摘要
目的:观察超声引导下针刀治疗腰椎间盘突出症的临床疗效。方法:选择腰椎间盘突出症患者90例,按随机数字表法分为治疗组和对照组,各45例,试验过程中治疗组脱落7例,对照组脱落9例。治疗组采用超声引导下针刀松解、多裂肌刺激、神经根触激治疗,并辨证加减服用桃红四物汤合独活寄生汤,对照组应用牵引联合阻滞治疗。检测并比较2组治疗前后视觉疼痛量表评分(VAS)、日本矫形外科协会评分(JOA)以及多裂肌横截面积和多裂肌萎缩率。结果:治疗组总有效率为94.7%,显著高于对照组80.6%,差异有统计学意义(P <0.05)。治疗前,2组VAS评分、JOA评分、多裂肌横截面积、多裂肌萎缩率比较,差异均无统计学意义(P> 0.05)。治疗后,2组VAS评分均较治疗前降低(P <0.05),JOA评分均较治疗前升高(P <0.05);治疗组多裂肌萎缩率较治疗前降低(P <0.05);治疗组VAS评分低于对照组,JOA评分、临床改善率、多裂肌横截面积高于对照组,差异均有统计学意义(P <0.05)。结论:超声引导针刀治疗腰椎间盘突出症疗效确切,通过改变多裂肌形态学活化多裂肌,达到调节和稳定腰椎的目的,可能系针刀治疗腰椎间盘突出症的机理之一。
Objective： To observe the clinical effect of ultrasound-guided needle knife for lumbar disc herniation. Methods. Selected 90 cases of patients with lumbar disc herniation and divided them into the control group and the treatment group randomly, 45 cases in each group. During the experiment, there were 7 cases of abscission in the treatment group and 9 cases in the control group. The treatment group was treated with ultrasound-guided needle knife release, multifidus muscle stimulation and tactile stimulation for nerve root as well as the modified combination of Taohong Siwu tang and Duhuo Jisheng tang by syndrome differentiation, while the control group was given traction combined with block for treatment. Detected and compared the scores of visual analogue scale/VAS）, scores of Japanese Qrthopaedic Association（JOA）, and the sectional area and atrophy rate of multifidus muscle before and after treatment. Results： The total effective rate was 94.7% in the treatment group, significantly higher than that of 80.6% in the control group, difference being significant（P 〈 0.05）. Before treatment, there were no significant differences being found in the comparisons of VAS scores, JOA scores, sectional areas and atrophy rates of multifidus muscle in the two groups（P 〉 0.05）. After treatment, compared with those before treatment, the VAS scores in the two groups were decreased（P 〈 0.05）; the JOA scores were increased（P 〈 0.05）; the atrophy rate of multifidus muscle in the treatment group was decreased（P 〈 0.05）; the VAS score in the treatment group was lower than that in the control group and its JQA score, clinical improvement rate and sectional area of the multifidus muscle were higher than those in the control group, differences being significant（P 〈 0.05）. Conclusion, Ultrasound-guided needle knife is effective in treating lumbar disc herniation. It may be one of the mechanisms of needle knife treating lumbar disc herniation to change the multifidus morphology to activate the
作者
陈智能
谢丽丽
徐杰
叶俊材
陶志东
吕一
姚新苗
CHEN Zhineng;XIE Lili;XU Jie;YE Juncai;TAO Zhidong;LYU Yi;YAO Xinmiao
出处
《新中医》
CAS
2018年第11期186-190,共5页
New Chinese Medicine
基金
全国名老中医药专家传承工作室建设项目(国中医药人教发[2014] 20号)
浙江省名老中医药专家传承工作室建设项目(GZS2012015)
浙江省中医药科技计划项目(2011ZZ007)
关键词
腰椎间盘突出症
多裂肌形态学
超声引导
针刀
桃红四物汤合独活寄生汤
视觉疼痛量表评分(VAS)
日本
Lumbar disc herniation
Multifidus morphology
Ultrasound guidance
Needle knife
Taohong Siwu tang combined with Duhuo Jisheng tang
Scores of visual analogue scale（VAS）
Scores of Japanese Orthopaedic Association（JQA）
