| BACKGROUNDMost patients in Beijing massage hospital have different degrees of back pain,which is caused by a variety of causes,such as lumbar disc herniation,lumbar muscle strain,lumbar fasciitis,lumbar spinal stenosis,lumbar tumors and spinal canal tumors,lumbar fractures,among which lumbar disc herniation is the most common.Due to its complex etiology,unknown pathogenesis and easy recurrence,it is the focus of current research.Lumbar intervertebral disc herniation is caused by degeneration of lumbar intervertebral disc,rupture of annulus fibrosus,protrusion of nucleus pulposus or nucleus pulposus,and compression of nerve root or spinal cord.The main clinical manifestations of lumbar and hip pain,numbness and pain of lower limbs,and limited movement are 14-15 and 15-s1,with the highest incidence of intervertebral disc herniation clinically.Epidemiological investigation shows that lumbar disc herniation is related to age and occupation,with the highest incidence in the 25-55 age range,which is related to heavy work load,more labor activity and more injury opportunities.Especially in medium and large cities,the clinical incidence of lumbar disc herniation has been increasing year by year with the acceleration of life rhythm and the increase of work fatigue.At present,there are a lot of treatments for lumbar disc herniation in China and abroad,but the clinical effect is difficult to determine,there is a certain recurrence rate,and most patients do not want to receive surgical treatment.Lumbar disc herniation has brought serious troubles to People’s Daily life.Therefore,it has become an urgent problem to seek the best treatment method and improve the quality of life of patients with lumbar disc herniation.OBJECTIVEThis subject adopts acupotomy combined with massage to treat patients with lumbar intervertebral disc herniation,aiming to analyze the clinical efficacy of acupotomy combined with massage for patients with lumbar intervertebral disc herniation through clinical observation,so as to provide new ideas and methods for clinical treatment of lumbar intervertebral disc herniation.METHODS100 patients with lumbar disc herniation admitted to Beijing massage hospital(from January 2017 to August 2018)were randomly divided into observation group and control group according to the order of treatment.Observation group(needle knife combined with massage therapy,50 cases),first massage treatment,any needle knife therapy,needle knife therapy selected xi jiu brand I type needle knife 4(sino-german joint venture,maanshan bond medical instruments co.,LTD.,batch number 1808001),preoperative preparation,postures,fixed-point tag,regular disinfection,anesthesia,and strictly follow four steps into the needle steps operation procedures.Operation choice position:(1)the point between the spine(2)articular process capsule point(3)transverse process point(4)sciatic nerve exit point(5)buttock epithelial nerve into buttock point(6)waist buttock leg leg positive reaction point(7)leg lateral side or posterior side point.Acupotomology was performed once a week for a total of 2 weeks.Control group:(massage therapy,50 cases).Basic manipulation:massage,massage,plucking,point manipulation,holding and rubbing,pulping and rubbing were mainly used,which mainly acted on the routes of du meridian,foot sun bladder meridian,foot yangming meridian and foot shaoyang meridian.Appropriate symptomatic manipulation and massage therapy.Acute stage:local soft,moderate manipulation,appropriate with the distal point selection.Remission period:adjust stimulation amount and intensity appropriately according to patients’ condition.2 times/day,15 minutes/time,7 days/week,for a total of 2 weeks.At the end of the course,the patients were instructed to strengthen the lumbar back muscle exercise.Follow-up was conducted after 1 month.Manipulation in the observation group was the same as that in the control group.To collect all of the patients before and after treatment the waist pain visual analog scale of VAS score,record daily life ability of JOA score before and after the treatment,patients with finishing for statistical data,using statistical software SPSS21.0 to statistically analyze the markedly effective rate of two groups of patients(treatment 2 weeks after the evaluation results)and the recurrence rate(follow-up after 1 month of course).According to the calculated statistical results,the clinical significance of this study was analyzed,and finally the efficacy evaluation results and conclusions of this clinical study were obtained.RESULTS1.General information:there were 33 female patients and 17 male patients in the observation group;The average age was(51.20±1.83)years,and the average duration of disease was(47.16±5.93)days.Thirty-eight patients had lower limb symptoms and 12 patients had no lower limb symptoms.There were 35 female patients and 15 male patients in the control group.The average age was(52.08± 1.92)years,and the average duration of disease was(44.82±6.96)days.Thirty-four patients had lower limb symptoms and 16 had no lower limb symptoms.There was no statistically significant difference between the two groups in terms of gender ratio,average age,average duration of disease and whether there were lower limb symptoms(P>0.05).2.VAS scores of the observation group were 6.78±0.97 before treatment and 2.62±0.69 after treatment.VAS scores of the control group were 6.36±1.02 before treatment and 3.12±0.77 after treatment.Both the observation group and the control group had curative effect after treatment,and the comparison between the groups showed that P<0.05,the difference between the observation group before and after treatment was significant and statistically significant.3.JOA score of the observation group was 12.34±3.47 before treatment and 23.64±2.94 after treatment.JOA score of the control group was 12.30±3.76 before treatment and 22.44±3.48 after treatment.Both the observation group and the control group had curative effect after treatment,and the comparison between the groups showed that P<0.05,the difference between the observation group before and after treatment was significant and statistically significant.4.Improvement rate of the observation group:18 cases were clinically controlled,28 cases showed obvious effect,4 cases were effective,0 cases were invalid,and the more obvious rate of treatment(clinical control+obvious effect)was 92.00%(46/50).Improvement rate of the control group:14 cases were clinically controlled,22 cases showed obvious effect,14 cases were effective,0 cases were ineffective,and the more obvious rate of treatment(clinical control+obvious effect)was 72.00%(36/50).The comparison between groups showed that P<0.05,the treatment of the observation group was significantly better than that of the control group.5.Follow-up after 1 month of treatment showed 1 case recurrence in the observation group(2%)and 5 cases recurrence in the control group(10%).The comparison between groups showed that P<0.05,the recurrence rate in the observation group was significantly lower than that in the control group.CONCLUSIONSAcupotomology combined with massage is significantly better than manipulation alone in the treatment of patients with lumbar disc herniation,and the recurrence rate is low during the return visit,which is an economic,safe and effective treatment program. |
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