摘要
目的分析针灸联合温经通络方治疗腰椎间盘突出症(LDH)患者的临床效果。方法选择2021年4月至2022年4月在焦作市第五人民医院治疗的86例LDH患者为研究对象,按随机数字表分为对照组(针灸)、联合组(针灸+温经通络方),各43例。并比较两组临床疗效、中医证候积分、日本骨科协会评估治疗(JOA)评分、表面肌电图、疼痛介质[5-羟色胺(5-HT)、多巴胺(DA)、P物质(SP)]、视觉模拟评分(VAS)评分、炎性因子[白细胞介素(IL)-6、环氧酶-2(COX-2)、转化生长因子-β1(TGF-β1)、降钙素原(PCT)]。结果联合组总有效率为93.02%高于对照组76.74%(P<0.05);治疗14 d后、治疗28 d后联合组中医证候积分、VAS评分为(19.47±2.72)分、(16.81±1.69)分、(3.69±0.62)分、(2.87±0.44)分均低于对照组(21.74±2.65)分、(18.34±1.88)分、(4.36±0.77)分、(3.41±0.59)分,JOA评分(19.77±2.15)分、(23.85±3.01)分高于对照组(16.74±1.87)分、(19.62±3.46)分(P<0.05);治疗14 d后、治疗28 d后联合组多裂肌、竖脊肌的平均肌电波幅(53.42±5.59)μV、(62.94±7.43)μV、(55.42±5.44)μV、(67.42±5.46)μV均高于对照组(46.43±4.74)μV、(55.12±6.82)μV、(49.52±4.34)μV、(59.58±7.92)μV,多裂肌、竖脊肌的平均频率斜率(-0.41±0.06)、(-0.29±0.09)、(-0.32±0.08)、(-0.23±0.04)均低于对照组(-0.47±0.08)、(-0.37±0.10)、(-0.38±0.07)、(-0.29±0.07),P<0.05;治疗14 d后、治疗28 d后联合组5-HT、DA、SP、IL-6、COX-2、TGF-β1、PCT均低于对照组,P<0.05。结论针灸联合温经通络方可提高LDH治疗效果,改善患者腰椎功能、腰背伸肌群功能,减轻疼痛、炎症反应。
Objective To analyze the clinical effect of acupuncture and moxibustion combined with Wenjing Tongluo prescription in the treatment of lumbar disc herniation(LDH).Methods A total of 86 LDH patients treated in the Fifth People's Hospital of Jiaozuo City from April 2021 to April 2022 were selected as the study objects.According to the random number table,they were divided into control group(acupuncture and moxibustion)and combined group(acupuncture and moxibustion+Wenjing Tongluo prescription),with 43 cases in each group.The clinical efficacy,TCM syndrome score,Japanese Orthopaedic Association Evaluation Treatment(JOA)score,surface electromyography,pain mediators[5-hydroxytryptamine(5-HT),dopamine(DA),Substance P(SP)],visual analogue scale(VAS)score,inflammatory factors[interleukin-6(IL-6),cyclooxygene-2(COX-2),and transforming growth factor-β1(TGF-β1),procalcitonin(PCT)]were compared between the two groups.Results The total effective rate of the combined group was 93.02%,higher than that of the control group(76.74%,P<0.05);After 14 days of treatment and 28 days of treatment,the TCM syndrome product and VAS score of the combined group were(19.47±2.72),(16.81±1.69),(3.69±0.62),(2.87±0.44),lower than those of the control group(21.74±2.65),(18.34±1.88),(4.36±0.77),(3.41±0.59),JOA was(19.77±2.15),(23.85±3.01),higher than those of the control group(16.74±1.87),(19.62±3.46),P<0.05;After 14 days of treatment and 28 days of treatment,the average EMG amplitude of multifidus muscle and erector spinal muscle(53.42±5.59)μV,(62.94±7.43)μV,(55.42±5.44)μV,(67.42±5.46)μV in the combined group were higher than those in the control group(46.43±4.74)μV,(55.12±6.82)μV,(49.52±4.34)μV,(59.58±7.92)μV,and the average frequency slope(-0.41±0.06),(-0.29±0.09),(-0.32±0.08),(-0.23±0.04)were lower than those in the control group(-0.47±0.08),(-0.3±0.10),(-0.38±0.07),(-0.29±0.07),P<0.05;After 14 days of treatment and 28 days of treatment,5-HT,DA,SP,IL-6,COX-2,TGF-β1,and PCT in the combined group were lower than those of the control group(P<0.05).Conclusion Acupuncture and moxibustion prescription combined with Wenjing Tongluo prescription can improve the therapeutic effect of LDH,improve the function of lumbar vertebra and lumbar dorsal extensor muscle group,and reduce pain and inflammation.
作者
李彩红
韩东
刘峰
LI Cai-hong;HAN Dong;LIU Feng
出处
《中国疗养医学》
2023年第1期108-112,共5页
Chinese Journal of Convalescent Medicine
关键词
针灸
温经通络方
腰椎间盘突出症
表面肌电图
疼痛指数
Acupuncture and moxibustion
Wenjing Tongluo prescription
Lumbar disc herniation
Surface electromyography
Pain index
