针药结合核心稳定训练治疗非特异性腰痛的效果观察

Effect of acupuncture and medicine combined with core stability training in treating nonspecific low back pain

  • 摘要:
    目的 观察针药结合核心稳定训练治疗非特异性腰痛患者的临床效果。
    方法 选取106例非特异性腰痛患者作为研究对象, 随机分为对照组和观察组,每组53例。对照组采用核心稳定训练治疗,观察组采用针药结合核心稳定训练治疗,持续4周,比较2组患者治疗前后Oswestry功能障碍指数(ODI)评分、视觉模拟评分法(VAS)评分、多裂肌表面肌电图指标平均肌电值(AEMG)、均方根值(RMS)、中位频率(MF)、平均功率频率(MPF)水平、腰部肌耐力评估结果、腰椎活动度和临床疗效、治疗期间不良反应发生情况。
    结果 治疗后,观察组ODI评分、VAS评分依次为(22.56±2.63)、(2.29±0.28)分,分别低于对照组的(29.11±3.14)、(2.85±0.26)分,且2组ODI评分、VAS评分均低于治疗前,差异有统计学意义(P < 0.05)。治疗后,观察组多裂肌AEMG、RMS依次为(579.92±40.36)、(279.91±21.35)μV, 分别高于对照组的(530.87±36.81)、(256.27±17.16)μV, 且2组AEMG、RMS均高于治疗前,差异有统计学意义(P < 0.05);治疗后,观察组MF、MPF依次为(184.89±12.15)、(179.84±13.67)Hz, 分别低于对照组的(218.35±13.42)、(207.41±13.38)Hz, 且2组MF、MPF均低于治疗前,差异有统计学意义(P < 0.05)。治疗后, 2组腰部肌耐力评估中的静态保持时间、动态完成次数分别长于、多于治疗前,且观察组长于、多于对照组,差异有统计学意义(P < 0.05)。治疗后, 2组腰椎前屈、后伸、左侧屈、右侧屈、左旋转、右旋转活动度均大于治疗前,且观察组大于对照组,差异有统计学意义(P < 0.05)。治疗后,观察组临床治疗总有效率为88.68%, 高于对照组的71.70%, 差异有统计学意义(P < 0.05)。治疗期间, 2组患者均未发生明显不良反应。
    结论 针药结合核心稳定训练可降低非特异性腰痛患者疼痛评分,改善腰部神经肌肉功能,增加腰椎活动度,且整体安全性较高。

     

    Abstract:
    Objective To observe the clinical efficacy of acupuncture and medicine combined with core stability training in the treatment of patients with nonspecific low back pain.
    Methods A total of 106 patients with nonspecific low back pain were selected as study subjects, and they were randomly divided into control group and observation group, with 53 cases in each group. The control group was treated with core stability training, while the observation group was given acupuncture and medicine combined with core stability training, and both groups were continuously treated for 4 weeks. Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) score and multifidus surface electromyography indicators average electromyography (AEMG), root mean square (RMS), median frequency (MF), mean power frequency (MPF) before and after treatment, assessment of lumbar muscle endurance, lumbar range of motion, clinical efficacy and adverse reactions during treatment were compared between the two groups.
    Results After treatment, the scores of ODI and VAS were (22.56±2.63) and (2.29±0.28) in the observation group, which were lower than (29.11±3.14) and (2.85±0.26) in the control group(P < 0.05). The scores of ODI and VAS of two groups were lower than those before treatment(P < 0.05). AEMG and RMS in two groups were higher than those before treatment (P < 0.05). After treatment, the AEMG and RMS of multifidus were (530.87±36.81) μV and (256.27±17.16) μV in the control group, which were lower than (579.92±40.36) μV and (279.91±21.35) μV in the observation group(P < 0.05). After treatment, MF and MPF of the observation group were (184.89±12.15) Hz and (179.84±13.67) Hz, respectively, which were lower than (218.35±13.42) and (207.41±13.38) Hz in the control group, and MF and MPF of the two groups were lower than those after treatment, the static holding time and dynamic completion frequency of lumbar muscle endurance test in both groups were lengthened or increased, and were longer or higher in the observation group than those in the control group (P < 0.05). After treatment, the ranges of motions of forward flexion, rear protraction, left-right flexion and left-right rotation of lumbar in two groups were larger than before treatment, and the above ranges of motions were higher in the observation group than those in the control group (P < 0.05). After treatment, the total clinical effective rate was 88.68% in the observation group, which was higher than 71.70% in the control group (P < 0.05). No obvious adverse reactions occurred in the two groups during treatment.
    Conclusion Acupuncture and medicine combined with core stability training can reduce the pain score of patients with nonspecific low back pain, improve the lumbar nerve function and muscle function, and enhance the lumbar range of motion, and has higher integral security.

     

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