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[1]王雷生,楊勇.經(jīng)膀胱經(jīng)腧穴透刺關(guān)節(jié)突關(guān)節(jié)溫針灸治療腰椎關(guān)節(jié)突關(guān)節(jié)源性腰痛的臨床研究[J].中醫(yī)正骨,2018,30(05):6-9.
　WANG Leisheng,YANG Yong.A clinical study of acupuncture at zygapophysial joint with warmed needle that reaches there by penetrating acupoint of bladder meridian for treatment of low back pain originated from lumbar zygapophysial joints[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(05):6-9.
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經(jīng)膀胱經(jīng)腧穴透刺關(guān)節(jié)突關(guān)節(jié)溫針灸治療腰椎關(guān)節(jié)突關(guān)節(jié)源性腰痛的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年05期
頁碼:
6-9
欄目:
臨床研究
出版日期:
2018-05-20

文章信息/Info

Title:
A clinical study of acupuncture at zygapophysial joint with warmed needle that reaches there by penetrating acupoint of bladder meridian for treatment of low back pain originated from lumbar zygapophysial joints
作者:
王雷生1; 楊勇2
1.河南省中醫(yī)藥研究院附屬醫(yī)院,河南 鄭州 450004; 2.河南中醫(yī)藥大學第三附屬醫(yī)院,河南 鄭州 450008
Author(s):
WANG Leisheng1; YANG Yong2
1.The Affiliated Hospital of Henan Academy of Traditional Chinese Medicine,Zhengzhou 450004,Henan,China 2.The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450008,Henan,China
關(guān)鍵詞:
腰痛;  椎關(guān)節(jié)突關(guān)節(jié);  溫針療法;  膀胱經(jīng);  透針;  臨床試驗
Keywords:
low back pain;  zygapophyseal joint;  needle warming therapy;  bladder meridian;  point-through-point method;  clinical trial
文獻標志碼:
A
摘要:
目的:觀察經(jīng)膀胱經(jīng)腧穴透刺關(guān)節(jié)突關(guān)節(jié)溫針灸治療腰椎關(guān)節(jié)突關(guān)節(jié)源性腰痛的臨床療效和安全性。方法:將72例符合要求的腰椎關(guān)節(jié)突關(guān)節(jié)源性腰痛患者隨機分為2組,每組36例。直刺組在患者L4、L5、S1椎體雙側(cè)上關(guān)節(jié)突與相應橫突根部的交界點實施溫針灸治療,透刺組采用經(jīng)雙側(cè)氣海俞、大腸俞、關(guān)元俞向L4、L5、S1椎體同側(cè)上關(guān)節(jié)突與相應橫突根部交界點透刺溫針灸治療。2組的溫針灸治療均每天1次,10次為1個療程,間隔7 d后進行下一療程治療,共治療2個療程。采用視覺模擬量表(visual analogue scale,VAS)評定患者的腰部疼痛情況,采用BCS-400背力計測定患者的腰背伸力,采用Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)問卷表評定腰痛對患者日常生活的影響,同時觀察患者試驗期間的不良反應發(fā)生情況。結(jié)果:2組患者均完成試驗,試驗過程中均未出現(xiàn)不良反應。治療前2組患者的腰痛VAS評分比較,差異無統(tǒng)計學意義(t=0.081,P=0.936); 治療結(jié)束后2組患者的腰痛VAS評分均較治療前降低[(6.62±1.50)分,(3.18±1.09)分,t=7.635,P=0.000;(6.71±1.59)分,(2.10±1.13)分,t=12.875,P=0.001]; 治療結(jié)束后直刺組的評分高于透刺組(t=5.473,P=0.008)。治療前2組患者的腰背伸力比較,差異無統(tǒng)計學意義(t=0.253,P=0.880); 治療結(jié)束后2組患者的腰背伸力均較治療前增大[(58.02±3.67)N,(64.64±5.23)N,t=11.771,P=0.000;(57.89±5.77)N,(67.17±4.46)N,t=8.005,P=0.000]; 治療結(jié)束后直刺組的腰背伸力低于透刺組(t=-3.751,P=0.000)。治療前2組患者的ODI比較,差異無統(tǒng)計學意義(t=1.240,P=0.287); 治療結(jié)束后2組患者的ODI均較治療前降低[(68.45±13.67)%,(17.64±11.23)%,t=15.332,P=0.000;(69.19±12.77)%,(13.17±10.46)%,t=17.653,P=0.000]; 治療結(jié)束后直刺組的ODI高于透刺組(t=-4.369,P=0.001)。結(jié)論:經(jīng)膀胱經(jīng)腧穴透刺關(guān)節(jié)突關(guān)節(jié)溫針灸治療和關(guān)節(jié)突關(guān)節(jié)溫針灸治療均能有效緩解腰椎關(guān)節(jié)突關(guān)節(jié)源性腰痛患者的腰部疼痛、增強患者的腰背伸力、改善腰部功能,且均有較高的安全性,但前者的療效更好。
Abstract:
Objective:To observe the clinical curative effects and safety of acupuncture at zygapophysial joint with warmed needle that reaches there by penetrating acupoint of bladder meridian for treatment of low back pain originated from lumbar zygapophysial joints.Methods:Seventy-two patients with low back pain originated from lumbar zygapophysial joints enrolled in the study were randomly divided into straight acupuncture group and penetrating acupuncture group,36 cases in each group.The patients in straight acupuncture group were treated with acupuncture with warmed needles at the junction points of bilateral superior articular processes of L4-S1 and corresponding roots of transverse processes,while the patients in penetrating acupuncture group were treated with acupuncture at the junction points of ipsilateral superior articular processes of L4-S1 and corresponding roots of transverse processes with warmed needles that reached there by penetrating bilateral acupoints of Qihaishu(BL24),Dachangshu(BL25)and Guanyuanshu(BL26).The needle warming therapy was performed on patients once a day for 2 courses of treatment,10 times for each course with a 7-day rest-insertion between courses.The low back pain,the low back tensility and the effect of low back pain on daily living were evaluated by using visual analogue scale(VAS),BCS-400 back strength dynamometer and Oswestry disability index(ODI)questionnaires respectively,meanwhile,the adverse reactions were observed.Results:The clinical trial was finished successfully in all patients,and no adverse reactions were found in the 2 groups during the clinical trial.There was no statistical difference in the low back pain VAS scores between the 2 groups before the treatment(t=0.081,P=0.936).The low back pain VAS scores decreased after the end of the treatment compared to pretreatment in the 2 groups(6.62+/-1.50 vs 3.18+/-1.09 points,t=7.635,P=0.000; 6.71+/-1.59 vs 2.10+/-1.13 points,t=12.875,P=0.001).The low back pain VAS scores were higher in straight acupuncture group compared to penetrating acupuncture group after the end of the treatment(t=5.473,P=0.008).There was no statistical difference in the low back tensility between the 2 groups before the treatment(t=0.253,P=0.880).The low back tensility increased after the end of the treatment compared to pretreatment in the 2 groups(58.02+/-3.67 vs 64.64+/-5.23 N,t=11.771,P=0.000; 57.89+/-5.77 vs 67.17+/-4.46 N,t=8.005,P=0.000).The low back tensility was lower in straight acupuncture group compared to penetrating acupuncture group after the end of the treatment(t=-3.751,P=0.000).There was no statistical difference in the ODI between the 2 groups before the treatment(t=1.240,P=0.287).The ODI decreased after the end of the treatment compared to pretreatment in the 2 groups(68.45+/-13.67 vs 17.64+/-11.23%,t=15.332,P=0.000; 69.19+/-12.77 vs 13.17+/-10.46%,t=17.653,P=0.000).The ODI was higher in straight acupuncture group compared to penetrating acupuncture group after the end of the treatment(t=-4.369,P=0.001).Conclusion:Both acupuncture at zygapophysial joint with warmed needle that reaches there by penetrating acupoint of bladder meridian and straight acupuncture at zygapophysial joint with warmed needle can effectively relieve low back pain,enhance low back tensility and improve low back function in patients with low back pain originated from lumbar zygapophysial joints,and they have high safety,however,the former surpasses the latter in curative effect.

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備注/Memo

備注/Memo:
基金項目:河南省中醫(yī)藥科學研究專項課題(2015ZY02070) 通訊作者:楊勇 E-mail:[email protected]
更新日期/Last Update: 1900-01-01