不同体位牵引配合针灸治疗腰椎间盘突出症  

Different Position Traction Combined with Acupuncture for Prolapse of Lumbar Intervertebral Disc

作　　者：尉志强 韩良 赵东方[1] 王亚非[1] WEI Zhiqiang;HAN Liang;ZHAO Dongfang;WANG Yafei(Oriental Hospital,Beijing University of Chinese Medicine,Beijing China 100078)

机构地区：[1]北京中医药大学东方医院,北京100078

出　　处：《中医学报》2018年第11期2267-2270,共4页Acta Chinese Medicine

基　　金：北京市中医药科技发展基金项目(JJ2005-25)

摘　　要：目的:探讨不同体位牵引配合针灸治疗腰椎间盘突出症的临床疗效。方法:选取腰椎间盘突出症患者166例为研究对象,根据随机数字表法随机分为仰卧位组(n=83)和俯卧位组(n=83)。仰卧位组采取仰卧位牵引配合针灸治疗,俯卧位组采取俯卧位牵引配合针灸治疗。比较两组患者临床疗效、疼痛视觉模拟评分法(visual analogue scale,VAS)评分、日本骨科协会评估治疗(Japanese orthopaedic associationscores,JOA)评分和Oswestry功能障碍指数问卷表(Oswestry dability index,ODI)评分、血清白细胞介素-1β(interleukin-1β,IL-1β)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平变化。结果:仰卧位组有效率为83. 13%,俯卧位组有效率为93. 98%,两组比较,差异有统计学意义(P <0. 05);治疗后,仰卧位组VAS评分为(3. 36±0. 91)分,俯卧位组VAS评分为(2. 13±0. 87)分,两组比较,差异有统计学意义(P <0. 05);仰卧位组JOA和ODI评分分别为(15. 45±3. 73)分、(48. 29±18. 23)分,俯卧位组JOA和ODI评分分别为(20. 18±4. 34)分、(41. 47±18. 18)分,两组比较,差异有统计学意义(P <0. 05);仰卧位组血清IL-1β和TNF-α水平分别为(0. 33±0. 11) mg·L-1和(1. 45±0. 34) mg·L-1,俯卧位组血清IL-1β和TNF-α水平分别为(0. 24±0. 08) mg·L-1和(1. 17±0. 28) mg·L-1,两组比较,差异有统计学意义(P <0. 05)。结论:俯卧位牵引配合针灸可有效减轻腰椎间盘突出症患者疼痛感,改善其功能性障碍,降低血清炎性因子水平,较仰卧位牵引配合针灸治疗疗效显著。Objective: To explore the clinical effect of supine position traction combined with acupuncture and prone position combined with acupuncture in the treatment of prolapse of lumbar intervertebral disc. Methods: A total of 166 patients with lumbar disc herniation were selected and randomly divided into supine position group ( n = 83) and prone position group ( n = 83) according to random number table method. Results: The supine position group was treated with supine position traction and acupuncturet,and the prone position group was treated with prone position traction and acupuncture. The clinical efficacy,visual analogue scale ( VAS) score,Japanese orthopaedic association scores ( JOA) score,Oswestry dability index ( ODI) score,changes in serum levels of interleukin-1β ( IL-1β) and tumor necrosis factor-α ( TNF-α) were compared. Conclusion: The effective rate was 83. 13% in the supine position and 93. 98% in the prone position. The difference was statistically significant ( P < 0. 05) . After treatment,the VAS score of the supine position group was ( 3. 36 ± 0. 91) points,and the VAS score of the prone position group was ( 2. 13 ± 0. 87) points. The difference between the two groups was statistically significant ( P < 0. 05) . The JOA and ODI scores in the supine position were ( 15. 45 ± 3. 73) and ( 48. 29 ± 18. 23) respectively. The JOA and ODI scores in the prone group were ( 20. 18 ± 4. 34) and ( 41. 47 ± 18. 18) respectively. The differences were statistically significant ( P < 0. 05) . The levels of serum IL-1β and TNF-α in the supine position were ( 0. 33 ± 0. 11) mg·L^-1 and ( 1. 45 ± 0. 34) mg·L^-1 respectively. The levels of serum IL-1β and TNF-α in the prone group were ( 0. 24 ± 0. 08) mg·L^-1 and ( 1. 17 ± 0. 28) mg·L^-1 . The differences were statistically significant ( P < 0. 05) . Conclusion: Prone position traction combined with acupuncture can effectively alleviate the pain of patients with prolapse of lumbar intervertebral disc,improve their functional disorders,and reduce

关 键 词：腰椎间盘突出症 仰卧位 俯卧位 牵引 针灸 

分 类 号：R245.815.3[医药卫生—针灸推拿学]