铍针治疗腰椎间盘突出合并臀部筋结病变的临床研究

目的：评价铍针治疗腰椎间盘突出合并臀部筋结病变的临床疗效。方法：2009年8月至2010年2月,将符合纳入标准的83例（男29例,女54例）腰椎间盘突出合并臀部筋结病变的患者随机分为铍针组和针刺组。铍针组采用铍针治疗,垂直点刺法进针,铍针疾刺疾出,不捻转,进针深度以通过筋结表层为度,2次为1个疗程;针刺组采用针刺治疗,穴位选用阿是穴,即条索样包块或筋结等压痛点处,进针后寻找沉紧滞涩的针感,留针20min,10次为1个疗程。末次治疗后即时进行VAS评分。末次治疗后3d复查B超。观察指标为两组治疗前后VAS评分变化和筋结的B超炎性反应带宽度变化。结果：臀部筋结病变的B超表现为炎性反应带或筋结,治疗后两组B超炎性反应带宽度均明显减小,差异无统计学意义（P=0.635）。比较两组B超炎性反应带宽度变化的差值,无统计学意义（P=0.813）。结论：铍针疗法对臀部筋结病变的减张、减压效果优于针刺疗法。B超给出了臀部筋结病变的形态学表现,其内容物为低回声的炎性渗出。B超对臀部筋结病变的诊断、形态学方面的治疗作用及疗效判定有肯定意义。

Treatment of lumbar disc herniation combine with buttock tender node with Pizhen

Objective: To observe the therapeutic effects of Pizhen in treating lumbar disc herniation combined with buttock tender node.Methods: From August 2009 to February 2010,83 patients (29 males and 54 females) with lumbar disc herniation combined with buttock tender node were randomly divided into the Pizhen group and acupuncture group.Pizhen group were treated with Pizhen manipulation,inserting needle by vertical prick with quacking inserting and quick withdrawing the needle,no rotating and the depth was through the surface of fascia,two times as a course of treatment;acupuncture group were treated with acupuncture,inserting Ashi-point,retaining the needle 20 min,ten times as a course of treatment.VAS scoring at the end of treatment and B ultrasonic image at 3d after treatment was carried out to observe the therapeutic effects.Results: B ultrasonic image of buttock tender node showed inflammation reaction or ellipse.The width of the inflammation reaction decreased after treatment,but there has no statistical significance(P=0.635).There was no significant difference between two groups(P=0.813).Conclusion: Pizhen manipulation is better than acupuncture.B ultrasonic image gives morphological performance of buttock tender node,the content is inflammatory infiltrates.B ultrasound has certainly significance in diagnosing,treating and evaluating the clinical effect of Pizhen manipulation on treating buttock tender node.