摘要
目的探讨电针夹脊穴结合导引治疗功能性腰椎不稳患者的临床疗效。方法纳入2020年5—12月在上海市中医院骨伤科就诊的功能性腰椎不稳患者120例,通过随机数字分组法分为3组,每组40例(对照组1例、其余2组各2例失访)。对照组给予塞来昔布胶囊口服及功能锻炼治疗;电针联合功能锻炼组在所选病灶两侧的华佗夹脊穴进行电针治疗,同时进行功能锻炼;电针联合导引组在选取病变节段两侧华佗夹脊穴施以电针治疗,同时进行导引功法锻炼。3组均连续治疗4周。比较3组患者治疗前及治疗4周、8周、12周后的Oswestry功能障碍指数(ODI)评分、疼痛视觉模拟评分(VAS)、腰椎功能JOA评分和治疗前、治疗12周后的腰椎稳定性相关影像学参数(腰椎矢状位曲度、腰椎活动度及过伸过屈位片椎体滑移距离、角位移),统计3组治疗4周后的临床疗效。结果3组患者治疗4周、8周、12周后的ODI评分、VAS评分均明显低于治疗前(P均<0.05),JOA评分均明显高于治疗前(P均<0.05);且电针联合导引组治疗4周、8周、12周后的ODI评分均明显低于其他2组(P均<0.05),JOA评分均明显高于其他2组(P均<0.05),3组间VAS评分比较差异均无统计学意义(P>0.05)。3组患者治疗前后腰椎矢状位曲度、椎体滑移距离、角位移比较差异均无统计学意义(P均>0.05);3组患者治疗12周后的腰椎活动度均较治疗前明显增加(P均<0.05),且电针联合导引组腰椎活动度明显大于其他2组(P均<0.05)。治疗4周后,电针联合导引组愈显率为100%(38/38),明显高于对照组的53.8%(21/39)和电针联合功能锻炼组的81.6%(31/38),差异均有统计学意义(P均<0.05)。结论电针联合导引治疗功能性腰椎不稳的疗效显著,可以明显减轻患者疼痛,改善腰椎功能,恢复腰椎稳定性。
Objective It is to investigate the clinical efficacy of electro-acupuncture at Jiaji acupoints combined with Daoyin in the treatment of patients with functional lumbar instability.Methods One hundred and twenty patients with functional lumbar instability treated in the Department of Orthopedics of Shanghai Municipal Hospital of Traditional Chinese Medicine from May to December 2020 were selected and divided into 3 groups according to random number grouping method,with 40 cases in each group(1 case in the control group,and 2 cases in the other two groups were lost to follow-up).The control group was treated with celecoxib capsules by oral administration and functional exercise;the electro-acupuncture combined with functional exercise group(combination groupⅠ)was treated with electro-acupuncture at Huatuo Jiaji acupoints on both sides of the selected lesions,and with functional exercise at the same time;the electro-acupuncture combined with Daoyin group(combination groupⅡ)was treated with electro-acupuncture at Huatuo Jiaji acupoints on both sides of the selected lesions,and with Daoyin exercise at the same time.All the three groups were continuously treated for 3 weeks.The Oswestry dysfunction index(ODI)scores,pain visual analog scale(VAS)scores,lumbar spine function JOA scores of the patients in the three groups before and after 4,8,12 weeks of treatment,and their lumbar spine stability related imaging parameters(lumbar sagittal curvature,lumbar range of motion,hyperextension and flexion radiographs of spondylolisthesis and angular displacement)before and after 12 weeks of treatment were compared,and the clinical efficacies of the three groups were assessed after 4 weeks of treatment.Results The ODI scores and VAS scores of the patients in the three groups after 4,8,and 12 weeks of treatment were significantly lower than those before treatment(all P<0.05),and their JOA scores were significantly higher than those before treatment(all P<0.05);the ODI scores and VAS scores of the patients in the combination grou
作者
杜玲怡
陈德塔
李玉梅
樊天佑
DU Lingyi;CHEN Deta;LI Yumei;FAN Tianyou(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)
出处
《现代中西医结合杂志》
CAS
2024年第11期1520-1525,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
上海市卫生健康委员会科研课题(202040258)。
关键词
功能性腰椎不稳
电针
导引
夹脊穴
functional lumbar instability
electro-acupuncture
Daoyin
Jiaji acupoints
