| 摘要: |
| [目的] 分析研究中药热敷联合刮痧和针灸治疗腰椎管狭窄术后残留腰腿痛的疗效及对腰椎功能的影响。[方法] 选取 2023 年 6 月—2024 年 12 月收治的 124 例腰椎管狭窄术后残留腰腿痛患者，根据治疗方式分为研究组、对照组，每组 62 例，对照组采用常规西医干预及功能锻炼，研究组在对照组基础上给予中药热敷联合刮痧和针灸治疗。比较两组患者临床疗效，及治疗前后腰椎功能评分量表（JOA）评分、Oswestry 功能障碍指数（ODI）评分、疼痛视觉模拟量表（VAS）评分、日常生活能力量表（ADL）评分、健康状况调查简表（SF-36）评分变化以及神经根水肿情况。[结果] 研究组治疗 1 个月后的显效率为 67.74%，高于对照组（46.77%），总体临床疗效、水肿情况、优于对照组，差异有统计学意义（P<0.05）。重复测量方差分析显示，时间效应与组间效应均有统计学意义（P<0.001），治疗后1 周至 1 个月，研究组 VAS、ODI 评分的下降幅度及 JOA 评分的上升幅度均显著优于对照组（P<0.001）。治疗后1 个月，研究组 ADL、SF-36 评分亦高于对照组（P<0.001）。[结论] 中药热敷联合刮痧和针灸治疗腰椎管狭窄术后残留腰腿痛的疗效良好，可有效减轻术后疼痛，改善腰椎功能以及生活质量，值得临床进一步研究和推广。 |
| 关键词: 中药热敷 刮痧 针灸 腰椎管狭窄 腰腿痛 |
| DOI：10.11656/j.issn.1672-1519.2026.10.03 |
| 分类号:R274.34 |
| 基金项目:广东省中医药局科研项目（20231142）。 |
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| Efficacy of traditional Chinese Medicine hot compress combined with gua-sha and acupuncture for residual lumbocrural pain post-lumbar spinal stenosis surgery and its impact on lumbar function |
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MAO Yuexia, CHEN Shaohua, HU Tianhong, ZHANG Dihui
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Minimally Invasive Spine Surgery Department, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, China
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| Abstract: |
| [Objective] To investigate the efficacy of traditional Chinese medicine（TCM）hot compress combined with gua-sha and acupuncture in treating residual low back and leg pain after lumbar spinal stenosis（LSS）surgery and its impact on lumbar function. [Methods] The 124 patients with residual lower back and leg pain after lumbar spinal stenosis surgery admitted from June 2023 to December 2024 were selected and divided into a study group and a control group according to the treatment method，with 62 patients in each group. The control group received conventional Western medical intervention and functional exercises，while the study group received additional TCM hot compress combined with gua-sha and acupuncture therapy on the basis of the control group. The clinical efficacy was compared between the two groups，along with changes in japanese orthopaedic association（JOA） scores，oswestry disability index（ODI），visual analog scale（VAS）scores，activities of daily living（ADL）scale scores，SF-36 scores and nerve root edema status before and after treatment. [Results] The marked effectiveness rate of the research group after one month of treatment was 67.74%，higher than that of the control group（46.77%）. The overall clinical efficacy and edema status of the research group was superior to that of the control group，and the difference was statistically significant（P<0.05）. Repeated measures ANOVA revealed statistically significant time effects and group effects（P<0.001）. From 1 week to 1 month post-treatment，the study group demonstrated significantly greater reductions in VAS and ODI scores，as well as a significantly greater increase in JOA score，compared with the control group（P<0.001）. At 1 month post-treatment，the study group also exhibited higher ADL and SF-36 scores than the control group （P<0.001）. [Conclusion] The combination of TCM hot compress，gua-sha，and acupuncture demonstrates good efficacy in treating residual low back and leg pain after LSS surgery. It effectively alleviates postoperative pain，improves lumbar function，and enhances quality of life，warranting further clinical research and promotion. |
| Key words: traditional Chinese medicine hot compress gua-sha acupuncture lumbar spinal stenosis low back and leg pain |
