發(fā)布時間：2018-05-16 16:13

  本文選題：腰三針療法 + 康復(fù)訓(xùn)練　； 參考：《廣州中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：腰椎間盤突出癥(Lumbar disc herniation,LDH)是一種以腰痛、下肢放射痛為主要表現(xiàn)的臨床常見病,目前治療的方法可基本分為手術(shù)治療與非手術(shù)治療兩大類,針灸康復(fù)在LDH的非手術(shù)治療中占有重要地位。本文主要將通過概述LDH的現(xiàn)代針灸治療進展,展示近年來針灸治療的研究方向與思路,并提出本病在臨床研究中尚且存在的問題,為進一步研究針灸康復(fù)治療LDH提供參考。目的:觀察腰三針為主單獨電針及與康復(fù)訓(xùn)練配合治療的效應(yīng)對腰椎間盤突出癥的臨床療效,發(fā)掘兩者的配合優(yōu)勢,為非手術(shù)治療LDH的方法提供進一步參考。方法:采用簡單隨機對照法,選取符合納入標(biāo)準(zhǔn)的病例62例,按1:1的比例隨機分入腰三針組與聯(lián)合治療組,其中腰三針組予以腰三針為主的辨證取穴電針治療,聯(lián)合治療組予以腰三針為主的辨證取穴電針治療配合康復(fù)訓(xùn)練。每天治療1次,每周治療5日,10次治療為一個療程。治療前后分別進行JOA下腰痛評價表及0DI問卷表的觀察評分,并在完成全部療程后根據(jù)《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》中的內(nèi)容進行療效評價。統(tǒng)計分析處理采用SPSS 19.0統(tǒng)計軟件包,分別進行組內(nèi)與組間的相關(guān)統(tǒng)計學(xué)比較。成果:兩組患者的一般情況及臨床基線資料分別進行對比分析后得出其均無統(tǒng)計學(xué)意義(P0.05),說明兩組的基線水平一致,研究資料具有可比性。經(jīng)過一個療程的治療后,聯(lián)合治療組總有效率為96.7%,腰三針組總有效率為90.3%,兩者比較結(jié)果具有統(tǒng)計學(xué)意義(P0.05)。治療后兩組患者的JOA量表評分均較前提高(P0.05),其中聯(lián)合治療組評分的提高更顯著,且組間比較具有明顯差異(P0.01),故認(rèn)為聯(lián)合治療組療效優(yōu)于腰三針組;治療后兩組患者的ODI問卷表評分均較前下降(P0.05),其中聯(lián)合治療組評分下降更顯著,且組間比較具有明顯差異(P0.01),故認(rèn)為聯(lián)合治療組療效優(yōu)于腰三針組。結(jié)論:腰三針為主的針刺療法與其配合康復(fù)訓(xùn)練的療法對LDH都有著不錯的療效,能較為明顯地改善患者的臨床癥狀及活動功能障礙。相比而言,在腰三針理念指導(dǎo)之下配合康復(fù)訓(xùn)練的治療對改善患者腰腿痛癥狀及活動功能、日常工作和生活等方面的效果更為顯著,聯(lián)合治療比單獨運用針刺治療的臨床療效更佳。
[Abstract]:Lumbar disc herniation (LDH) is a common clinical disease characterized by low back pain and radiation pain of lower extremity. The current treatment methods can be divided into two categories: surgical treatment and non-operative treatment. Acupuncture rehabilitation plays an important role in non-operative treatment of LDH. This article will summarize the progress of modern acupuncture and moxibustion therapy of LDH, show the research direction and train of thought of acupuncture treatment in recent years, and put forward the existing problems of this disease in clinical research, which will provide a reference for further research on acupuncture rehabilitation therapy LDH. Objective: to observe the clinical effect of the treatment of lumbar intervertebral disc herniation with three lumbar acupuncture and rehabilitation training, explore the advantages of the two, and provide a further reference for the non-operative treatment of LDH. Methods: 62 cases were randomly divided into three lumbar acupuncture group and combined treatment group according to the 1:1 ratio, in which the lumbar three acupuncture group was treated with the syndrome differentiation and acupoint electroacupuncture of the lumbar three acupuncture group, and 62 patients who met the inclusion criteria were randomly divided into the lumbar three acupuncture group and the combined treatment group. The combined treatment group was treated with syndrome differentiation and acupoint electroacupuncture combined with rehabilitation training. Once a day, 5 days a week, 10 times a course of treatment. The JOA low back pain evaluation table and the 0DI questionnaire were observed before and after the treatment, and the curative effect was evaluated according to the content of TCM disease syndrome diagnosis curative effect standard after the completion of the whole course of treatment. The statistical analysis was carried out by SPSS 19.0 software package, and the correlation between the two groups was compared. Results: the general situation and clinical baseline data of the two groups were compared and analyzed respectively. The results showed that there was no statistical significance between the two groups, indicating that the baseline level of the two groups was the same, and the research data were comparable. After a course of treatment, the total effective rate of the combined treatment group was 96.7g and the total effective rate of the lumbar three-needle group was 90.30.The comparison between the two groups was statistically significant (P 0.05). After treatment, the scores of JOA scale in both groups were higher than those in the previous group, and the scores of the combined treatment group were significantly higher than those of the former group, and there was a significant difference between the two groups. Therefore, the therapeutic effect of the combined treatment group was better than that of the lumbar three-needle group. After treatment, the scores of ODI questionnaire in the two groups were lower than those in the former group (P 0.05), and the scores of the combined treatment group were significantly lower than those of the control group, and there was a significant difference between the two groups. It was concluded that the therapeutic effect of the combined treatment group was better than that of the lumbar three needle group. Conclusion: the acupuncture therapy combined with rehabilitation training has a good effect on LDH and can obviously improve the clinical symptoms and motor dysfunction of the patients. In contrast, the treatment with rehabilitation training under the guidance of the idea of three lumbar needles is more effective in improving the symptoms and activities of low back pain, daily work and life, etc. The clinical effect of combined therapy is better than that of acupuncture alone.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.9
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本文編號：1897540