[1]田育魁,崔小锋,摆雪,等.中医外治法不同应用模式对腰椎间盘突出症疗效影响的临床研究[J].中医正骨,2025,37(04):50-54.
　TIAN Yukui,CUI Xiaofeng,BAI Xue,et al.Effects of different application modalities of traditional Chinese medicine external therapies on clinical efficacy in treatment of lumbar disc herniation:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2025,37(04):50-54.
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中医外治法不同应用模式对腰椎间盘突出症疗效影响的临床研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第37卷
期数:
2025年04期
页码:
50-54
栏目:
临床研究
出版日期:
2025-04-20

文章信息/Info

Title:
Effects of different application modalities of traditional Chinese medicine external therapies on clinical efficacy in treatment of lumbar disc herniation:a clinical study
作者:
田育魁1; 崔小锋1; 摆雪1; 王程2; 刘俊昌1
1.新疆医科大学中医学院,新疆 乌鲁木齐 830017; 2.新疆医科大学附属中医医院,新疆 乌鲁木齐 830000
Author(s):
TIAN Yukui1; CUI Xiaofeng1; BAI Xue1; WANG Cheng2; LIU Junchang1
1.School of Traditional Chinese medicine,Xinjiang Medical University,Urumqi 830017,Xinjiang,China 2.The Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China
关键词:
椎间盘移位;  腰椎;  针刺;  电针;  推拿疗法;  八段锦;  临床研究专题
Keywords:
intervertebral disc displacement;  lumbar vertebrae;  acupuncture;  electroacupuncture;  tui na therapy;  eight-sectioned exercise;  clinical studies as topic
摘要:
目的:探讨中医外治法不同应用模式对腰椎间盘突出症(lumbar disc herniation,LDH)疗效的影响。方法:以2023年1月至2024年8月收治的LDH患者为研究对象,根据患者意愿,从针刺、电针、推拿、中医功法中选择至少1种中医外治法进行治疗,治疗次数≥5次。根据患者治疗过程中中医外治法的实际应用情况,将各种外治法的应用情况分为未使用、间断使用、连续使用3个类别。治疗5次后,依据日本骨科学会腰痛评分进行疗效评价。结果:①一般情况。共纳入2249例患者,按照疗效分为3组,无效组128例、有效组1725例、显效组396例。3组患者疾病分期的差异有统计学意义(χ2=55.849,P=0.000),其余基线资料的组间差异均无统计学意义。②中医外治法应用情况。3组患者的针刺、推拿、中医功法应用情况的组间差异均有统计学意义(χ2=30.178,P=0.000; χ2=93.027,P=0.000; χ2=46.264,P=0.000),电针应用情况的组间差异无统计学意义(P=0.920)。③中医外治法不同应用模式对LDH疗效影响的多因素分析。以治疗是否有效作为因变量(疗效评价结果中的有效和显效均视为有效),以针刺、推拿、中医功法的应用情况及临床分期作为自变量进行二分类Logistic回归分析。结果显示,康复期、间断/连续使用推拿、连续使用中医功法均为LDH中医外治法治疗有效的保护因素[B=1.074,P=0.000,OR=5.911,95%CI(3.210,10.886); B=0.852,P=0.000,OR=5.762,95%CI(3.230,10.278); B=0.047,P=0.000,OR=2.576,95%CI(1.477,4.491); B=0.648,P=0.001,OR=4.120,95%CI(1.764,9.622)]。结论:间断/连续使用推拿及连续使用中医功法均有助于提高LDH的疗效,而且康复期的治疗效果更好。
Abstract:
Objective:To explore the effects of different application modalities of traditional Chinese medicine(TCM)external therapies on the clinical efficacy in treatment of lumbar disc herniation(LDH).Methods:The patients with LDH recruited from January 2023 to August 2024 were selected as the subjects,based on their preferences,they were treated with at least one TCM external therapy,such as acupuncture therapy,electroacupuncture therapy,tuina therapy,or TCM exercise therapy,for at least 5 sessions.According to the actual application status during the treatment,the TCM external therapies were categorized into non-application,intermittent application,and sustained application,and the therapeutic efficacy was evaluated using the Japanese Orthopaedic Association(JOA)low back pain score following 5 treatment sessions.Results:①General condition.Two thousand two hundred and forty-nine patients were included in the study,and they were stratified into non-response group(128 cases),response group(1725 cases),and marked response group(396 cases)based on the therapeutic efficacy.The significant difference was observed in the disease stage among the 3 groups(χ2=55.849,P=0.000),but not in the other baseline characteristics.②The application of TCM external therapies.The significant differences were found in the application of acupuncture therapy,tuina therapy,and TCM exercise therapy among the 3 groups(χ2=30.178,P=0.000; χ2=93.027,P=0.000; χ2=46.264,P=0.000),but not in the the application of electroacupuncture therapy(P=0.920).③Multifactor analysis of the effects of different application modalities of TCM external therapies on the therapeutic efficacies in treatment of LDH.A binary logistic regression analysis was conducted with whether the treatment was effective(both effective and markedly effective in the therapeutic evaluation were defined as effective)as the dependent variable,and the application of acupuncture therapy,tuina therapy and TCM exercise therapy,as well as the clinical stage as independent variables,and the results showed that the convalescent-phase,intermittent or sustained application of tuina therapy,and sustained practice of TCM exercise acted as the protective factors for TCM external therapies in effective treatment of LDH(B=1.074,P=0.000,OR=5.911,95%CI(3.210,10.886); B=0.852,P=0.000,OR=5.762,95%CI(3.230,10.278); B=0.047,P=0.000,OR=2.576,95%CI(1.477,4.491); B=0.648,P=0.001,OR=4.120,95%CI(1.764,9.622)).Conclusion:The intermittent or sustained application of tuina therapy,and sustained practice of TCM exercise are beneficial to enhancing the efficacy in treating LDH,with superior clinical efficacy exhibited in the convalescent-phase.

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备注/Memo

备注/Memo:
基金项目:新疆维吾尔自治区重点研发计划项目(2022B03011-3); 新疆维吾尔自治区科技创新团队项目(2022TSYCTD0008)
通讯作者:刘俊昌 E-mail:625854402@qq.com
更新日期/Last Update: 1900-01-01