针刺配合痹痛散外敷治疗急性期中央型腰椎间盘突出症疗效观察

The Curative Effect of Acupuncture and External Application ofBitong San for Acute Stage of Central Type Prolapse of LumbarIntervertebral Disc

庄子齐; 江钢辉

广州中医药大学第一附属医院 510405

广东

新中医.-2002,34(3) 47-48

目的：观察针刺特定穴配合痹痛散外敷治疗急性期中央型腰椎间盘突出症临床疗效。方法：随机分为两组。本组针刺治疗，选穴：委中、委阳、外丘、侠溪、金门、阿是穴。阿是穴向双侧椎间孔方向深刺至椎间孔附近，得气后加电15分钟；委阳、侠溪点刺出血3-5滴；委中刺络拔罐，留罐3-5分钟；外丘、金门用1-2寸毫针针刺得气后，行导气法3分钟后，加电疏密波15分钟出针。隔日1次，15次为1疗程。针刺后用痹痛散外敷，药物组成：牡丹皮、马钱子、两面针、秦艽、闹洋花等。按3：0.5：3：3：0.5比例打成粉剂，用水、蜜糖调成糊膏状，取穴：阿是穴、腰阳关、大肠俞、关元俞、环跳、阳陵泉等，据症加减。每次每穴热敷5-10g，外敷6-8小时，隔日1次，15次为1疗程。对照组常规针刺治疗，取穴：阿是穴、夹脊、次髎、环跳、委中、阳陵泉、膈俞。委中刺络拔罐，环跳深刺，其他穴位常规针刺，得气后加电疏密波15分钟。隔日1次，15次为1疗程。疗效标准：参照《中医病证诊断疗效标准》、Macab手术、疗效评分标准《腰椎间盘突出症的评分法疗效评定标准》及Fairbankjcp腰痛病情计分表，选择与腰椎间盘突出症关系最为密切的症状、下肢功能活动，临床体征等进行量化评分，各项评分相加为总分。优：40-50分。良：30-40分。可：20-30分。差：20分以下。结果：本组33例，优13例，良10例，可6例，差4例，总有效率87.9%；对照组30例，优6例，良9例，可5例，差10例，总有效率66.7%。本组疗效及平均疗程均明显优于对照组（P<0.01-0.05)。结论：本法具有除湿通络，活血止痛的作用，治疗本病，疗效显著。

Objective: To observe the curative effect of acupuncture to specific acupoints and external application of Bitong San (BS) for acute stage of central type Prolapse of lumbar intervertebral disc (APID). Methods: Waiqiu (GB36), Xiaxi (GB43), Jinmen (BL63), Weizhong (BL40) and Weiyang (BL39) were needled. Ashi point was deeply punctured, and BS was applied on Ashi, Yaoyangguan (DU3), Dachangshu (BL35), Guanyuanshu (BL26), Huantiao (GB30) and Yanglingquan (GB34) in 33 cases of APID. 30 cases receiving routine acupuncture treatment served as control. Results: In treatment group, total effective rate was 87.9%; in control group, total effective rate was 66.7%. The statistical analysis showed significant differences. Conclusion: The curative effect of treatment group is superior than that of control group. Its mechanism may relate with relief of local edema of nerve root, elimination of local inflammation, reduction of analgesic chemicals, absorption of protruding pulpiform nucleus, Promotion of local blood circulation and relief of nerve compression.

中文

椎间盘移位/针灸疗法；腰椎；中药外敷；穴位贴敷法；祛寒；祛湿；活血通络；穴，阿是；穴，腰阳关；穴，关元；秦艽/治疗应用；牡丹皮/治疗应用；马钱子/治疗应用

青年人（13-18)；成年人（19-44)；中年人（45-64)；临床文献；随机对照试验（PT)；人类；男性；女性

历史文献

散剂

椎间盘移位; 针灸疗法; 穴位贴敷法; 急症

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