小针刀配合手法治疗腰椎间盘突出症的临床疗效观察  

Clinical effect of small needle knife plus manipulation on lumbar intervertebral disc herniation

作　　者：李楷 徐世红[1] 赵军[1] 王兴盛[1] 张丽娟[1] LI Kai;XU Shihong;ZHAO Jun;WANG Xingsheng;ZHANG Lijun

机构地区：[1]甘肃省中医院,甘肃兰州730000

出　　处：《中医临床研究》2023年第9期105-108,共4页Clinical Journal Of Chinese Medicine

基　　金：甘肃省中医药管理局重点项目(GZKZ-2021-4);甘肃省自然科学基金(20JR10RA360);兰州市人才创新创业专项(2020-RC-55)。

摘　　要：目的:按照随机、对照原则,评估小针刀配合手法治疗腰椎间盘突出症的临床疗效。方法:将甘肃省中医院脊柱骨科2019年1月―2020年10月收治的60例腰椎间盘突出症患者随机分为观察组和对照组,每组各30例。对照组予以腰椎斜扳法、按抖法等手法治疗,2天一次,每次10次作为一个疗程;观察组在对照组治疗的基础上予以压痛点局部浸润麻醉后小针刀治疗,每7天一次,7天为一个疗程,两组共治疗2个疗程。参照中华人民共和国中医药行业标准发布的《中医病证诊断疗效标准》中腰椎间盘突出症的疗效标准评估其治疗效果,以腰腿痛消失,直腿抬高70°以上,能恢复原工作为治愈标准;以腰腿痛减轻,腰部活动功能改善为好转标准;以症状、体征无改善为无效标准。结果:经过2个疗程的治疗,观察组的治愈率为53.3%(16/30),总有效率为96.4%(29/30)。对照组的治愈率为30.0%(9/30),总有效率为76.7%(23/30)。结论:手法是治疗腰椎间盘突出症常用的保守治疗方法,具有舒筋通络,行气活血的作用;针刀疗法是针刀医学治疗腰椎间盘突出症的新方法,是一种中医经络与脊柱微创结合的一种闭合微创伤性手术疗法。本研究表明小针刀配合手法较单一手法治疗腰椎间盘突出症疗效显著,具有松解脊柱周围软组织粘连、消除疼痛、恢复脊柱力学等作用,同时具有不易复发的特点,值得临床推广应用。Objective:To evaluate the clinical efficacy of small needle knife plus manipulation on lumbar disc herniation(LDH)according to the randomized and controlled principle.Methods:A total of 60 LDH patients admitted to the Spinal Department of Gansu Hospital of Traditional Chinese Medicine from January 2019 to October 2020 were randomly divided into the observation group and the control group,with 30 cases in each group.The control group was treated by lumbar oblique-pulling and shaking methods,once every 2 days,10 times as a course of treatment.On the basis of the treatment in the control group,the observation group was given lo­cal infiltration on the tender points and small needle knife treatment,once every 7 days,7 days as a course of treatment,and the two groups were treated for a total of 2 courses of treatment.The therapeutic effect on LDH was evaluated according to the curative effect criteria of Diagnosis and Curative Effect Criteria of TCM Diseases issued by the Industry Standard of Traditional Chinese Medicine of the People’s Republic of China.The treatment criteria was the removal of back and leg pain,the elevation of straight leg more than 70°,and the recov­ery of original work.The reduction of back and leg pain and the improvement of waist activity function were considered as the improve­ment standard.No amelioration of symptoms and signs was considered as invalid.Results:After 2 courses of treatment,the cure rate in the observation group was 53.3%(16/30),the total effective rate was 96.4%(29/30).In the control group,the cure rate was 30.0%(9/30)and the total effective rate was 76.7%(23/30).Conclusion:Manipulation is the most commonly used conservative treatment for LDH,which has the effect of relaxing tendons and clearing collaterals,promoting Qi(气)and blood circulation.Small needle knife is a new method in the treatment of LDH.It is a kind of closed microtraumatic surgical therapy which is a minimally invasive combination of meridians and spine of traditional Chinese medicine.This study shows t

关 键 词：小针刀 手法 腰椎间盘突出症 临床效果 

分 类 号：R274[医药卫生—中医骨伤科学]