本文選題：第三腰椎橫突綜合征 + 電針治療��； 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的探討針刀松解療法治療第三腰椎橫突綜合征的臨床療效,以及其對第三腰椎橫突局部軟組織壓痛的改善情況,為更規(guī)范的使用針刀松解法治療第三腰椎橫突綜合征提供臨床依據(jù)和數(shù)據(jù)支持。方法選取2015年2月-2017年1月到湖北省第三人民醫(yī)院康復(fù)科門診就診的第三腰椎橫突綜合征患者。本次研究共68例患者,根據(jù)隨機(jī)、對照原則,隨機(jī)分為針刀松解治療組和電針治療對照組兩組,每組34例。對照組采用L1-L3夾脊穴、局部阿是穴、氣海俞、腎俞、腰陽關(guān)[1]進(jìn)行電針治療,治療組采用局部阿是穴進(jìn)行針刀松解法治療。兩組均1周為一個(gè)療程,連續(xù)治療3個(gè)療程以后以臨床療效評定、VAS疼痛分值表、改良的日本骨科學(xué)會下腰痛評分[2]進(jìn)行客觀評價(jià),觀察療效。結(jié)果1.在整體臨床療效的比較上,治療結(jié)束后,針刀松解治療組控制達(dá)13例,顯效有10例,有效9例,總有效率94.11%;電針治療對照組控制6例,顯效有9例,有效15例,總有效率88.24%。數(shù)據(jù)差別存在統(tǒng)計(jì)學(xué)價(jià)值(P0.05),說明兩組患者經(jīng)治療后均恢復(fù)良好;但是針刀治療組的總有效率明顯優(yōu)于對照組,且治愈例數(shù)和顯效例數(shù)均高于對照組,說明針刀松解法對于第三腰椎橫突綜合征的療效更好,明顯優(yōu)于電針治療組。2.治療前兩組的下腰痛評分(J0A評分)無顯著性差異(P0.05),表明兩組數(shù)據(jù)具有可比性。3個(gè)療程結(jié)束后,兩個(gè)組的下腰痛評分(J0A評分)較前相比都有顯著性的增加,說明兩組治療方式均對該病有較好的療效;治療后電針治療組平均(21.16±3.04)分,針刀松解治療組平均(25.83±1.33)分,兩組下腰痛評分(J0A評分)有顯著差異(P0.05),針刀松解治療組評分顯著高于電針治療組,表明針刀松解法對患者主觀癥狀、臨床體征和日常生活能力等的改善明顯優(yōu)于電針治療。3.治療前兩組的VAS疼痛評分無顯著性差異(P0.05),表明兩組數(shù)據(jù)具有可比性。治療后VAS疼痛分值比較:電針對照組平均(5.98±2.66)分,針刀松解治療組平均(2.34±1.78)分;兩組VAS評分均有顯著差異(P0.05),針刀松解治療組VAS疼痛評分顯著高于電針治療組,表明針刀松解法對患者橫突尖部及其他壓痛點(diǎn)的疼痛的緩解、改善明顯優(yōu)于電針治療。結(jié)論針刀松解法對第三腰椎橫突綜合征的主觀癥狀、臨床體征和日常生活能力改善良好,鎮(zhèn)痛效果明顯,對橫突尖部軟組織具有良性的調(diào)節(jié)作用,且整體的綜合療效明顯優(yōu)于電針治療組。針刀松解法治療第三腰椎橫突綜合征療效顯著、簡單易行、安全準(zhǔn)確、成本低、性價(jià)比高、創(chuàng)傷及副作用小,值得臨床廣泛應(yīng)用。
[Abstract]:Objective to investigate the clinical effect of acupuncture knife release therapy in the treatment of the third lumbar transverse process syndrome and the improvement of local soft tissue tenderness of the third lumbar transverse process. To provide clinical basis and data support for the treatment of the third lumbar transverse process syndrome with needle knife release. Methods the patients with transverse process syndrome of the third lumbar vertebrae were selected from February 2015 to January 2017 in the Department of Rehabilitation of the third people's Hospital of Hubei Province. In this study, 68 patients were randomly divided into two groups according to the principle of randomization and electroacupuncture treatment, 34 cases in each group. The control group was treated with L1-L3 Jiaji point, local Ashi point, Qi Haishu, Shenshu, Yaoyang Guan [1], and the treatment group was treated with local Ashi acupoint. The two groups were treated for one week. After 3 consecutive courses of treatment, the VAS pain score was evaluated by clinical efficacy, and the lower back pain score [2] of the modified Japanese Orthopaedic Society was evaluated objectively and the curative effect was observed. Result 1. After the treatment, 13 cases were controlled, 10 cases were markedly effective, 9 cases were effective, and the total effective rate was 94.11% in the treatment group, while in the electroacupuncture treatment group, 6 cases were controlled, 9 cases were effective, 15 cases were effective, and the total effective rate was 88.24%. The difference between the two groups showed that the two groups recovered well after treatment, but the total effective rate of the acupuncture knife treatment group was significantly better than that of the control group, and the number of cases of cure and significant effect were higher than that of the control group. The results showed that the treatment of the third lumbar vertebrae transverse process syndrome by needle knife loosening method was better than that of electroacupuncture treatment group. 2. There was no significant difference in the low back pain score and J0A score between the two groups before treatment, indicating that the data of the two groups were comparable. After three courses of treatment, the lower back pain score and the J0A score of the two groups increased significantly compared with the previous ones. The average score of electroacupuncture treatment group was 21.16 鹵3.04, and that of acupuncture knife release treatment group was 25.83 鹵1.33, and that of electroacupuncture treatment group was 21.16 鹵3.04. There was significant difference between the two groups in the score of lower back pain (P 0.05), and the score in the treatment group was significantly higher than that in the electroacupuncture group, indicating that the improvement of subjective symptoms, clinical signs and daily life ability of the patients with acupuncture loosening was better than that of electroacupuncture. There was no significant difference in VAS pain score between the two groups before treatment (P 0.05), which indicated that the data of the two groups were comparable. Comparison of VAS pain scores after treatment: the average score of VAS was 5.98 鹵2.66 in the electroacupuncture control group and 2.34 鹵1.78 in the acupuncture treatment group, and there was a significant difference in VAS score between the two groups (P 0.05). The VAS pain score in the acupuncture treatment group was significantly higher than that in the electroacupuncture treatment group. The results showed that the relief of pain in the transverse process tip and other tenderness points by acupuncture was better than that by electroacupuncture. Conclusion the method of needle knife release can improve the subjective symptoms, clinical signs and daily living ability of the third lumbar vertebrae transverse process syndrome, and the analgesic effect is obvious, and it has a benign regulating effect on the transverse process tip soft tissue. The comprehensive curative effect of the whole group was better than that of the electroacupuncture group. The treatment of the third lumbar transverse process syndrome by needle-knife loosening is effective, simple, safe, accurate, low cost, high cost, low trauma and little side effects, so it is worthy of wide clinical application.
【學(xué)位授予單位】：湖北中醫(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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