超声引导下针刀松解序贯腰三针治疗腰椎间盘突出症临床研究  

作　　者：邓小彬 陈波涛 杨利 侯文 匡军 廖仁飞 王柄棋 

机构地区：[1]重庆市九龙坡区中医院/重庆中医药学院附属九龙坡医院中医大厦10楼骨二科,重庆400080

出　　处：《实用中医药杂志》2025年第3期628-630,共3页Journal of Practical Traditional Chinese Medicine

基　　金：重庆市2021年科卫联合中医药技术创新与应用发展项目(2020ZY023557)。

摘　　要：目的:观察超声引导下针刀松解序贯腰三针治疗腰椎间盘突出症的疗效。方法:68例按随机数字表法分为针刀组和联合组各34例。联合组超声引导下进行针刀松解椎间孔、关节突及横突共1次,次日序贯患侧腰三针针刺治疗10天。针刀组采取超声引导针刀松解治疗,每周1次,共2次。结果:两组治疗后各时间点VAS评分和JOA评分均改善(F_(VAS)=420.815,P<0.001;F_(JOA)=254.359,P<0.001)。术后3个月及12个月联合组VAS评分较针刀组低(t_(3m)=0.010,P<0.05;t_(12m)=0.112,P<0.05)。联合组JOA评分术后不同时间点均较针刀组高(t_(3d)=1.420,P<0.05;t_(3m)=0.007,P<0.05,t_(12m)=1.241,P<0.05)。治疗后3个月联合组治愈率和未愈率优于针刀组(χ^(2)=6.208,P<0.05),1年复发率低于针刀组(χ^(2)=4.660,P<0.05)。两组均无晕针、皮下血肿、神经损伤或感染等不良反应。结论:超声引导下针刀松解序贯腰三针针刺治疗腰椎间盘突出症疗效好且稳定,术后1年内复发率低,安全性高。Objective:To evaluate the efficacy of ultrasound-guided acupotomy release followed by sequential"Lumbar Three Needles"acupuncture in the treatment of lumbar disc herniation(LDH).Methods:Sixty-eight cases were randomly divided into the acupotomy group and the combined group,with 34 cases in each group.The combined group underwent ultrasound-guided acupotomy release targeting the intervertebral foramen,articular processes,and transverse processes once,followed by sequential"Lumbar Three Needles"acupuncture on the affected side for 10 days starting the next day.The acupotomy group received ultrasound-guided acupotomy release once weekly for two sessions.Results:The VAS score and JOA score of the two groups were improved at each time point after treatment(F_(VAS)=420.815,P<0.001;F_(JOA)=254.359,P<0.001).The VAS scores of the combined group were lower than those of the acupotomy group at 3 months and 12 months after operation(t_(3m)=0.010,P<0.05;t_(12m)=0.112,P<0.05).The JOA score of the combined group was higher than that of the acupotomy group at different time points after operation(t_(3d)=1.420,P<0.05;t_(3m)=0.007,P<0.05,t_(12m)=1.241,P<0.05).After 3 months of treatment,the curative rate and unhealed rate of the combined group were better than those of the acupotomy group(χ^(2)=6.208,P<0.05),and the 1-year recurrence rate was lower than that of the acupotomy group(χ^(2)=4.660,P<0.05).There were no adverse reactions such as fainting,subcutaneous hematoma,nerve injury or infection in the two groups.Conclusion:Ultrasound-guided needle knife release sequential lumbar three-needle acupuncture is effective and stable in the treatment of lumbar disc herniation,with low recurrence rate and high safety within 1 year after operation.

关 键 词：腰椎间盘突出症 超声引导 针刀 针刺 

分 类 号：R247.481.53[医药卫生—中医临床基础]