刮痧治疗不同证型腰椎间盘突出症的临床疗效观察  

Clinical curative effects of scraping in the treatment of lumbar disc herniation with different syndromes

作　　者：姜荣荣[1] 陈丽虹[1] 王秋琴[1] 郝晓蓓 杨敏[1] 王庆[1] 陈华[1] 严姝霞[1] 徐桂华[1] 许红梅 马波 Jiang Rongrong;Chen Lihong;Wang Qiuqin;Hao Xiaobei;Yang Min;Wang Qing;Chen Hua;Yan Shuxia;Xu Guihua;Xu Hongmei;Ma Bo(School of Nursing,Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Orthopedics,Yangzhou Hospital of Traditional Chinese Medicine,Yangzhou 225000,China)

机构地区：[1]南京中医药大学护理学院,南京210023 [2]扬州市中医院骨伤科,扬州225000

出　　处：《中华现代护理杂志》2022年第6期770-775,共6页Chinese Journal of Modern Nursing

基　　金：江苏省高等学校自然科学研究项目(No.21KJB360024);江苏省研究生培养创新工程研究生科研与实践创新计划(No.KYCX20_1517)。

摘　　要：目的观察刮痧对不同证型腰椎间盘突出症(LDH)的临床干预效果。方法采用便利抽样法,选取2017年7月—2018年6月扬州市中医院骨伤科门诊收治的30例非急症期LDH患者为研究对象,其中气滞血瘀型11例,湿热痹阻型8例,寒湿痹阻型7例,肝肾亏虚型4例。主要刮拭督脉、足太阳膀胱经,以及病变或疼痛段的夹脊穴、阿是穴、肾俞穴、委中穴,每次以刮至出痧为度,2~5 d(痧退)刮1次,2次为1个疗程,共刮3个疗程。比较刮痧前后日本骨科学会评分(JOA)、视觉模拟评分(VAS)以及血清白介素1β(IL-1β)、白介素10(IL-10)。结果与刮痧前比较,刮痧后患者JOA评分提高、VAS评分降低、血清IL-1β含量减少、血清IL-10含量上升,差异均具有统计学意义(P<0.01);其中气滞血瘀型、寒湿痹阻型患者JOA评分提高高于湿热痹阻型和肝肾亏虚型患者,差异具有统计学意义(P<0.05);气滞血瘀型、湿热痹阻型、寒湿痹阻型患者血清IL-10含量提升高于肝肾亏虚型患者,差异具有统计学意义(P<0.05)。结论刮痧治疗LDH疗效确切,对实证证型疗效更好。Objective To observe the clinical effect of scraping therapy on lumbar disc herniation(LDH)with different syndromes.Methods Using the convenient sampling method,a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects.Among them,there were 11 cases of qi stagnation and blood stasis syndrome,8 cases of damp-heat obstruction syndrome,7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome.Du meridian,the bladder meridian of Foot Taiyang,as well as Jiaji(EX-B2)in pathological or painful sections,Ashi point,Shenshu(BL 23),and Weizhong(BL 40)were mainly scraped.The treatment interval is 2~5 days(the marks of scrapping fade),twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment.Japanese Orthopaedic Association(JOA)Score,Visual Analogue Scale(VAS),serum interleukin-1β(IL-1β)and interleukin-10(IL-10)were compared before and after scraping.Results Compared with those before scraping,the JOA score increased,the VAS decreased,the serum IL-1βcontent decreased and the serum IL-10 content increased after scraping,and the differences were sttaistically significant(P<0.01).Among them,the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome,and the differences were statistically significant(P<0.05).The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome,damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome,and the differences were statistically significant(P<0.05).Conclusions The curative effect of scraping in the treatment of LDH is definite,and the curative effect is better for excessive syndromes.

关 键 词：腰椎间盘突出症 刮痧 证型 

分 类 号：R244.4[医药卫生—针灸推拿学]