexamethasone. It could be a valuable alternative for patients with acute lumbar intervertebral disc herniation.

关 键 词：电针 腰椎间盘突出症 急性痛 美洛昔康 地塞米松 

分 类 号：R246.2[医药卫生—针灸推拿学]