银质针为主综合治疗腰椎间盘突出症临床分析

目的评价银质针温针灸、普通毫针温针灸、理筋手法对腰椎间盘突出症镇痛的效果。方法将90例腰椎间盘突出症患者随机分为3组,每组30例。药物组口服消炎镇痛药物塞来昔布胶囊,其余两组分别予银质针温针灸治疗和毫针温针灸治疗,每组中都有一半患者随机接受推拿理筋手法治疗。在治疗前(T0)、治疗1个疗程后(第35天T1),采集各组功能疼痛障碍指数量表(ODI)的结果。结果银针组治疗后有效率为96.7%,毫针组为90.0%,药物组为83.3%,3组比较差异具有统计学意义(P0.05),银针组有效率优于其他两组。经析因设计的方差分析,3组患者治疗后ODI分值均较治疗前降低(P0.05),3种治疗方法都具有良好的镇痛效果。治疗后银针组ODI分值与毫针组、药物组比较差异具有统计学意义(P0.05),银质针镇痛较佳。温针灸配合推拿理筋手法对疼痛的改善具有较好的效果(P0.05)。针刺、药物和推拿治疗未见明显交互作用,其作用效果相互独立。结论银质针温针灸为主配合推拿理筋手法能明显改善腰椎间盘突出症的疼痛症状。

Clinical Analysis of A Composite Treatment with Silver Needles for Lumbar Intervertebral Disc Herniation

Objective To evaluate the analgesic effects of warm acupuncture with silver needles, warm acupuncture with filiform needles and sinew injury-treating manipulation on lumbar intervertebral disc herniation. Method Ninety patients with lumbar intervertebral disc herniation were allocated to three groups, 30 cases each. The medication group received oral administration of celecoxib capsules, an anti-inflammatory and analgesic drug and the other two groups, warm acupuncture with silver needles and warm acupuncture with filiform needles, respectively. Random half patients of every group received sinew injury-treating manipulation as well. An evaluation was made using the Oswestry Disability Index（ODI） in every group before treatment（T0） and after one course of treatment（35th day, T1）. Result After treatment, the improvement rate was 96.7% in the silver needle group, 90.0% in the filiform needle group and 83.3% in the medication group; there was a statistically significant difference among the three groups（P0.05） and the improvement rate was higher in the silver needle group than in the other two groups. Analysis of variance of factorial design showed that the ODI score changed in all the three groups after treatment compared with before（P0.05）. All the three treatments had a good analgesic effect. There was a statistically significant post-treatment difference in the ODI score among the silver needle, filiform needle and medication groups（P0.05） and silver needles had a better analgesic effect. Warm needling moxibustion plus sinew injury-treating manipulation had a better relieving effect on the pain（P0.05）. Acupuncture, medication and manipulation did not produce a marked reciprocal effect and their effects were mutually independent. Conclusion Warm acupuncture with silver needles plus sinew injury-treating manipulation can markedly relieve the pain in lumbar intervertebral disc herniation.