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针刀治疗深筋膜激痛点对椎管外源性腰痛作用的临床研究(1)
http://www.100md.com 2016年2月25日 中外医疗2016年第6期
     [摘要] 目的 观察针刀松解腰方肌、臀中小肌激痛点对椎管外源性腰痛的作用。 方法 整群选取自2015年1—10月该院收治的204例患者,随机分成两组治疗。治疗组运用针刀松解疗法,对照组采用针刺法治疗。治疗后分别观察病例的症状、体征是否改善。结果 治疗组:102例,治愈76例,好转17例,无效9例;总有效率为91.17 %,对照组:102例,治愈56例,好转19例,无效27例总有效率为73.52%。两组疗效比较,差异有统计学意义,P<0.05。 结论 针刀松解腰方肌、臀中小肌激痛点治疗椎管外源性腰痛疗程短,效果良好,优于单纯针刺疗法,操作安全,适宜在骨伤科门诊及基层推广。

    [关键词] 针刀松解;椎管外腰痛;激痛点

    [中图分类号] R246.9 [文献标识码] A [文章编号] 1674-0742(2016)02(c)-0153-03

    Clinical Research on Effect of Acupotomy Treatment for Fascia Profunda irritative Painful Point on Exogenous Low Back Pain in Spinal Canal

    LV Yao, LIU Yun-peng, QUAN Ge, TONG Rui-hua

    Hunchun Hospital of traditional Chinese Medicine, Hunchun, Jilin Province, 133300 China

    [Abstract] Objective To observe the effect of acupotomy for the irritative painful points of quadratus lumborum and small middle gluteal muscle on exogenous low back pain in spinal canal. Methods 204 cases of patients from January 2015 to October 2015 were randomly divided into two groups with 102 cases in each, the treatment group were treated with acupotomy, the control group were treated with acupuncture, the improvement of symptoms and signs of the cases were observed after treatment. Results In the treatment group, 76 cases were cured, 17 cases were improved, 9 cases were ineffective, the total effective rate was 91.17%, in the control group, 56 cases were cured, 19 cases were improved, 27 cases were ineffective, the total effective rate was 73.52%, the difference in the curative effect was statistically significant by comparison, P<0.05. Conclusion Compared with the simple acupuncture treatment, the acupotomy for the irritative painful points of quadratus lumborum and small middle gluteal muscle in treatment of exogenous low back pain in spinal canal has a short course of treatment, good effect and safe operation, which is suitable for promotion in the clinic of orthopaedics and communities.

    [Key words] Acupotomy; Exogenous low back pain in spinal canal; Irritative painful point

    腰腿痛发病率高,一直是困扰人们正常生活的世界性难题。该研究主要通过中医针刀微创刺激腰方肌、臀中小肌激痛点,治疗椎管外源性腰痛,此研究在相关领域尚无明确研究,具有很大的价值意义,有疗程短,费用低,疗效可靠等诸多优点,在骨科门诊有较高实用性,适宜推广。该院于2015年1—10月间,给102例患者以中医针刀微创治疗肌筋膜激点治疗椎管外源性腰痛与针灸治疗进行对照,现报道如下。

    1 资料与方法

    1.1 一般资料

    整群选取自2015年1—10月该组病例共204例,随机分成两组。治疗组102例,男性57例,女性45例;年龄25~70岁,平均(56±8.3)岁;病程1个月~20年平均(7±1.6)。对照组102例,男性54例,女性48例;年龄25~70岁,平均(55±0.4)岁;病程1个月~20年,平均(8±1.5)。两组一般资料差异无统计学意义(P>0.05),具有可比性。

    纳入和排除标准:参照中华医学会《临床诊疗指南—骨科分册》典型表现:多见于中年以上,经常弯腰的体力劳动者,多伴有腰椎退行性病变。腰部持续性或间断性钝痛,出现脊神经刺激时伴有臀部、大腿部放射痛。专科检查 查体:腰方肌、腰大肌、臀中肌、臀小肌有条索状压痛点,点压刺激数分钟后腰痛减轻,“4”字试验阳性,直腿抬高试验阴性。跟膝腱反射正常,皮肤感觉正常。影像学检查:X线检查可见椎间隙变窄,关节突关节面骨质密度增高;局部增生形成骨赘,偶有腰椎侧弯;CT检查:排除椎管内占位,排除脊柱感染及间盘突出。 (吕尧 刘云鹏 权革 佟瑞华)
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