皮肤针与体针对腰肌劳损和增生性脊柱炎患者疼痛症状的改善作用

背景疼痛症在临床上极为常见,目前应用针灸治疗具有较好的效果.然而针灸疗法方法甚多,各有所长,认识不同针法对疼痛症治疗的疗效差异,在临床上具有重要意义.1999年,应厄瓜多尔医学疼痛学会的要求,开展此项观察.目的观察不同针法对不同疾病疼痛症的疗效差异.设计随机对照观察.单位厄瓜多尔三军总医院疼痛科,成都军区总医院中医科、外一科.对象选择1999-05/2000-11厄瓜多尔三军总医院疼痛科门诊腰肌劳损、增生性脊柱炎患者360例,其中腰肌劳损179例,增生性脊柱炎181例.随机对两类疾病患者进行分组,即腰肌劳损皮肤针组88例,体针组91例;增生性脊柱炎皮肤针组92例,体针组89例.方法分别运用皮肤针、体针对上述疾病患者进行治疗,并同时对治疗前后患者症状加以观察.隔日治疗1次,腰肌劳损5次为基本疗程,增生性脊柱炎则为7次.治疗结果按Budzynski疼痛分级标准进行评定,统计方法采用MEPS统计软件处理数据.主要观察指标皮肤针、体针组对腰肌劳损、增生性脊柱炎治疗前后患者疼痛症状缓解情况,并对同种疗法治疗异病、不同疗法治疗同病的疗效、疗程进行相关分析.结果观察病例366例,剔除病例6例,实际完成完整病例360例.①皮肤针、体针疗法治疗后患者的疼痛分级均较治疗前减轻(P＜0.01).②皮肤针对腰肌劳损、增生性脊柱炎治疗,以腰肌劳损疗效明显(P＜0.01);皮肤针对腰肌劳损治疗疗效优于体针组(P＜0.05).③体针组增生性脊柱炎疼痛分级Ⅰ级者明显高于皮肤针组,但总疗效差异不显著(P＞0.05).④两组患者疼痛分级减少1个等级时,平均治疗次数皮肤针组少于体针组(P＜0.05).结论皮肤针与体针对增生性脊柱炎、腰肌劳损两类疾病疼痛症的治疗上,均有较好疗效,其中,以皮肤针对软组织损伤疗效明显,且起效迅速;体针对增生性脊柱炎患者疼痛改善上较皮肤针更为彻底.

Improvement of dermal needle and body acupuncture on pain due to lumbar strain and hyperplastic spondylitis

BACKGROUND:Pain is the extremely common disease in clinic. At present, acupuncture provides good therapeutic effect on it. But, there are many methods in acupuncture with various advantages individually.To understand the differences in therapeutic effects on pain with various needling techniques is significant in clinic. In 1999, the relevant observation was carried on in the demand of Ecuadorian Medical Pain Association.OBJECTIVE: To observe the differences in therapeutic effects on pain with various needling techniques.DESIGN: Randomized controlled observation was designed.SETTING: Department of Pain, Hospital General de las FF. AA. Quito, Ecuador, Department of Traditional Chinese Medicine and 1st Department of Surgery, General Hospital of Chengdu MilitaryArea Command of Chinese PLA.PARTICIPANTS: Totally 360 cases of lumber strain and hyperplastic spondylitis were selected in Department of Pain, Clinic of Ecuadorian 3rd Military General Hospital from May 1999 to November 2000, in which,179 cases were lumber strain and 181 cases were hyperplastic spondylitis.The groups were randomized in two kinds of diseases, named for lumber strain, dermal-needling group (88 cases) and body-acupuncture group (91cases); for hyperplastic spondylitis, dermal-needling group (92 cases) and body-acupuncture group (89 cases).METHODS: Dermal needling and body acupuncture were used to treat the diseases respectively and the symptom changes were observed before and after treatment simultaneously. The treatment was given once every two days. 5 treatments made one basic course for lumber strain and 7 treatments for hyperplastic spondylitis. The treating results were evaluated according to Budzynski grading criteria on pain. MEPS statistical software was used for statistical management of data.MAIN OUTCOME MEASURES: Pain relieving before and after treatment with dermal needling and body acupuncture for lumber strain and hyperplastic spondylitis was evaluated. Correlative analysis on therapeutic effects and course of treatment for different diseases with same therapy and on same disease with different therapies were carried on.RFSULTS: Altogether 366 cases were observed and 6 of them were excluded. Totally, 360 cases finished the experiment. ① The severity was alleviated in pain grading after treatment with dermal needling and body acupuncture compared with that before the treatment (P ＜ 0.01). ② In treatment of lumber strain and hyperplastic spondylitis with dermal needling, the therapeutic effects on lumber strain were more remarkable (P ＜ 0.01). The therapeutic effects of dermal needling on lumber strain were superior to that of body acupuncture (P ＞ 0.05). ③ The therapeutic effects of body acupuncture group on pain of Ⅰ grade in hyperplastic spondylitis were remarkably better than that of dermal needling group,but the significant difference in the total therapeutic effects of two techniques did not present (P ＞ 0.05). ④ When pain grading was reduced by 1 level in two groups, the average times of treatment in dermal needling group were less than that in body-acupuncture group (P ＜ 0.05).CONCLUSION: Good therapeutic effects of dermal needling and body acupuncture are achieved for both hyperplastic spondylitis and lumber strain,in which, the therapeutic effects of dermal needling are remarkable on injury of soft tissue and achieved swiftly; body acupuncture improves pain in hyperplastic spondylitis more radically compared with dermal needling.