摘要
目的 探讨腰椎骨边取穴针刺联合美式整脊治疗产后非特异性下腰痛(nonspecific low back pain, NLBP)的临床疗效。方法 选取2019年6月至2021年5月北京市东城区第一人民医院收治的产后NLBP患者70例,采用随机数字隐匿信封法分为对照组(35例,美式整脊常规治疗)与观察组(35例,美式整脊常规治疗联合针刺治疗)。采用简明McGILL疼痛问卷(short-form McGill pain questionnaire, SF-MPQ)评估疼痛程度,包括疼痛分级指数(pain rating index,PRI)、疼痛视觉模拟评分(visual analogue scale, VAS)和疼痛强度(present pain intensity, PPI)。采用日本骨科协会(Japanese Orthopaedic Association, JOA)下腰痛评分表和改良Oswestry功能障碍指数(Oswestry disability index, ODI)评估日常生活能力。采用生活满意度指数A(life satisfaction index A, LSIA)评估生存质量。结果 治疗2周及4周后,两组患者PRI、VAS和PPI评分均较治疗前有显著下降,且治疗4周后PRI、VAS和PPI评分均低于治疗2周后,差异有统计学意义(P<0.01);治疗4周后,观察组PRI、VAS和PPI评分均低于对照组,差异有统计学意义(P<0.05)。治疗2周及治疗4周后,两组JOA评分呈上升、ODI评分呈下降趋势(P<0.001),且治疗4周后的JOA评分高于治疗2周后,ODI评分低于治疗2周后,差异有统计学意义(P<0.05);治疗2周后,观察组JOA评分高于对照组,但差异无统计学意义(P>0.05),ODI评分低于对照组,差异有统计学意义(P<0.01);治疗4周后,观察组JOA评分高于对照组、ODI评分低于对照组,差异均有统计学意义(P<0.05)。治疗4周后,两组患者LSIA评分均较治疗前升高(P<0.01),且观察组较对照组升高更显著(P<0.05)。结论 腰椎骨边取穴针刺联合美式整脊与单一美式整脊治疗对产后NLBP均有较好的镇痛效果,均能提升患者的日常生活能力,改善生存质量,但前者优于后者。
Objective To investigate the clinical efficacy of acupuncture combined with American chiropractic at the edge of lumbar vertebrae in the treatment of postpartum nonspecific low back pain(NLBP). Methods Seventy patients with postpartum NLBP admitted to the First People’s Hospital of Dongcheng District from June 2019 to May 2021 were selected and divided into the control group(35 patients, treated with American chiropractic treatment) and the observation group(35patients, American chiropractic treatment combined with acupuncture treatment) based on the randomized digital hidden envelope method. The pain level was assessed by the short-form McGill pain questionnaire(SF-MPQ), including pain rating index(PRI), visual analogue scale(VAS) and the present pain intensity(PPI). Activity of daily living was assessed by the Japanese Orthopaedic Association(JOA) lower back pain scale and the Oswestry disability index(ODI). The quality of life was assessed by the life satisfaction index A(LSIA). Results After two and four weeks of treatment, the PRI, VAS and PPI scores of the two groups reduced obviously compared with those before treatment, and the PRI, VAS and PPI scores of four weeks of treatment were lower than those of two weeks of treatment, the differences were statistically significant(P < 0.01).After four weeks of treatment, PRI, VAS and PPI scores in the observation group were lower than those in the control group,the differences were statistically significant(P < 0.05). After two weeks and four weeks of treatment, JOA score increased and ODI score decreased in both groups(P < 0.001), and JOA score of four weeks of treatment was higher than that of two weeks of treatment, while ODI score was lower than that of two weeks of treatment with statistical significance(P < 0.05). After two weeks of treatment, JOA score in the observation group was higher than that in the control group, with no statistical difference(P > 0.05), while ODI score was lower than that in the control group, the difference was statistically significant(P < 0.01).After four weeks of treatment, JOA score in the observation group was higher than that in the control group, while ODI score was lower than that in the control group, with statistical significance(P < 0.05). After four weeks of treatment, LSIA scores in both groups were higher than those before treatment(P < 0.01), and the increasement in observation group was greater than that in control group(P < 0.05). Conclusions Both lumbar vertebral edge acupuncture combined with American chiropractic and single American chiropractic treatment have good analgesic effects on postpartum nonspecific lower back pain and can improve patients’ activity of daily living and quality of life, but the former is better.
作者
谢占国
刘璋
陈宇征
李诗梦
许璐凡
沈喜萍
Xie Zhanguo;Liu Zhang;Chen Yuzheng;Li Shimeng;Xu Lufan;Shen Xiping(Department of Acupuncture and Moxibustion,The First People’s Hospital of Dongcheng District,Beijing 100075,China)
出处
《北京医学》
CAS
2022年第7期581-585,共5页
Beijing Medical Journal
基金
北京中医药薪火传承“3+3”工程(SZ-A-12)。
关键词
产后
非特异性下腰痛
针刺
美式整脊
镇痛
postpartum
nonspecific low back pain(NLBP)
acupuncture
American chiropractic
analgesia
