于忠行 张敬中

【摘要】 目的：探讨针灸推拿联合牵引治疗腰椎间盘突出症的临床效果。方法：选取2019年3-12月于本院门诊及病房就诊的腰椎间盘突出症患者68例为研究对象。按隨机数字表法将患者分为对照组和观察组，每组34例。对照组行牵引治疗，观察组在对照组基础上行针灸与推拿治疗。比较两组患者VAS评分、腰椎JOA评分、炎性因子水平及临床疗效。结果：对照组治疗总有效率为76.5%低于观察组的94.1%，差异有统计学意义（P<0.05）。治疗后，两组VAS评分均低于治疗前，且观察组VAS评分明显低于对照组，差异均有统计学意义（P<0.05）。治疗后，两组JOA评分均高于治疗前，且观察组JOA评分明显高于对照组，差异均有统计学意义（P<0.05）。治疗后，观察组炎性因子TNF-α、IL-1β及hs-CRP水平均低于对照组，差异均有统计学意义（P<0.05）。结论：针灸推拿联合牵引治疗腰椎间盘突出症效果确切，患者临床症状明显改善，痛感明显减轻，生活质量明显提升，适合临床上选择应用。

【关键词】 针灸推拿 牵引治疗 腰椎间盘突出症

Clinical Observation of Acupuncture and Massage Combined with Traction in the Treatment of Lumbar Disc Herniation/YU Zhongxing， ZHANG Jingzhong. //Medical Innovation of China， 2021， 18（10）： 0-028

[Abstract] Objective： To explore the clinical effect of acupuncture and massage combined with traction in the treatment of lumbar disc herniation. Method： A total of 68 patients with lumbar disc herniation who visited the outpatient department and ward of our hospital from March to December 2019 were selected as the research subjects. According to random number table method， the patients were divided into control group and observation group， 34 cases in each group. The control group received traction treatment， and the observation group received acupuncture and massage treatment on the basis of the control group. VAS score， lumbar JOA score， levels of inflammatory factors and clinical efficacy were compared between two groups. Result： The total effective rate of control group was 76.5% lower than 94.1% of observation group， the difference was statistically significant （P<0.05）. After treatment， VAS scores in both groups were lower than those of before treatment， and VAS scores in the observation group was significantly lower than that in the control group， the differences were statistically significant （P<0.05）. After treatment， JOA scores in both groups were higher than those of before treatment， and JOA scores in the observation group was significantly higher than that in the control group， the differences were statistically significant （P<0.05）. After treatment， the levels of TNF-α， IL-1β and hs-CRP in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Acupuncture and massage combined with traction in the treatment of lumbar disc herniation has a definite effect， the clinical symptoms of patients are significantly improved， the pain is significantly reduced， the quality of life is significantly improved， and it is suitable for clinical application.

[Key words] Acupuncture and massage Traction treatment Lumbar disc herniation

First-authors address： Beiling District， General Hospital of the Northern Theater of the Chinese Peoples Liberation Army， Shenyang 110031， China

doi：10.3969/j.issn.1674-4985.2021.10.006

腰椎间盘突出症为临床中引发腰腿疼痛的常见原因，主要是指腰椎间盘的退行性改变与突出，导致腰椎关节发生错位旋转等一系列连锁病变[1]。根据严重程度的不同，轻症患者主要表现为腰腿部放射性疼痛，影响人们正常生活;严重者可累及马尾神经，出现阴部感觉异常，大小便排泄障碍等，甚至失去运动能力，瘫痪在床[2-3]。研究发现，本病男性患者多于女性，且随着社会进步，脑力劳动已成为主要劳动力，坐位办公已成常态，加上体育锻炼减少等不良生活习惯，致本病发病率持续走高并向低龄发展[4]。西医对于腰椎间盘突出症的治疗分为手术与非手术两类，其中手术治疗效果并不满意，多数患者术后仍保有腰腿部症状，因此一般情况下非手术治疗为临床中的首选方案[5-6]。为更好提高腰椎间盘突出症治疗效果，笔者将针灸推拿与康复治疗中牵引疗法联合应用，取得了较好的效果，现报道如下。……