Objective: To observe the effect of electroacupuncture (EA) combined with caudal epidural injection on subjective pain, walking capability, lumbar flexibility and muscle strength in patients with lumbar disc hernia (LDH).
Methods: Sixty LDH patients were randomly allocated to the control group and the research group. The patients of the control group received ultrasound guided caudal epidural injection, and those of the research group received EA combined with ultrasound guided caudal epidural injection. Bilateral Jiaji (EX-B2) and adjunct points Guanyuanshu (BL26), Shenshu (BL23), Chengfu (BL36), Huantiao (GB30), Zhibian (BL54), etc. on the affected side were stimulated with EA (2 Hz/16 Hz, 5-8 mA) for 30 min each time, once every other day for 4 weeks, with 2 days' rest between every two weeks. The patients' pain was evaluated by using visual analogue scale (VAS), walking capability assessed by timed-up and go (TUG) test (time of walking back and forth in 3 m distance), lumbar flexibility (range of motion, ROM) detected by using an inclinometer and the strength of the lumbar flexor and extensor determined by using a push-pull dynamometer.
Results: After the treatment, self-comparison showed that the VAS score and TUG-measured time in both groups were significantly decreased (P<0.01, P<0.05), and the post-bucking ROM and extension ROM in the research group, and the lumbar flexor and extensor muscle strength in both groups were obviously increased compared with their own pre-treatment (P<0.05). Comparison between two groups showed that the VAS score and TUG-measured time of the research group were significantly lower than those of the control group (P<0.01), while the lumbar flexor's ROM as well as the extensor's strength were significantly higher in the research group than in the control group (P<0.05).
Conclusion: For patients with LDH, EA combined with caudal epidural injection can alleviate pain, improve the walking capability, lumbar flexibility and strength of the lumbar extensor, and the therapeutic effect of the combined treatment is significantly better than that of simple caudal epidural injection.
目的：观察电针结合骶裂孔注射对腰椎间盘突出症(LDH)患者的主观疼痛及步行能力、腰部活动性和屈伸肌肌力的影响。方法：将60例LDH患者随机分为对照组和研究组，每组各30例。对照组患者接受超声引导骶裂孔注射治疗；研究组在骶裂孔注射治疗基础上给予电针治疗，取双侧夹脊穴和患侧环跳、秩边等配穴，每次治疗30 min，隔日治疗1次，每周治疗3次，休息2 d，共治疗4周。两组患者分别在治疗前后进行视觉模拟评估量表(VAS)评分、站立行走计时(TUG)测试、腰部活动范围(ROM)和屈伸肌肌力的评估。结果：与本组治疗前比较，两组患者治疗后VAS评分、TUG均显著降低(P<0.01，P<0.05)，腰部屈肌和伸肌肌力均显著增加(P<0.05)；研究组治疗后腰部屈曲ROM和伸展ROM较治疗前显著增加(P<0.05)。与对照组比较，治疗后研究组VAS评分、TUG均显著降低(P<0.01)，腰部屈曲ROM、伸肌肌力均显著增加(P<0.05)。结论：电针结合骶裂孔注射治疗有助于缓解LDH患者疼痛，改善步行功能，提高腰部活动性和伸肌肌力，其功能康复效果明显优于单纯骶裂孔注射。.
Keywords: Caudal epidural injection; Electroacupuncture; Functional rehabilitation; Lumbar disc hernia; Muscle function.