毫火针结合按摩治疗退行性腰椎管狭窄症的临床研究

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摘要目的观察毫火针结合按摩治疗退行性腰椎管狭窄症（DLSS）的临床效果。方法选择2015年8月～2017年5月在河北省三河市医院中医科和三河市中医医院针灸科就诊的老年DLSS患者82例，按随机数字表法将其分为治疗组（41例）和对照组（41例）。治疗组采用毫火针结合按摩治疗，对照组采用针刺结合按摩治疗。两组均为隔日1次，10 d为1个疗程，疗程期间休息2 d，共3个疗程。随访7～13个月。采用视觉模拟评分法（VAS）评定腰、腿部的疼痛程度，采用日本骨科协会评估治疗分数（JOA）对患者的主观症状、日常生活、临床体征进行评价，采用标准的SF-36量表中文版对患者的生活健康质量（HQOL）进行评价，观察两组不良反应情况。结果治疗后及随访结束时，两组VAS评分均低于治疗前，JOA评分均高于治疗前，且治疗组VAS评分低于对照组，JOA评分高于对照组，差异均有高度统计学意义（均P ＜ 0.01）。治疗组总有效率（92.68%）明显高于对照组（78.05%），差异有高度统计学意义（P ＜ 0.01）。治疗后及随访结束时，两组HQOL评分均高于治疗前，且治疗组均高于对照组，差异均有高度统计学意义（均P ＜ 0.01）。两组治疗过程中均未见明显不良反应。结论毫火针结合按摩治疗DLSS的效果优于针刺结合按摩，可明显减轻患者疼痛，改善体征与症状，提高生活质量，安全性好，值得进一步进行大样本研究，为临床提供治疗DLSS的循证依据。

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	康广华1 刘海永1▲ 李学军2 杨建强1 高福相1 李冬辉2 张朝东2

关键词 ：毫火针, 按摩, 针刺, 退行性腰椎管狭窄症

Abstract：Objective To observe clinical effect of filiform needle combined with massage in the treatment of patients with degenerative lumbar spinal stenosis (DLSS). Methods Eighty-two cases of elderly patients with DLSS treated in Department of Traditional Chinese Medicine, Sanhe Hospital of Hebei Province, and Department of Acupuncture, Sanhe Hospital of Traditional Chinese Medicine from August 2015 to May 2017 were selected and divided into treatment group (41 cases) and control group (41 cases) by random number table. The treatment group was treated with filiform needle combined with massage. The control group was treated with acupuncture combined with massage. The two groups were all treated once daily, 10 days as 1 course, rest for 2 days during the treatment, total of three courses. All of the patients were followed up for 3-7 months. The degree pain of waist and legs was evaluated by the visual analogue scale (VAS). The subjective symptoms, daily of life, clinical signs were assessed by the Japanese orthopaedic association (JOA) score. The health-related quality of life (HQOL) was evaluated by the Chinese version standard scale SF-36. The adverse reactions were observed between the two groups. Results After treatment and at the end of follow-up, the scores of VAS in the two groups were all lower than those before treatment, and the scores of JOA were all higher than those before treatment, and the score of VAS in the treatment group was lower than that of control group, the score of JOA in the treatment group was higher than that of control group, with statistically significant differences (all P ＜ 0.05). The total effective rate in the treatment group (92.68%) was much higher than that of control group (78.05%), with highly statistically significant difference (P ＜ 0.01). After treatment and at the end of follow-up, the scores of HQOL in the two groups were higher than those before treatment, and the score in the treatment group was much higher than that of control group, with statistically significant differences (P ＜ 0.05). No obvious adverse reactions were observed between the two groups during the treatment. Conclusion The curative effect of filiform needle therapy combined with massage is better than that of acupuncture combined with massage in the treatment of DLSS, which can alleviate the pain, improve the signs and symptoms, promote the living quality, and it is safe. It is worthy of further study in large sample, so as to provide evidence for clinical treatment of DLSS.

Key words： Filiform needle Massage Acupuncture Degenerative lumbar spinal stenosis

基金资助:河北省中医药管理局科研计划项目（2016293）。

通讯作者: ▲通讯作者

引用本文:

康广华1 刘海永1▲ 李学军2 杨建强1 高福相1 李冬辉2 张朝东2. 毫火针结合按摩治疗退行性腰椎管狭窄症的临床研究[J]. 中国医药导报, 2017, 14(30): 85-88.
KANG Guanghua1 LIU Haiyong1▲ LI Xuejun2 YANG Jianqiang1 GAO Fuxiang1 LI Donghui2 ZHANG Chaodong2. Clinical study of filiform needle combined with massage in the treatment of degenerative lumbar spinal stenosis. 中国医药导报, 2017, 14(30): 85-88.

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