本文關(guān)鍵詞： 坐骨神經(jīng)痛 夾脊穴 火針 針刺　出處：《廣州中醫(yī)藥大學(xué)》2016年博士論文　論文類型：學(xué)位論文

【摘要】：目的：為治療腰椎間盤突出癥繼發(fā)的根性坐骨神經(jīng)痛探索出最佳療效且簡單易行的方案,故在眾多療法中,以具備簡便、安全、效果明顯而副作用少等優(yōu)勢的中醫(yī)針灸為方向,并以其中具有驅(qū)寒逐濕、溫通經(jīng)絡(luò)作用的火針療法為對象,探討火針與體針結(jié)合治療,對坐骨神經(jīng)痛的止痛療效,在臨床中進(jìn)行對比研究,期望進(jìn)一步提高中醫(yī)治療坐骨神經(jīng)痛的針對性,為臨床治療本病提供有用的參考。方法：將診斷為腰椎間盤突出癥繼發(fā)根性坐骨神經(jīng)痛病人,并自愿參加本研究的患者共90例,采隨機(jī)對照的研究方法,將患者分為治療組(火針結(jié)合常規(guī)針刺組)30例,對照一組(單純火針組)30例,對照二組(常規(guī)針刺組)30例。在相同治療次數(shù)的情況下,觀察患者治療前后的改善情況。結(jié)果：1.治療組治療前、后疼痛評分(VAS)比較有顯著性差異(P0.01);Oswestry功能障礙指數(shù)比較有顯著性差異(P0.01)；腰痛疾患治療成績判定基準(zhǔn)(JOA)比較有顯著性差異(P0.01)。2.治療組治療后疼痛評分(VAS)分別與對照一組和對照二組比較,有顯著性差異(P0.01)。3.治療組治療后疼痛評分(VAS)總有效率分別與對照一組和對照二組比較,有顯著性差異(P0.01)。4.治療組治療后Oswestry功能障礙指數(shù)分別與對照一組和對照二組比較,有顯著性差異(P0.01)。5.治療組治療后腰痛疾患治療成績判定基準(zhǔn)(JOA)分別與對照一組和對照二組比較,有顯著性差異(P0.01)。6.治療組治療后腰痛疾患治療成績判定基準(zhǔn)(JOA)總有效率分別與對照一組和對照二組比較,有顯著性差異(P0.01)。7.治療組治療寒濕型和腎虛失養(yǎng)型的療效,分別與對照一組和對照二組比較,有顯著性差異(P0.01),表明治療組療效明顯優(yōu)于兩對照組；對照一組與對照二組比較無顯著性差異(P0.05),表明兩對照組的療效相當(dāng)。三組對濕熱型和瘀血內(nèi)阻型的療效比較,三組比較均無顯著性差異(P0.05),表明三組的療效相當(dāng)。結(jié)論：火針夾脊穴配合常規(guī)針刺治療腰椎間盤突出癥繼發(fā)根性坐骨神經(jīng)痛,可明顯改善根性坐骨神經(jīng)痛的疼痛程度、對日常生活的影響及腰椎功能等情況,治療后均未見不良反應(yīng),有較好的臨床作用。
[Abstract]:Objective: to explore the best curative effect and simple and easy scheme for the treatment of sciatica secondary to lumbar disc herniation. Acupuncture and moxibustion with obvious effect and less side effect is the direction of acupuncture and moxibustion, which has the function of driving away cold and removing dampness and warming the meridian as the object, and discusses the combination of fire acupuncture and body acupuncture. In order to improve the pertinence of traditional Chinese medicine treatment of sciatica, the curative effect of sciatica was compared in clinic. Methods: 90 patients who were diagnosed as secondary radical sciatica of lumbar intervertebral disc herniation and volunteered to participate in this study were selected as randomized controlled study. The patients were divided into treatment group (30 cases in fire acupuncture combined with routine acupuncture group), control group (30 cases in simple fire acupuncture group and 30 cases in control group) (30 cases in routine acupuncture group). Results: before and after treatment, the pain scores of the treatment group were significantly different (P 0.01). There was significant difference in Oswestry dysfunction index (P 0.01). There was a significant difference between the two groups (P < 0.01). The pain scores of the treatment group were compared with those of the control group and the control group. The total effective rate of pain score after treatment in the treatment group was compared with that of the control group and the control group. There was significant difference (P 0.01). 4. The Oswestry dysfunction index of the treatment group was compared with that of the control group and the control group. There was a significant difference (P 0.01) .5.The treatment group after treatment of low back pain disease treatment results judging standard (JOA) were compared with the control group and control group two groups. There was significant difference (P 0.01). 6. The total effective rate of the treatment group was compared with that of the control group and the control group. There was significant difference (P 0.01). There was significant difference between the treatment group and the control group (P 0.01) in the treatment of cold dampness type and kidney deficiency loss of nourishment type, compared with the control group and the control group two groups, respectively. The results showed that the curative effect of treatment group was better than that of two control groups. There was no significant difference between the control group and the control group, which indicated that the two control groups had the same curative effect, and the three groups had the same curative effect on the damp-heat type and the blood stasis type. There was no significant difference among the three groups (P 0.05), which indicated that the curative effect of the three groups was equal. Conclusion: the treatment of sciatica secondary to lumbar disc herniation by fire needle Jiaji point combined with routine acupuncture. It can obviously improve the pain degree of radical sciatica, the influence of daily life and lumbar vertebrae function, etc. There is no adverse reaction after treatment, so it has good clinical effect.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R246.9

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