牵抖整脊法联合椎间盘方对腰椎间盘突出症临床早期疗效及相关炎性因子的影响  

Effect of traction and shaking chiropractic method combined with Zhuijianpanfang on early clinical efficacy and related inflammatory factors in patients with lumbar disc herniation

作　　者：周剑鹏 蔡迎峰 田天照 刘保新 秦启宁 周沛 Zhou Jianpeng;Cai Yingfeng;Tian Tianzhao;Liu baoxing;Qin Qining;Zhou Pei(Department of Orthopedics,The Affiliated TCM Hospital of Guangzhou Medical University,Guangzhou 510130,China)

机构地区：[1]广州医科大学附属中医医院骨伤科,510130

出　　处：《国际医药卫生导报》2021年第23期3631-3635,共5页International Medicine and Health Guidance News

基　　金：广东省中医药局科研项目(20212173)。

摘　　要：目的观察牵抖整脊法联合椎间盘方对腰椎间盘突出症(lumbardischerniation,LDH)患者的临床早期疗效及血清中相关联的炎性因子血清浓度的影响。方法将2021年1月1日至11月1日在广州医科大学附属中医医院骨伤科门诊或住院治疗的LDH患者,采用前瞻性研究,将40例符合研究标准的腰椎间盘突出症患者,按随机数字表法分为两组,每组20例。治疗组:男6例,女14例,年龄38~80(59.1±12.1)岁;对照组:男8例,女12例,年龄52~78(61.9±7.4)岁。对照组:采用卧床休息、贴敷疗法及相关理疗治疗等基础治疗持续2周;治疗组:在基础治疗的基础上行牵抖整脊法,并服用椎间盘方2周。观察两组患者在治疗前、后2周的疼痛[采用视觉模拟量表(VisualAnalogueScale,VAS)]评分、Oswestry功能障碍指数(Oswestrydisabilityindex,ODI)、血清中肿瘤坏死因子-α(tumor necrosisfactor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)指标的变化,以及观察患者血常规、肝肾功能、胃肠道反应、皮疹、药物过敏及其他不良反应等相关安全性指标。结果经过2周的治疗,治疗组患者的VAS评分为(1.91±0.60)分,改善程度优于对照组[(2.77±0.65)分],差异有统计学意义(t=3.885,P<0.05);治疗组的ODI为(21.80±4.76)%,改善程度优于对照组[(29.4±4.90)%],差异有统计学意义(t=3.671,P<0.05);治疗组血清中的TNF-α浓度为(5.82±2.20)pg/ml,较同时期对照组[(6.83±2.67)pg/ml]显著降低,差异有统计学意义(t=2.259,P<0.05);治疗组血清中的IL-6浓度为(2.31±0.69)pg/ml,较同时期对照组[(3.35±1.93)pg/ml]显著降低,差异有统计学意义(t=2.178,P<0.05);经过2周治疗后,治疗组的VAS评分较治疗前明显改善[(1.91±0.60)分比(6.26±0.59)分],差异有统计学意义(t=23.948,P<0.05);ODI较治疗前明显改善[(21.80±4.76)%比(61.90±5.41)%],差异有统计学意义(t=24.575,P<0.05);TNF-α浓度较治疗前显著降低[(5.82±2.20)分比(8.90±3.16)],差异有统计学意义(t=6.254,P<0.Objective To observe the effect of traction and shaking chiropractic method combined with Zhuijianpanfang on early clinical efficacy and related inflammatory factors in patients with lumbar disc herniation(LDH).Methods From January 1 to November 1,2021,40 patients with LDH who were treated at the clinic of Department of Orthopedics,The Affiliated TCM Hospital of Guangzhou Medical University or were hospitalized into this hospital were divided into a treatment group and a control group by the random number table method,with 20 cases in each group.The treatment group had 6 males and 14 females,and were 38-80(59.1±12.1)years old.The control group had 8 males and 12 females,and were 52-78(61.9±7.4)years old.The control group rested in bed and took sticking therapy and related physiotherapy for 2 weeks.On the basis of basic treatment,the treatment group took prone traction and shaking,spine and tendon regulation,and Zhuijianpanfang for 2 weeks.The scores of Visual Analogue Scale(VAS),the Oswestry disability indexes(ODI),and the serum levels of tumor necrosis factorα(TNFα)and interleukin-6(IL-6)were observed before and 2 weeks after the treatment.The related safety indicators,such as blood routine,liver and kidney function,gastrointestinal reaction,rash,drug allergy,and other adverse reactions,were observed.Results After 2 weeks'treatment,the VAS score and ODI of the treatment group were significantly better than those of the control group[(1.91±0.60)vs.(2.77±0.65)and(21.80±4.76)%vs.(29.4±4.90)%],with statistical differences(t=3.885 and 3.671,both P<0.05);and the serum levels of TNF-αand IL-6 in the treatment group were obviously lower than those in the control group[(5.82±2.20)pg/ml vs.(6.83±2.67)pg/ml and(2.31±0.69)pg/ml vs.(3.35±1.93)pg/ml],with statistical differences(t=2.259 and 2.178,both P<0.05).The VAS score,ODI,and serum levels of TNF-αand IL-6 after 2 weeks'treatment were significantly better than those before the treatment in the treatment group[(1.91±0.60)vs.(6.26±0.59),(21.80±4.76)%vs.(61.

关 键 词：腰椎间盘突出症 椎间盘方 牵抖整脊法 

分 类 号：R274.9[医药卫生—中西医结合]