三维牵引联合中药外敷治疗腰间盘突出症随机平行对照研究  

Three Dimensional Traction combined with Traditional Chinese Medicine Treatment of Lumbar Disc Herniation Randomized Controlled Study

作　　者：曾凡建 

机构地区：[1]湖南省衡阳市江东中医院骨科,湖南衡阳421000

出　　处：《实用中医内科杂志》2017年第8期63-66,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察三维牵引联合中药外敷治疗腰间盘突出症疗效。[方法]使用随机平行对照方法,将120例住院及门诊患者按抛硬币方法简单随机分为两组。对照组60例中药外敷:羌活、独活、细辛各12g,肉桂8g,川芎、当归、川乌、乳香、防风、没药、牛膝、红花各15g,透骨草20g,研末,用蜂蜜和松节油调成糊状,敷于腰椎处,24h/次,每两次间隔36h。治疗组60例三维牵引,纵向、成角、摇摆侧扳牵引同时使用;纵向牵引:患者仰卧于床面上,臀腰之间界限位于两床面交界处,腰细者用毛巾或沙袋等围垫,牵引重量以35~40kg为起始量,逐渐加大,最大不可于自身体重;成角牵引:±15°~30°;摇摆牵引:旋转度数±5°~25°,成角方向以先背伸旋转、后屈曲旋转为原则,旋转方向以右突向右转,左突向左转,中央突双转为原则,进行纵向牵引;牵引过程中密切关注患者情况,以免发生受伤,30min/次,牵引后不可以立即活动,平卧30min,1次/d;中药外敷同对照组。连续治疗3周为1疗程。观测临床症状、症状积分、不良反应。治疗1疗程(3周),判定疗效。[结果]治疗组临床痊愈31例,显效18例,有效8例,无效3例,总有效率95.00%;对照组临床痊愈18例,显效16例,有效16例,无效10例,总有效率83.33%;治疗组疗效优于对照组(P<0.051)。症状积分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]三维牵引联合中药外敷治疗腰间盘突出症,疗效满意,无严重不良反应,值得推广。[Objective] To observe the external application of Chinese medicine combined with the treatment of lumbar disc herniation traction. [Method] 120 cases of inpatients and outpatients were randomly divided into two groups according to the coin tossing method. The control group of 60 cases of external application of Chinese medicine： notopterygium, angelica, asarum 12 g, cinnamon 8g, rhizoma Chuanxiong, radix angelicae sinensis, radix aconiti, frankincense, myrrh, windproof, achyranthes, safflower, 15 g, lopseed 20 g, at the end of the research, with honey and turpentine tune into a paste, apply at the lumbar spine, 24 h/times, every two time interval 36 h. The treatment group of 60 cases of three dimensional traction, vertical, angle, swing side pulling traction simultaneously; longitudinal traction： patient supine on the bed surface, the boundary between hip to waist at two bed at the junction, with a towel or sandbags around the waist cushion fine, traction weight in 35-40 kg for the initial amount, gradually increase large, maximum cannot be its own weight; angle traction： ＋15 degrees to 30 degrees; the degree of rotation swing traction： ＋5 degrees to 25 degrees, the angle direction to dorsiflexion rotation, postbuckling rotation principle, the direction of rotation to the right process to the right, left to the left, the central process of double turn the principle of longitudinal traction; traction in the process of paying close attention to patients, so as to avoid injuries, 30 min/times, after traction can not immediately, supine 30 min 1/d, external application of Chinese medicine with the control group. Continuous treatment for 3 weeks for 1 courses. Clinical symptoms, symptom scores and adverse reactions were observed. Treatment for 1 courses（3 weeks）, determine the efficacy. 31 cases were cured after treatment in the treatment group [Result] 18 cases were markedly effective, 8 cases effective, 3 cases ineffective, the total efficiency of 95%; control group 18 cases were cured clinically, 1

关 键 词：腰间盘突出症 三维牵引 纵向牵引 成角牵引 摇摆牵引 症状积分 中药外敷 三维多功能牵引床 中医药治疗 随机平行对照研究 

分 类 号：R441.1[医药卫生—诊断学]