【摘要】：腰椎間盤突出癥是患者以腰腿痛為主訴的一種常見疾病,長時間慢性的腰部椎間盤退行性病變的基礎(chǔ)上加之外傷、寒冷刺激等外因的影響,腰椎神經(jīng)根或者馬尾神經(jīng)被纖維環(huán)破裂后髓核突出物壓迫,造成了腰痛、下肢放射痛等癥狀。腰椎間盤突出癥多與年齡因素、體重負(fù)擔(dān)、外傷損害、寒冷刺激、勞損等因素息息相關(guān)。隨著社會的發(fā)展,腰椎間盤突出癥的影響因素越來越凸顯,人們壓力越來越大,腰椎退變速度加快,未能及時引起重視和對癥處理,最終對自己和社會造成了巨大的影響。目的:本課題觀察走罐出痧,選擇最明顯痧點點刺拔罐出痧(刺痧拔罐)結(jié)合推拿治療腰椎間盤突出癥的療效,臨床研究腰椎間盤突出癥的診療方案提供了理論支持和經(jīng)驗積累。方法:收錄病例時間在2016年2月至2017年2月期間,60例就診于廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院推拿科本人導(dǎo)師門診的腰椎間盤突出癥患者進(jìn)行研究。按照隨機方案處理,分派到治療組和對照組中,兩組都以推拿治療為基本操作,不同之處是治療組加用刺痧拔罐,對照組加用刺絡(luò)拔罐。兩組的治療1個療程為2次,一共3個療程。主要記錄主要療效指標(biāo)(JOA量表評分)和次要療效指標(biāo)(SF-MPQ量表評分)數(shù)據(jù)進(jìn)行系統(tǒng)客觀的觀察和評價,使用統(tǒng)計軟件SPSS19.0進(jìn)行數(shù)據(jù)錄入然后再分析。結(jié)果:1.兩組在總體的臨床療效評價方面具有統(tǒng)計學(xué)意義(P0.05)。在有效率上,治療組刺痧拔罐結(jié)合推拿組的有效率為96.67%,對照組刺絡(luò)拔罐結(jié)合推拿組的有效率為83.33%,說明兩組治療效果都良好,但是治療組的總有效率比對照組的高。2.治療組和對照組患者在治療前的JOA量表積分比較無統(tǒng)計學(xué)意義,那么兩組在治療前是具有可比性的。治療后治療組和對照組JOA量表積分比較有統(tǒng)計學(xué)意義(P0.05),有顯著差異。而且治療后兩組的JOA量表積分比治療前普遍提高,說明兩種治療都有效果,而且治療組的治療療效優(yōu)于對照組。3.在SF-MPQ評分的比較方面,治療前治療組和對照組的SF-MPQ評分無統(tǒng)計學(xué)意義(P0.05),治療前兩組是具有可比性的。治療后兩組的SF-MPQ評分比較是有統(tǒng)計學(xué)意義的,說明治療組的療效優(yōu)于對照組。結(jié)論:在治療腰椎間盤突出癥患者療效方面上,治療組(刺痧拔罐結(jié)合推拿治療)同對照組(刺絡(luò)拔罐結(jié)合推拿治療)兩者均可以達(dá)到臨床上的滿意效果。其中治療組刺痧拔罐結(jié)合推拿治療比對照組刺絡(luò)拔罐結(jié)合推拿治療在總體療效水平方面更突出,治療組在緩解患者癥狀方面、提高JOA和SF-MPQ量表的積分方面優(yōu)于對照組。
[Abstract]:Lumbar disc herniation is a common disease that patients mainly complain of lumbago and leg pain. On the basis of long-term chronic lumbar intervertebral disc degenerative disease, combined with external factors such as trauma, cold stimulation, etc. Lumbar nerve root or cauda equina nerve is compressed by nucleus pulposus protruding after fibrous ring rupture, causing low back pain, lower extremity radiation pain and so on. Lumbar disc herniation is closely related to age, weight burden, trauma, cold stimulation, strain and so on. With the development of society, the influencing factors of lumbar disc herniation are more and more prominent, people are under more and more pressure, the speed of lumbar degenerative degeneration is quickening, and the failure to pay attention to and deal with the disease in time has caused great influence on themselves and the society. Objective: to observe the curative effect of treating lumbar intervertebral disc herniation with cupping and cupping combined with massage. The clinical research on the diagnosis and treatment of lumbar disc herniation provides theoretical support and experience accumulation. Methods: from February 2016 to February 2017, 60 patients with prolapse of lumbar intervertebral disc were studied in the clinic of Tuina Department of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine. According to the random scheme, the treatment group and the control group were assigned to the treatment group and the control group, the two groups were treated with massage therapy as the basic operation, the difference was that the treatment group plus prickle cupping, the control group plus prickle cupping. Two courses of treatment for two groups, a total of 3 courses of treatment. The main curative effect index (JOA scale score) and the secondary curative effect index (SF-MPQ scale score) data were recorded for systematic and objective observation and evaluation. The data were input and analyzed by SPSS19.0. The result is 1: 1. The two groups in the overall clinical efficacy evaluation had statistical significance (P0.05). In the effective rate, the effective rate of the treatment group was 96.677.The effective rate of the control group was 83.33, which indicated that the two groups had good therapeutic effect. But the total response rate in the treatment group was higher than that in the control group. 2. 2. There was no significant difference in JOA scores between the treatment group and the control group before treatment, so the two groups were comparable before treatment. There was significant difference in JOA scale between treatment group and control group after treatment (P0.05). After treatment, the scores of JOA scale in the two groups were generally higher than those before treatment, indicating that both treatments had effect, and the curative effect of the treatment group was better than that of the control group. In the comparison of SF-MPQ scores, the SF-MPQ scores of the treatment group and the control group before treatment were not statistically significant (P0.05), the two groups were comparable before treatment. There was significant difference in SF-MPQ score between the two groups after treatment, indicating that the curative effect of the treatment group was better than that of the control group. Conclusion: in the treatment of lumbar intervertebral disc herniation, both the treatment group (pricking and cupping combined with massage treatment) and the control group (pricking and cupping combined with massage treatment) can achieve satisfactory clinical effect. The treatment group was more prominent than the control group in the overall curative effect level, the treatment group improved the score of JOA and SF-MPQ scale better than the control group in relieving the symptoms of patients.
【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】：R244.3
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本文編號：2342304