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阐释艾灸联合腰痛散药烫治疗寒湿型腰椎间盘突出症临床护理

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论文导读:tionassesentindexesoftreatmentgroupweresignificantlybetterthanthoseofcontrolgroup(P<0.05).Thetwogroupshadnoobviousadversereactions.ConclusionTheclinicalnursingeffectofmoxibustioncombinedwithYaotongPowdermedicinehottreatmentforcolddampnesssyndromeoflumbar
[摘要] 目的 探讨艾灸联合腰痛散药烫治疗寒湿型腰椎间盘突出症的临床护理效果。策略 选取2012年3月~2013年3月在广东省韶关市中医院住院的寒湿型腰痛患者120例,随机分为治疗组和对照组各60例。对照组予艾灸疗法及常规护理,治疗组予艾灸联合腰痛散药烫及综合护理干预。比较两组的临床疗效及疼痛视觉模拟评分法(VAS)、数字评分法(NRS)、腰椎功能评定情况。 结果 治疗组有效率为91.67%,对照组为81.67% ,两组比较,差异有统计学作用(P < 0.05)。两组VAS评分治疗后与治疗前比较,差异有统计学作用(P < 0.05);治疗后,治疗组的VAS评分为(2.34±0.57)分,对照组为(3.07±0.83)分,治疗组显著低于对照组,两组比较,差异有统计学作用(P < 0.05)。两组NRS评分治疗后与治疗前比较,差异有统计学作用(P < 0.05);治疗后,治疗组的NRS评分为(3.21±0.87)分,对照组为(4.23±0.89)分,治疗组显著低于对照组,两组比较,差异有统计学作用(P < 0.05)。治疗后治疗组患者的疼痛程度较冶疗前均得到改善,屈曲伸直比明显减小,中位频率斜率明显增大;腰椎功能评定指标比较,治疗组均明显优于对照组,差异有统计学作用(P < 0.05)。两组均未见明显不良反应。 结论 艾灸联合腰痛散药烫治疗寒湿型腰椎间盘突出症临床护理效果显著,值得在临床推广应用。
[关键词] 艾灸;腰痛散;药烫治疗;寒湿型腰椎间盘突出症;护理
[] B[文章编号] 1673-7210(2014)05(c)-0134-04
Observation on clinical nursing effect of moxibustion combined with Yaotong Powder medicine hot treatment for cold dampness syndrome of lumbar disc herniation
JIANG Shangqun
Shaoguan Hospital of Traditional Chinese Medicine, Guangdong Province, Shaoguan 510026, China
[Abstract] Objective To explore the clinical nursing effect of moxibustion combined with Yaotong Powder medicine hot treatment for cold dampness syndrome of lumbar disc herniation. Methods 120 cases of cold dampness syndrome of lumbar disc herniation from March 2012 to March 2013 in Shaoguan Hospital of Traditional Chinese Medicine were collected, all patients were randomly divided into treatment group and control group with 60 cases in each. The control group was treated with moxibustion and routine nursing, while the treatment group was treated with moxibustion combined with Yaotong Powder medicine hot treatment and integrated nursing intervention. The clinical therapeutic effect, VAS, NRS score and lumbar function assesent of two groups were compared. Results The effective rate of treatment group was 91.67%, which was higher than 81.67% of control group(P < 0.05). The differences were statistically significant in the VAS, NRS scores of the two groups before and after treatment (P < 0.05); after treatment, the VAS, NRS scores of treatment group were (2.34±0.57), (3.21±0.87) scores respectively, which were significantly lower than control group of (3.07±0.83), (4.23±0.89) scores, the differences were statistically significant (P < 0.05). The degree of pain in treatment group were improved after treatment, flexion extension ratio were decreased, median frequency slope were increased; the lumbar function assesent indexes of treatment group were significantly better than those of control group (P < 0.05). The two groups had no obvious adverse reactions. Conclusion The clinical nursing effect of moxibustion combined with Yaotong Powder medicine hot treatment for cold dampness syndrome of lumbar disc herniation is significant, and worthy of clinical application.
[Key words] Moxibustion; Yaotong Powder; Medicine hot treatment; Cold dampness syndrome of lumbar disc herniation; Nursing
腰椎间盘突出症在临床较为常见,究其病因主要是因外力、劳损、扭伤等刺激使得患者的腰椎间盘受到牵拉、挤压和、扭转,从而导致腰椎间盘的纤维环部分或全部破裂,髓核向后侧,或者后外侧突出,导致腰腿痛综合症候的发生[1]。20~40岁的青壮年好发,临床主要表现为腰痛、下肢放射痛、麻木感等,严重影响患者的工作及生活。本研究对60例寒湿型腰椎间盘突出症患者采用艾灸联合腰痛散药烫治疗及护理,临床疗效显著,现报道如下:
中药药熨法是将加热后的药物放于人体的某一部位或穴位来回运转,使药力和热力同时自体表毛窍透入经络、血脉,达到温经通络、祛瘀消肿、散寒止痛的功效[8]。药物局部热熨可使腰椎间盘突出症局部温度升高,血管得到扩张,加快微循环,使药物利于吸收。温热效应同时可以镇痛、改善血液循环,推动炎症的吸收。腰痛散由当归、川芎、生草乌、走马胎、五指毛桃、生川乌、半枫荷等16味中草药组成。方中,川乌、草乌祛风散寒、除湿止痛,桂枝温经散寒、止痛,共为君药;生用川乌、草乌以使得止痛效果加强。姜黄为臣,舒筋活血、祛风除湿、通经止痛。细辛为臣,祛风散寒,止痛。羌活为臣,祛风,胜湿,止痛。当归、田七、川芎活血化瘀,通滞、行气,消肿止痛。过山风、威灵仙、忍冬藤、海风藤祛风通络,止痛。走马胎为引经药,祛风活血、消肿止痛,论文导读:
善走四肢。再加上白酒性温走串,加强药效。诸药合用,共奏温经散寒、通经活络、行气活血止痛之功效[9-10]。
本研究对寒湿型腰椎间盘突出症患者在艾灸基础上采用药物热熨治疗,同时给予综合护理策略,如生活起居调护、情志及饮食调护及功能康复指导等,结果显示,治疗组有效率高于对照组(P < 0.05)。两组治疗前后VAS、NRS评分比较,差异有统计学作用(P < 0.05);治疗后治疗组VAS、NRS评分显著低于对照组(P < 0.05)。两组均未见明显不良反应。说明采用艾灸联合腰痛散药烫治疗寒湿型腰痛患者的护理效果更为理想,能够明显改善寒湿性腰痛患者的症状,提高治疗效果。
综上所述,艾灸联合腰痛散药烫治疗寒湿型腰痛患者护理效果较好,能提高治疗效果,有助于药物的吸收,且能松弛肌肉,缓解肌肉痉挛,推动组织修复,明显改善患者症状,维持脊柱稳定性,患者易于接受,值得在临床推广应用。
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(收稿日期:2014-03-10本文编辑:卫轲)
[基金项目] 广东省韶关市医学科研基金立项课题(编号Y14103)。