缪刺联合掌背部全息动气针法治疗急性腰痛的临床疗效及作用机制探讨  

Clinical efficacy and mechanism of contralateral needling combined with holographic moving qi therapy on carpal dorsum in patients with acute lumbago

作　　者：芮庆林 袁思成 胡书凤 黄美 RUI Qinglin;YUAN Sicheng;HU Shufeng;HUANG Mei(Department of Emergency,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210029;不详)

机构地区：[1]南京中医药大学附属医院急诊科,江苏南京210029 [2]南京中医药大学,江苏南京210023 [3]南京中医药大学附属医院门诊部,江苏南京210029

出　　处：《河北中医》2021年第8期1352-1356,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：江苏省中医药局中医重点学科项目(编号:K2013XK03)。

摘　　要：目的观察缪刺联合掌背部全息动气针法治疗急性腰痛的临床疗效,并探讨其可能的作用机制。方法将92例患者按照平行分组体系随机分为2组,对照组46例予常规针刺治疗,治疗组46例予缪刺联合掌背部全息动气针法治疗。2组治疗3 d后统计疗效,比较2组治疗前后疼痛视觉模拟评分法(VAS)、即刻止痛率、腰椎Oswetry功能障碍指数(ODI)评分及腰椎活动度(包括腰部前屈和后伸)变化情况,比较2组治疗前后血清炎症指标超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)及白细胞介素6(IL-6)水平变化情况。结果治疗组总有效率89.13%(41/46),对照组71.74%(33/46),治疗组疗效优于对照组(P<0.05)。2组治疗后疼痛VAS与本组治疗前比较均降低(P<0.05),且治疗组治疗后疼痛VAS评分低于对照组(P<0.05),即刻止痛率明显高于对照组(P<0.05)。与本组治疗前比较,2组治疗后ODI评分均降低(P<0.05),腰椎前屈及腰椎后伸角度均增加(P<0.05),且治疗组治疗后改善均优于对照组(P<0.05)。2组治疗后血清hs-CRP、TNF-α及IL-6水平与本组治疗前比较均降低(P<0.05),且治疗组治疗后血清hs-CRP及IL-6水平均低于对照组(P<0.05)。结论缪刺联合掌背部全息动气针法治疗急性腰痛临床疗效确切,可明显缓解患者疼痛症状,达到快速止痛效果,改善腰椎功能,增加腰部活动度,安全可靠,其作用机制可能与降低炎症指标水平,抑制早期炎性反应有关。Objective To observe the clinical efficacy of contralateral needling combined with holographic moving qi therapy on carpal dorsum in patients with acute lumbago(AL),and to explore its possible mechanism.Methods Totally 92 patients with AL were randomly divided into two groups based on parallel-group system,46 cases in control group were treated with conventional acupuncture treatment,and 46 cases in treatment group with contralateral needling combined with holographic moving qi therapy on carpal dorsum.Treated for 3 days,aiming to compare visual analogue score(VAS)for pain,immediate analgesia effect,oswestry dysfunction index(ODI),Angle of lumbar muscle activity(flexion and extension),serum inflammatory factor including high-sensitivity c-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6).Results The total effective rates in treatment group were better than those in control group[89.1%(41/46)vs 71.3%(33/46),(P<0.05),respectively].Compared with before treatment,VAS for pain in groups was lower after treatment(P<0.05),which in treatment group was significantly decreased(P<0.05),while immediate analgesia effect was significantly higher in treatment group than in control group(P<0.05);ODI in groups was decreased(P<0.05),while the angle(flexion and extension)were increased(P<0.05),and the improvement was better in treatment group than in control group(P<0.05);hs-CRP,TNF-αand IL-6 in groups was lower after treatment(P<0.05),hs-CRP and IL-6 in treatment group was significantly decreased(P<0.05).Conclusion For AL patients,contralateral needling combined with holographic moving qi therapy on carpal dorsum has a definite curative effect,can significantly relieve pain symptoms,achieve rapid pain relief,improve lumbar function,increase lumbar muscle activity,which is safe and reliable.Its mechanism may be related to reducing the level of inflammatory factors and inhibiting early inflammatory response.

关 键 词：腰痛 急性病 缪刺 第二掌骨全息穴位诊断 中医全息论 

分 类 号：R245.319[医药卫生—针灸推拿学]