推拿联合针灸治疗腰椎间盘突出症的疗效及对相关炎性因子影响的临床研究  

The Clinical Effect of Massage Combination with Acupuncture for Treatment Lumbar Intervertebral Disc and Its Influence on Inflammatory Factors

作　　者：陈婷婷[1] 曾宪敏[1] 李安洪 CHEN Tingting;ZENG Xianmin;LI Anhong(Department of Rehabilitation,Shifang Peoples Hospital of Sichuan Procince ,Shifang 618400;Department of Rehabilitation,The Affiliated Mianyang Hospital of Chengdu University of Chinese Medicine,Mianyang 621000)

机构地区：[1]什邡市人民医院康复科,四川什邡618400 [2]成都中医药大学附属绵阳医院康复科,四川绵阳621000

出　　处：《贵阳中医学院学报》2019年第1期36-41,46,共7页Journal of Guiyang University of Chinese Medicine

基　　金：四川省中医药管理局资助课题项目;项目编号:201083

摘　　要：目的:探讨推拿联合针灸治疗对腰椎间盘突出症患者的疗效以及对血清相关炎性因子影响。方法:将180例腰椎间盘突出症患者随机分为对照组、推拿组、针灸组及针推联合组。对照组行休息、锻炼、牵引及中药外敷治疗;推拿组、针灸组及联合组分别在对照组治疗基础上行推拿、针灸单独治疗及联合治疗,治疗两疗程。观察患者治疗前后的临床症状及检测血清促炎因子IL-1β、IL-6、IL-8、MMP-3、TNF-α和抗炎因子IL-4、IL-10含量。结果:对照组、推拿组、针灸组和联合组的总有效率分别为80. 00%、87. 67%、88. 89%、95. 56%,JOA评分、抗炎因子含量升高,VAS评分、感觉和感情PRI评分及促炎因子含量降低,推拿组、针灸组、联合组上述指标与对照组比较有统计学意义(P<0. 05),联合组与推拿组和针灸组相比有统计学意义(P<0. 05),推拿组与针灸组相比无明显差异(P>0. 05)。结论:推拿联合针灸治疗腰椎间盘突出症,能够明显改善患者腰腿痛症状及抑制促炎性因子生成,促进抗炎因子生成,降低局部炎性状态,综合疗效好,治疗方式安全可靠,值得临床应用。Objective: To explore the clinical curative effect of massage combination with acupuncture for treatment patients with lumbar disc prolapse and its influence on serum inflammatory factors. Methods: 180 patients with prolapse of lumbar intervertebral disc were randomly divided into control group,massage group,acupuncture group and joint group. For two courses treatment,the control group was given conventional treatment such as rest,functional exercise,lumbar tractionandexternal application of Chinese medicine,while massage,acupuncture and a combined approach were used for massage group,acupuncture group and joint group.Before and after treatment,the changes of clinical symptoms,pain of leg and lumbar,the contents of serum IL-1β、IL-6、IL-8、MMP-3、TNF-α、IL-4、IL-10 were observed for four groups.Results: The total effective rate of control group,massage group,acupuncture group and joint group was 80. 00%,87. 67%,88. 89% and 95. 56% respectively. The total effective rate was significantly higher in massage group,acupuncture group and joint group than that of in control group( P<0. 05).After treatment,JOA scores and the levels of serum IL-4、IL-10 were significantly increased,VAS scores and the levels of serum IL-1β,IL-6,IL-8,MMP-3 and TNF-α were significantly decreased( P<0. 05) in four groups,and the improvements of these indexes in massage group,acupuncture group and joint group were better than that in control group( P<0.05).while the improvements of these indexes in joint group were better than that of in massage group and acupuncture group( P < 0. 05). Conclusions: The integrated massage and acupuncture treatment may significantly inhibit inflammatory factors of patients with lumbar intervertebral disc prolapse pain,relieve the inflammatory state and alleviate patient ’s pain and symptoms.The curative effect of this comprehensive treatment is safe,reliable and valueable to use in clinical trial.

关 键 词：腰椎间盘突出症 针灸 推拿 炎性因子 

分 类 号：R246.9[医药卫生—针灸推拿学]