一指禅推拿法治疗急性腰椎间盘突出症的疗效观察  

Efficacy Observation of Yizhichan Tuina in Treating Acute Lumbar Disc Herniation

作　　者：丁灿群 谭啟恩 张盛强[1] 朱干[1] 郭志彬[1] 李冠彦 古远莉 Ding Canqun;Tan Qien;Zhang Shengqiang;Zhu Gan;Guo Zhibin;Li Guanyan;Gu Yuanli(Foshan Hospital of Traditional Chinese Medicine,Guangdong,Foshan 528000,China)

机构地区：[1]广东省佛山市中医院,广东佛山528000

出　　处：《中国中医急症》2025年第2期275-279,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：佛山市科学技术局自筹经费类科技创新项目(2320001006707)。

摘　　要：目的 观察一指禅推拿法治疗急性腰椎间盘突出症的临床疗效。方法 将106例急性腰椎间盘突出症患者随机分为观察组与对照组各53例,两组均给予常规治疗,观察组在此基础上加用一指禅推拿治疗,疗程为1周。于治疗前后采用简明疼痛问卷(SF-MPQ)、Oswestry功能障碍指数(ODI)、日本骨科学会(JOA)腰背痛评分、Roland-Morris功能障碍问卷(RMDQ)评估疼痛和功能障碍改善情况,测量腰椎活动度,检测血清白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平,测定胫神经和腓总神经传导速度,并评估临床疗效。结果 治疗后,两组SF-MPQ评分(包括VAS评分、RPI评分、PPI评分)、ODI和RMDQ评分均较治疗前降低(P <0.05),JOA评分、腰椎屈曲、伸展及侧曲活动度较治疗前升高(P <0.05),且观察组改善优于对照组(P <0.05)。治疗后,两组IL-6、IL-1β、TNF-α水平较治疗前降低(P <0.05),胫神经和腓总神经传导速度较治疗前升高(P <0.05),且观察组优于对照组(P <0.05)。观察组总有效率为94.40%,高于对照组的81.32%(P <0.05)。结论 一指禅推拿法能有效缓解急性腰椎间盘突出症患者的疼痛,改善腰椎功能,提高腰椎活动度,降低炎症因子水平,促进神经功能恢复,临床疗效确切。Objective:To observe the clinical efficacy of Yizhichan Tuina in treating acute lumbar disc hernia⁃tion.Methods:106 patients with acute lumbar disc herniation were randomly divided into an observation group(n=53)and a control group(n=53).Both groups received conventional treatment,while the observation group ad⁃ditionally received Yizhichan Tuina for one week.Before and after treatment,pain and functional impairment were assessed using the Short-Form McGill Pain Questionnaire(SF-MPQ),Oswestry Disability Index(ODI),Japanese Orthopedic Association(JOA)score for low back pain,and Roland-Morris Disability Questionnaire(RMDQ).Lum⁃bar range of motion was measured,serum levels of interleukin-6(IL-6),IL-1β,tumor necrosis factor-alpha(TNFα)were detected,and tibial nerve and common peroneal nerve conduction velocities were determined.Clinical effi⁃cacy was also evaluated.Results:After treatment,the SF-MPQ scores(including VAS,RPI,PPI scores),ODI,and RMDQ scores in both groups were significantly lower than before treatment(P<0.05),while JOA scores and lum⁃bar flexion,extension,and lateral bending ranges of motion were higher(P<0.05).Improvements in the observa⁃tion group were better than those in the control group(P<0.05).After treatment,levels of IL-6,IL-1β,and TNFαin both groups decreased(P<0.05),and tibial nerve and common peroneal nerve conduction velocities increased(P<0.05),with the observation group having better outcomes(P<0.05).The total effective rate in the observation group was 94.40%,which was higher than 81.32%in the control group(P<0.05).Conclusion:Yizhichan Tuina effectively alleviates pain,improves lumbar function,enhances lumbar range of motion,reduces inflammatory factor levels,and promotes neurological recovery in patients with acute lumbar disc herniation,which shows clear clinical efficacy.

关 键 词：急性腰椎间盘突出症 一指禅推拿 疼痛 功能障碍 炎症因子 神经传导速度 

分 类 号：R681.53[医药卫生—骨科学]