摘要
[目的]观察辨证分型针刺与电针及推拿联合综合康复疗法治疗坐骨神经痛疗效。[方法]使用随机平行对照方法,将106例门诊及住院患者按就诊顺序号、病志号抽签简单随机分为两组。综合康复治疗,1急性期甘露醇静点;维生素B1、B12肌注;丹参川芎嗪注射液静点等对症治疗;2超短波及电脑中频脉冲。对照组53例推拿,SET悬吊,患侧腰臀及下肢轻柔滚、按、引（用手指轻柔吸定皮肤,诱导骨盆前倾后伸活动）等;痉挛肌肉（如条索状物等）松解,双侧对称协调,继行先健侧或患侧腰部斜扳法,左、右各一次,以听到弹响,达到左右深浅层筋肉协调及紊乱的关节、棘突曲线回复正常为标准,1次/d。治疗组53例针灸,第4、5腰椎棘突下旁开3寸处,向大肠俞、关元俞方向斜刺3寸,出现沿坐骨神经通路上感传时留针,若针刺时患者出现向下放射性疼痛,禁止强刺激,将针向上稍提起（湿热配阴陵泉、行间,寒湿配腰阳关、肾俞,针刺后加灸;肝肾不足配太溪、太冲;瘀血配膈俞、委中、阿是穴）,刺络法,得气后选2~4个穴连接电针治疗仪,疏密波,频率1.5Hz,强度以患者耐受、肌肉出现轻微抽动为宜;肝肾不足尽量减少电针刺激,手法尽量轻柔,补法,1次/d;推拿治疗同对照组。连续治疗10d为1个疗程,间隔2d继续下1个疗程。观测临床症状、腰部功能、小腿足部麻木、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组临床治愈36例,显效11例,有效5例,无效1例,总有效率98.11%。对照组临床治愈30例,显效15例,有效5例,无效3例,总有效率94.34%。治疗组疗效优于对照组（P〈0.05）。[结论]辨证分型针刺与电针及推拿联合综合康复疗法治疗腰椎间盘突出致坐骨神经痛,疗效满意,无严重不良反应,值得推广。
[Objective]To observe the efficacy of sciatica of syndrome type acupuncture combined with electro- acupuncture and massage routine comprehensive rehabilitation therapy. [Methods]According random parallel control method, 106 cases of Panjin city hospital Rehabilitation outpatient and inpatient randomly divided into two groups in treatment order number and number of medical record. Conventional comprehensive rehabilitation,1acute phase of mannitol infusion; vitamin B1, B12 intramuscular injection; salvia TMP intravenous injection and other symptomatic treatment;2VHF and intermediate frequency pulses. 53 cases in the control group massage, SET suspended, ipsilateral waist-hip and lower extremity soft roll, press, lead（given skin with your fingers gently suck induced pelvic forward extension activities）, etc; spastic muscles（such as cords, etc.） released, bilateral symmetry coordination, following with the contralateral or the ipsilateral lumbar oblique pull method, left and right each time, to hear the snapping, reach the standard of deep layer of muscle coordination and joint disorders, spinous process back to normal, 1 times / d. Acupuncture treatment group of 53 patients, the needle were pierced in the fourth and the next fifth lumbar spinous process to three inches at the colon Yu, Guan Yuan Yu direction obliquely 3 inches. Needled when the propagated sensation along the sciatic nerve pathway. If acupuncture to patients caused Radioactive pain, prohibit strong stimulation, lift up the needle slightly.（humid with Yinlingquan, Xingjian, cold with Yaoyangguan, Shenshu, acupuncture and moxibustion; liver and kidney deficiency with Taixi, Taichong; stasis blood with Geshu, Weizhong, Ashi）.Pricking method, choose two to four points acupuncture therapy device connected after the gas, density wave, frequency 1.5Hz, the intensity of patient tolerance, a slight twitch muscle appropriate; liver and kidney deficiency minimize electrical stimulation, the way as gently as possible, and fill method, 1 times / d. Ma
出处
《实用中医内科杂志》
2015年第4期23-26,共4页
Journal of Practical Traditional Chinese Internal Medicine
基金
辽宁省自然科学基金(NO.201102146)
关键词
坐骨神经痛
腰椎间盘突出
痹证
辨证分型
针刺
电针
推拿
综合康复
超短波
电脑中频脉冲
随机平行对照研究
sciatica
lumbar disc
arthralgia
syndromes
acupuncture
electro-acupuncture
massage
comprehensive rehabilitation
VHF
intermediate frequency pulse
randomized parallel group study
