不同透灸量治疗腰椎间盘突出症疼痛的临床研究  

Treatment Effect of Different Quantities of Acupuncture and Moxibustion on Pain of Patients Caused by Lumbar Discherniation

作　　者：高希言[1] 郭娅静[1] 王鑫[1] 林永青[1] 范雅丽[1] 陈新旺[1] 高崚[2] 马尚[1] 王栋斌[1] 

机构地区：[1]河南中医学院针灸推拿学院,河南郑州450008 [2]香港浸会大学中医药学院,香港999077

出　　处：《中华中医药学刊》2016年第12期2823-2826,共4页Chinese Archives of Traditional Chinese Medicine

摘　　要：目的:观察在不同灸量下,针刺透灸40 min、50 min、60 min三组,腰椎间盘突出症患者疼痛减轻的时间差异,比较:治疗前、治疗结束后、及1个月后的疗效差异。为临床缓解腰椎间盘突出症疼痛症状提供依据,为运用透灸法治疗其他疾病提供较为可靠的参考。方法:采用随机平行对照研究,将90例符合纳入标准的腰突症患者,分为三组,即针刺透灸40 min组、针刺透灸50 min组、针刺透灸60 min组,各30例。选取肾俞、大肠俞、阿是穴、委中进行针灸。施灸过程中记录患者温度出现情况、持续时间,观察灸后效应,记录治疗前后患者症状及综合评分,并于1个月后进行随访,进行统计学分析,评价疗效。结果:1综合疗效:针刺透灸40 min组,治愈率60.0%,显愈率76%;针刺透灸50 min组,治愈率73.0%,显愈率90%;针刺透灸60 min组,治愈率90%,显愈率93%。(P<0.05),差异有统计学意义。2症状、体征评分:三组治疗前后M-JOA总分、VAS评分组内自身比较,及三组治疗后比较,均P<0.05,差异有统计学意义。31个月后随访,针刺透灸40 min组,复发率为40%;针刺透灸50 min组,复发率为20%;针刺透灸60 min组,复发率为0%,F=8.70,P=0.000<0.05,差异有统计学意义。结论:1灸量增加对于腰椎间盘突出症患者有效止痛时间缩短,充分激发经气,达到透灸效果,能显著提高艾灸的疗效。2针刺透灸60 min组1个月后的随访情况良好,优于针刺透灸40 min组及针刺透灸50 min组,远期疗效显著,治愈后不易复发,对透灸量效关系使用提供较为可靠的依据标准。3灸量的积累,是透灸法止痛起效的前提,提高了临床工作效率,可作为临床上治疗腰椎间盘突出症的主要方法。Objective：By dividing the participants into three groups（40 minutes,50 minutes and 60 minutes）,this research was designed to investigate the difference of time to ease the pain of those patients suffered from lumbar discherniation and the clinical efficacy difference of using acupuncture and diathermal moxibustion before treatment,immediately after treatment and one month after treatment.This article aims at discovering the best quantity of acupuncture and moxibustion on treating lumbar discherniation,therefore offering the evidence for the expected effect of acupuncture and moxibustion on relieving the pain of lumbar discherniation and the reference for the expected effect on other diseases.Methods：By the random parallel control study,this research divided 90 patients of lumbar disc herniation who met the criteria into three categories randomly,which were 40-min group,50-min group and 60-min group,with 30 participants in each group.In this research,four acupoints [Shenshu（BL23）,Dachangshu（BL25）,Ashi and Weizhong（BL40）] were chosen and the treatment was carried out once every day.Requests and records on how patients felt in and after the process of being treated with acupuncture and moxibustion were kept every day.The symptom of the patients was kept and a comprehensive judgment was given both before and after treatment and following that,a statistical analysis was conductedto judge the efficacy of the treatment.Results：（1）Comprehensive efficacy of the treatment： in the 40-min group,the recovery rate was 60% and the effective rate was 76%;in the 50-min group,the recovery rate was 73% and the effective rate was 90%;in the 60-min group,the recovery rate was 90% and the effective rate was 93%.After the statistical analysis,P = 0.000（P〈0.05）.Hence the difference had statistical meaning.（2）Evaluation of the symptom and sign： either the total score of M-JOA for those three groups before and after the treatment or the contrast of VAS within those groups or the effectiveness of tre

关 键 词：透灸 时间 不同灸量 腰椎间盘突出症 针刺 

分 类 号：R681.53[医药卫生—骨科学]