| Objective:Intervention by needle knife Sacroiliac joint(Sacroiliac be,SIJ)adjust the pelvis treatment of Lumbar disc disease(Lumbar disc herniation,LDH)and the12 th five-year plan teaching material "needle knife therapy" in conventional treatment method of Lumbar disc prolapse comparisons to observe clinical curative effect difference between two groups of patients.This paper aims to explore the mechanism of acupotomy intervention in the sacroiliac joint for the treatment of lumbar disc herniation,analyze the relationship between the sacroiliac joint,pelvic dysfunction and LDH,and open a new idea for the treatment of lumbar disc herniation.Methods:From November 2018 to December 2019,60 patients with LDH combined with sacroiliac joint dislocation or pelvic tilt were included according to inclusion and exclusion criteria.The shortest course was 4 days and the longest was 10 years.Among the 60 patients,there were 23 males and 37 females,aged from 20 to 65 years,with an average age of 37.98±12.886 years.All the patients were classified according to the type of protrusion: 48 cases of protrusion and 12 cases of swelling.Classification by protruding segment: 5 cases of l3/4 segment protrusion and6 cases of extruding were involved.40 cases of l4/5 segment protrusion and 12 cases of extruding were involved.34 cases of L5/S1 segment protrusion and 9 cases of extruding were involved,including 18 cases of single segment protrusion or extruding.Forty-two patients with 2 or more segments protruding or bulging were involved.Patients were randomly divided into observation group of 30 patients and control group of 30 patients according to the order of visit date and random number differentiation method.The control group was treated with routine LDH acupotomology,and the observation group was treated with sacroiliac joint + routine treatment.According to the evaluation results of patients and the improvement of treatment,the patients were treated for 1 to 3 weeks respectively,and 3 weeks was a course of treatment.The improvement of symptoms was observed after 1 month of treatment.Improvement was assessed by The Oswestry Disability Index(ODI)score,lumbar spine flexor and dorsiflexor range of motion before and one month after treatment.Select four measures of imaging index as a comparison,pelvic incidence Angle respectively(pelvic incidence,PI),Sacral slope Angle(Sacral slope,SS),bilateral iliac projection height difference,bilateral iliac projection width is poor.The image analysis software viewpoint of the film reading system of our hospital was used for the measurement.The above indicators were used as the objective indicators for comparison before and after treatment to analyze and evaluate the sacroiliac joint and pelvic function as well as the improvement effect of LDH symptoms in the two groups of patients.Results :1.ODI score,lumbar forward flexion and dorsiflexion range of motion:there was no significant difference in ODI score,lumbar forward flexion and dorsiflexion range of motion between the observation group and the control group before treatment(P>0.05),the two were comparable.There were significant differences in both indicators between the two groups before and after treatment(P<0.05),and the ODI score after treatment was lower than that before treatment,and the activity range of lumbar spine flexion and dorsal extension were better than that before treatment.There were also significant differences in scores between the observation group and the control group after treatment(P<0.05),and the score of the observation group was significantly lower than that of the control group,and the activity range of lumbar spine flexion and dorsiflexion in the observation group was significantly better than that of the control group.The results showed that acupotomology intervention in sacroiliac joint treatment improved the symptoms,signs and lumbar functional activities of LDH patients more significantly than routine acupotomology treatment.2.Four pelvic projection parameters: there was no significant difference in pelvic projection parameters between the observation group and the control group before treatment(p>0.05),the two were comparable.There were significant differences in pelvic projection parameters before and after treatment in the observation group(P<0.05),and the indexes after treatment were significantly better than before treatment.However,there was no significant difference in pelvic projection parameters before and after treatment in the control group(P>0.05).The resultsshowed that after acupotomy intervention on the sacroiliac joint,the pelvic parameters of LHD patients tended to be normal,and the degree of correction of sacroiliac joint dislocation and pelvic tilt was significantly better than that of conventional LDH acupotomy,indicating that correction of pelvic tilt and sacroiliac joint dislocation had a profound impact and pathological significance on the treatment of LDH.3.Effective rate: after the treatment of sacroiliac joint with acupotomy,the total effective rate of the observation group was 90%,and the cure rate was 43.33%.The total effective rate and cure rate of the control group with LDH were 80% and 20%respectively.There were significant differences between the two groups(P<0.05).This indicated that the efficacy of acupotomy in sacroiliac joint was better than that of routine acupotomy in LDH patients.4.Recurrence rate of patients three months after the end of the treatment course:the total effective number of patients in the observation group was 27,and the recurrence rate of 2 patients was 7.4%.The total effective number of patients in the control group was 24,and the recurrence rate was 20.83%.The recurrence rate of the observation group was much lower than that of the control group after 3 months,indicating that the acupotomology method in the observation group could solve the LDH problem more fundamentally.Conclusion: The therapeutic effect of acupotomology in LDH patients is better than that of traditional acupotomology,which is based on the idea of correcting sacroiliac joint dislocation and pelvic inclination.After the elaboration of this article,the idea of acupotomology is clear and logical.For learners engaged in the treatment of diseases in related fields,it is easy to operate,high safety and easy to learn,which is worthy of clinical application and promotion. |
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