Yu Xiao-Jie, Zhang Lin, Lu Wen-Yu, Gao Qiang, Liu Liang, Wang Ying
College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China; Department of Rehabilitation, Central Hospital of Jiading District, Shanghai University of Medicine & Health Sciences, Shanghai 201800.
Department of Rehabilitation, Central Hospital of Jiading District, Shanghai University of Medicine & Health Sciences, Shanghai 201800.
Zhen Ci Yan Jiu. 2021 Jul 25;46(7):605-9. doi: 10.13702/j.1000-0607.200383.
To observe the effect of electroacupuncture (EA) combined with caudal epidural injection on subjective pain, walking capability, lumbar flexibility and muscle strength in patients with lumbar disc hernia (LDH).
Sixty LDH patients were randomly allocated to the control group and the research group. The patients of the control group received ultrasound guided caudal epidural injection, and those of the research group received EA combined with ultrasound guided caudal epidural injection. Bilateral Jiaji (EX-B2) and adjunct points Guanyuanshu (BL26), Shenshu (BL23), Chengfu (BL36), Huantiao (GB30), Zhibian (BL54), etc. on the affected side were stimulated with EA (2 Hz/16 Hz, 5-8 mA) for 30 min each time, once every other day for 4 weeks, with 2 days' rest between every two weeks. The patients' pain was evaluated by using visual analogue scale (VAS), walking capability assessed by timed-up and go (TUG) test (time of walking back and forth in 3 m distance), lumbar flexibility (range of motion, ROM) detected by using an inclinometer and the strength of the lumbar flexor and extensor determined by using a push-pull dynamometer.
After the treatment, self-comparison showed that the VAS score and TUG-measured time in both groups were significantly decreased (<0.01, <0.05), and the post-bucking ROM and extension ROM in the research group, and the lumbar flexor and extensor muscle strength in both groups were obviously increased compared with their own pre-treatment (<0.05). Comparison between two groups showed that the VAS score and TUG-measured time of the research group were significantly lower than those of the control group (<0.01), while the lumbar flexor's ROM as well as the extensor's strength were significantly higher in the research group than in the control group (<0.05).
For patients with LDH, EA combined with caudal epidural injection can alleviate pain, improve the walking capability, lumbar flexibility and strength of the lumbar extensor, and the therapeutic effect of the combined treatment is significantly better than that of simple caudal epidural injection.
观察电针（EA）联合骶管硬膜外注射对腰椎间盘突出症（LDH）患者主观疼痛、步行能力、腰椎灵活性及肌力的影响。
将60例LDH患者随机分为对照组和研究组。对照组患者接受超声引导下骶管硬膜外注射，研究组患者接受EA联合超声引导下骶管硬膜外注射。采用电针（2Hz/16Hz，5-8mA）刺激患侧双侧夹脊穴（EX-B2）及相关穴位，如关元俞（BL26）、肾俞（BL23）、承扶（BL36）、环跳（GB30）、秩边（BL54）等，每次30分钟，隔日1次，共4周，每两周休息2天。采用视觉模拟评分法（VAS）评估患者疼痛程度，采用计时起立行走测试（TUG）（在3m距离内来回行走的时间）评估步行能力，采用倾角仪检测腰椎灵活性（活动范围，ROM），采用推拉力计测定腰椎屈伸肌肌力。
治疗后，两组自身比较显示VAS评分和TUG测试时间均显著降低（<0.01，<0.05），研究组后伸ROM和前屈ROM以及两组的腰椎屈伸肌肌力与治疗前相比均明显增加（<0.05）。两组间比较显示，研究组的VAS评分和TUG测试时间显著低于对照组（<0.01），而研究组的腰椎前屈ROM以及后伸肌力显著高于对照组（<0.05）。
对于LDH患者，EA联合骶管硬膜外注射可减轻疼痛，改善步行能力、腰椎灵活性及腰椎伸肌力量，联合治疗的疗效明显优于单纯骶管硬膜外注射。
