穴位皮内针联合腰痛宁胶囊治疗老年慢性腰腿痛的临床疗效观察

doi:10.3760/cma.j.issn.1007-1245.2022.02.026

摘要/Abstract

摘要： 目的探讨穴位皮内针联合腰痛宁胶囊治疗老年慢性腰腿痛的临床疗效。方法选取 2019年5月至2020年12月于费县人民医院中医科接收的老年慢性腰腿痛患者120例作为研究对象，采用随机数字表法对半分为对照组与观察组，每组各 60 例。对照组男 28 例、女 32 例，年龄（68.42± 6.09）岁；观察组男 26例、女 34例，年龄（68.05±6.26）岁。对照组在生活指导与运动指导基础上，口服腰痛宁胶囊治疗；观察组在对照组基础上实施穴位皮内针治疗，2周为1个疗程，1个疗程后评价疗效。比较两组患者的疗效及治疗前后的疼痛数字评分法（NRS）评分、日本骨科协会（JOA）腰椎评分。计数资料组间比较采用 χ2 检验，计量资料组间比较采用独立样本 t 检验，组内采用配对 t 检验。结果观察组治疗总有效率为91.67%（55/60），高于对照组76.67%（46/60），差异有统计学意义（χ2 =5.065，P< 0.05）。两组治疗后腰部、腿部NRS评分均低于治疗前，且观察组治疗后的腰部、腿部NRS评分分别为（2.95±0.73）分、（3.03±0.78）分，均低于对照组的（3.54±0.92）分、（3.69±0.95）分，差异均有统计学意义（均P<0.05）。两组患者治疗后JOA腰椎评分中主观症状、临床体征、日常活动受限度及膀胱功能评分均高于治疗前，且观察组治疗后的JOA腰椎评分中主观症状、临床体征、日常活动受限度及膀胱功能评分分别为（6.30±0.65）分、（5.25±1.04）分、（11.08±1.54）分、（-1.02±0.21）分，均高于对照组的（5.63± 0.74）分、（4.76±0.93）分、（9.81±1.61）分、（-1.33±0.28）分，差异均有统计学意义（均P<0.05）。结论穴位皮内针联合腰痛宁胶囊在老年慢性腰腿痛患者治疗可降低疼痛感，提升腰椎功能，提升治疗有效率。

关键词: 穴位皮内针, 腰痛宁胶囊, 老年, 慢性腰腿痛, 疼痛, JOA腰椎评分

Abstract: Objective To explore the clinical efficacy of acupoint intradermal acupuncture combined with Yaotongning capsules in the treatment of elderly patients with chronic low back pain. Methods A total of 120 elderly patients with chronic low back pain accepted by the Department of Traditional Chinese Medicine of Feixian People's Hospital of Linyi City from May 2019 to December 2020 were divided into a control group and an observation group with the random number table method, 60 cases in each group. There were 28 males and 32 females in the control group, with an age of (68.42±6.09) years old; there were 26 males and 34 females in the observation group, with an age of (68.05±6.26) years old. The control group was treated with Yaotongning capsules orally on the basis of life guidance and exercise guidance; the observation group was treated with acupoint intradermal acupuncture combined with Yaotongning capsules. The course of treatment was 2 weeks.After 1 course, the efficacy, the scores of Numerical Rating Scale (NRS) and Japanese Orthopaedic Association (JOA) lumbar spine scores before and after the treatment were compared between the two groups. Independent sample t test was used for inter-group comparison of the measurement data, paired t test was used for intra-group comparison of the measurement data, and χ2 test was used for the count data. Results The total effective rate of the observation group was higher than that of the control group [91.67% (55/60) vs. 76.67% (46/60)], with a statistically significant difference (χ2 =5.065, P<0.05). After the treatment, the NRS scores of waist and legs in the two groups were lower than those before the treatment, and the NRS scores of waist and legs in the observation group were (2.95±0.73) points and (3.03±0.78) points, respectively, lower than (3.54±0.92) points and (3.69±0.95) points in the control group, with statistically significant differences (all P<0.05). The scores of subjective symptoms, clinical symptoms, limit of daily activities, and bladder function of JOA lumbar spine score in the two groups after the treatment were all higher than those before the treatment, and the scores of subjective symptoms, clinical symptoms, limit of daily activities, and bladder function in the observation group after the treatment were (6.30±0.65) points, (5.25± 1.04) points, (11.08±1.54) points, and (-1.02±0.21) points, respectively, higher than (5.63±0.74) points, (4.76±0.93) points, (9.81±1.61) points, (-1.33±0.28) points in the control group, with statistically significant differences (all P<0.05). Conclusion Acupoint intradermal acupuncture combined with Yaotongning capsules in the treatment of elderly patients with chronic low back pain can reduce the pain degree, improve the lumbar function, and improve the treatment efficiency.

Key words: Acupoint intradermal acupuncture, Yaotongning capsules, Elderly; Chronic low back pain, Pain, JOA lumbar spine score

李玲, 丁元珍, 石廷琪. 穴位皮内针联合腰痛宁胶囊治疗老年慢性腰腿痛的临床疗效观察[J]. 国际医药卫生导报, 2022, 28(2): 251-255.

Li Ling , Ding Yuanzhen , Shi Tingqi. Clinical efficacy observation on acupoint intradermal acupuncture combined with Yaotongning capsules in the treatment of elderly patients with chronic low back pain[J]. International Medicine and Health Guidance News, 2022, 28(2): 251-255.

参考文献

[1] 易端,朱薇,孟秀丽,等 . 慢性腰腿痛患者微创术前焦虑、抑郁状态及相关影响因素分析[J]. 北京大学学报(医学版), 2020, 52(2): 285-289. DOI: 10.19723/j. issn. 1671- 167X.2020.02.015.

[2] Adilay U, Guclu B, Goksel M, et al. The correlation of SCL-90-R anxiety, depression, somatization subscale scores with chronic low back pain[J]. Turk Neurosurg, 2018, 28(3): 434-438. DOI: 10.5137/1019-5149. JTN. 19318-16.2.

[3] 赵启,赵明宇,杨萌,等."辨三症"理论及其在慢性颈肩腰腿痛疾病诊疗中的应用[J].中医正骨,2020,32(5):19-21.

[4] 龚政 . 小柴胡汤配合穴位埋针治疗腰椎间盘突出症 55 例 [J]. 河北中医 , 2017, 39(10): 1510-1513. DOI: 10.3969/j. issn.1002-2619.2017.10.018.

[5] 王拓然,邓雪皎,张溪,等 . 埋针法治疗面肌痉挛的研究进展 [J]. 中国针灸,2021,41(2):233-236. DOI:10.13703/j.0255- 2930.20191117-0002.

[6] 胡迪,姜杨,朱言静,等. 针刺治疗中风后呃逆临床概况[J]. 内蒙古中医药, 2020, 39(9): 153-155. DOI: 10.16040/j. cnki. cn15-1101.2020.09.093.

[7] 晏飞,陈星燃,谢双喜,等 . 腰痛宁胶囊联合脊柱微调整脊手法治疗椎间盘源性腰痛30例临床观察[J]. 中医杂志,2021, 62(2):147-150. DOI:10.13288/j.11-2166/r.2021.02.012.

[8] 郁汉明 .颈肩腰腿痛[M].北京:中国医药科技出版社,2009: 55-63.

[9] 王志恒,周奎龙,梁志杰,等 . 温针灸联合中药熏蒸治疗老年颈肩腰腿痛的临床效果[J]. 世界中医药, 2020, 15(12):1801-1805. DOI:10.3969/j.issn.1673-7202.2020.12.027.

[10] 黄章洪,田银萍,刘凡,等. 17例腰椎间盘巨大突出患者神经损害的临床分析[J]. 湖北科技学院学报(医学版),2017, 31(5): 401-403. DOI: 10.16751/j. cnki. 2095-4646. 2017. 05.0401.

[11] 韩志敏. 针灸埋线联合穴位注射治疗绝经后骨质疏松腰腿痛临床观察 [J]. 光明中医 , 2021, 36(4): 610-612. DOI: 10.3969/j.issn.1003-8914.2021.04.041.

[12] 田丙生,齐春蕾. 益气舒筋汤联合推拿治疗颈肩腰腿痛的临床研究[J]. 中国医药导报,2020,17(12):157-160.

[13] 罗建民,吕金柱,朱求亮 . 腰痛宁胶囊治疗腰椎骨性关节炎患者的临床疗效 [J]. 中国生化药物杂志 , 2016, 36(6):136-138. DOI:10.3969/j.issn.1005-1678.2016.06.40.

[14] 陈中,郑阳,张信成,等 . 腰痛宁胶囊治疗腰腿痛临床研究的 meta 分析 [J]. 中草药 , 2020, 51(21): 5414-5420. DOI: 10.7501/j.issn.0253-2670.2020.21.002.

[15] 关啸,崔晓光 . 针刺镇痛的研究进展[J]. 医学综述,2019, 25(24):4972-4975,4980. DOI:10.3969/j.issn.1006-2084. 2019.24.030.

[16] 苏毅,朱俊琛,马幸福,等 . 夹脊穴温针灸治疗腰椎间盘突出症的疗效及安全性评价[J]. 针灸临床杂志,2021,37(1): 44-47. DOI:10.19917/j.cnki.1005-0779.021012.

[17] 石天爱,谢梦洲,李金香 . «针灸大成»委中穴的穴性及临床应用探析[J]. 中国中医药科技,2020,27(6):1003-1005.