明視針刀治療腰椎間盤突出合并側(cè)隱窩狹窄癥的臨床研究
發(fā)布時間：2018-08-13 12:24
【摘要】：目的:將針刀操作工具和現(xiàn)代西醫(yī)微創(chuàng)介入技術(shù)相結(jié)合,L5/S1夾脊穴為進針點,在全程可視條件下進行針刀松解側(cè)隱窩內(nèi)束縛神經(jīng)根的纖維隔附著處,從而治療L5/S1椎間盤突出合并側(cè)隱窩狹窄癥所引起的臨床癥狀,通過臨床觀察,與傳統(tǒng)糾正脊柱生理曲度的針刀治療相比較,踐實該方案的臨床優(yōu)越性,探索出針刀療法治療該病更安全、有效、便捷的現(xiàn)代化臨床路徑。方法:本課題篩選L5/S1椎間盤突出合并側(cè)隱窩狹窄癥60例,依照就診次序運用spss軟件隨機分為試驗組和對照組各30例,各組治療一個療程均為15天,試驗組給予明視針刀治療,療程時間內(nèi)共治療1次,對照組給予傳統(tǒng)針刀治療,每7日1次,療程時間內(nèi)共治療兩次。療程結(jié)束后進行統(tǒng)計分析,評價兩組組內(nèi)、組間治療前后JOA評分、VAS評分等相關(guān)數(shù)據(jù)。結(jié)果:治療后數(shù)據(jù)分析:1、治療前兩組VAS評分無顯著差別(p0.05),治療后兩組VAS評分差別顯著(p0.05);2、治療前兩組JOA評分無顯著差別(p0.05),治療后兩組JOA評分分析,腰椎功能改善指數(shù)、改善率差別顯著(p0.05);結(jié)果分析明視針刀治療較傳統(tǒng)針刀治療有更好的臨床療效;3.總體療效分析,試驗組7例治愈、15例顯效、6例好轉(zhuǎn)、2例無效,總有效率93.3%,治愈率為23.3%;對照組1例治愈、15例顯效、8例好轉(zhuǎn)、6例無效,總有效率80%,治愈率為3%。兩組具有統(tǒng)計學意義且差別顯著(p0.05)。試驗組臨床療效優(yōu)于對照組。結(jié)論:明視針刀松解腰部夾脊穴治療L5/S1椎間盤突出合并側(cè)隱窩狹窄癥,在腰椎功能改善及臨床療效上均優(yōu)于傳統(tǒng)針刀治療,本治療方案結(jié)合傳統(tǒng)針灸、現(xiàn)代針刀以及西醫(yī)微創(chuàng)介入技術(shù),于全程明視條件下直達病所,進行針刀松解,安全、有效、可重復性高,值得臨床推廣運用。
[Abstract]:Objective: to combine the needle knife operation tool with the modern western medicine minimally invasive interventional technique to release the fiber septal attachment of the bound nerve root in the lateral recess under the whole visual condition by using L5 / S1 Jiaji point as the point of entry. In order to treat the clinical symptoms caused by L5/S1 disc herniation and lateral recess stenosis, compared with the traditional needle-knife therapy to correct the physiological curvature of the spine, the clinical advantages of this scheme were confirmed. To explore a more safe, effective and convenient modern clinical pathway of needle-knife therapy for the disease. Methods: 60 cases of L5/S1 disc herniation with lateral recess stenosis were selected. According to the order of seeing a doctor, 60 cases were randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). One course of treatment was 15 days in each group. The experimental group was treated with clear vision needle knife. The control group was treated with traditional needle knife once every 7 days, and the control group was treated twice during the course of treatment. At the end of the course of treatment, the data of JOA score and VAS score were evaluated before and after treatment. Results: after treatment, there was no significant difference in VAS score between the two groups before and after treatment (p0.05). After treatment, there was no significant difference in VAS score between the two groups (p0.05). There was no significant difference in JOA score between the two groups before and after treatment (p0.05). After treatment, the JOA score of the two groups was analyzed, and the improvement index of lumbar vertebrae function was found. The improvement rate was significantly different (p0.05). Results the apparent acicular knife therapy had better clinical effect than traditional needle-knife therapy (p0.05). The overall curative effect was analyzed. In the test group, 15 cases were cured, 15 cases improved significantly, 6 cases were improved, 2 cases were ineffective, the total effective rate was 93.33.The cure rate was 23.30.The control group (1 case) cured 15 cases with remarkable effect and 8 cases had no effect, the total effective rate was 80%, and the cure rate was 3%. The two groups had statistical significance and significant difference (p0.05). The clinical effect of experimental group was better than that of control group. Conclusion: the treatment of L5/S1 disc herniation with lateral recess stenosis with clear vision needle knife is superior to that of traditional acupuncture therapy in improving lumbar function and clinical curative effect. This treatment scheme combined with traditional acupuncture and moxibustion is superior to that of traditional acupuncture treatment in the treatment of lumbar disc herniation and lateral recess stenosis. Modern needle-knife and western minimally invasive interventional technique, under the condition of the whole open vision, the needle knife release, safe, effective, high reproducibility, worthy of clinical application.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.9
[Abstract]:Objective: to combine the needle knife operation tool with the modern western medicine minimally invasive interventional technique to release the fiber septal attachment of the bound nerve root in the lateral recess under the whole visual condition by using L5 / S1 Jiaji point as the point of entry. In order to treat the clinical symptoms caused by L5/S1 disc herniation and lateral recess stenosis, compared with the traditional needle-knife therapy to correct the physiological curvature of the spine, the clinical advantages of this scheme were confirmed. To explore a more safe, effective and convenient modern clinical pathway of needle-knife therapy for the disease. Methods: 60 cases of L5/S1 disc herniation with lateral recess stenosis were selected. According to the order of seeing a doctor, 60 cases were randomly divided into two groups: the experimental group (n = 30) and the control group (n = 30). One course of treatment was 15 days in each group. The experimental group was treated with clear vision needle knife. The control group was treated with traditional needle knife once every 7 days, and the control group was treated twice during the course of treatment. At the end of the course of treatment, the data of JOA score and VAS score were evaluated before and after treatment. Results: after treatment, there was no significant difference in VAS score between the two groups before and after treatment (p0.05). After treatment, there was no significant difference in VAS score between the two groups (p0.05). There was no significant difference in JOA score between the two groups before and after treatment (p0.05). After treatment, the JOA score of the two groups was analyzed, and the improvement index of lumbar vertebrae function was found. The improvement rate was significantly different (p0.05). Results the apparent acicular knife therapy had better clinical effect than traditional needle-knife therapy (p0.05). The overall curative effect was analyzed. In the test group, 15 cases were cured, 15 cases improved significantly, 6 cases were improved, 2 cases were ineffective, the total effective rate was 93.33.The cure rate was 23.30.The control group (1 case) cured 15 cases with remarkable effect and 8 cases had no effect, the total effective rate was 80%, and the cure rate was 3%. The two groups had statistical significance and significant difference (p0.05). The clinical effect of experimental group was better than that of control group. Conclusion: the treatment of L5/S1 disc herniation with lateral recess stenosis with clear vision needle knife is superior to that of traditional acupuncture therapy in improving lumbar function and clinical curative effect. This treatment scheme combined with traditional acupuncture and moxibustion is superior to that of traditional acupuncture treatment in the treatment of lumbar disc herniation and lateral recess stenosis. Modern needle-knife and western minimally invasive interventional technique, under the condition of the whole open vision, the needle knife release, safe, effective, high reproducibility, worthy of clinical application.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.9
【參考文獻】
相關(guān)期刊論文 前10條
1 李慶華;鄧芳;雷志凱;孫建良;;超聲引導下小針刀松解頸椎間孔外口治療神經(jīng)根型頸椎病[J];浙江中西醫(yī)結(jié)合雜志;2015年06期
2 費志軍;黃山東;趙曉亮;何s，
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