针刺加前屈位o角牵引治疗腰椎间盘突出症的临床研究.docVIP

针刺加前屈位30o角牵引治疗腰椎间盘突出症的临床研究 专 业：针灸推拿学 研究生：魏毅 导 师：林俊山 副教授 副主任医师 摘 要 目的： 探讨针刺加不同角度牵引对腰椎间盘突出症临床疗效的影响。 本课题主要探讨针灸疗法配合成角度牵引对腰椎间盘的影响。对针刺加成角度牵引和单纯成角度牵引治疗“腰突症”进行疗效和治疗时间对比研究，从而确定腰椎间盘突出症的最佳治疗方法，并揭示其可能的治疗机理。 方法： 将60例临床确诊为L5/S1腰椎间盘突出症患者，随机分为治疗组和对照组，治疗组采取针刺加前屈位30o牵引，对照组采取单纯前屈位30o牵引不针刺。分别在治疗10天和20天后，采用卡方检验和t检验评定比较各组间疗效。 结果： 针刺加前屈位30o牵引和单纯前屈位30o牵引不针刺治疗L5/S1腰椎间盘突出症均有效。但针刺加前屈位30o牵引可明显缩短治疗时间（P0.01），提高治愈率。 结论： 针刺加前屈位30o牵引和单纯前屈位30o牵引治疗L5/S1腰椎间盘突出症均有效，但前者在治疗时间上优于单纯前屈位30o牵引。 关键词：1.椎间盘移位/.针灸疗法 2.腰椎/针灸效应 3.牵引术/方法 .  Control Observation on clinical Therapeutic Effects of Intervertebral Disk Displacement Treated with Acupuncture and Traction in 30篴nterior eflexion Mayor: Acupuncture and Modxibustion, Massage Postgraduate: Wei Yi Supervisor: Professor Lin Junshan Abstract Objective : To observe the influence of acupuncture combined with different angulation traction on lumbar intervertebral disc herniation (LIDH). Methods: 60 cases of LIDH in L5/S1 were randomly divided into two group as the treatment group treated with acupuncture and traction in 30?anterior tflexion, and the control group treated with only traction in 30?anterior flexion. Their therapeutic effects and treatment time were compared after 10 day and 20 day. Results: The results showed that the therapeutic effects in every group were good without significant difference, while the time of treatment in treatment group was shorter than the control group (p0.01). Conclusion: It indicates that acupuncture and traction in 30?anteriorn flexion was superior to the other methods in the time of treatment with lumbar intervertebral disc herniation. KEY WORDS 1.intervertebral disc displacement/am ther 2.lumber vertebrae/am eff 3.traction/methods 前 言 腰椎间盘突出症是由于腰椎间盘损伤、退变、纤维环破裂，髓核组织从破裂的纤维环处向后外侧或正后方突出压迫脊神经根、硬膜囊或马尾神经，产生下腰部疼痛和下肢的坐骨神经痛等的临床征候群。腰椎间盘突出症发病患者多为青壮年，男性多于女性。这与劳动强度及外伤有关。据统计20~50岁患者达70%以上，20岁以下发病患者仅占6%左右。值得注意的是：目前国内高龄人群增多，发病年龄有增高之趋势。就发病部位而言，L4/5和L5/S1椎间盘发病率最高，国内外报告均在90%以上，2节段以上突出者占15%以上。[1][