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督脉穴位通督针刺技术联合电针治疗轻中度腰椎间盘突出症血瘀证的临床研究

[Clinical research of mild and moderate lumbar disc herniation of blood stagnation syndrome treated with -conducting needling technique at the governor vessel acupoints combined with electroacupuncture].

作者信息

Wu Yaochi, Sun Yijun, Zhang Junfeng, Li Yan, Wang Chongmiao

机构信息

Department of Acupuncture and Tuina, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.

出版信息

Zhongguo Zhen Jiu. 2017 May 12;37(5):467-472. doi: 10.13703/j.0255-2930.2017.05.004.

Abstract

OBJECTIVE

To compare the difference in the clinical therapeutic effects on mild and moderate lumbar disc herniation (LDH) of blood stagnation syndrome between -conducting needling technique at the governor vessel acupoints combined with electroacupuncture (EA) and conventional EA.

METHODS

Two hundred and one patients of LDH at the mild and moderate stage, differentiated as blood stagnation syndrome were randomized into an observation group (101 cases) and a control group (100 cases). In the observation group, the -conducting needling technique at the governor vessel acupoints and EA were used. The acupoints were Yaoyangguan (GV 3), Shiqizhui (EX-B 8), Huantiao (GB 30) and Yanglingquan (GB 34). After arrival, the -conducting needling technique was used at Yaoyangguan (GV 3) and Shiqizhui (EX-B 8); the EA was at Huantiao (GB 30) and Yanglingquan (GB 34). The treatment was given once every two days, 3 times a week. The treatment for 12 times was as one session. The observation lasted for 1 session. In the control group, the acupoints were the same as the observation group and stimulated with EA. The EA parameters, treatment frequency and duration were all the same as the observation group. The lumbar back pain score of Japanese Orthopedics Association (JOA) score before treatment, after treatment and in 3-month follow-up visit in the two groups, the infrared thermogram temperature in lumbar region and the relaxation area under curve (RAUC) before and after treatment as well as the short-term and the long-term therapeutic effects were compared between the two groups.

RESULTS

The total short-term effective rate was 89.11% (90/101) and the total long-term effective rate was 91.11% (82/90) in the observation group, and those were 86.00% (86/100) and 89.53% (77/86) in the control group respectively, without significant differences between the groups (both >0.05). The short-term clinical curative rate was 52.48% (53/101) and the long-term clinical curative rate was 55.56% (50/90) in the observation group, better than 36.00% (36/100) and 34.88% (30/86) in the control group (both <0.05). Compared with those before treatment, JOA scores were all improved after treatment and in follow-up visit in the two groups (all <0.01), without statistical significance at each time point between the two groups (all >0.05). The infrared thermogram temperature was improved after treatment in the two groups (both <0.01). The increasing amplitude in the observation group was higher than that in the control group (<0.01). The lumbar RAUC after treatment was increased apparently as compared with that before treatment in the observation group (<0.01) and larger than that in the control group (<0.01).

CONCLUSIONS

The -conducting needling technique at the governor vessel acupoints combined with EA achieve the better clinical therapeutic effects than regular EA in the treatment of mild and moderate LDH of blood stagnation sydrome.

摘要

目的

比较督脉穴位通督针刺技术结合电针(EA)与传统电针治疗气滞血瘀型轻中度腰椎间盘突出症(LDH)的临床疗效差异。

方法

将201例轻中度LDH且辨证为气滞血瘀型的患者随机分为观察组(101例)和对照组(100例)。观察组采用督脉穴位通督针刺技术结合电针治疗。穴位选取腰阳关(GV 3)、十七椎(EX-B 8)、环跳(GB 30)、阳陵泉(GB 34)。进针后,在腰阳关(GV 3)和十七椎(EX-B 8)采用通督针刺技术;电针取环跳(GB 30)和阳陵泉(GB 34)。治疗每两天进行1次,每周3次。治疗12次为1个疗程。观察持续1个疗程。对照组穴位与观察组相同,采用电针刺激。电针参数、治疗频率和疗程均与观察组相同。比较两组治疗前、治疗后及3个月随访时的日本骨科学会(JOA)下腰痛评分、腰部红外热像图温度以及治疗前后的曲线下松弛面积(RAUC),并比较两组的短期和长期治疗效果。

结果

观察组短期总有效率为89.11%(90/101),长期总有效率为91.11%(82/90);对照组短期总有效率为86.00%(86/100),长期总有效率为89.53%(77/86),两组间差异无统计学意义(均>0.05)。观察组短期临床治愈率为52.48%(53/101),长期临床治愈率为55.56%(50/90),优于对照组的36.00%(36/100)和34.88%(30/86)(均<0.05)。与治疗前比较,两组治疗后及随访时JOA评分均升高(均<0.01),两组各时间点比较差异无统计学意义(均>0.05)。两组治疗后红外热像图温度均升高(均<0.01)。观察组升高幅度高于对照组(<0.01)。观察组治疗后腰部RAUC较治疗前明显增大(<0.01),且大于对照组(<0.01)。

结论

督脉穴位通督针刺技术结合电针治疗气滞血瘀型轻中度LDH的临床疗效优于常规电针。

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