| Objective:To observe the improvement of pain,lumbar function and lumbar mobility of patients with lumbar disc herniation treated by needle-knife in two different intervention methods.Evaluating the difference of comprehensive clinical efficacy,so as to optimize the treatment approach point for lumbar disc herniation by needle-knife.Methods:From September 2018 to November 2019,80 patients that met the inclusion and exclusion criteria established by the research institute were collected from the acupuncture department of Nanjing traditional Chinese medicine hospital and Daishan community Health Service Center.According to the method of random number table,80 patients were randomly divided into 40 cases of tenderness point needle knife release group(tenderness point group)and 40 cases of joint point needle knife release group(facet joint group).The tenderness point group was treated with Needle-knife to loosen the tenderness point of the patient's waist and buttock.The facet joint group was treated with Needle-knife to loosen the Lumbar faacet joint.once a week for a total of 4 treatments.The primary outcome measures were the Japanese Orthopaedic Association(JOA),Oswestry Dability index(ODI),Visual Analogue Scale(VAS)and Lumbar mobility,Clinical observation was conducted before treatment,2,4 and 3 months of follow-up.Statistical analysis was carried out on all the observation indicators,and the occurrence of adverse reactions was recorded to comprehensively evaluate the clinical comprehensive efficacy and feasibility of the two groups.Results:1.Of the 80 cases in this research,1 case fell off in each group and 78 cases were actually completed.Before treatment,the two groups of patients were compared in terms of gender,age,course of disease,JOA score,ODI%,VAS score and lumbar mobility,with no statistical difference(P>0.05).The case data of the two groups of patients were comparable.2.JOA,ODI%,VAS score and lumbar mobility were significantly improved after treatment compared with before in the two groups,and the difference was statistically significant(P<0.001),indicating that needle-knife treatment in the two groups could significantly improve the pain,lumbar dysfunction and lumbar activity limitation of patients with lumbar disc herniation.3.There was no significant difference between the two groups in JOA,ODI%,VAS scores and lumbar motion after treatment and follow-up(P>0.05).indicating that the two intervention programs have the same effect on on the improvement of pain,lumbar dysfunction and lumbar activity imitation in patients with lumbar disc herniation.4.VAS score and ODI%were compared between the two groups after two weeks of treatment,tenderness point group was better than facet joint group,with statistical difference(P<0.05),indicating that the tenderness point group showed faster improvement in pain and lumbar function in patients with lumbar disc herniation than the facet joint group.5.Comparison of clinical comprehensive efficacy between the two groups:Tenderness point group:8 cases were clinically cured,12 cases were significantly effective,16 cases were effective,and 3 cases were ineffective,with a total effective rate of 92.31%.Facet joint group:6 cases were clinically cured,11 cases were markedly effective,18 cases were effective and 4 cases were ineffective,with a total effective rate of 89.74%.The difference was not statistically significant(P>0.05),indicating that the two intervention programs have the similar clinical effect in the treatment of lumbar disc herniation.6.Comparison of Follow-up efficacy:Tenderness point group:9 cases were clinically cured,17 cases were significantly effective,10 cases were effective,and 3 cases were ineffective,with a total effective rate of 92.31%.Facet joint group:8 cases were clinically cured,13 cases were markedly effective,14 cases were effective and 4 cases were ineffective,with a total effective rate of 89.74%.The difference was not statistically significant(P>0.05).There was no recurrence in the follow-up of the two groups,and the number of cured cases was further improved than that at the end of the course of treatment,indicating that the two groups had good long-term curative effect.7.No serious adverse reactions occurred during the treatment of both groups of patients,indicating that safety of needle-knife treatment in the two groups was satisfactory.Conclusion:1.Needle-knife is effective in treating lumbar disc herniation which can significantly improve the pain symptoms,lumbar function and quality of life.Needle-knife is safe in clinical operation and has good long-term curative effect.2.Two different needle-knife methods have similar effects on improving pain,lumbar function and comprehensive clinical efficacy in patients with lumbar disc herniation.3.The tenderness point group takes effect faster than the facet joint group in improving the pain and lumbar function of patients with lumbar disc herniation. |
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