刺络拔罐联合超声药物透入治疗绝经后骨质疏松性腰背痛临床观察  

Clinical Observations on Pricking-cupping Bloodletting plus Ultrasound Drug Penetration for Postmenopausal Osteoporotic Lumbodorsal Pain

作　　者：段远芳 安月 陈静霞 DUAN Yuan-fang;AN Yue;CHEN Jing-xia(Qinhuangdao Jiulongshan Hospital,Qinhuangdao 066000,China;Qinhuangdao Military Industrial Hospital,Qinhuangdao 066000 China)

机构地区：[1]秦皇岛市九龙山医院,秦皇岛066000 [2]秦皇岛军工医院,秦皇岛066000

出　　处：《上海针灸杂志》2020年第8期1047-1052,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药管理局科研计划项目(2019528)。

摘　　要：目的观察刺络拔罐联合超声药物透入治疗绝经后骨质疏松性腰背痛的临床疗效。方法选取124例绝经后骨质疏松性腰背痛患者,运用简单随机数字表法将其随机分成观察组(62例)与对照组(62例)。对照组采取超声药物透入理疗治疗,观察组在此基础上联合刺络拔罐治疗,两组患者均治疗14 d后评估临床疗效。治疗前后使用视觉模拟量表(VAS)对两组患者腰背痛的主观感受进行量化评价,运用Roland-Morris功能障碍问卷表(RDQ)对所有受试者腰背功能状况进行测评,并利用Oswestry功能障碍指数(ODI)评估两组患者机体功能丧失情况,通过36项健康调查简表(SF-36)评价两组患者生活质量状况,同时测定两组患侧竖脊肌软组织张力指标[施加0.5 kg载荷时局部软组织的位移大小(以下记为"FDD")、局部软组织所吸收能量占所做功的百分比(以下记为"S")]。并汇总两组患者治疗过程中出现的不良反应。结果观察组总有效率为96.8%(60/62),显著高于对照组的87.1%(54/62,P<0.05)。两组腰背痛VAS评分、RDQ评分及ODI评分均随治疗时间的延长而逐渐降低(P<0.05)。且在治疗7 d、14 d后,观察组腰背痛VAS评分、RDQ评分和ODI评分均显著低于对照组(P<0.05)。两组治疗14 d后患侧竖脊肌FDD值和S值均显著增加(P<0.05);治疗14 d后,观察组患侧竖脊肌以上软组织张力指标的改善效果较对照组同期均更显著(P<0.05)。两组治疗14 d后SF-36中两大领域(生理健康和心理健康)评分较治疗前均显著升高(P<0.05);且治疗14 d后,观察组SF-36评分显著高于对照组(P<0.05)。两组均无严重不良事件发生。结论刺络拔罐联合超声药物透入理疗治疗绝经后骨质疏松性腰背痛,可明显缓解患者腰背痛的程度,有助于腰背部软组织功能的恢复,改善腰背部功能障碍,提高患者生活质量,整体疗效确切,且安全可靠。Objective To investigate the clinical efficacy of pricking-cupping bloodletting plus ultrasound drug penetration for postmenopausal osteoporotic lumbodorsal pain.Method One hundred and twenty-four patients with osteoporotic lumbodorsal pain were allocated,using a random number table,to an observation group(62 cases)and a control group(62 cases).The control group received physiotherapy with ultrasound drug penetration and the observation group,pricking-cupping bloodletting in addition.The clinical therapeutic effects were evaluated in the two groups of patients after 14 days of treatment.Before and after treatment,subjective lumbodorsal pain was quantitatively assessed using the Visual Analogue Scale(VAS)in the two groups of patients;lumbodorsal function,using the Roland-Morris Disability Questionnaire(RDQ)in all the subjects;bodily function;using the Oswestry Disability Index(ODI)in the two groups of patients;the quality of life,using the 36-Items Short From Health Survey(SF-36)in the two groups of patients.Meanwhile,indicators for erector spinae soft tissue on the affected side[force-displacement distance under 0.5 kg pressure(FDD for short)and energy absorbed by local soft tissue as the percentage of work done(S for short)]were measured in the two groups.Adverse reactions were recorded in the two groups of patients during treatment.Result The total efficacy rate was 96.8%(60/62)in the observation group,which was significantly higher than in the control group 87.1%(54/62,P<0.05).The lumbodorsal pain VAS score,the RDQ score and the ODI score decreased gradually in the two groups with the extension of treatment time(P<0.05)and were significantly lower in the observation group than in the control group at seven and fourteen days of treatment(P<0.05).Affected-side erector spinae FDD and S increased significantly in the two groups after fourteen days of treatment(P<0.05).An indicator for erector spinae soft tissue tension improved more in the observation group than in the control group at fourteen days of treatment(P

关 键 词：骨质疏松症 绝经后 腰背痛 刺络拔罐疗法 超声药物透入理疗 视觉模拟评分 Roland-Morris功能障碍问卷表 36项健康调查简表 OSWESTRY功能障碍指数 

分 类 号：R246.3[医药卫生—针灸推拿学]