银质针导热疗法与整骨理筋疗法对腰椎间盘突出症的治疗研究

目的探讨整骨理筋疗法与银质针导热疗法治疗腰椎间盘突出症的互补作用及机制。方法选择2007年2月—2011年8月我科收治的腰椎间盘突出症患者90例。按随机数字表法分成三组：整骨理筋组（A组）,银质针导热组（B组）,整骨理筋联合银质针导热组（C组）,每组30例。A组采用整骨理筋疗法,1次/周。B组采用银质针导热疗法1次/周。C组先后采用整骨理筋疗法和银质针导热疗法,各1次。比较三组患者治疗前、治疗后3个月和6个月疼痛数字评分及治疗后3个月的临床体征改善情况。结果所有患者均完成治疗和指标评定。（1）治疗后3个月三组疼痛数字评分值与治疗前比较均有降低,而C组更为明显（P〈0.01）。治疗后6个月,三组患者的疼痛症状大多数获得控制,以C组更为明显（P〈0.01）。其中A、B组与C组比较,以及A组与B组比较差异均有统计学意义（P〈0.05）。（2）治疗后3个月各组临床体征均较治疗前明显改善,尤其是直腿抬高试验阳性率,C组与A组、B组比较差异均有显著统计学意义（P〈0.01）,A组与B组比较差异无统计学意义（P〉0.05）。（3）A、B、C三组的有效率（痊愈及有效）分别为56.7%、56.7%和80.0%,C组与A、B组比较差异有显著统计学意义（P〈0.01）。结论银质针导热疗法与整骨理筋疗法均是治疗腰椎间盘突出症的有效疗法,联合应用效果更好。

Interventional effects of Zheng Gu Li Jin treatment and silver needle heat conductive treatment for lumbar disc herniation

Objective To explore the complementary action and mechanism of Zheng Gu Li Jin treatment and silver needle heat conductive treatment for lumbar disc herniation（LDH）.Methods Totally 90 LDH patients were selected from our department between February 2007 and August 2011.They were divided into three groups with 30 patients in each group according to randomized digital table： Zheng Gu Li Jin treatment（Group A） was performed once per week totally.Silver needle heat conductive treatment（Group B） was conducted once per week totally.Zheng Gu Li Jin treatment and silver needle heat conductive treatment（Group C） were successively done,each for one time.The numeric rating scale（NRS） score and improvements of clinical signs as well as curative effects were compared in three groups before treatment and 3-6 months after treatment.Results All the patients accomplished the treatment and index assessment,thus entered the result analysis.（1）The NRS scores decreased in three groups after 3-month treatment,especially in group C（P0.01）,and most of the painful symptoms were controlled after 6-month treatment,obviously in group C（P0.01）.There were significant differences between group A and group B,and between group B and group C（P0.05）.（2）After 3-month treatment,the clinical signs of three groups were all improved notably,especially the positive rate of straight-leg raising test.The difference was quite significant between group C and group B,and between group C and group A（P0.01）,whereas insignificant between group A and group B（P0.05）.（3）The percentage of validity（fully recovery or effective） was 56.7% in group A,56.7% in group B and 80% in group C.Moreover,there were also quite significant differences between group A and group C,and between group C and group B（P0.01）.Conclusion Both of silver needle heat conductive treatment and Zheng Gu Li Jin treatment have good effects on lumbar intervertebral disc protrusion,while the curative effect of the integrated treatment is the best.