Imithi YesiShayina YesiShayina yoLwaphulo oluPhezulu oluPhezulu ngenxa yeLumbar Disc Herniation

Ukuqonda oku kulandelayo, iyeza lesiNtu laseTshayina lisebenzisa amayeza esintu kunye neendlela ezahlukeneyo zengqondo kunye nomzimba, njenge-acupuncture kunye ne-tai chi, ukunyanga okanye ukuthintela imiba emininzi yezempilo. Iyeza lemveli laseTshayina, okanye i-TCM, yavela kwi-China yakudala kwaye iye yavela kumawaka eminyaka. I-TCM isetyenziswe ngokuyinhloko njengendlela eyongezelelweyo yezempilo kunye nezinye iindlela zonyango ezifana nokunakekelwa kwe-chiropractic. Njenge-TCM, ukunyamekelwa kwe-chiropractic yindlela yokunakekelwa kwempilo engenye egxile ekuxilongweni, unyango kunye nokukhusela iintlobo ezahlukeneyo zokulimala kunye neemeko ze-musculoskeletal kunye ne-nervous system, ngokugxininiswa kwi-manipulations manual kunye nohlengahlengiso lomqolo. Njengogqirha we-chiropractic, okanye i-DC, i-TCM inokuphinda inikezelwe ukunyanga iintlobo ezahlukeneyo zokulimala kunye neemeko.

 

Kwinqaku, I-TCM edibeneyo yonyango yolondolozo isetyenziselwe ukunceda ukunyanga iimpawu zentlungu ephantsi ngenxa ye-lumbar disc herniation, okanye i-LDH. Izinto ze-Disc ezivela kwi-disc ruptured okanye i-herniated disc kwi-lumbar spine inokucaphukisa okanye ukucinezela enye okanye ezininzi zeentsholongwane ezifumaneka kumqolo ophantsi. Uxinzelelo kunye ne-nerve ye-sciatic inokubangela iimpawu ze-sciatica, ezifana nentlungu kunye nokungahambi kakuhle, ukutshisa kunye nokuvakalelwa, kunye ne-numbness enokuthi ikhuphe ukusuka emlenzeni ukuya emlenzeni kwaye ngamanye amaxesha, ukuya ezinyaweni. ukulinganisa iziphumo zonyango lwendabuko lwaseTshayina kwiintlungu ezisezantsi ngenxa ye-LDH. Iziphumo zibhalwe ngezantsi.

 

Abstract

 

Iintlungu ezisezantsi ngenxa ye-lumbar disc herniation (LDH) zixhaphake kakhulu kwikliniki. Olu vavanyo olulawulwa ngokungenamkhethe lwenzelwe ukuphanda imiphumo ye-TCM edibeneyo yonyango lolondolozo lwentlungu ephantsi ngenxa ye-LDH. Itotali yezigulane ze-408 ezineentlungu ezisezantsi ngenxa ye-LDH zabelwa ngokungenamkhethe kwiqela lokulinga kunye nonyango oludibeneyo lwe-TCM kunye neqela elilawulayo elinonyango oluqhelekileyo lolondolozo ngomlinganiselo we-3?:? Isiphumo esiphambili sasiyintlungu ye-analogue scale scale (VAS). Isiphumo sesibini sasiyimisebenzi ephantsi yokusebenza kwe-back back yi-Chinese Short Form Oswestry Disability Index (C-SFODI). Ngokukhawuleza emva kokonyango, izigulane kwiqela lokulinga zafumana ukuphuculwa okuphawulekayo kwi-VAS kunye ne-C-SFODI xa kuthelekiswa neqela lokulawula (ukwahlukana kweqela phakathi kokutshintsha kwentsingiselo ukusuka kwisiseko, i-1 amaphuzu, i-P <16.62 kwi-VAS; 0.001 kwi-C-SFODI). Umahluko wahlala ekulandeleni kwenyanga enye, kodwa kubaluleke kakhulu kwi-C-SFODI ekulandeleni kweenyanga ezintandathu (? Amanqaku e-15.55, P <0.001). Akuzange kubonwe ziziganeko ezimbi kakhulu. Ezi ziphumo zibonisa ukuba unyango oludibeneyo lwe-TCM lunokuba luncedo oluncedisayo kunye nonyango olulolunye lwezigulane ezineentlungu ezisezantsi ngenxa ye-LDH.

 

intshayelelo

 

I-Lumbar disc herniation (i-LDH) isifo esiqhelekileyo kunye negalelo elikhulu leentlungu ezisezantsi. Nangona uphando oluninzi luye lwaqinisekisa ukuba utyando lusebenza kakuhle kwi-LDH, unyango olulondolozayo luye lwaqatshelwa ukuba luncedo lwabo lwezokwelapha. Ukuqwalasela ukuba i-20% yezigulane zisabandezeleka emva kokuhlinzwa, i-7% ukuya kwi-15% yezigulane ezigqityiweyo zingaphinde zahluleka ukuhlinzwa kwe-back back syndrome, kwaye ezinye izigulane zinoyika utyando, unyango olulondolozayo luseyindlela enye yokuqala ye-LDH.

 

E-China, i-TCM yenye yezona zonyango ezisisiseko zokukhusela i-LDH. Izifundo zangaphambili ziqinisekisile ukuba ezinye iindlela zokwelapha ze-TCM zineempembelelo ezithile kwiintlungu ezisezantsi emva kweLDH. Ezi ziquka ukulungiswa komzimba, ukulawulwa komlomo kwamayeza aseTshayina, ukusetyenziswa kwangaphandle kwamayeza aseShayina, i-Chinese Tuina (ukusilalisa), kunye nokusetyenziswa komsebenzi we-TCM. Kwizonyango, ezi ndlela zonyango azizisetyenziswanga zodwa kodwa zihlala zidibeneyo. Kungekudala, indlela yeklinikhi yokwelapha i-LDH kunye ne-TCM yokwelapha idibeneyo ithande ingqwalasela. I-Shi ye-Traumatology Centre yeZonyango kwiSibhedlele saseShuang esithintekayo kwiYunivesithi yaseShailand yeMveli yeMveli yaseTshayina iyaqatshelwa kakuhle ngokuzinikela kwayo kwangexesha elide kuphando olwenziwe unyango olulondolozo lwe-LDH, kunye neprotocol ye-LDH. Nangona kunjalo, ubungqina bophando oluphezulu lufunekayo ukuxhasa ukusebenza kweprotocol.

 

Olu vavanyo lweklinikhi lujolise ekufundeni ukusebenza nokukhuseleko lwe-TCM yokwelapha i-LDH kwaye ngaloo ndlela iqinisekisa umphumo wayo wekliniki.

 

Impahla nenkqubo

 

uyilo

 

Senze uvavanyo oluninzi olulawulwa ngokungahleliwe ukuvavanya ukusebenza ngokudibeneyo kokonyango olondolozayo lwe-TCM kwizigulana ezineentlungu ezisezantsi ngenxa ye-LDH. Izigulana zabelwa ngokulandelelana kwiqela lokulinga kunye neqela lolawulo ngomyinge we-3?:? 1 kusetyenziswa amanani aveliswe ngekhompyuter. Ulwabiwo olungenamkhethe lwatywinwa kwiimvulophu ze-opaque kwaye lwavulwa ngokukodwa kwisigulana ngasinye esivumile ukuba kolu phononongo. Umongikazi, owayengenandima kuyilo nasekuqhubeni isifundo, walungisa iimvulophu. Izigulana kwiqela lokulinga zanyangwa ngonyango oludibeneyo lwe-TCM kanye ngemini, iiveki ezimbini, ngelixa abaguli abakwiqela lolawulo babephathwa ngongenelelo oluqhelekileyo lweeveki ezimbini. Kwisiseko, kwangoko emva konyango, inyanga enye kunye neenyanga ezintandathu emva konyango, isikali se-analog anal (VAS) kunye neFomu emfutshane yaseTshayina i-Oswestry Disability Index (C-SFODI) yasetyenziswa kuvavanyo lwesiphumo. Eli tyala libhalisiwe kwiRejista yeTliniki yaseTshayina yezeKlinikhi (Hayi.

 

I zifundo

 

Izigulane zaqashwa kwiSibhedlele saseShuang ezixhaswe kwiYunivesithi yaseShailand yezoMveli zakwaShayina, iSibhedlele saseRuijin ezibandakanyekayo kwiYunivesithi yeJiaotong Yunivesithi, kunye neYueyang Integrative Traditional Chinese ne-Western Medicine Hospital ezixhaswe kwiYunivesithi yeShayina yamaShayina eChina phakathi kukaJanuwari 2011 no-Agasti 2012.

 

Iinqobo zokubandakanywa: (1) ukuguga iminyaka eyi-20�60; (2) ukuba neentlungu ezisezantsi ngenxa ye-LDH (i-MRI scan iqinisekisile i-lumbar disk herniation) kunye nokulawula ezinye izifo eziqhubekayo eziqhubekayo ezifana nokuphuka, i-spondylolisthesis ye-lumbar, i-tumor, i-osteoporosis, okanye ukusuleleka; (3) ukulungele ukuthatha inxaxheba kolu phononongo kunye nokusayina imvume enolwazi.

 

Imigaqo yokukhutshwa: (1) inezinye iintlungu zesifo; (2) efumana imbali yokuhlinzwa komgudu; (3) enezifo zengqondo; (4) enezifo zengqondo; (5) enezifo ezingapheliyo ezingaphazamisa iziphumo (umz., Isifo senhliziyo, isifo se-rheumatoid, isifo sokuxhamla, okanye ezinye izimo ezingafanelekanga); (6) wesaba ukukhwa; (7) ukhulelwe okanye uceba ukukhulelwa ngexesha lokufunda; (8) enezinye izifo abaphandi bakholelwa ukuba azifanelekanga ukufundisisa.

 

impatho

 

Iqela lovavanyo

 

Izigulane kwiqela lovavanyo zifumana unyango lwe-TCM oludibanisayo lweeveki ezimbini. Baye bahlulwa kwakhona baba ngamacandelwana amathathu (ngokwexesha elisusela kwiintlungu zokuqala ezisezantsi ukuya ekufumaneni unyango) kwiindlela ezahlukeneyo zonyango: i-acute stage (0�14 days), subacute stage (15�30 days), kunye nesigaba esingapheliyo (>30) iintsuku).

 

Isigaba esilungileyo: (1) I-electroacupuncture + (i-2) injola ye-herbal (i-Salvia miltiorrhiza injection) + (3) i-plaster yangaphandle (i-Compound Redbud yokuphulukisa i-Cataplasms); I-stag: (i-1) I-Chinese Tuina (i-massage) + (2) icindezela ngokutsha usebenzisa amayeza aseShayina + (3) i-plaster yangaphandle (i-Compound Redbud yokuphulukisa i-Cataplasms); Isigaba esingapheliyo: (1) I-TCM yokusebenza ngokusebenzayo (2) i-plaster yangaphandle (i-Compound Redbud yokuphulukisa i-Cataplasms).

 

IPraam Parameters

 

I-Electroacupuncture. Amaphuzu: i-Dachangshu emibini (BL 25) kunye ne-Baihuanshu (BL 30).

 

Indlela: Faka iinaliti (iinaliti ezingenazintsholongwane, ezilahlwayo, 0.3 � 75?mm, ezenziwe yiSuzhou Medical Supplies Factory Co., Ltd.) 2.5 ukuya kwi-2.8?cun. Phezu kwe-De Qi (i-needling sensation), qhagamshela iinaliti kunye nesixhobo se-electroacupuncture (Imodeli: G6805-II, eyenziwa yi-Guangzhou KangMai Medical Devices Co., Ltd.), usebenzisa i-wave eqhubekayo, i-wave stimulation pulse wave emalunga ne-0.6?ms? kunye nokuphindaphinda kwe-20?Hz. Unyango lwaqhutywa kanye yonke imihla, imizuzu engama-30 kunyango ngalunye.

 

Plaster yangaphandle. IiCapaplasms zokuphulukisa i-Redbud ekwenzeni i-Injury (Ukuvunywa akukho. Z19991106, eyenziwe ngu-Shanghai LEY's Pharmaceutical Co., Ltd.).

 

Izithako eziphambili: i-Zi Jing Pi (i-Cortex Cercis Chinensis), i-Huang Jing Zi (i-Negundo Chastetree Fruit), i-Da Huang (i-Radix ne-Rhizoma Rhei), i-Chuan Xiong (iRhizoma Chuanxiong), i-Tian Nan Xing (i-Rhizoma Arisaematis) kunye ne-Ma Qian Zi ( ISenen Strychni).

 

Imisebenzi: Ijikeleza igazi, isombulula i-stasis, iphelisa ukuvuvukala, kwaye iyanciphisa intlungu.

 

Indlela: Faka isicelo se-cataplasms ukuya kwindawo ebuhlungu kunabo bonke, i-plaster eyodwa ngalunye, kanye ngosuku.

 

Injection yeHeralbal Injection. I-Salvia miltiorrhiza injection (I-approx no-Z51021303, eyenziwe yi-Sichuan ShengHe Pharmaceutical Co., Ltd.).

 

Isithako esiyinhloko sesoyilo nguSalvia ingcambu PE Isebenza ngokujikeleza igazi kunye nokuxazulula i-stasis.

 

Indlela: Ukungena ngaphakathi kwe-20? ML salvia miltiorrhiza inaliti kunye ne-250 ml ye-5% yeswekile, kanye ngemini.

 

Ukunciphisa Okushisayo Ukusebenzisa iMicrosoft Medicine. Izithako: I-20? G yeCang Zhu (Rhizoma Atractylodis), iQin Jiao (iRadix Gentianae Macrophyllae), iSang Zhi (Ramulus Mori), Mu Gua (Fructus Chaenomelis), Hong Hua (Flos Carthami), Chuan Xiong (Rhizoma Chuanxiong), Hai UFeng Teng (Caulis Piperis Kadsurae) kunye noLei Gong Teng (Radix Tripterygii Wilfordii), ngokwahlukeneyo. Onke amayeza anikezelwa yiShanghai Hongqiao Pharmaceutical Co, Ltd. kwaye kuvavanyiwe kwaye kwafaneleka.

 

Indlela: Faka iyeza langaphambili kwibhegi yegauze, decoct ngamanzi i-20?mins ulikhuphe. Emva kokuba iqondo lobushushu lipholile ukuya kwi-40 ~ 45�C, sebenzisa umva kwindawo ephantsi echaphazelekayo ye-30�40 imizuzu, kanye ngosuku. I-compress eshushu inokunceda ukujikeleza igazi kunye nokusombulula i-stasis.

 

I-TCM Exercise Functional. Lo msebenzi waziwa ngokuba yi-�Fei Yan Shi� (igama elithetha ukuthi �isimbo senkonjane esibhabhayo) ngesiTshayina.

 

Indlela: Cela umguli ukuba athathe isikhundla esifanelekileyo, wandise izandla zombini emva, uphakamise isifuba kunye neenyawo ezincinci ebhedeni usebenzisa isisu njengesigxina, uze ukhulule. Ukuqhuba lo msebenzi kanye ngosuku kwaye uphinde uhlawule ii4-5 ngamaxesha ngamaxesha.

 

Imisebenzi: Ukuqinisa amandla emisipha yangemva, ukwandisa ukuzinza komgudu, kwaye oko kukuthintela kwakhona.

 

IsiTshayina iTaina (ukuSusa). Buza isigulana ukuba sithathe indawo efanelekileyo kwaye sifumane amabala okuthantamisa kumqolo osezantsi. Emva koko faka ukuqengqeleka kwemipu (i-10? Min), ukucofa i-Anrou kunye nokuxolela (i-10? Min), kunye nokuqhekeza i-Tanbo (i-5? Min) kwiindawo zokuthamba kunye neendawo ezikufutshane. Gqibezela ngokutsala oblique ngobuqhetseba bomqolo osezantsi. Ukuqhuba unyango kanye ngemini.

 

ImiSebenzi: Ibuyisela kwakhona i-spasm ye-back back muscle kwaye ilungisa i-subluxation.

 

Emva kweveki enye yonyango lwe-TCM, ukuba isigulane esingaphantsi kwesigulana singenasiphelo okanye siphumelele, imithi yesigulane isilungiswa ngokuya kwizikhokelo zeklinikhi, iirekhodi ezicacileyo uhlobo kunye neqondo lezonyango ezithathwa zizigulane, kwaye isigulane sachongwa akukho mphumo.

 

Iqela lo Lawulo

 

Izigulane kwiqela lolawulo zifumana unyango oluqhelekileyo lweeveki ezimbini. Amanyathelo okungenelela aquka amacandelo amathathu, (1) yempilo. Izigulane zamenywa ukuba zithole imfundo yezempilo ye-LDH kabini ngeveki kwisigulane; imfundo yempilo yenzelwe kuphela ukwazisa izigulane malunga nenkalo yemvelo yokugula kwabo kunye nokulindela ukuphulukana ngokuphumelelayo, kungakhathaliseki ubunzima bokuqala beentlungu zabo, ukufundisa izigulane ukuphepha imikhwa emibi eyenza isisifo sibe nzima, njengendawo yokuhlala ixesha elide kwaye ethwala imithwalo enzima, kwaye ukhuthaze izigulane ukuba zithathe inxaxheba kwimisebenzi yoluntu. (2) Ukuphumla: ngaphezu kokulala okuqhelekileyo, izigulane zifuna ukulala ebhedini okungenani iiyure ze-1-2 ngosuku. (I-3) Iyeza zonyango okanye unyango lomzimba: emva kweveki enye yemfundo yempilo, ukuba isigulane esingaphantsi kwesigulane singenasisiphumo okanye siphumelele, imithi yesifo seyilungiso ishintshwe ngokwemiqathango yezikliniki, iirekhodi ezixeliweyo uhlobo kunye nesosi seyeza zi gulane. Kwaye ukuba izigulane azifuni ukuthatha imithi yesifo, ke izigulane zithunyelwa kwi-physiotherapist.

 

Imilinganiselo

 

Zonke iziphumo zihlolwe ngababukeli abaqaphele ukuba iqela, kumgangatho wesiseko (M1), ngokukhawuleza emva kokungenelela kokugqibela (M2). Ulandelelwano luquka ukuhlolwa kwenyanga enye (M3) kunye neenyanga ezintandathu (M4) emva kokungenelela kokugqibela.

 

Isisiphumo esiphambili siphumo sasiyizigulo kwi-analogue scale (VAS), amanqaku e-0 ukuya kwi-100, kwaye amanqaku aphezulu abonisa intlungu enkulu, i-0 ayithethi intlungu, kwaye i-100 ithetha intlungu engenakuxoxwa.

 

Umlinganiselo wesiphumo sesibini wawutshintsho kwi-Chinese Short Form Oswestry Disability Index (C-SFODI), uluhlu lwe-0 ukuya kwi-100%. I-C-SFODI inemibuzo esithoba, evela kwi-Oswestry Disability Index (ODI); shiya umbuzo wobomi besondo kwiCandelo ??8, kuba lo mbuzo uhlala ungamkelekanga ngamaTshayina. Ifomula yokubala ye-C-SFODI lelona nqaku longezelekayo/45 � 100%, nepesenti ephezulu ebonisa ukhubazeko olumandla kakhulu. Kwaye uphando lubonise ukuba i-C-SFODI inokuthembeka okulungileyo kunye nokunyaniseka.

 

Uhlalutyo lweSatisati

 

Ukubalwa kwamandla okumbalwa kwangaphambili kubonisa ukuba izigulane ze-81 kwiqela lokulinga zazifunwa ukuba zibone ukungafani kwintlungu yovavanyo olusekelwe kwinqanaba eliphambili le-5% (i-test-side-t-test) kunye ne-80% yamandla. Ngokukulindeleka kwezinga le-20% yokulinganisa, safuna izigulane ze-102 ubuncinane kwiqela lokulinga. Ukuqwalasela impembelelo engafanelekiyo yokulawula unyango, izigulane ze-102 zafakwa kwiqela lolawulo.

 

Ukwahlula phakathi kwamacandelo kwinqanaba lokuhlalutya lucatshungulwa ngokusebenzisa iisampuli ezizimeleyo okanye uvavanyo lwe-Chi-square. Utshintsho kwiimilinganiselo eziqhubekayo zahlaziywa ngohlalutyo lokuhluka (ANOVA). Iimpembelelo zavandlakanywa ngesiseko sokwenza unyango (ITT), kwaye abathathi-nxaxheba abangazange bazalise ixesha lokulandelwa babecingelwa ukuba bengenakho utshintsho kwizikolo. Inani elisezantsi le-P elingaphantsi kwe-0.05 libonise ukubaluleka kobalo. Iziphumo zenziwe njengentsingiselo kunye nokuphambuka okusemgangathweni (SD) kwi-M1 kwaye njengomehluko phakathi kweqela kunye ne-95% yexesha lokuzithemba (CI) kwi-M2, M3, kunye ne-M4.

 

Ulawulo lwemeko

Ngaphambi kokuqala kovavanyo, bonke abaphandi kufuneka bafumane uqeqesho lweprotocol. I-kliniki yophando yecliniki (CRC) iqeshwe ukunceda abaphandi kwiziko ngalinye. Kwakhona iliso liye laqeshwa ukuba liqinisekise umgangatho wophando.

 

Insight of Dr. Alex Jimenez

Ulingo olungenhla lwekliniki lugxile ekuphandeni ukhuseleko kunye nokusebenza kweTCM, okanye amayeza aseShayina amasiko, ngenxa yeentlungu ezisezantsi ezibangelwa i-lumbar disniation kunye nokuqinisekisa isiphumo sayo seklinikhi. Abathathi-nxaxheba besifundo sophando ngeentlungu eziphantsi kwe-LDH zahlula ngamacandelo amabini: iqela lokulinga, elaphathwa nge-TCM ehlanganyayo yonyango; kunye neqela lokulawula, elaphethwe unyango oluqhelekileyo lonyango. Iqela lokulinga laza lahlukana ngakumbi libe ngamacandelwana amathathu. Iinkcukacha zendlela yokwelapha nganye yeTCM esetyenziswe kwiinkqutyana, kuquka igama, izithako, indlela kunye nomsebenzi ngamnye, kuchazwe ngasentla. Iziphumo zacatshulwa ngokufanelekileyo ngababukeli abaqapheliyo ngokwahlukileyo kweqela. Iziphumo zababalo ziye zahlaziywa ngokufanelekileyo ngabaphandi abafumana ukuqeqeshwa kweprotocol ngaphambi kokuqala kwesifundo.

 

iziphumo

 

Phakathi kukaJanuwari 2011 no-Agasti 2012, abaguli abangama-480 bebonke abaneentlungu ezisezantsi ngenxa ye-LDH baye bagaywa, abangama-72 banqatshwa ngenxa yeendlela zokuthintelwa, kwaye izigulana ezifanelekileyo ezingama-408 zabelwa ngokulandelelana ngokomyinge we-3? Iqela lokulinga kunye neqela lolawulo, i-1 kwiqela lokulinga kunye ne-306 kwiqela lolawulo. Izigulana kwiqela lokulinga zonke zigqibe unyango lweeveki ezimbini. Kwiqela lolawulo, kwiveki yesibini esinye isigulana kwiqela lolawulo besingathandi ukuqhubeka nokuthatha inxaxheba kwaye siyirhoxise imvume yakhe enolwazi, kwaye abaguli ababini bathathe i-Fenbid (102? Mg yedosi nganye, iidosi ezi-500 ngosuku) okoko iintlungu zaba mandundu ngexesha unyango (Umzobo 2).

 

 

Iimpawu ezisisiseko zeZigulana

 

Itheyibhile 1 ibonisa idatha eseleyo yabathathi-nxaxheba be-408. Iminyaka yobudala yezigulane yiminyaka eyi-45, kwaye i-51% yabafazi. Ngokubhekiselele kwizifo zesigulane, iqela lokulinga kunye neqela lokulawula lalifaniswa. Kwaye kunye nesiphumo esisezantsi esineenkcukacha ze-VAS kunye ne-C-SFODI nazo zilungelelanise ngokufanelekileyo phakathi kweqela lokulinga kunye neqela lokulawula.

 

 

Ukuphuculwa kweSiphumo esiPhambili

 

Utshintsho kwiziphumo eziphambili ukusuka kwisiseko ukuya ekulandeleni iinyanga ezintandathu kubonisiwe kwiTheyibhile 2 kwaye Umzobo 2. Ngokukhawuleza emva kongenelelo, amaqela amabini abonisa ukwehla okukhulu kwi-VAS kunesiseko sokuqala. Kwaye iqela lokulinga libonakalise ukwehla okubaluleke ngakumbi kuneqela lolawulo (? Amanqaku ayi-16.62 [95% isithuba sokuzithemba {CI},? 20.25 kuye? 12.98]; P <0.001).

 

 

 

Kwinyanga enye emva kongenelelo, amaqela amabini nawo anciphise kakhulu i-VAS kunesiseko sokuqala. Kwaye kwakhona, iqela lokulinga libonakalise ukwehla okubaluleke ngakumbi kuneqela lolawulo (? 6.37 amanqaku [95% CI,? 10.20 ukuya ku-2.54]; P = 0.001).

 

Kwiinyanga ezintandathu emva kokungenelela, xa kuthelekiswa nesiseko, iinguqu kwi-VAS zahlala ziphawuleka kwiqela lokulinga kunye neqela lokulawula, kodwa ukuhlula phakathi kweqela kwakungabalulekanga (P = 0.091).

 

Ukuphuculwa kweSiphumo seSekondari

 

Ngokukhawuleza emva kongenelelo, amaqela amabini abenokuphucuka okubonakalayo kwi-C-SFODI kunakwesiseko sokuqala, kwaye iqela lokulinga libonakalise ukuphucuka okubaluleke ngakumbi kuneqela lolawulo (? 15.55 amanqaku [95% CI,? 18.92 ukuya ku-12.18]; P <0.001) .

 

Kwinyanga enye emva kongenelelo, amaqela amabini nawo abenokuphucuka okubonakalayo kwi-C-SFODI kunesiseko sokuqala. Kwaye kwakhona, iqela lokulinga liphucule ngakumbi (? Amanqaku ayi-11.37 [95% CI,? 14.62 ukuya ku-8.11]; P <0.001).

 

Kwiinyanga ezintandathu emva kongenelelo, amaqela amabini nawo agcina ukuphucuka okukhulu, kwaye iqela lokulinga libonise ukongama (? 7.68 amanqaku [95% CI,? 11.42 kuye? 3.94]; P <0.001).

 

Iziganeko ezimbi

 

Omnye isigulane kwinqanaba lokulinga lalinomphefumlo omncinci ngexesha lokulungisa umzimba, ukuxolelwa ngokuphumla kombhede, waza wagqiba unyango olusele. Izigulane ezimbini kwiqela lolawulo zanikwa i-Fenbid ngomlomo ngenxa yeentlungu ezibuhlungu ezisezantsi. Akukho ziganeko ezimbi eziye zaphawulwa kuyo iqela lokuhlola okanye iqela lokulawula.

 

ingxoxo

 

Nangona iimeko zentlungu ezisezantsi ezibangelwa yi-lumbar disc herniation (i-LDH) ayengacacanga kakuhle, imbono ekhangelekileyo kukuba intlungu ephantsi ye-LDH yafunyanwa ukuba ayikho nje kuphela ekuphenduleni i-stimuli kodwa ibe nefuthe leekhemikhali ezungeze Ingcambu yengcambu yesondo kunye ne-sinuvertebral nerve.

 

Iindlela zonyango ze-TCM ezahlukeneyo zineenzuzo ezahlukeneyo kunyango lwe-LDH. Intlungu yimpawu ephambili kwinqanaba elibukhali le-LDH; i-acupuncture inefuthe elihle le-analgesic kwiintlungu ezisezantsi ngenxa ye-LDH. I-Lumbar dysfunction iyona mpawu ephambili kwinqanaba lokuxolelwa; I-massage yaseTshayina inefuthe elihle ekuphuculeni ukungasebenzi. I-Oral Chinese herbal formulae, ukusetyenziswa kwangaphandle kwamayeza aseTshayina, kunye nenaliti ye-herbal yaseTshayina nayo yabonisa umphumo omuhle ekupheliseni intlungu kunye nokuphucula ukungasebenzi okubangelwa yi-LDH. Kwaye olunye uphononongo lukwafumanise ukuba inaliti yeSalvia miltiorrhiza isebenza ngcono kwaye ngokukhawuleza kwinqanaba elibukhali xa ithelekiswa nemannitol. Nangona indlela ye-acupuncture, i-massage yaseTshayina, kunye namayeza emveli aseTshayina kunyango lwe-LDH isahlala ingacacanga, kuvunyelwene ngokubanzi ukuba ezi ndlela zonyango zidlala indima ngokwandisa ukujikeleza kwegazi kwindawo, ukukhulula i-edema yengcambu ye-nerve, kunye nokukhawulezisa imetabolism. abalamli basekuhlaleni abavuthayo. Kwinqanaba lokubuyisela lesi sifo, umsebenzi omkhulu kukuqinisa imisipha yesinqe kunye nesisu ukukhusela ukuphindaphinda, kwaye umsebenzi we-TCM osebenzayo unenzuzo kulo mbandela kwaye unokunyusa ukuqina kwe-lumbar ukukhusela ukuphindaphinda.

 

Ukunyanga i-LDH ngokwezigaba ezahlukeneyo kuye kwamkelwa ngokwengeziwe. E-China, i-LDH ihlukaniswe ngokubanzi kwiinqanaba ezintathu, kubandakanywa isigaba esicacileyo, isigaba se-subacute (okanye i-remission stage), kunye nesigaba esingapheliyo (okanye isigaba sokubuyisela). Ucwaningo luye lwafakazela ukuba unyango lwe-LDH ngokwezigaba ezahlukeneyo lufumene i-kliniki efanelekileyo. Ukongezelela, uphando luye lwacetyiswa ukuba lufumane umphumo olungcono kunonyango ngaphandle kokuhlula amanqanaba ahlukeneyo.

 

Iminyaka eyi-20 edlulileyo yokuqhelana nekliniki iye yabona ukhuseleko lweempawu zonyango ezisetyenziswe kule sifundo. Ngelo xesha, ukusebenza kwayo kuqinisekiswe okokuqala; Noko ke, ubungqina obuphezulu bophando luyafuneka. Kwimiqathango yonyango, iintlobo ezahlukeneyo zokwelapha ze-TCM zikhethwe ngokwemiqathango yezigaba ezahlukeneyo. Ngokukodwa, izigulane ze-acupuncture nezamaTshayina zasetyenziselwa kwisigaba esichukumisayo sokunceda intlungu, i-Chinese Tuina (ukusilisa) kunye nokusetyenziswa kwangaphandle kwamayeza aseShayina kwakusetyenziselwa ukuphuculwa kwemisebenzi ye-lumbar, kunye nokusetyenziswa kwe-muscle low back isigaba esingapheliyo sokwandisa ukuzinza komgudu nokukhusela kwakhona.

 

E-China, unyango lwe-lumbar disc herniation ikakhulu lusebenzisa iziyobisi, unyango lomzimba, okanye unyango lwe-TCM. Unyango lwe-TCM olusetyenziswe kwiqela lokulinga lusetyenzisiwe kwinkqubo yeklinikhi kwaye ithathwa njengelinempumelelo yeklinikhi; Ukusebenza konyango olulondolozayo olusetyenziswe kwiqela lolawulo kuthathwa njengobuthathaka kakhulu, kuhlala njengonyango oluncedisayo lwezinye iindlela zonyango. Ikomiti yeenqobo ezisesikweni ithathela ingqalelo ukuba ukukhulisa ukhuseleko lomdla wabaguli, kunyanzelekile ukuba izigulana zifumane ithuba lokufumana unyango lwe-TCM, ke kolu phando ubungakanani besampulu yeqela lokulinga kunye neqela lolawulo li-3? 1?

 

Iziphumo zolu cwaningo ziye zabonisa ukuba ngokukhawuleza kunye nenyanga enye emva kokungenelela, unyango oluhlanganisayo lwe-TCM unyango lunganciphisa kakhulu amanqaku e-VAS kunye ne-C-SFODI, kwaye emva kwenyanga yesithandathu emva kokungenelela, unyango oluhlangeneyo lwe-TCM lunokunciphisa kakhulu i-C-SFODI, kodwa amaqela amabini awanalo mmahluko omkhulu ekunciphiseni amanqaku e-VAS. I-VAS yi-analog ebonakalayo yintlungu yomhlaba jikelele, kunye ne-C-SFODI yinguqu ephuculweyo ye-ODI (i-Oswestry Disability Index), kwaye iqukethe imibuzo ye-9, ipesenti ephezulu ebonisa ukukhubazeka kanzima komsebenzi.

 

Ngokubhekiselele kwiziganeko ezimbi, esinye isigulane sasinefuthe elincinci kwiqela lokulinga, izigulane ezimbini kwiqela lokulawula zanikwa umlomo we-Fenbid ngenxa yokunciphisa intlungu ephantsi, kwaye akukho ziganeko ezimbi eziye zaphawulwa kuyo nayiphi iqela lokuhlola okanye iqela lokulawula. Inkqubo yokuxhatshazwa kwe-TCM yokuncedisa unyango ye-LDH iyaqhubeka ingacacanga, kwaye iya kuba yinkqubela yethu yophando ngokuzayo.

 

Olona thintelo luphambili lolu phononongo lixesha elifutshane lokulandelela. Ngenxa yoko, asiphumelelanga ukwenza uvandlakanyo olubanzi malunga nokusebenza kwexesha elide le-TCM edibeneyo yonyango lolondolozo lwe-LDH.

 

izigqibo

 

Olu vavanyo lwekliniki olulawulwa ngokungahleliwe lubonelela ubungqina obuthembekileyo malunga nokusebenza kwe-TCM edibeneyo yonyango olulondolozayo kwizigulane ezineentlungu ezisezantsi ngenxa ye-lumbar disc herniation. Isampulu enkulu yokulandela ixesha elide iyafuneka ngakumbi kuphando lwexesha elizayo.

 

Ulwaphulo lomdla

 

Akukho nto ingqubanayo yezinto ezinxulumene nalolu cwaningo lwabikwa.

 

Imibulelo

 

Lo msebenzi uxhaswa nguLuleko oluPhambili lwe-TCM ye-Orthopedic and Traumatic yoMphathiswa weMfundo weRiphabhlikhi yaBantu baseChina (100508); iProjekthi engundoqo yezoNyango yeKhomishini yeSayensi kunye neTekhnoloji yaseShanghai (09411953400); iprojekthi ye Shanghai Medical italente ehamba phambili (041); i-National Natural Science Foundation yaseTshayina (81073114, 81001528); iProjekthi yeSizwe ePhambili eNtsha yokuDala iZiyobisi, uphando lweziyobisi olutsha kunye neqonga lophuhliso lobuchwephesha (no. 2012ZX09303009-001); Iprojekthi yoLwakhiwo lweQela leYunivesithi yaseShanghai yeQela loLwakhiwo lweSifo soMnqongo weSifo seMveli saseTshayina (2009-26).

 

Ukuququmbela, kunye neziphumo ezilinganisiweyo kunye neziphumo zokugqibela zamaqela amabini abathathi-nxaxheba abaneentlungu ezisezantsi ngenxa ye-lumbar disc herniation, ulingo olulawulwa ngokungahleliwe luncede igalelo ngolwazi oluxabisekileyo malunga nokhuseleko kunye nokusebenza kakuhle, kunye nesiphumo seklinikhi yonyango olulondolozayo lwe-TCM. Ulwazi olubhekiselele kwiZiko leSizwe loLwazi lweBiotechnology (NCBI). Ububanzi bolwazi lwethu bukhawulelwe kwi-chiropractic kunye nokulimala komgogodla kunye neemeko. Ukuxoxa ngombandela, nceda uzive ukhululekile ukubuza uDkt Jimenez okanye uqhagamshelane nathi 915-850-0900 .

 

Ikhutshwe nguDkt. Alex Jimenez

 

 

Imixholo eyongezelelweyo: iSciatica

 

I-Sciatica ibhekiselwa kuyo njengeqoqo leempawu kunokuba luhlobo oluthile lokulima okanye imeko. Iimpawu zibonakaliswa njenge-radiating intlungu, ukuxubha kunye nokuvakala kwintsholongwane kwi-nerve ye-sciatic kumqolo ongaphantsi, phantsi kweentsimbi kunye namathanga kunye nemilenze enye okanye zombini kunye neenyawo. I-Sciatica idla ngokubangelwa ukucaphukisa, ukuvuvukala okanye ukunyanzeliswa kwesibindi esikhulu kunazo zonke emzimbeni womntu, ngokuqhelekileyo ngenxa ye-disc okanye i-bone spur.

 

 

INGXELO EBALULEKILEYO: UKUPHATHA KWE-EXTRA: Ukunyanga i-Sciatica Pain