摘要
目的:观察以痛为腧压痛点按揉法对发作期腰椎间盘突出症所致的腰腿痛的镇痛作用,并与传统斜扳法治疗的效果进行比较。方法:采用单盲随机对照平行试验的方法,选择2003-02/2004-04在上海中医药大学附属岳阳医院推拿科住院的60例单侧型发作期腰椎间盘突出症患者,按随机数字表法将其分为压痛点治疗组和斜扳法对照组(n=30)。压痛点治疗组施用拇指按揉法于患者腰部压痛点和委中(处进行治疗;斜扳法对照组施用腰椎斜扳法。治疗均为20min/次,1次/d,7d为1个疗程,共2个疗程。治疗前后应用腰痛疗效的分级表(总分为100分,评分越低腰痛越剧烈)评估2组患者症状体征改变情况,应用目测类比评分(总分为10分,评分越高疼痛越剧烈)评估疼痛程度,并检测推拿前和推拿后1周两组血清β-内啡肽和P物质水平。结果:60例患者全部进入结果分析。①腰痛疗效积分:压痛点治疗组患者治疗后高于治疗前(64.77±4.14,40.63±2.93,P=0.01);斜扳法对照组患者治疗后也高于治疗前(60.70±5.78,42.83±3.63,P=0.0);2组治疗前后比较差异均不显著(P>0.05)。②目测类比评分:压痛点治疗组治疗后低于治疗前(4.71±0.52,8.99±0.26,P=0.0);斜扳法对照组治疗后也低于治疗前(5.59±0.80,8.94±0.27,P=0.0);2组治疗前后比较差异均不显著(P>0.05)。③血清β-内啡肽水平:治疗1周后压痛点治疗组患者高于治疗前[(55.83±5.53),(46.07±5.10)ng/L,P=0.0];斜扳法对照组患者低于治疗前[(46.50±3.72),(49.87±4.38)ng/L,P=0.15];2组治疗前后差值比较差异显著(P=0.01)。④血清P物质水平:治疗1周后压痛点治疗组患者低于治疗前[(34.73±4.98),(37.95±4.66)ng/L,P=0.01];斜扳法对照组患者高于治疗前[(42.04±4.06),(39.92±3.32)ng/L,P=0.19];2组治疗前后差值比较差异显著(P=0.01)。结论:①以痛为腧按揉法和斜扳法均能使腰椎间盘突出症患者的疼痛减轻,具有明显的镇痛作用。②以痛为
AIM： To observe the analgesic effects of the kneading method of taking the tender point as acupoint on back-leg pain induced by lumbar intervertebral disc protrusion （LIDP） in the period of onset, and compare with that of “obliquely-polling” therapy.
METHODS： Sixty inpotients with one-sided fits of LIDP from February 2003 to April 2004 were selected from the Department of Tuina, Yueyang Hospital Affiliated to Shanghai University of TCM were selected according to single-blind parallel randomized experimental method, and randomly divided into living acupoint treatment group （treatment group） and obliquepulling control group （control group ） （n=30）. Patients in the treatment group were treated with the approach of “pressing and kneading with the thumb” on the living acupoint and acupoint of Weizhong （B40）, while patients in the control group received treatment with approach of oblique pulling on the patient＇s lumbar vertebra. Patients of beth groups were treated once a day and 20 minutes each time for totally 2 courses with 7 days in one course. The efficiency scale of lumbar pain （the total score was 100 points, and the lower the score was, the severer the lumbar pain was） was used to evaluate changes in symptoms and physical signs of patients in beth groups before and after treatment. Visual Analog Scale （VAS） （the total score was 10 points, and the higher the score was the severe the pain was） was adopted to evaluate the pain. Levels of β-endorphin anti substance P were detected in patients of beth groups before Tuina and one week after Tuina.
RESULTS： A total of 60 patients were involved in the analysis of results. ①Scores of efficacy of lumbar pain： the scores of patients in the treatment group were higher than those before administration [（64.77±4.14）, （40.63±2.93）, p=0.0], and the scores of patients in the control group were higher than those before treatment [（60.70±5.78）; （42.83±3.63）, p=0.0]. The differences before and after treatme
出处
《中国临床康复》
CSCD
北大核心
2006年第23期25-27,共3页
Chinese Journal of Clinical Rehabilitation
