[1]张英杰,唐树杰.独活寄生汤加减联合手法治疗腰椎间盘突出症的临床观察[J].中医正骨,2013,25(12):35-38.
 Zhang Yingjie*,Tang Shujie.*.Observation on the curative effect of oral application of DUHUO JISHENG decoction combined with manipulation in the treatment of lumbar disk herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(12):35-38.
点击复制

独活寄生汤加减联合手法治疗腰椎间盘突出症的临床观察()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年12期
页码:
35-38
栏目:
临床研究
出版日期:
2013-12-30

文章信息/Info

Title:
Observation on the curative effect of oral application of DUHUO JISHENG decoction combined with manipulation in the treatment of lumbar disk herniation
作者:
张英杰1唐树杰2
1.山东省青州市中医院,山东 青州 262500;
2.暨南大学医学院,广东 广州 510632
Author(s):
Zhang Yingjie*Tang Shujie.*
Qingzhou Hospital of Traditional Chinese Medicine,Qingzhou 262500, Shandong,China
关键词:
椎间盘移位 腰椎 独活寄生汤 手法捏脊 治疗临床研究性
Keywords:
Intervertebral disk displacement Lumbar vertebrae DUHUO JISHENG decoction Manipulationchiropractic Therapiesinvestigational
摘要:
目的:观察独活寄生汤加减联合手法治疗腰椎间盘突出症的临床疗效。方法:将符合要求的138例腰椎间盘突出症患者随机 分为2组,每组69例。治疗组应用独活寄生汤加减联合手法治疗; 对照组采用牵引、理疗及口服非甾体类抗炎药和神经营养药物 进行治疗。观察比较2组患者治疗前和治疗21 d后的腰部疼痛情况和腰部功能,同时比较2组患者的总体疗效及复发率。结果:① 腰部疼痛情况。治疗前2组患者VAS评分比较,差异无统计学意义[(6.49±1.22)分,(6.33±1.41)分,t=0.713,P=0.886]; 治疗后2组患者的VAS评分均降低,治疗组降低更明显[(4.75±0.46)分,(3.71±0.68)分,t=10.522,P=0.005]。②腰部功 能。治疗前2组患者JOA评分比较,差异无统计学意义[(10.50±1.23)分,(10.46±1.38)分,t=0.180,P=0.895]; 治疗后2 组患者的JOA评分均增加,治疗组增加更明显[(12.91±0.51)分,(8.77±0.64)分,t=42.023,P=0.005]。③总体疗效。治 疗组治愈36例,好转21例,有效8例,无效4例; 对照组治愈19例,好转14例,有效16例,无效20例。治疗组总体疗效优于对照组[治疗 组95%CI为(0.334,0.471),R^-=0.403; 对照组95%CI为(0.529,0.666),R^-=0.598]。④复发情况。治疗后12个月内,治疗组3例复 发,对照组11例复发,对照组复发率高于治疗组(χ2=5.088,P=0.024)。结论:独活寄生汤加减联合手法可有效缓解腰 椎间盘突出症患者的疼痛症状,改善患者腰部功能,且复发率低,是治疗该病的有效方法。
Abstract:
Objective:To observe the clinical curative effect of oral application of DUHUO JISHENG decoction combined with manipulation on lumbar disk herniation(LDH).Methods:One hundred and thirty-eight patients with LDH met the requirements were randomly divided into 2 groups,69 cases in each group.Patients in the treatment group were treated with oral application of DUHUO JISHENG decoction combined with manipulation,while the others in the control group were treated with lumbar traction,physiotherapy and oral application of non-steroid anti- inflammatory drugs and neurotrophic drugs.The 2 groups were compared with each other in low back pain and lumbar performance before the treatment and after 21-day treatment,meanwhile the total effect and recurrence rate were compared between the 2 groups.Results:There was no statistical difference in visual analogue score (VAS)between the 2 groups before the treatment(6.49+/-1.22 vs 6.33+/-1.41 points,t=0.713,P=0.886),while the VAS decreased in both of the 2 groups after the treatment,and the VAS decreased more significantly in the treatment group(4.75+/-0.46 vs 3.71+/-0.68 points,t=10.522,P=0.005).There was no statistical difference in JOA score between the 2 groups before the treatment(10.50+/-1.23 vs 10.46+/-1.38 points,t=0.180,P=0.895),while the JOA score increased in both of the 2 groups after the treatment,and the JOA score increased more significantly in the treatment group(12.91+/-0.51 vs 8.77+/-0.64 points,t=42.023,P=0.005).Thirty-six patients obtained an excellent result,21 good,8 fair and 4 poor in the treatment group; while 19 patients obtained an excellent result,14 good,16 fair and 20 poor in the control group.The treatment group surpassed the control group in the total curative effect(treatment group:95%CI(0.334,0.471),R^-=0.403; control group:95%CI(0.529,0.666),R^- =0.598).Three patients with recrudescent symptoms of LDH were found in the treatment group,while 11 patients with recrudescent symptoms of LDH were found in the control group within 12 months after the treatment.The recurrence rate of the control group was higher than that of the treatment group (χ2=5.088,P=0.024).Conclusion:The method of oral application of DUHUO JISHENG decoction combined with manipulation can relief the pain obviously and improve the lumbar performance with low recurrence rate,so it is an effective method for LDH.

参考文献/References:

[1] 国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:201.
[2] 蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2010:118-124.
[3] 胡有谷.腰椎间盘突出症[M].北京:人民卫生出版社,1995:221-256.
[4] 涂院海.牵引按摩法治疗腰椎间盘突出症远期疗效观察[J].中医正骨,2008,20(10):20-21.
[5] 陈勤,宋跃明,邓宁,等.四川省腰椎间盘突出症诊治座谈会会议纪要[J].中国修复重建外科杂志,2007,21(6):665-666.
[6] 王爱武,刘娅,雒琪,等.独活寄生汤抗炎、镇痛作用的药效学研究[J].中国实验方剂学杂志,2008,14(12):61-64.
[7] 傅超文,吕一,王龙剑,等.独活寄生汤加减治疗PLDD术后腰腿痛[J].中医正骨,2009,21(3):47-48.
[8] 赵平,冯天有.腰椎力学结构失衡与腰椎间盘突出的发病[J].中医正骨,1993,5(3):37-39.
[9] 毕胜,李义凯,赵卫东,等.推拿手法治疗腰椎间盘突出症的机制[J].中国康复医学杂志,2001,16(1):8-10.
[10] 戴国文,苏明霞,许世雄,等.中医调曲法治疗腰椎间盘突出症、腰椎管狭窄症的临床研究[J].中国中医骨伤科杂 志,2012,20(2):14-16.
[11] 张建宏,范建中,彭楠.手法复位治疗急性腰椎间盘突出症的临床研究[J].中国临床康复,2002,6(2):108.
[12] 王力平,黄承军.试论腰椎间盘突出症中医外治疗法中的辨证论治和整体观[J].中医杂志,2011,52(4):288-291.
[13] 郑晓静,司晓一.应用治未病理论治疗腰椎间盘突出症的临床研究[J].中医正骨,2012,24(6):23-25.

相似文献/References:

[1]范德辉,林锦坤,张振宁,等.腹针疗法联合龙氏手法治疗寰枢关节半脱位致颈性眩晕[J].中医正骨,2014,26(04):19.
 Fan Dehui*,Lin Jinkun,Zhang Zhenning,et al.Observation on curative effects of abdominal acupuncture combined with Long's manipulation in the treatment of cervical vertigo caused by atlanto-axial subluxation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(12):19.
[2]林松青,罗勇杰,陈肖,等.神经阻滞联合整脊手法治疗腰椎间盘突出症的临床研究[J].中医正骨,2014,26(06):31.
 Lin Songqing*,Luo Yongjie,Chen Xiao,et al.Clinical study on nerve block combined with chiropractic manipulation in the treatment of lubar disk herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(12):31.
[3]郑胜明,陈鹏,张海芬.单次仰卧位拔伸手法在颈性高血压诊断中的应用[J].中医正骨,2012,24(04):19.
 ZHENG Sheng-ming*,CHEN Peng,ZHANG Hai-fen.*.Study on the application of single pulling-extending manipulation in supine position in the diagnosis of cervicogenic hypertension[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(12):19.
[4]姚本顺,谢远军.改进型仰卧整复法治疗颈椎间盘突出症的疗效观察[J].中医正骨,2012,24(03):15.
 YAO Ben-shun*,XIE Yuan-jun.*.Observation on the curative effect of the modified manipulative reduction in supine position on cervical disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(12):15.

备注/Memo

备注/Memo:
2012-10-07收稿 2012-11-23修回
更新日期/Last Update: 2013-12-30