熏蒸、针灸联合治疗老年颈肩腰腿痛对腰椎功能及肢体运动功能的影响
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摘要
目的探讨熏蒸、针灸联合治疗老年颈肩腰腿痛对腰椎功能及肢体运动功能的影响。方法抽签法选择某院134例老年颈肩腰腿痛患者,按随机数表法分为观察组(中药熏蒸联合针灸治疗)与对照组(针灸治疗)各67例。对比两组临床疗效、中医症候积分、腰椎功能、肢体运动功能及不良反应发生率。结果观察组总有效率95.52%,高于对照组的83.58%,差异有统计学意义(P<0.05)。两组治疗前、治疗后1周、治疗后2周肿胀、疼痛、功能受限评分呈降低趋势(P<0.05)。观察组治疗后1周、治疗后2周各中医症状积分均低于对照组,差异有统计学意义(P<0.05)。两组治疗前、治疗后1周、治疗后2周日本骨科学会下腰痛(Japanese Orthopaedic Associationscores,JOA)评分、肢体运动功能评分(Fugl-Meyer)呈增高趋势(P <0.05)。观察组治疗后1周、治疗后2周JOA评分、Fugl-Meyer评分高于对照组,差异有统计学意义(P<0.05)。两组患者均未发生明显不良反应。结论与单纯针灸治疗相比,熏蒸、针灸联合治疗老年颈肩腰腿痛疗效更优,可明显改善患者临床症状、腰椎功能及肢体运动功能,安全性高,具有较好的临床应用价值。
Objective To explore the effect of fumigation combined with acupuncture on lumbar function and limb motor function in the treatment of neck and back pain among elderly patients.Me thods 134 cases of elderly patients with neck and shoulder pain in a hospital were randomly divided into the observation group(herbal fumigation combined with acupuncture) and the control group(acupuncture),with 67 cases in each group.The clinical curative effect,TCM syndrome score,lumbar function,limb movement function and the incidence of adverse reaction were compared between the two groups.Re s ults The total effective rate of the observation group(95.52%) was higher than that of the control group( 83. 58 %) and the difference showed significant statistical significance( P < 0. 05). The scores of swelling,pain and function limitation before the treatment,1 week and 2 weeks after the treatment decreased in the two groups(P <0.05).The TCM syndrome scores in the observation group 1 week and 2 weeks after the treatment were lower than those in the control group and the difference was of statistical significance( P <0.05).Before the treatment,1 week and 2 weeks after the treatment,the JOA score and Fugl-Meyer score increased in the two groups(P <0.05).1 week and 2 weeks after the treatment,the JOA score and Fugl-Meyer score in the observation group were higher than those in the control group and the difference was statistically significant( P<0.05).No significant adverse reactions occurred in all two groups.Conclus ion Compared with acupuncture therapy,acupuncture combined with fumigation in the treatment of elderly patients with neck and shoulder pain enjoyed better curative effect and can significantly improve the clinical symptoms,lumbar function and limb motor function of patients.It has high safety and good clinical application value.
Objective To explore the effect of fumigation combined with acupuncture on lumbar function and limb motor function in the treatment of neck and back pain among elderly patients.Me thods 134 cases of elderly patients with neck and shoulder pain in a hospital were randomly divided into the observation group(herbal fumigation combined with acupuncture) and the control group(acupuncture),with 67 cases in each group.The clinical curative effect,TCM syndrome score,lumbar function,limb movement function and the incidence of adverse reaction were compared between the two groups.Re s ults The total effective rate of the observation group(95.52%) was higher than that of the control group( 83. 58 %) and the difference showed significant statistical significance( P < 0. 05). The scores of swelling,pain and function limitation before the treatment,1 week and 2 weeks after the treatment decreased in the two groups(P <0.05).The TCM syndrome scores in the observation group 1 week and 2 weeks after the treatment were lower than those in the control group and the difference was of statistical significance( P <0.05).Before the treatment,1 week and 2 weeks after the treatment,the JOA score and Fugl-Meyer score increased in the two groups(P <0.05).1 week and 2 weeks after the treatment,the JOA score and Fugl-Meyer score in the observation group were higher than those in the control group and the difference was statistically significant( P<0.05).No significant adverse reactions occurred in all two groups.Conclus ion Compared with acupuncture therapy,acupuncture combined with fumigation in the treatment of elderly patients with neck and shoulder pain enjoyed better curative effect and can significantly improve the clinical symptoms,lumbar function and limb motor function of patients.It has high safety and good clinical application value.
引文
[1]刘芳,吕客,宋一平.放散式冲击波循经取穴治疗颈肩腰腿痛的临床疗效观察[J].颈腰痛杂志,2015,36(3):233-235.
[2]贺跃光,易晓阳,杨黎,等.亚高原地区某部飞行员颈肩腰腿痛发生情况调查与分析[J].西南国防医药,2015,25(1):114-116.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:162.
[4]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,1994:86.
[5]张丽,郭光昕.艾灸神阙、关元穴联合推拿治疗腰椎间盘突出症临床研究[J].中医学报,2017,32(9):1774-1777.
[6]周晓林,朱兰,曹广文.社区分级康复管理模式对脑卒中后居家患者功能恢复的效果评价[J].中华全科医学,2017,15(7):1201-1203.
[7]Tunwattanapong P,Kongkasuwan R,Kuptniratsaikul V.The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain:a randomized controlled trial[J].Clinical Rehabilitation,2016,30(1):64.
[8]宋宇锋,张昱.中药穴位贴敷辅助治疗颈肩腰腿痛的疗效分析[J].中国药物与临床,2016,16(2):271-272.
[9]刘虹豆,余洋,樊效鸿.中医综合疗法治疗颈椎病100例临床观察[J].吉林中医药,2015,35(1):34-36.
[10]王平,李永春.针灸联合中药熏蒸辨治颈肩腰腿痛的临床观察[J].辽宁中医杂志,2016,43(9):1968-1971.
[11]梁新丽,朱梦良,赵国巍,等.白芷中呋喃香豆素类成分对葛根素、芍药苷、长春新碱肠道转运的影响[J].中草药,2015,46(7):1007-1011.
[12]任星宇,罗敏,邓才富,等.白芷挥发油提取方法及药理作用的研究进展[J].中国药房,2017,28(29):4167-4170.
[13]李伟锋,蒋建兰.姜黄素药理作用的研究现状[J].中国临床药理学杂志,2017,33(10):957-960.
[14]张立国,马东升,程佳佳,等.中药挥发油/水提物的细胞抗炎、免疫及骨细胞修复活性的比较[J].中药新药与临床药理,2015,26(1):34-39.
[15]朱继孝,李雪,钟国跃,等.栀子柏皮汤及其拆方对中医阳黄证黄疸大鼠退黄作用的研究[J].中药新药与临床药理,2015,26(1):25-30.
[16]冯娅茹,张文婷,李二文,等.三棱化学成分及药理作用研究进展[J].中草药,2017,48(22):4804-4818.
[17]胡飞,焦亚军.中药熏蒸结合西医治疗腰椎间盘突出症37例临床观察[J].四川中医,2016,34(1):167-168.
[18]宋学军.疼痛信号外周神经转导的分子生物学机制[J].中国疼痛医学杂志,2016,22(1):2-7.
[2]贺跃光,易晓阳,杨黎,等.亚高原地区某部飞行员颈肩腰腿痛发生情况调查与分析[J].西南国防医药,2015,25(1):114-116.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:162.
[4]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,1994:86.
[5]张丽,郭光昕.艾灸神阙、关元穴联合推拿治疗腰椎间盘突出症临床研究[J].中医学报,2017,32(9):1774-1777.
[6]周晓林,朱兰,曹广文.社区分级康复管理模式对脑卒中后居家患者功能恢复的效果评价[J].中华全科医学,2017,15(7):1201-1203.
[7]Tunwattanapong P,Kongkasuwan R,Kuptniratsaikul V.The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain:a randomized controlled trial[J].Clinical Rehabilitation,2016,30(1):64.
[8]宋宇锋,张昱.中药穴位贴敷辅助治疗颈肩腰腿痛的疗效分析[J].中国药物与临床,2016,16(2):271-272.
[9]刘虹豆,余洋,樊效鸿.中医综合疗法治疗颈椎病100例临床观察[J].吉林中医药,2015,35(1):34-36.
[10]王平,李永春.针灸联合中药熏蒸辨治颈肩腰腿痛的临床观察[J].辽宁中医杂志,2016,43(9):1968-1971.
[11]梁新丽,朱梦良,赵国巍,等.白芷中呋喃香豆素类成分对葛根素、芍药苷、长春新碱肠道转运的影响[J].中草药,2015,46(7):1007-1011.
[12]任星宇,罗敏,邓才富,等.白芷挥发油提取方法及药理作用的研究进展[J].中国药房,2017,28(29):4167-4170.
[13]李伟锋,蒋建兰.姜黄素药理作用的研究现状[J].中国临床药理学杂志,2017,33(10):957-960.
[14]张立国,马东升,程佳佳,等.中药挥发油/水提物的细胞抗炎、免疫及骨细胞修复活性的比较[J].中药新药与临床药理,2015,26(1):34-39.
[15]朱继孝,李雪,钟国跃,等.栀子柏皮汤及其拆方对中医阳黄证黄疸大鼠退黄作用的研究[J].中药新药与临床药理,2015,26(1):25-30.
[16]冯娅茹,张文婷,李二文,等.三棱化学成分及药理作用研究进展[J].中草药,2017,48(22):4804-4818.
[17]胡飞,焦亚军.中药熏蒸结合西医治疗腰椎间盘突出症37例临床观察[J].四川中医,2016,34(1):167-168.
[18]宋学军.疼痛信号外周神经转导的分子生物学机制[J].中国疼痛医学杂志,2016,22(1):2-7.