摘要
目的探讨“飞经走气”针法针刺“腰突五穴”联合独活寄生汤治疗腰椎间盘突出症(lumbar disc herniation,LDH)的疗效。方法选取2023年5月—2024年2月医院收治的200例LDH患者作为研究对象,按照随机数表法分为青龙摆尾组(采用“青龙摆尾”手法联合独活寄生汤治疗,40例)、白虎摇头组(采用“白虎摇头”手法针刺联合独活寄生汤治疗,40例)、苍龟探穴组(采用“苍龟探穴”手法针刺联合独活寄生汤治疗,40例)、赤凤迎源组(采用“赤凤迎源”手法针刺联合独活寄生汤治疗,40例)及常规毫针组(采用常规毫针深刺联合独活寄生汤治疗,40例),比较5组临床疗效、视觉模拟评分(visual analogue scale,VAS)、日本骨科协会评估治疗评分(Japanese Orthopaedic Association,JOA)、疼痛匹配阈值(pain matching threshold,PMT)、电流感觉阈值(current perception threshold,CPT)、细胞炎症因子[白细胞介素(interleukin,IL)-1β、IL-10、IL-17、肿瘤坏死因子(tumor necrosis factor,TNF)-α]、免疫功能指标[CD+4、CD+8、CD+4/CD+8]。结果青龙摆尾组、白虎摇头组、苍龟探穴组、赤凤迎源组总有效率高于常规毫针组(P<0.05);治疗后,青龙摆尾组、白虎摇头组、苍龟探穴组、赤凤迎源组VAS评分、PMT水平低于常规毫针组,JOA评分高于常规毫针组(P<0.05);治疗后,青龙摆尾组、白虎摇头组、苍龟探穴组、赤凤迎源组L4、L5和S1神经根CPT值低于常规毫针组(P<0.05);治疗后,青龙摆尾组、白虎摇头组、苍龟探穴组、赤凤迎源组血清IL-1β、IL-17、TNF-α水平低于常规毫针组,IL-10水平高于常规毫针组(P<0.05);治疗后,青龙摆尾组、白虎摇头组、苍龟探穴组、赤凤迎源组CD+4、CD+4/CD+8高于常规毫针组(P<0.05)。结论“飞经走气”针法针刺“腰突五穴”联合独活寄生汤治疗LDH患者的效果显著,其可有效缓解患者腰痛,降低炎症反应,改善免疫功能和外周神经功能损伤,进而提高腰椎功能。
Objective To explore the curative effect of Feijing Zouqi acupuncture at five points of lumbar process combined with Duhuo Jisheng Decoction(独活寄生汤)in lumbar disc herniation(LDH).Methods A total of 120 patients with LDH were enrolled as the research objects between May 2023 and February 2024.According to random number table method,they were divided into Qinglong Baiwei group(treated with Qinglong Baiwei technique combined with Duhuo Jisheng Decoction,40 cases),Baihu Yaotou group(treated with Baihu Yaotou technique combined with Duhuo Jisheng Decoction,40 cases),Canggui Tanxue group(treated with Canggui Tanxue acupuncture combined with Duhuo Jisheng Decoction,40 cases),and Chifeng Yingyuan group(treated with Chifeng Yingyuan acupuncture combined with Duhuo Jisheng Decoction,40 cases),and conventional millineedles group(treated with conventional millineedles deep acupuncture combined with Duhuo Jisheng Decoction,40 cases).The clinical curative effect,the scores of visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA),pain matching threshold(PMT),current perception threshold(CPT),cellular inflammatory factors[interleukin-1β(IL-1β),interleukin-10(IL-10),interleukin-17(IL-17),tumor necrosis factor-α(TNF-α)]and immune function indexes(CD+4,CD+8,CD+4/CD+8)were compared between the five groups.Results The total response rate of Qinglong Baiwei group,Baihu Yaotou group,Canggui Tanxue group and Chifeng Yingyuan group was higher than that of conventional millineedles group(P<0.05).After treatment,VAS score and PMT in Qinglong Baiwei group,Baihu Yaotou group,Canggui Tanxue group and Chifeng Yingyuan group were lower than those in conventional millineedles,while JOA score was higher than that in conventional millineedles group(P<0.05).After treatment,CPT values of L4,L5 and S1 nerve roots in Qinglong Baiwei group,Baihu Yaotou group,Canggui Tanxue group and Chifeng Yingyuan group were lower than those in conventional millineedles group(P<0.05).After treatment,the levels of serum IL-1β,IL-17 and TNF-αin Qinglong Baiwei group,Baihu Yaotou group,Canggui Tanxue group and Chifeng Yingyuan group were lower than those in conventional millineedles group,while IL-10 level was higher than that in conventional millineedles group(P<0.05).After treatment,CD+4 and CD+4/CD+8 in Qinglong Baiwei group,Baihu Yaotou group,Canggui Tanxue group and Chifeng Yingyuan group were higher than those in conventional millineedles group(P<0.05).Conclusion Curative effect of Feijing Zouqi acupuncture at five points of lumbar process combined with Duhuo Jisheng Decoction is significant in LDH patients,which can effectively relieve lumbago,reduce inflammatory response,improve immune function and function injury of peripheral nerves,and thus improve the lumbar function.
作者
韩雪梅
李佳仪
卢梦晗
刘玮
孙炜
HAN Xuemei;LI Jiayi;LU Menghan;LIU Wei;SUN Wei(Qingdao Hospital of Traditional Chinese Medicine,Qingdao 266000,Shandong,China)
出处
《辽宁中医杂志》
CAS
北大核心
2024年第9期178-182,共5页
Liaoning Journal of Traditional Chinese Medicine
基金
青岛市医药卫生科研指导项目(2022-WJZD039)
山东省中医药科技项目(M-2023081)。
关键词
腰椎间盘突出症
飞经走气
腰突五穴
独活寄生汤
lumbar disc herniation
Feijing Zouqi
five points of lumbar process
Duhuo Jisheng Decoction(独活寄生汤)
