银质针导热治疗腰椎间盘突出症的临床观察  

Clinical Observation of Silver-needle Diathermy for Lumbar Disc Herniation

作　　者：马余鸿 裴建[1] 叶刚[3] 刘丽娟[3] MA Yu-hong;PEI Jian;YE Gang;LIU Li-juan(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Luodian Hospital of Baoshan District,Shanghai,Shanghai 201908,China;Tongji Hospital of Tongji University,Shanghai 200065,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海市宝山区罗店医院,上海201908 [3]同济大学附属同济医院,上海200065

出　　处：《上海针灸杂志》2021年第4期452-457,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市卫计委海派中医流派传承研究基地项目(ZY3-CCCX-1-1007)。

摘　　要：目的观察银质针导热治疗腰椎间盘突出症的临床疗效。方法将108例腰椎间盘突出症患者随机分治疗1组、治疗2组和对照组,每组36例。治疗1组采用银质针导热治疗20 min,治疗2组采用银质针导热治疗30 min,对照组采用银质针非导热治疗。比较3组治疗前后疼痛视觉模拟量表(VAS)评分、日本骨科协会(JOA)评分、下背痛功能障碍调查问卷(RMDQ)评分和Oswestry功能障碍指数(ODI)评分。观察3组临床疗效。结果3组治疗前VAS、RMDQ、ODI和JOA评分比较差异无统计学意义(P>0.05)。治疗2周、治疗1个月,3组VAS、RMDQ和ODI评分均较治疗前降低(P<0.01),而JOA评分均较治疗前升高(P<0.01)。治疗1个月,治疗2组VAS、RMDQ和ODI评分均低于治疗1组和对照组(P<0.01,P<0.05),而治疗2组JOA评分高于治疗1组和对照组(P<0.05)。治疗2组临床总有效率高于治疗1组和对照组,差异具有统计学意义(P<0.01,P<0.05)。结论银质针导热治疗20 min、30 min和银质针非导热治疗腰椎间盘突出症均能有效地缓解疼痛,改善患者下腰背功能障碍,促进患者腰部功能恢复,改善患者日常生活;且银质针导热治疗30 min效果最佳。Objective To observe the clinical efficacy of silver-needle diathermy in treating lumbar disc herniation(LDH).Method A total of 108 LDH patients were randomized into treatment group 1,treatment group 2 and a control group,with 36 cases in each group.Treatment group 1 was intervened by silver-needle diathermy for 20 min,treatment group 2 was given silver-needle diathermy for 30 min,and the control group was treated with silver needle therapy but without diathermy.The Visual Analogue Scale(VAS),Japanese Orthopedic Association(JOA),Roland-Morris Disability Questionnaire(RMDQ)and Oswestry Disability Index(ODI)scores were compared amongst the three groups before and after treatment.The clinical efficacy was observed in the three groups.Result There were no significant differences in the VAS,RMDQ,ODI and JOA scores among the three groups before treatment(P>0.05).After 2-week and 1-month treatment,respectively,the VAS,RMDQ and ODI scores declined compared with the baseline in the three groups(P<0.01)and the JOA score increased compared with the pre-treatment score(P<0.01).After 1-month treatment,the VAS,RMDQ and ODI scores were lower in treatment group 2 than in treatment group 1 and the control group(P<0.01,P<0.05),and the JOA score was higher in treatment group 2 than in treatment group 1 and the control group(P<0.05).The clinical total effective rate was higher in treatment group 2 than in treatment group 1 and the control group,and the differences were statistically significant(P<0.01,P<0.05).Conclusion The three treatment protocols,silver-needle diathermy for 20 min and 30 min and silver needle without diathermy,all can effectively mitigate pain,improve the lower back dysfunction,promote the recovery of lumbar function and improve the daily living in treating LDH patients;among the three treatments,silver-needle diathermy for 30 min produces most significant efficacy.

关 键 词：针刺疗法 银质针 腰椎间盘突出症 椎间盘移位 视觉模拟量表 功能障碍问卷 

分 类 号：R246.2[医药卫生—针灸推拿学]