针灸结合梅花针叩刺拔罐治疗腰椎间盘突出症适宜证型研究

目的：探讨针灸结合梅花针叩刺拔罐治疗腰椎间盘突出症作用机理和适宜治疗证型方法。方法：将腰椎间盘突出症患者70例按中医辨证分型分为4型——湿寒型、气血瘀滞型、气虚肾亏型、复杂型。均采用针刺结合梅花针叩刺拔罐疗法,观察并比较不同证型在治疗前后相关量表评分——日本骨科协会评分（JOA）。结果：4组疗效比较,差异有统计学意义（P〈0.05）,其中寒湿型、气血瘀滞型、复杂型均优于气虚肾亏型。结论：针刺结合梅花针叩刺拔罐治疗腰椎间盘突出症不同中医分型疗效有一定差别,说明本疗法的疗效机理主要为温经通络、活血化瘀。对气虚肾亏型患者应考虑加用其他补肾益气的方法。

Study on Proper Syndrome of LDH to Acupuncture Combined with Plum-needle-stabknocking-cutem Therapy

Objective： To study the mechanism of acupuncture combined with plum-needle-stab-knocking-cutem on lumbar intervertebral disc protrusion and proper Syndrome for the treatment. Methods： The 70 patients with LIDH were divided into four types according to traditional Chinese Medicine （TCM） syndrome differentiation typing, cold dampness type, Qi stagnation and blood stasistype, deficiency of Qi and kidney as well as complex sub type; all of the patients were treated with acupuncture combined with plum-needle-stab-knocking-cutem therapy, and the related scale scores, Japan Association for Department of or- thopedics score （JOA）, were evaluated. Results： The comparison of efficacy among four groups showed statistical significance （P〈 0.05）. Thc effect of cold dampness type, Qi stagnation and blood stasistype, as well as complex sub type were better than that of the deficiency of Qi and kidney. Conclusion： The clinical curative effects of acupuncture combined with plum-needle-stabknocking-cutem showed difference on efficacy for different TCM syndrome types of LIDH. The results showed that the main mechanism of the therapeutic effects might be warming meridians, promoting blood circulation and removing blood stasis. Other method of invigorating qi should be considered for type of deficiency of kidney patients.