中药药熨联合皮内针对气滞血瘀型腰椎间盘突出症的疗效观察

doi:10.3760/cma.j.issn.1007-1245.2024.14.027

国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (14): 2419-2422.DOI: 10.3760/cma.j.issn.1007-1245.2024.14.027

中药药熨联合皮内针对气滞血瘀型腰椎间盘突出症的疗效观察

刘琪玉李沙易建军陈梦

广东省第二中医院骨科，广州　510095

收稿日期:2023-09-11 出版日期:2024-07-15 发布日期:2024-08-05
通讯作者: 李沙，Email：595312966@qq.com
基金资助:
广东省中医药局科研项目（20211037）

Effect of Chinese medicine hot compress therapy combined with intradermal needling on patients with lumbar disc herniation of the qi stagnation-blood stasis type

Liu Qiyu, Li Sha, Yi Jianjun, Chen Meng

Department of Orthopedics, Guangdong Second Hospital of Traditional Chinese Medicine, Guangzhou 510095, China

Received:2023-09-11 Online:2024-07-15 Published:2024-08-05
Contact: Li Sha, Email: 595312966@qq.com
Supported by:
Scientific Research Project of Guangdong Traditional Chinese Medicine Bureau (20211037)

摘要/Abstract

摘要：

目的　观察中药药熨联合皮内针对气滞血瘀型腰椎间盘突出症（LDH）患者的短期及远期效果。方法　选取2021年3月至2023年3月在广东省第二中医院骨三科住院的气滞血瘀型LDH患者70例，采用随机数字表法将患者分为观察组和对照组，每组各35例。对照组男17例，女18例；年龄45～60（68.20±11.54）岁；病程1～3（2.51±0.94）年。观察组男19例，女16例；年龄45～60（69.69±3.54）岁；病程1～3（2.54±1.06）年。两组均给予骨科常规护理，对照组采用口服塞来昔布治疗，观察组在对照组基础上采用中药药熨联合皮内针治疗。两组均连续治疗14 d，3个月后给予电话随访。比较两组患者治疗前、治疗3 d后、治疗14 d后、治疗后3个月视觉模拟评分法（VAS）评分、日本骨科协会腰椎功能量表（JOA）评分。观察两组患者治疗前后临床表现改善情况，进行疗效评价。采用独立样本t检验、配对样本t检验和χ²检验。结果　观察组治疗3 d后、治疗14 d后、治疗后3个月VAS评分［（3.97±0.95）分、（3.91±0.89）分、（3.74±0.74）分］均低于对照组［（6.46±1.15）分、（6.23±0.94）分、（6.29±1.15）分］，差异均有统计学意义（均P<0.05）。观察组治疗3 d后、治疗14 d后、治疗后3个月JOA评分［（21.74±1.52）分、（22.03±1.38）分、（22.51±1.20）分］均高于对照组［（18.83±1.51）分、（19.49±1.34）分、（20.26±1.07）分］，差异均有统计学意义（均P<0.05）。观察组总有效率为94.29%（33/35），高于对照组的65.71%（23/35），差异有统计学意义（P<0.05）。结论　中药药熨联合皮内针治疗气滞血瘀型LDH，不仅起效快，改善疼痛、腰椎功能，总体疗效亦优于单用塞来昔布。

关键词:

腰椎间盘突出症, 气滞血瘀型, 皮内针, 中药药熨

Abstract:

Objective　To observe the short-term and long-term effects of Chinese medicine hot compress therapy combined with intradermal needling on patients with lumbar disc herniation (LDH) of the qi stagnation-blood stasis type. Methods　A total of 70 patients with LDH of the qi stagnation-blood stasis type admitted to the department of orthopedics, Guangdong Second Hospital of Traditional Chinese Medicine from March 2021 to March 2023 were selected and were divided into an observation group and a control group by the random number table method, with 35 cases in each group. There were 17 males and 18 females in the control group, aged 45-60 (68.20±11.54) years, and the course of disease was 1-3 (2.51±0.94) years. There were 19 males and 16 females in the observation group, aged 45-60 (69.69±3.54) years, and the course of disease was 1-3 (2.54±1.06) years. Both groups were given orthopedic nursing care, the control group was given celecoxib, and the observation group was treated with Chinese medicine hot compress therapy combined with intradermal needling on the basis of the control group. Both groups were treated continuously for 14 days, and a telephone follow-up was conducted 3 months after treatment. The Visual Analogue Scale (VAS) scores and Japanese Orthopedic Association Lumbar Function Scale (JOA) scores were compared before treatment, after 3 days of treatment, after 14 days of treatment, and 3 months after treatment. The improvement of clinical performance before and after treatment was observed and the curative effect was evaluated. Independent sample t test, paired t test, and χ² test were used. Results　The VAS scores of the observation group after 3 days of treatment, after 14 days of treatment, and 3 months after treatment [(3.97±0.95) points, (3.91±0.89) points, and (3.74±0.74) points] were lower than those of the control group [(6.46±1.15) points, (6.23±0.94) points, and (6.29±1.15) points], with statistically significant differences (all P<0.05). The JOA scores of the observation group after 3 days of treatment, after 14 days of treatment, and 3 months after treatment were (21.74±1.52) points, (22.03±1.38) points, (22.51±1.20) points, respectively, which were higher than those of the control group [(18.83±1.51) points, (19.49±1.34) points, and (20.26±1.07) points], with statistically significant differences (all P<0.05). The total effective rate of the observation group was 94.29% (33/35), which was higher than that of the control group [65.71% (23/35)], with a statistically significant difference (P<0.05). Conclusion　Combination of Chinese medicine hot compress therapy and intradermal needling for LDH patients with the qi stagnation-blood stasis type not only can relieve the pain and improve the lumbar spine function in the short term, but also has better overall efficacy than using celecoxib alone.

Key words:

Lumbar disc herniation, Qi stagnation-blood stasis type, Intradermal needling, Chinese medicine hot compress therapy

刘琪玉李沙易建军陈梦.

中药药熨联合皮内针对气滞血瘀型腰椎间盘突出症的疗效观察 [J]. 国际医药卫生导报, 2024, 30(14): 2419-2422.

Liu Qiyu, Li Sha, Yi Jianjun, Chen Meng.

Effect of Chinese medicine hot compress therapy combined with intradermal needling on patients with lumbar disc herniation of the qi stagnation-blood stasis type [J]. International Medicine and Health Guidance News, 2024, 30(14): 2419-2422.

参考文献

[1] 钱向辉,王波.CT检查及图像后处理对腰椎间盘突出症的诊断价值和射频消融治疗的定位意义[J].影像科学与光化学,2021,39(5):760-763.DOI:10.7517/issn.1674-0475. 201226.
[2] 谢卓君,付丽珊,王婉飞.刺血拔罐联合薄氏腹针对老年血瘀型腰椎间盘突出症疼痛及腰椎功能的影响[J].中国老年学杂志,2021,41(4):793-796.DOI:10.3969/j.issn.1005- 9202.2021.04.038.
[3] 吴军尚,吴军瑞,吴汉卿,等.中医筋骨三针疗法治疗腰椎间盘突出症经验探析[J].中国针灸,2023,43(2):203-206.DOI:10.13703/j.0255-2930.20220714-k0002.
[4] 陈秀花,李梅,刘超.腰椎间盘突出症患者术后复发的相关因素调查及护理对策研究[J].国际医药卫生导报,2021,27(2):279-282.DOI:10.3760/cma.j.issn.1007-1245.2021. 02.033.
[5] 秦晓宽,孙凯,徐卫国,等.腰椎间盘突出症中医循证实践指南[J].西部中医药,2024,37(5):1-15.DOI:10.12174/j.issn.2096-9600.2024.05.01.
[6] 李小明.腰椎间盘突出症的保守治疗与手术治疗[J].国际医药卫生导报,2005,11(6):52-53.DOI:10.3760/cma.j.issn.1007-1245.2005.06.025.
[7] 张艳琳,陈松,罗志辉,等.动气针法治疗急性腰扭伤临床疗效及时效关系观察[J].中国针灸,2022,42(12):1368-1372.DOI:10.13703/j.0255-2930.20220117-0001.
[8] 王玥,王玮,李超,等.中药热奄包联合皮内针治疗腰椎间盘突出症的效果观察[J].实用医院临床杂志,2022,19(2):73-75.DOI:10.3969/j.issn.1672-6170.2022.02.020.
[9] 欧小燕,柳刚.针灸治疗腰椎间盘突出症机制研究进展[J].辽宁中医药大学学报,2023,25(4):162-166.DOI:10.13194/j.issn.1673-842x.2023.04.035.
[10] 王邦博,杨晓倩,栾逸先.针灸治疗腰椎间盘突出症的临床研究进展[J].广州中医药大学学报,2022,39(9):2206-2212.DOI:10.13359/j.cnki.gzxbtcm.2022.09.041.
[11] 陈涛,余光明.桃红四物汤联合中药药熨治疗气滞血瘀证腰椎间盘突出症临床疗效[J].深圳中西医结合杂志,2022,32(23):45-47.DOI:10.16458/j.cnki.1007-0893.2022. 23.014.
[12] 李建超.中医综合治疗腰椎间盘突出疗效研究[J].河北医药,2012,34(19):3009-3010.DOI:10.3969/j.issn.1002- 7386.2012.19.083.
[13] 吴国林,何元诚.中医药治疗腰椎间盘突出症的治疗进展[J].中国中医骨伤科杂志,2010,18(5):70-72.
[14] 蔡成君,李亚平,颜文才,等.腰椎间盘突出中医证型与旋切治疗[J].辽宁中医杂志,2001,28(6):324-326.DOI:10.3969/j.issn.1000-1719.2001.06.002.
[15] 张扬,韩蕊,宋翠翠. 腰椎间盘突出症椎间孔镜治疗术后的中医护理干预[J]. 世界最新医学信息文摘,2017,17(54):235-238.
[16] 温桂香,黄素嫦,袁圆.六子散热熨联合皮内针治疗原发性痛经寒凝血瘀型疗效观察[J].实用中医药杂志,2022,38(4):543-544.
[17] Haro H, Ebata S, Inoue G, et al. Japanese Orthopaedic Association (JOA) clinical practice guidelines on the management of lumbar disc herniation, third edition - secondary publication[J]. J Orthop Sci, 2022, 27(1):31-78. DOI: 10.1016/j.jos.2021.07.028.
[18] «骨科疾病疗效评价标准»出版[J].实用骨科杂志,2012,18(8):691.
[19] 曹盼举,于海洋,张晓刚,等.腰椎间盘突出症的中医病因病机及其治疗思考[J].中医药临床杂志,2018,30(11):1999-2002.DOI:10.16448/j.cjtcm.2018.0615.
[20] 崔学军,梁倩倩.腰椎间盘突出症中西医结合诊疗专家共识[J].世界中医药,2023,18(7):945-952.
[21] Burnett M, Lemyre M. No. 345-primary dysmenorrhea consensus guideline[J]. J Obstet Gynaecol Can, 2017, 39(7):585-595. DOI: 10.1016/j.jogc.2016.12.023.
[22] Lefebvre G, Pinsonneault O, Antao V, et al. Primary dysmenorrhea consensus guideline[J]. J Obstet Gynaecol Can, 2005, 27(12):1117-1146. DOI: 10.1016/s1701- 2163(16)30395-4.
[23] 黄硕薇,陈长贤,魏彩虹,等.实施骨伤科专病护理路径的体会[J].中国卫生产业,2011,8(10):118-119.DOI:10.16659/j.cnki.1672-5654.2011.10.044.
[24] 黄彬.针刺运动疗法配合中医定向透药治疗腰椎间盘突出症的临床研究[J].基层医学论坛,2022,26(25):114-116.DOI:10.19435/j.1672-1721.2022.25.038.
[25] 易建军,范烁楠,刘琪玉.皮内针疗法在腰椎间盘突出症患者中的应用效果[J].当代护士(上旬刊),2022,29(5):97-100.DOI:10.19791/j.cnki.1006-6411.2022.13.029.
[26] 彭科志,向开维,崔瑾.皮内针配合推拿治疗腰椎间盘突出症疗效观察[J].中国针灸,2008,28(12):894-896.
[27] 秦宇航,吴云川,熊英,等.基于"腰为肾之府"理论运用按穴擦腰法治疗腰椎间盘突出症的临床观察[J].世界科学技术-中医药现代化,2018,20(10):1854-1859.DOI:10.11842/wst.2018.10.023.
[28] 张彦军,朱宝,邓强.赵继荣主任医师基于"腰为肾之府"论治肝肾亏虚型腰椎间盘突出症经验[J].中医研究,2016,29(7):32-35.DOI:10.3969/j.issn.1001-6910.2016.07.16.
[29] 高俊虎,王博仑,刘巍,等.基于"腰背委中求"理论浅谈对委中穴治疗腰痛病的认识[J].针灸临床杂志,2020,36(8):91-94.DOI:10.3969/j.issn.1005-0779.2020.08.022.
[30] 任宏斌,孙玉新,梁海丽,等.从"腰背委中求"浅议经穴效应之特异性[J].中国乡村医药,2019,26(18):85-86.DOI:10.3969/j.issn.1006-5180.2019.18.047.
[31] 夏有兵,张建斌,王红云,等.简析澄江针灸学派的学术源流[J].中国针灸,2012,32(8):759-764.DOI:10.13703/j.0255-2930.2012.08.029.
[32] 刘琪玉,张曼竹,苏程,等.中药热奄包联合皮内针治疗气滞血瘀型急性期老年腰椎间盘突出症的疗效观察[J].现代医院,2023,23(10):1618-1621.DOI:10.3969/j.issn.1671- 332X.2023.10.039.

中药药熨联合皮内针对气滞血瘀型腰椎间盘突出症的疗效观察

Effect of Chinese medicine hot compress therapy combined with intradermal needling on patients with lumbar disc herniation of the qi stagnation-blood stasis type

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 4

编辑推荐

Metrics

[1]	刘琪玉陈梦张曼竹李沙. 中药药熨联合皮内针治疗腰椎间盘突出症的效果 [J]. 国际医药卫生导报, 2023, 29(4): 488-491.
[2]	李修智李玉伟. 经皮椎间孔镜腰椎间盘切除术治疗腰椎融合术后症状性相邻节段退变的疗效 [J]. 国际医药卫生导报, 2023, 29(20): 2873-2877.
[3]	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.
[4]	林诗鹏, 陈芙蓉, 郑赛媚. 少腹逐瘀颗粒联合头孢他啶治疗慢性盆腔炎（气滞血瘀型）的随机对照研究[J]. 国际医药卫生导报, 2022, 28(11): 1574-1578.