本文選題：腰椎間盤突出癥　切入點(diǎn)：微針刀　出處：《浙江中醫(yī)藥大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：腰椎間盤突出癥(LDH)是指由于腰椎間盤退變,腰椎骨質(zhì)增生、纖維環(huán)變性,當(dāng)椎間盤受力不均時(shí),髓核膨出或突出,刺激或壓迫了馬尾神經(jīng)或脊神經(jīng),導(dǎo)致神經(jīng)根炎性水腫、微循環(huán)障礙,發(fā)生的以腰腿疼痛、感覺障礙為主的一種臨床綜合癥候群。該病好發(fā)于30～60歲的體力勞動(dòng)者或平時(shí)缺乏鍛煉者,臨床上以L4～L5、L5～S1椎間盤突出發(fā)病率最高。目前國(guó)內(nèi)外臨床上治療LDH的方法可謂多種多樣,但臨床療效都很難確定,而且都存在一定的復(fù)發(fā)率。LDH是臨床常見病、多發(fā)病,對(duì)人類健康及正常的日常生活帶來(lái)了極大的不便,因此尋求最佳治療方法,提高患者的生活質(zhì)量已成為醫(yī)學(xué)界的重點(diǎn)課題。目的:對(duì)比研究微針刀淺筋膜松解術(shù)和傳統(tǒng)針刺療法治療腰椎間盤突出癥的臨床治療效果。方法:本課題根據(jù)隨機(jī)分配原則,根據(jù)患者簽定知情書時(shí)間依次編號(hào)后,將符合納入標(biāo)準(zhǔn)的60例LDH患者進(jìn)行隨機(jī)對(duì)照觀察,分為治療組30例和對(duì)照組30例。治療組給予微針刀在腰臀腿部位淺筋膜層松解治療,每3天1次,4次為1個(gè)療程,做1個(gè)療程。對(duì)照組予毫針常規(guī)穴位針刺治療,每日1次,每周5次,10次為1個(gè)療程。共治療1個(gè)療程。采用疼痛視覺模擬評(píng)分法(Visual analogue scale,VAS)評(píng)估2組患者治療前、治療1次和治療1療程后腰腿疼痛情況,腰椎功能障礙指數(shù)(Oswestry disability index,ODI)評(píng)估2組患者治療前、治療1療程后腰椎功能情況,對(duì)比2組臨床療效。結(jié)果:所有患者均治療1療程并隨訪。兩組治療后VAS和ODI評(píng)分與治療前比較均有下降,差異有統(tǒng)計(jì)學(xué)意義(均P0.05)。治療組評(píng)分下降更加明顯(P0.05),在療效方面:治療組總有效率為94.3%,對(duì)照組有效率83.3%,微針刀優(yōu)于針灸治療。結(jié)論:微針刀淺筋膜松解術(shù)和傳統(tǒng)針刺療法都能有效緩解腰椎間盤突出癥患者的腰腿疼痛癥狀,改善腰椎功能,兩者比較,微針刀淺筋膜松解術(shù)療法優(yōu)于傳統(tǒng)針刺療法。
[Abstract]:Lumbar disc herniation (LDH) refers to the degeneration of lumbar intervertebral disc, the proliferation of lumbar vertebrae bone, and fiber ring degeneration. When the intervertebral disc is unevenly loaded, the nucleus pulposus bulges or protrudes and stimulates or compresses the cauda equina nerve or spinal nerve, resulting in inflammatory edema of nerve root. Microcirculation disorder, a clinical syndrome characterized by pain in the waist and leg, and sensory disorders. The disease is common in 30 to 60 year old manual workers or people who usually lack exercise. The incidence of disc herniation in L4 / L5 / L5 / S1 is the highest. At present, there are a variety of clinical methods to treat LDH at home and abroad, but the clinical efficacy is difficult to determine, and there is a certain recurrence rate. It brings great inconvenience to human health and normal daily life, so we seek the best treatment. To improve the quality of life of patients has become a key issue in the medical field. Objective: to compare and study the clinical effect of microneedle scalpel superficial fascia lysis and traditional acupuncture therapy in the treatment of lumbar disc herniation. Methods: according to the principle of random distribution, According to the number of love letters signed by the patients, 60 patients with LDH who met the inclusion criteria were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with microneedle knife in the superficial fasciolysis of waist and hip legs. Once every 3 days, 4 times as a course of treatment, 1 course of treatment. The control group was treated with routine acupuncture, once a day, Five times a week and 10 times a week as a course of treatment. Visual analogue scale scale score (VAS) was used to evaluate the pain of waist and leg before treatment once and after one course of treatment. The lumbar spine dysfunction index (Oswestry disability index ODI) was used to evaluate the lumbar function before and after treatment in two groups. Results: all the patients were treated for one course and followed up. The scores of VAS and ODI were decreased after treatment in both groups. The difference was statistically significant (P 0.05). The score of the treatment group decreased more obviously than that of the control group. The total effective rate of the treatment group was 94.34.The effective rate of the control group was 83.3%, and the micro-needle knife was superior to the acupuncture treatment. Conclusion: the treatment of superficial fascia lysis with microneedle knife and the traditional treatment are better than that of the control group. Acupuncture therapy can effectively relieve the pain symptoms of lumbar intervertebral disc herniation patients. To improve lumbar vertebrae function, microneedle scalpel superficial fascia lysis is superior to traditional acupuncture therapy.
【學(xué)位授予單位】：浙江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R246.9

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