Clinical Journal of Chinese Medicine 2018 V ol.(10) No.6 -124- 中西医学·针灸推拿推拿配合中药塌渍治疗干性坐骨神经痛32例Treating 32 cases of secondary sciatica by massage therapy combined with Chinese medicine collapse stains常进奇郭波波（河南中医药大学，河南郑州， 450003）中图分类号：R274.9文献标识码：A文章编号：1674-7860（2018）06-0124-【摘要】目的：对推拿配合中药塌渍治疗干性坐骨神经痛的疗效进行临床观察。方法：将32例患者先采用推拿、按、揉、颤压、点穴、叩击等手法作用于患侧臀部及下肢，尤以臀中肌髂骨附着处为主进行操作，治疗约30min，配合自制中药塌渍方塌渍臀中肌髂骨附着，以特定电磁波治疗器投射加热20min，1次/d，10次为1个疗程。结果：治愈21例，好转10例，未愈1例。有效率96.9%。结论：通过推拿疗法促进局部血液循环和炎性介质的吸收，增强局部代谢能力，放松痉挛肌肉，起到“去痛致松”“以松治痛”的治疗作用；配合中药的活血化瘀、理气止痛、舒筋活络作用，加之特定电磁波治疗器持续温热的作用，三者结合，相辅相成，对治疗干性坐骨神经痛起到了显著作用。【关键词】推拿；中药塌渍；干性坐骨神经痛【Abstract】Objective: To observe the effect of the massage therapy combined with Chinese medicine collapse stains for the treatment of secondary sciatica. Methods: 32 cases were treated by massage therapy such as rolling, pressing, rubbing, trembling, pointing, knocking on the hip and lower limb for about 30 minutes, especially on where the gluteus medius attached on the ilium, combined with Chinese traditional medicine collapse stains and heated with the specific electromagnetic wave therapeutic lamp for about 20 minutes, once a day, 10 times were for a course of treatment. Results: 21 cases were cured, 10 cases recovered and 1 case wasn’t cured. The cure rate was 96.9%. Conclusion: Massage therapy combined with Chinese medicine collapse stains could promote local blood circulation and mediators of inflammation absorption, relax the spasmodic muscles combined with the efficacy of Chinese traditional medicine collapse stains and the continuous warming of the specific electromagnetic wave therapeutic lamp. The combination of the three therapies complemented each other, and had remarkable effect on treating secondary sciatica.【Keywords】Massage; Chinese medicine collapse stains; Secondary sciaticadoi：10.3969/j.issn.1674-7860.2018.06.055坐骨神经痛是以坐骨神经径路及分布区域疼痛为主的综合征，按病损部位分根性和干性坐骨神经痛两种。笔者以受《宣蜇人软组织外科学》理论启发，采用推拿疗法针对坐骨神经分布区域，尤其是臀中肌髂骨附着处进行推拿，并配合中药塌渍治疗干性坐骨神经痛，取得令人满意临床疗效，现报告如下。1临床资料1.1 一般资料32例患者均为自2015年6月－2017年1月以来门诊就诊的患者，其中男18例，女14例，年龄20～75岁，平均（46.21±7.52）岁；病程最短3～25个月，平均（14.35±8.27）个月。1.2 纳入标准①主要表现为臀部、大腿后、小腿后外侧和足部外侧放射性烧灼样痛或刺痛，受凉及劳累后加重，咳嗽、喷嚏或腹部用力时疼痛无明显加重，病程较长者可见不同程度的小腿肌肉萎缩。②腰部脊柱两侧无明显压痛，臀中肌附着处、腘窝中央、外踝后侧等沿坐骨神经走向处压痛，屈颈试验、直腿抬高试验均为阴性。③X线摄片、CT等无异常改变。2治疗方法2.1 推拿疗法患者俯卧位，自然放松，医生立于患侧。①以㨰、按、揉三法放松整个腰骶部、臀部及下肢后外侧，以臀部为重点，施术3～5min，以改善循环、放松肌肉。②以双手拇指或中指叠指颤压臀肌髂骨附着处压痛区，重点针对臀部痛点、结节进行颤压。开始时以轻手法进行操作，随着推拿过程中患者痛阈的提高和疼痛的减轻，手法逐渐加重，以患者耐受为度，以促进气血循行、疏通经络、松解粘连，反复操作5～7min。③点按秩边、环跳、臀部压痛点、承扶、委中、阳陵泉、承山，以患者自觉酸胀为度，每穴1min，以达舒经通络，调和气血之效。④叩击臀部及下肢后侧、外侧3～5遍，力度应渗透肌肉深层。结束治疗。1次/d，10次为1个疗程。2.2 中药塌渍中药处方：桂枝、细辛、秦艽、羌活、独活、牛膝、当归、红花、川芎、乳香、没药各15g。以上诸药加50%酒精
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