大面积艾绒温灸对寒湿痹阻型腰椎间盘突出症下肢麻木的影响
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摘要
目的探讨大面积艾绒温灸对寒湿痹阻型腰椎间盘突出症下肢麻木患者的影响。方法分析四川省眉山市中医医院2017年7月～2018年3月收治的100例寒湿痹阻型腰椎间盘突出症下肢麻木患者的临床资料,依据治疗方式不同分为对照组(常规针刺)和观察组(大面积艾绒温灸),各50例。观察两组患者治疗前后视觉模拟评分(VAS)、日本骨科协会评估治疗分数(JOA)、腰椎活动度情况,比较两组患者的临床效果、满意度和3个月内复发率情况。结果两组患者治疗前VAS评分、JOA评分、腰椎活动度比较,差异均无统计学意义(P> 0.05)。治疗后两组VAS评分低于治疗前,JOA评分、腰椎活动度高于治疗前,且观察组治疗后VAS评分低于对照组,JOA评分、腰椎活动度高于对照组,差异有统计学意义(P <0.05)。观察组临床治疗总有效率、满意度高于对照组,3个月内复发率低于对照组,差异有统计学意义(P <0.05)。结论大面积艾绒温灸应用于寒湿痹阻型腰椎间盘突出症下肢麻木患者可以减轻疼痛,提高预后恢复和疗效,降低复发率,值得临床推广应用。
Objective To investigate the influence of large area of warming moxibustion with moxa on the numbness of lower limb in lumbar disc herniation patients with syndrome of blockade of cold-dampness. Methods The clinical data of numbness of lower limb in 100 cases of lumbar disc herniation patients with syndrome of blockade of cold-dampness admitted to TCM Hospital of Meishan City in Sichuan Province from July 2017 to March 2018 was analyzed. The patients were divided into control group(conventional acupuncture) and observation group(large area of warming moxibustion with moxa) according to different treatment methods, with 50 cases in each group. The visual analogue scale(VAS), Japanese Orthopaedic Association(JOA) scores, lumbar motility of the two groups were observed before and after treatment. The clinical effect, satisfaction degree and recurrence rate within 3 months of two groups were compared.Results Before treatment, there were no statistically significant differences of the VAS score, JOA score, lumbar motility between the two groups(P > 0.05). After treatment, the VAS scores of the two groups were lower than those before treatment, the JOA scores, lumbar motility were higher than those before treatment, and the VAS scores of observation group after treatment were lower than those of control group, the JOA scores and lumbar motility were higher than those of control group, the differences were statistically significant(P < 0.05). The clinical total effective rate, satisfaction degree of observation group were higher than those of control group, the recurrence rate within 3 months was lower than that of control group, the differences were statistically significant(P < 0.05). Conclusion The application of large area of warming moxibustion with moxa on the numbness of lower limb in lumbar disc herniation patients with syn-drome of blockade of cold-dampness can relieve pain of patients, improve the prognosis recovery and curative effect,decrease recurrence rate, which is worthy of clinical promotion and application.
Objective To investigate the influence of large area of warming moxibustion with moxa on the numbness of lower limb in lumbar disc herniation patients with syndrome of blockade of cold-dampness. Methods The clinical data of numbness of lower limb in 100 cases of lumbar disc herniation patients with syndrome of blockade of cold-dampness admitted to TCM Hospital of Meishan City in Sichuan Province from July 2017 to March 2018 was analyzed. The patients were divided into control group(conventional acupuncture) and observation group(large area of warming moxibustion with moxa) according to different treatment methods, with 50 cases in each group. The visual analogue scale(VAS), Japanese Orthopaedic Association(JOA) scores, lumbar motility of the two groups were observed before and after treatment. The clinical effect, satisfaction degree and recurrence rate within 3 months of two groups were compared.Results Before treatment, there were no statistically significant differences of the VAS score, JOA score, lumbar motility between the two groups(P > 0.05). After treatment, the VAS scores of the two groups were lower than those before treatment, the JOA scores, lumbar motility were higher than those before treatment, and the VAS scores of observation group after treatment were lower than those of control group, the JOA scores and lumbar motility were higher than those of control group, the differences were statistically significant(P < 0.05). The clinical total effective rate, satisfaction degree of observation group were higher than those of control group, the recurrence rate within 3 months was lower than that of control group, the differences were statistically significant(P < 0.05). Conclusion The application of large area of warming moxibustion with moxa on the numbness of lower limb in lumbar disc herniation patients with syn-drome of blockade of cold-dampness can relieve pain of patients, improve the prognosis recovery and curative effect,decrease recurrence rate, which is worthy of clinical promotion and application.
引文
[1]陶志东,陈智能,吴祥宗,等.中医火龙铺灸疗法治疗腰椎间盘突出症的疗效观察[J].中国中医药科技,2018,25(1):79-80.
[2]Choi G,Lee SH,Lokhande P,et al.Percutaneous endoscopic approach for highly migrated intracanal discherniations by foraminoplastic technique using rigid working channel endoscope[J].Spine,2008,33(15):508-515.
[3]王凌玲,黄碧,黎余余.中药艾箱灸用于腰椎间盘突出症患者的护理研究[J].光明中医,2018,33(4):575-576.
[4]Ofluoglu D,Akyuz G,Unay O,et al.The effect of calcitonin onβ-endorphin levels in postmenopausal osteoporotic patients with back pain[J].Clin Rheumatol,2007,26(1):44-49.
[5]黄奏琴,张慎,王伟明,等.银质针配合艾灸仪隔姜灸治疗腰椎间盘突出症疗效观察[J].上海针灸杂志,2017,36(2):193-197.
[6]Sadeghian H,Motiei-Langroudi R.Pitting Oedema in a Patient with Lumbar Disc Herniation:Case report of an unusual association[J].Sultan Qaboos Univ Med J,2017,17(4):e464-e467.
[7]鲁玉来,蔡钦林.腰椎间盘突出症[M].北京:人民军医出版杜,2001.
[8]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:202.
[9]苏水珠,庄垂加.灸法治疗腰椎间盘突出症的研究进展[J].湖南中医杂志,2015,31(19):159-165.
[10]Chan FK,Hsu CC,Lin HJ,et al.Physicians as well as nonphysician health care professionals in Taiwan have higher risk for lumbar herniated intervertebral disc than general population[J].Medicine(Baltimore),2018,97(1):e9561.
[11]刘尚礼,黄东生,梁安靖,等.人工腰椎间盘置换对维持腰椎活动度和椎间隙高度的作用[J].中华医学杂志,2005,85(1):41-44.
[12]Lee JA,Ha IH,Choi TY,et al.Evaluating the clinical application of a leaflet for clinical practice guideline in patients with lumbar herniated intervertebral discs:Randomized controlled trial[J].Medicine(Baltimore),2017,96(51):e9406.
[13]熊俊,耿乐乐,迟振海,等.艾灸治疗不同灸感腰椎间盘突出症急性期患者60例疗效观察[J].中医杂志,2015,56(21):1836-1839.
[14]盛有根,夏建洪,徐海波.热敏药灸配合汉防己甲素经皮给药治疗腰椎间盘突出症的疗效观察[J].上海针灸杂志,2018,37(3):320-323.
[15]周小芳,庄素芳.加味乌头散火龙灸对寒湿型腰椎间盘突出症患者JOA及SF-36评分影响研究[J].中国现代医生,2017,55(11):104-108.
[16]王小佶.推拿配合中药治疗湿热型腰椎间盘突出症的效果观察[J].中国医药科学,2017,7(17):66-68.
[17]卢璐,周俊合,刘月,等.天灸治疗腰椎间盘突出症之腰痛的临床疗效研究[J].中国全科医学,2017,20(4):497-500,506.
[18]宋雨思,谢晓龙,方伟.使用大面积艾绒温灸器艾灸治疗寒湿型腰椎间盘突出症的临床护理观察[J].四川中医,2017,35(8):209-210.
[19]张家富,王洪乐,来庆春,等.除痹止痛汤治疗寒湿痹阻型腰椎间盘突出症的临床效果及对睡眠质量的影响[J]中国医药导报,2017,14(19):102-105.
[20]李振朝,郭勇.定点运穴手法配合盘根消痛方治疗气虚型腰椎间盘突出疗效观察[J].中国现代医生,2017,55(25):94-96,100.
[21]李敏仪.探讨艾灸联合穴位贴敷对治疗腰椎间盘突出症的护理效果[J].哈尔滨医药,2018,38(1):88-89.
[22]秦登明,谭漪,纪国志,等.独活寄生汤配合手法治疗寒湿型腰椎间盘突出症临床观察[J].四川中医,2016,34(8):193-194.
[23]余金钟,李波.艾灸联合中药穴位贴敷治疗胃脘痛脾胃虚寒证160例临床观察[J].深圳中西医结合杂志,2016,26(15):62-63.
[24]张兰云,吕璟,于洪书.自制和胃降逆中药穴位贴敷联合艾灸辅助治疗功能性消化不良效果观察[J].护理学杂志,2016,31(5):37-38.
[25]吴名波,廖荣鑫,饶秀珍,等.补肾强督治尪汤治疗肾虚型腰椎间盘突出症临床疗效观察[J].中国医药科学,2017,7(3):66-69.
[26]汪宝军,王竹风,李爱君,等.中药熏蒸治疗腰椎间盘突出症的临床观察[J].中国医药导报,2017,14(35):172-175.
[27]汪素芬,周世红.透灸法对腰椎间盘突出症急性期的疗效及复发率的影响[J].中国中医急症,2017,26(2):360-362.
[28]Inglez de Souza MCCM,Ryan R,Ter Haar G,et al.Evaluation of the influence of kyphosis and scoliosis on intervertebral disc extrusion in French bulldogs[J].BMCVet Res,2018,14(1):5.
[29]魏新春,吴建贤.热敏灸疗法治疗腰椎间盘突出症的临床规律研究[J].颈腰痛杂志,2015,36(4):304-307.
[2]Choi G,Lee SH,Lokhande P,et al.Percutaneous endoscopic approach for highly migrated intracanal discherniations by foraminoplastic technique using rigid working channel endoscope[J].Spine,2008,33(15):508-515.
[3]王凌玲,黄碧,黎余余.中药艾箱灸用于腰椎间盘突出症患者的护理研究[J].光明中医,2018,33(4):575-576.
[4]Ofluoglu D,Akyuz G,Unay O,et al.The effect of calcitonin onβ-endorphin levels in postmenopausal osteoporotic patients with back pain[J].Clin Rheumatol,2007,26(1):44-49.
[5]黄奏琴,张慎,王伟明,等.银质针配合艾灸仪隔姜灸治疗腰椎间盘突出症疗效观察[J].上海针灸杂志,2017,36(2):193-197.
[6]Sadeghian H,Motiei-Langroudi R.Pitting Oedema in a Patient with Lumbar Disc Herniation:Case report of an unusual association[J].Sultan Qaboos Univ Med J,2017,17(4):e464-e467.
[7]鲁玉来,蔡钦林.腰椎间盘突出症[M].北京:人民军医出版杜,2001.
[8]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:202.
[9]苏水珠,庄垂加.灸法治疗腰椎间盘突出症的研究进展[J].湖南中医杂志,2015,31(19):159-165.
[10]Chan FK,Hsu CC,Lin HJ,et al.Physicians as well as nonphysician health care professionals in Taiwan have higher risk for lumbar herniated intervertebral disc than general population[J].Medicine(Baltimore),2018,97(1):e9561.
[11]刘尚礼,黄东生,梁安靖,等.人工腰椎间盘置换对维持腰椎活动度和椎间隙高度的作用[J].中华医学杂志,2005,85(1):41-44.
[12]Lee JA,Ha IH,Choi TY,et al.Evaluating the clinical application of a leaflet for clinical practice guideline in patients with lumbar herniated intervertebral discs:Randomized controlled trial[J].Medicine(Baltimore),2017,96(51):e9406.
[13]熊俊,耿乐乐,迟振海,等.艾灸治疗不同灸感腰椎间盘突出症急性期患者60例疗效观察[J].中医杂志,2015,56(21):1836-1839.
[14]盛有根,夏建洪,徐海波.热敏药灸配合汉防己甲素经皮给药治疗腰椎间盘突出症的疗效观察[J].上海针灸杂志,2018,37(3):320-323.
[15]周小芳,庄素芳.加味乌头散火龙灸对寒湿型腰椎间盘突出症患者JOA及SF-36评分影响研究[J].中国现代医生,2017,55(11):104-108.
[16]王小佶.推拿配合中药治疗湿热型腰椎间盘突出症的效果观察[J].中国医药科学,2017,7(17):66-68.
[17]卢璐,周俊合,刘月,等.天灸治疗腰椎间盘突出症之腰痛的临床疗效研究[J].中国全科医学,2017,20(4):497-500,506.
[18]宋雨思,谢晓龙,方伟.使用大面积艾绒温灸器艾灸治疗寒湿型腰椎间盘突出症的临床护理观察[J].四川中医,2017,35(8):209-210.
[19]张家富,王洪乐,来庆春,等.除痹止痛汤治疗寒湿痹阻型腰椎间盘突出症的临床效果及对睡眠质量的影响[J]中国医药导报,2017,14(19):102-105.
[20]李振朝,郭勇.定点运穴手法配合盘根消痛方治疗气虚型腰椎间盘突出疗效观察[J].中国现代医生,2017,55(25):94-96,100.
[21]李敏仪.探讨艾灸联合穴位贴敷对治疗腰椎间盘突出症的护理效果[J].哈尔滨医药,2018,38(1):88-89.
[22]秦登明,谭漪,纪国志,等.独活寄生汤配合手法治疗寒湿型腰椎间盘突出症临床观察[J].四川中医,2016,34(8):193-194.
[23]余金钟,李波.艾灸联合中药穴位贴敷治疗胃脘痛脾胃虚寒证160例临床观察[J].深圳中西医结合杂志,2016,26(15):62-63.
[24]张兰云,吕璟,于洪书.自制和胃降逆中药穴位贴敷联合艾灸辅助治疗功能性消化不良效果观察[J].护理学杂志,2016,31(5):37-38.
[25]吴名波,廖荣鑫,饶秀珍,等.补肾强督治尪汤治疗肾虚型腰椎间盘突出症临床疗效观察[J].中国医药科学,2017,7(3):66-69.
[26]汪宝军,王竹风,李爱君,等.中药熏蒸治疗腰椎间盘突出症的临床观察[J].中国医药导报,2017,14(35):172-175.
[27]汪素芬,周世红.透灸法对腰椎间盘突出症急性期的疗效及复发率的影响[J].中国中医急症,2017,26(2):360-362.
[28]Inglez de Souza MCCM,Ryan R,Ter Haar G,et al.Evaluation of the influence of kyphosis and scoliosis on intervertebral disc extrusion in French bulldogs[J].BMCVet Res,2018,14(1):5.
[29]魏新春,吴建贤.热敏灸疗法治疗腰椎间盘突出症的临床规律研究[J].颈腰痛杂志,2015,36(4):304-307.