[1]王一,戴国钢,夏姣,等.郑氏中医非手术疗法治疗破裂型腰椎间盘突出症[J].中医正骨,2021,33(03):73-77.
　WANG Yi,DAI Guogang,XIA Jiao,et al.Zheng’s TCM non-surgical therapies for treatment of rupture-type lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(03):73-77.
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郑氏中医非手术疗法治疗破裂型腰椎间盘突出症()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年03期
页码:
73-77
栏目:
临床报道
出版日期:
2021-03-20

文章信息/Info

Title:
Zheng’s TCM non-surgical therapies for treatment of rupture-type lumbar disc herniation
作者:
王一; 戴国钢; 夏姣; 廖仕川; 王丰; 李涛; 黄雷; 田国刚; 文江; 杜万里
(四川省骨科医院,四川 成都 610041)
Author(s):
WANG Yi; DAI Guogang; XIA Jiao; LIAO Shichuan; WANG Feng; LI Tao; HUANG Lei; TIAN Guogang; WEN Jiang; DU Wanli
关键词:
椎间盘移位;  腰椎;  中医疗法
摘要:
目的:观察郑氏中医非手术疗法治疗破裂型腰椎间盘突出症(ruptured lumbar disc herniation,RLDH)的临床疗效和安全性。方法:2017年10月至2020年3月,采用郑氏中医非手术疗法治疗RLDH患者258例。男167例,女91例。年龄18～60岁,中位数43岁。病变部位位于L3～45例、L4～594例、L5S1159例。所有患者均表现为严重的腰痛,且伴有严重的下肢根性症状,直腿抬高试验阳性。影像学检查均显示椎间盘突出明显并在椎管内上移或下移。采用疼痛视觉模拟量表(visual analogue scale,VAS)评分、日本骨科学会(Japanese Orthopedic Association,JOA)腰痛疗效评价量表及Oswestry功能障碍指数(Oswestry disability index,ODI)问卷表评价临床疗效,在站立位脊柱侧位X线片上测量骨盆入射角(pelvic incidence,PI)和腰椎前凸角(lumbar lordosis,LL),通过MRI评价突出椎间盘的变化情况,并观察并发症发生情况。结果:腰痛VAS评分,治疗前(7.3±0.8)分、治疗结束后(2.4±1.0)分; JOA评分,治疗前(10.2±5.5)分、治疗结束后(23.5±4.0)分; ODI评分,治疗前(30.1±10.6)分、治疗结束后(9.4±6.6)分。5例失访; 253例获得随访,随访时间23～25周,中位数24周。治疗结束后6个月,仅有78例患者复诊时行X线和MRI检查。PI,治疗前48.35°±6.46°、治疗结束后6个月49.53°±5.46°; LL,治疗前23.28°±5.79°,治疗结束后6个月29.19°±4.13°; 突出椎间盘消失8例、缩小43例、无变化22、增大5例。11例因临床症状加重而接受手术治疗; 23例仍有严重腰痛,其中15例再次接受郑氏中医非手术疗法治疗后腰痛缓解; 132例有轻微腰痛,继续坚持郑氏运动疗法后腰痛缓解; 87例基本无腰痛。均未出现药物过敏等不良反应。结论:采用郑氏中医非手术疗法治疗RLDH,可有效缓解腰痛,促进腰椎生理曲度的恢复、突出椎间盘的重吸收以及腰椎功能的恢复,且并发症少,值得临床推广应用。

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备注/Memo

备注/Memo:
基金项目:中国民族医药学会科研项目(2017KYXM-Z172-40); 四川省卫生和计划生育委员会科研课题(16PJ389); 四川省中医药管理局科学技术研究专项课题(2020JC0103); 四川省医学会骨科(尚安通)专项科研课题(2019SAT06); 四川省骨科医院科研项目(2017-4)
通讯作者:戴国钢 E-mail:guogang_dai@hotmail.com
更新日期/Last Update: 1900-01-01