【摘要】：目的:本研究擬采用激痛點針刺聯(lián)合神經(jīng)松動術治療干性坐骨神經(jīng)痛,觀察治療前后及隨訪兩個月患者的簡化McGill疼痛問卷積分(SF-MPQ評分,包括PRI、VAS及PPI評分)與Oswestry功能障礙指數(shù)(CODI評分)的變化及其臨床療效,分析其具體的作用原理,以期縮短患者的治療時間,提高干性坐骨神經(jīng)痛的遠期療效,為本病的診治提供新思路、新方法。方法:選取2015年6月至2016年12月在十堰市太和醫(yī)院東院區(qū)骨科康復3病區(qū)住院的且符合納入標準的患者60例,按照就診先后時間順序進行隨機分組(采用隨機數(shù)字表法),將其分為治療組和對照組,每組各30例。兩組患者均接受常規(guī)康復治療(磁療、超短波、經(jīng)皮電刺激),治療組加用激痛點針刺聯(lián)合神經(jīng)松動術進行治療,對照組加用普通針刺聯(lián)合傳統(tǒng)推拿術進行治療,每天1次,7天為一個療程,治療組共治療2個療程,對照組治療3個療程,每個療程期間休息一天。觀察兩組患者治療前后及隨訪2個月的SF-MPQ評分及CODI評分,并將兩組的療效進行對比。結果:(1)治療前,兩組研究對象的疼痛分級指數(shù)(PRI評分)、視覺模擬評估(VAS評分)、現(xiàn)時疼痛強度(PPI評分)、SF-MPQ總評分及CODI評分的對比結果顯示,兩組間差異無統(tǒng)計學意義(P0.05),表明組間具有可比性。(2)治療后,兩組研究對象的PRI評分、VAS評分、PPI評分、SF-MPQ總評分及CODI評分較治療前均有降低,差異均具有統(tǒng)計學意義(P0.01或P0.05);同時,治療組研究對象的上述評分較治療前降低程度更加明顯,差異有統(tǒng)計學意義(P0.01);由此說明,治療組在改善研究對象的疼痛及功能障礙方面更有優(yōu)勢。(3)2個月隨訪時,治療組與對照組的CODI評分及SF-MPQ總評分比較,治療組均低于對照組,差異仍具有統(tǒng)計學意義,說明治療組在遠期仍能更加有效地改善研究對象的疼痛及功能障礙。(4)治療結束后,治療組的總有效率(93.3%)明顯高于對照組(83.3%),二者差異無統(tǒng)計學意義(P0.05),說明治療后兩組總有效率基本相當;2個月隨訪時,治療組總有效率(92.9%)明顯高于對照組(66.7%),且二者差異具有統(tǒng)計學意義(P0.05),說明治療組的遠期總有效率優(yōu)于對照組。結論:(1)治療組與對照組采用的方法能有效減輕干性坐骨神經(jīng)痛患者的疼痛程度,且治療組采用的激痛點針刺聯(lián)合坐骨神經(jīng)松動術效果更加明顯,且這種效果遠期仍具有優(yōu)勢。(2)治療組與對照組采用的方法都能有效的改善干性坐骨神經(jīng)痛患者的功能障礙,且治療組采用的激痛點針刺聯(lián)合坐骨神經(jīng)松動術效果更加明顯,且這種效果遠期仍具有優(yōu)勢。(3)治療組與對照組采用的方法對干性坐骨神經(jīng)痛都具有顯著療效,且治療組采用的激痛點針刺聯(lián)合坐骨神經(jīng)松動術的遠期療效更加明顯。
[Abstract]:Objective: the purpose of this study was to treat dry sciatica with excitatory pain point acupuncture combined with nerve loosening, and to observe the simplified McGill pain questionnaire score (SF-MPQ score, including PRI,) before and after treatment and follow-up for two months. The changes of VAS and PPI scores and Oswestry dysfunction index (CODI score) and their clinical efficacy were analyzed, and the mechanism of their action was analyzed in order to shorten the treatment time and improve the long-term effect of dry sciatica. To provide new ideas and methods for the diagnosis and treatment of this disease. Methods: from June 2015 to December 2016, 60 patients who were hospitalized in the orthopaedic rehabilitation area of Taihe Hospital, Shiyan City, were randomly divided according to the order of visiting time (using random digital table method). They were divided into treatment group and control group with 30 cases in each group. The patients in both groups were treated with routine rehabilitation therapy (magnetic therapy, ultrashort wave, percutaneous electric stimulation), the treatment group was treated with excitatory pain point acupuncture combined with nerve loosening, and the control group was treated with common acupuncture combined with traditional massage once a day. 7 days as a course of treatment, treatment group 2 courses of treatment, control group 3 courses of treatment, each course of rest during one day. The SF-MPQ score and CODI score of the two groups were observed before and after treatment and 2 months follow-up, and the efficacy of the two groups was compared. Results: (1) before treatment, the pain grading index (PRI), visual analogue assessment (VAS), current pain intensity (PPI), total SF-MPQ score and CODI score were compared between the two groups. There was no significant difference between the two groups (P0.05), indicating comparability between the two groups. (2) after treatment, the PRI score, VAS score, PPI score, SF-MPQ total score and CODI score of the two groups were lower than those before treatment. The differences were statistically significant (P0.01 or P0.05). At the same time, the above scores of the treatment group were significantly lower than those before treatment (P0.01). The results showed that the treatment group had more advantages in improving pain and dysfunction. (3) after 2 months follow-up, the CODI score and the total SF-MPQ score of the treatment group and the control group were lower than those of the control group. The difference is still statistically significant, indicating that the treatment group can improve pain and dysfunction more effectively in the long term. (4) after treatment, The total effective rate of the treatment group (93.3%) was significantly higher than that of the control group (83.3%). There was no significant difference between the two groups (P0.05). After 2 months follow-up, the total effective rate in the treatment group (92.9%) was significantly higher than that in the control group (66.7%), and the difference between the two groups was statistically significant (P0.05), which indicated that the total long-term effective rate of the treatment group was better than that of the control group. Conclusion: (1) the treatment group and the control group can effectively reduce the pain degree of the patients with dry sciatica, and the effect of the treatment group is more obvious. Both the treatment group and the control group can effectively improve the dysfunction of patients with dry sciatica. The effect of acupuncture combined with sciatic nerve loosening was more obvious in the treatment group than in the control group. (3) both the treatment group and the control group had significant curative effects on dry sciatica. In the treatment group, the long-term effect of acupuncture combined with sciatic nerve loosening was more obvious.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

【參考文獻】

相關期刊論文 前10條

1 姜雪梅;鐘會清;劉智明;吳秀麗;蘇成康;郭周義;;肌筋膜扳機點的檢測及評價方法研究進展[J];中國疼痛醫(yī)學雜志;2016年09期

2 范新霞;;身痛逐瘀湯加味治療坐骨神經(jīng)痛臨床觀察[J];中醫(yī)學報;2013年02期

3 劉盼;張勇;羅唯師;;簡化的McGill疼痛問卷表在三叉神經(jīng)痛手術療效評估中的應用[J];中南醫(yī)學科學雜志;2013年01期

4 朱劍寰;陳海英;陳加云;;臀三針為主針灸治療干性坐骨神經(jīng)痛30例[J];中醫(yī)臨床研究;2011年05期

5 白躍宏;俞紅;楊新文;方偉明;曹曼林;;簡體中文版Oswestry功能障礙指數(shù)評定社區(qū)康復治療腰椎間盤突出癥的信度及效度分析[J];中華物理醫(yī)學與康復雜志;2010年08期

6 嚴志穎;;針刺與超短波配合治療坐骨神經(jīng)痛186例的體會[J];中外醫(yī)療;2009年31期

7 王淑娟;蘇妝;;針刺扳機點治療常見疼痛類疾患[J];上海針灸雜志;2009年09期

8 李曉慧;;通痹止痛湯治療干性坐骨神經(jīng)痛178例[J];陜西中醫(yī);2009年08期

9 廖良健;;痹癥治療五法[J];中國現(xiàn)代醫(yī)生;2009年20期

10 蘇紹華;;麻黃附子細辛湯加味治療坐骨神經(jīng)痛60例[J];江西中醫(yī)藥;2008年08期

相關碩士學位論文 前1條

1 鄭永豐;針刺足太陽足少陽經(jīng)聯(lián)合獨活寄生湯治療坐骨神經(jīng)痛的臨床研究[D];廣州中醫(yī)藥大學;2011年

，

本文編號：2299646