和血除痹膏摩法联合环跳穴芒针治疗腰椎间盘突出症术后下肢感觉障碍患者的临床效果观察  

Observation on the clinical efficacy of the combined treatment of Hexue Chubi Ointment massage and elongated needle therapy at Huantiao(GB 30)on patients with lower limb sensory disorders after lumbar disc herniation surgery

作　　者：戚天臣[1] 罗开民[1] 侯洁 王东利 寇军威 QI Tianchen;LUO Kaimin;HOU Jie;WANG Dongli;KOU Junwei(The Second Hostiptal of Tangshan,Tangshan,Hebei 063000,China)

机构地区：[1]河北省唐山市第二医院,河北唐山063000

出　　处：《湖南中医药大学学报》2024年第12期2245-2251,共7页Journal of Hunan University of Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2020430)。

摘　　要：目的探究和血除痹膏摩法联合环跳穴芒针治疗腰椎间盘突出症术后下肢感觉障碍患者的临床效果。方法选择河北省唐山市第二医院2021年1月至2023年6月收治的腰椎间盘突出症术后下肢感觉障碍患者84例,随机分为对照组(42例)、观察组(42例)。两组患者均常规给予甲钴胺片治疗,在此基础上,对照组采用环跳穴芒针治疗,观察组采用环跳穴芒针联合和血除痹膏摩法治疗,均连续治疗4周。比较治疗前后两组患者的麻木视觉模拟评分法(visual analogue scale,VAS)评分、棉签试验评分、针刺压力试验评分、下肢感觉传导速度、炎症反应,以及治疗后临床疗效,评价两组安全性。结果治疗后,两组麻木VAS评分、血清C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)水平均降低(P<0.05),棉签试验评分、针刺压力试验评分均提高(P<0.05);且观察组麻木VAS评分及血清CRP、TNF-α、IL-6水平均低于对照组(P<0.05),棉签试验评分、针刺压力试验评分均高于对照组(P<0.05)。治疗后,两组胫总神经、腓总神经传导速度以及F波出现率均升高(P<0.05);且观察组胫总神经、腓总神经传导速度以及F波出现率均高于对照组(P<0.05)。观察组愈显率为83.33%、总有效率为97.62%,均高于对照组的59.52%、83.33%(P<0.05)。两组治疗过程未发生断针、疼痛难忍等不良反应事件。结论和血除痹膏摩法联合环跳穴芒针治疗能够明显改善腰椎间盘突出症患者术后下肢感觉障碍,提高神经传导速度,减轻炎症程度,提高临床疗效,安全可行。Objective To explore the clinical effects of Hexue Chubi Ointment massage combined with elongated needle therapy at Huantiao(GB 30)on patients with lower limb sensory disorders after lumbar disc herniation(LDH)surgery.Methods A total of 84 patients with lower limb sensory disorders after LDH surgery,admitted to the Second Hospital of Tangshan,Hebei Province from January 2021 to June 2023,were randomized into a control group(n=42)and an observation group(n=42).Both groups of patients were treated with routine mecobalamin tablets.On this basis,the control group was treated with elongated needle therapy at Huantiao(GB 30),and the observation group was treated with the same therapy combined with Hexue Chubi Ointmen massage additionally.Both groups were treated continuously for four weeks.The visual analogue scale(VAS)score for numbness,cotton swab test score,pinprick test score,sensory conduction velocity of the lower limbs,and inflammatory response before and after treatment,as well as the clinical efficacy after treatment were compared between the two groups,and the safety of the treatment in the two groups was evaluated.Results After treatment,the scores of numbness VAS,and the serum levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)were all reduced in both groups(P<0.05),the scores of cotton swab test and pinprick test were elevated(P<0.05).Additionally,the score of numbness VAS and the serum levels of CRP,TNF-α,and IL-6 in observation group were lower than those in control group(P<0.05),while the scores of cotton swab test and pinprick test were higher than those in control group(P<0.05).After treatment,the conduction velocities and F-wave occurrence rates of both the common tibial nerve and the common peroneal nerve increased in both groups(P<0.05).Additionally,these nerves in observation group had higher conduction velocities and F-wave occurrence rates than those in control group(P<0.05).The cure-markedly effective rate in observation group was 83.33%and the total effe

关 键 词：腰椎间盘突出症 下肢感觉障碍 膏摩法 芒针 环跳穴 视觉模拟评分 神经传导速度 炎症反应 

分 类 号：R245[医药卫生—针灸推拿学]