电针针刺椎间孔与经椎间孔硬膜外阻滞治疗腰椎间盘突出症的临床疗效对比  

Comparison of the Clinical Efficacy of Electroacupuncture at the Intervertebral Foramen and Transforaminal Epidural Block in the Treatment of Lumbar Disc Herniation

作　　者：董胜军 郭中华[2] 李朝阳 DONG Sheng-jun;GUO Zhong-hua;LI Chao-yang

机构地区：[1]郑州市中医院,河南郑州450007 [2]河南省中医院,河南郑州450003 [3]周口市中医院,河南周口466000

出　　处：《风湿病与关节炎》2024年第8期17-21,共5页Rheumatism and Arthritis

基　　金：2021年河南省中医药拔尖人才培养项目资助(豫卫中医函〔2021〕15号)。

摘　　要：目的:观察对比电针针刺腰椎间孔与经椎间孔硬膜外阻滞治疗腰椎间盘突出症的疗效。方法:将81例腰椎间盘突出症患者随机分为观察组41例和对照组40例,观察组采用电针针刺腰椎间孔,配合局部取穴和经络取穴,对照组采用经椎间孔硬膜外阻滞治疗。观察2组治疗前及治疗后1个月、6个月疼痛视觉模拟评分法(VAS)评分、日本骨科协会评估治疗分数(JOA评分)、功能障碍指数(ODI)评分,临床疗效采用改良Macnab疗效评定标准进行评定。结果:治疗后1个月和6个月,2组VAS评分、腰椎JOA评分、ODI评分较治疗前均改善(P<0.05)。治疗后6个月,观察组VAS评分、ODI评分明显低于对照组,腰椎JOA评分明显高于对照组(P<0.05)。治疗后1个月,观察组临床治愈15例,显效16例,好转6例,无效4例,总有效率为90.24%;对照组临床治愈16例,显效14例,好转5例,无效5例,总有效率为87.50%;2组比较,差异无统计学意义(P>0.05)。治疗后6个月,观察组临床治愈14例,显效15例,好转6例,无效6例,总有效率为85.37%;对照组临床治愈8例,显效10例,好转7例,无效15例,总有效率为62.50%;2组比较,差异有统计学意义(P<0.05)。结论:电针针刺腰椎间孔与经椎间孔神经阻滞治疗腰椎间盘突出症早期均可取得良好临床效果,但电针针刺腰椎间孔治疗腰椎间盘突出症远期效果更佳。Objective:To observe and compare the efficacy of electroacupuncture at the lumbar intervertebral foramen and transforaminal epidural block in the treatment of lumbar disc herniation.Methods:Eighty-one patients with lumbar disc herniation were randomly divided into an observation group(41 cases)and a control group(40 cases).The observation group was treated with electroacupuncture at the lumbar intervertebral foramen,and combined with local acupoint selection and meridian acupoint selection,the control group was treated with transforaminal epidural block.The Visual Analogue Scale(VAS)score,Japanese Orthopaedic Association(JOA)score and Oswestry Disability Index(ODI)score were observed before treatment and one month and six months after treatment in both groups.The clinical efficacy was evaluated using the modified Macnab efficacy evaluation criteria.Results:One month and six months after treatment,the VAS score,lumbar JOA score and ODI score of both groups were improved compared with those before treatment(P<0.05).Six months after treatment,the VAS score and ODI score of the observation group were significantly lower than those of the control group,and the lumbar JOA score was significantly higher than that of the control group(P<0.05).One month after treatment,in the observation group,15 cases were clinically cured,16 cases were markedly effective,6 cases were improved,and 4 cases were ineffective,with a total effective rate of 90.24%;in the control group,16 cases were clinically cured,14 cases were markedly effective,5 cases were improved,and 5 cases were ineffective,with a total effective rate of 87.50%;there was no statistically significant difference between the two groups(P>0.05).Six months after treatment,in the observation group,14 cases were clinically cured,15 cases were markedly effective,6 cases were improved,and 6 cases were ineffective,with a total effective rate of 85.37%;in the control group,8 cases were clinically cured,10 cases were markedly effective,7 cases were improved,and 15 cases were ineff

关 键 词：腰椎间盘突出症 椎间孔 神经阻滞 电针 针刺深度 

分 类 号：R246.9[医药卫生—针灸推拿学]