岭南无痛蜂疗联合麦肯基疗法治疗腰椎间盘突出症临床研究  

Effect of Lingnan Painless Apitherapy combined with McKenzie Therapy on Patients with Lumbar Disc Herniation

作　　者：吴红波 陈兴华[1] 张锐科[2] 罗庆禄 成永明 WU Hongbo;CHEN Xinghua;ZHANG Ruike;LUO Qinglu;CHENG Yongming(The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou,Guangdong 510405,China;The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510700,China;Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou,Guangdong 510120,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405 [2]广州医科大学附属第五医院,广东广州510700 [3]广东省中医院,广东广州510120

出　　处：《康复学报》2020年第6期441-446,共6页Rehabilitation Medicine

基　　金：国家自然科学基金项目(81273774);中央财经支持地方高校项目(Q17051006)。

摘　　要：目的:观察岭南无痛蜂疗联合麦肯基(McKenzie)疗法治疗腰椎间盘突出症(LDH)患者的临床疗效。方法:选择2019年2月—2020年6月在广州医科大学附属第五医院康复医学科治疗的LDH患者80例,按照随机数字表法分为对照组和观察组,每组40例。对照组接受磁热振疗法和麦肯基疗法。磁热振疗法采用日本磁热振治疗仪(TM-3200),根据患者的感觉与症状选择合适强度(高温、热、温热、低温4个档位),每次20 min,1次/d,每周7次,共持续治疗2周。此外接受McKenzie疗法,由治疗师辅助或患者主动完成俯卧位伸展运动、俯卧位伸展运动配合加压、站立位侧移运动等步骤训练,每个步骤间休息1 min,每2 d治疗1次,共持续治疗2周。观察组在对照组基础上休息0.5 h后接受无痛蜂疗。治疗前先对患者进行蜂疗耐受试验,在双侧足三里分别使用1只蜜蜂进行蜂疗,观察15 min无不良反应后,在安静舒适的环境下每隔1 d给予无痛蜂疗。治疗选择腰椎棘突双侧的华佗夹脊穴,首次治疗选取穴位为第5腰椎棘突旁的华佗夹脊穴,左右各1穴。随后每次增加2穴,每穴1只蜜蜂,依次按第4腰椎、第3腰椎、第2腰椎、第1腰椎双侧夹脊穴的顺序加针,增加至10只蜜蜂量后不再增加。在治疗前、治疗2周后采用视觉模拟评分(VAS)评价患者疼痛程度;采用Oswestry功能障碍指数(ODI)评价腰椎功能障碍情况;采用中医证候积分进行疗效评价,根据《中医病证诊断疗效标准》判断临床疗效。结果:治疗前,2组VAS评分、ODI评分、中医证候积分均无明显区别,差异无统计学意义(P>0.05)。与治疗前比较,2组治疗2周后VAS评分、ODI评分、中医证候积分均明显降低,差异具有统计学意义(P<0.05)。与对照组比较,观察组VAS评分、中医证候积分明显降低,差异具有统计学意义(P<0.05);观察组ODI评分无明显差别,差异无统计学意义(P>0.05);观察组临床疗效(95%)明显高于Objective:To observe the clinical efficacy of Lingnan painless apitherapy combined with McKenzie therapy on patients with lumbar disc herniation(LDH).Methods:A total of 80 patients with LDH who were treated in the department of rehabilitation medicine of the fifth affiliated hospital of Guangzhou medical university from February 2019 to June 2020 were randomly divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group received magnetic thermal-vibration therapy and McKenzie therapy.The Japanese magnetic thermal-vibration therapy instrument(TM-3200)was used in the magnetic thermotherapy,the appropriate intensity(high,hot,warm and low temperature)was selected according to the patient's feeling and symptoms,20 minutes each time,once a day,seven times a week,continuous treatment for two weeks.In addition,the patients with LDH received McKenzie therapy,which was assisted by the therapist or the patient actively completed the flowing training,such as prone position stretching,prone position stretching combined with compression,standing position lateral movement and so on.Each step rested for one minute,once every two days,continuous treatment for two weeks.The observation group received Lingnan painless apitherapy on the basis of treatment in the control group after half an hour's rest.Before treatment,the patients were given apitherapy tolerance test,performing apitherapy with one bee on each Zusanli acupoints on both sides.After apitherapy for 15 minutes,if there was no adverse reaction,the patients were given painless apitherapy with a quiet and comfortable environment,every other day.In this treatment,both sides of Huatuo Jiaji acupoints on the lumbar spinous processes were selected,and Huatuo Jiaji acupoints on both sides of the 5th lumbar spinous process were selected in the first treatment,one acupoint on the left and one on the right.After that,two acupoints were added each time,and each acupoint was treated by one bee.Accor

关 键 词：腰椎间盘突出症 无痛蜂疗 麦肯基疗法 腰椎功能障碍 临床疗效 

分 类 号：R681.53[医药卫生—骨科学]