黎医药熨疗法联合针刺治疗腰椎间盘突出型根性坐骨神经痛急性期患者的临床效果及对患者血清致疼因子和炎症因子水平的影响  

Clinical effect of Li medicine hot medicinal compress therapy combined with acupuncture therapy on patients with lumbar disc herniation-caused root sciatica in acute stage and its impact on patients′serum levels of pain-causing factors and inflammatory factors

作　　者：陆征麟 牛淑芳 韩秋琼 杨帆 陈义坤 苟学健 LU Zheng-lin;NIU Shu-fang;HAN Qiu-qiong;YANG Fan;CHEN Yi-kun;GOU Xue-jian(Department of Acupuncture and Moxibustion,Haikou Hospital of Traditional Chinese Medicine,Haikou 570000,China;International Traditional Chinese Medicine Diagnosis and Treatment Center,Haikou Hospital of Traditional Chinese Medicine,Haikou 570000,China;School of Traditional Chinese Medicine,Hainan Medical College,Haikou 571199,China;Department of Orthopedics and Traumatology,Haikou Hospital of Traditional Chinese Medicine,Haikou 570000,China)

机构地区：[1]海南省海口市中医医院针灸科,海口市570000 [2]海南省海口市中医医院中医国际诊疗中心,海口市570000 [3]海南医学院中医学院,海口市571199 [4]海南省海口市中医医院骨伤科,海口市570000

出　　处：《广西医学》2021年第20期2425-2429,共5页Guangxi Medical Journal

基　　金：海南省卫生计生行业科研项目(15A200061)。

摘　　要：目的观察黎医药熨疗法联合针刺治疗腰椎间盘突出型根性坐骨神经痛急性期患者的临床效果及对患者血清致疼因子和炎症因子水平的影响。方法将114例腰椎间盘突出型根性坐骨神经痛急性期患者随机分为对照组与观察组,每组57例。对照组患者给予常规中医针刺治疗,观察组患者给予黎医药熨疗法联合常规中医针刺治疗。治疗后评价两组患者的中医疗效,并比较两组患者治疗前后的疼痛分级指数(PRI)、疼痛视觉模拟量表(VAS)评分、现有疼痛强度(PPI)评分,以及血清致疼因子(P物质、神经肽Y、神经激肽1)及炎症因子[白细胞介素6(IL-6)、单核细胞趋化蛋白1(MCP-1)、肿瘤坏死因子α(TNF-α)]水平。结果治疗后,观察组中医治疗的总有效率高于对照组;两组的患者PRI、疼痛VAS评分、PPI评分,以及血清P物质、神经肽Y、神经激肽1、IL-6、MCP-1、TNF-α水平均低于治疗前,且观察组的上述疼痛评分、血清致疼因子及炎症因子水平均低于对照组(均P<0.05)。结论与单纯中医针刺治疗相比,黎医药熨疗法联合针刺治疗可更有效地缓解腰椎间盘突出型根性坐骨神经痛急性期患者的腰部疼痛,改善相关症状,提高疗效,其机制可能与下调患者血清致疼因子及炎症因子水平有关。Objective To observe the clinical effect of Li medicine hot medicinal compress therapy combined with acupuncture therapy on patients with lumbar disc herniation-caused root sciatica in acute stage as well as its impact on the serum levels of pain-causing factors and inflammatory factors of the patients.Methods A total of 114 patients with lumbar disc herniation-caused root sciatica in acute stage were randomly divided into control group and observation group,with 57 cases in each group.Patients in the control group were given conventional traditional Chinese medicine(TCM)acupuncture therapy,and patients in the observation group were given Li medicine hot medicinal compress therapy combined with conventional TCM acupuncture therapy.After the treatment,TCM efficacy was evaluated in the two groups;besides,multiple indexes were compared between the two groups before and after treatment,including the pain rating index(PRI),the Visual Analogue Scale(VAS)pain score,the present pain intensity(PPI)score,as well as serum pain-causing factors(substance P,neuropeptide Y,neurokinin 1)levels and inflammatory factors(interleukin 6[IL-6],monocyte chemoattractant protein 1[MCP-1],tumor necrosis factorα[TNF-α])levels.Results After the treatment,the total effective rate of TCM therapy in the observation group was higher than that in the control group;PRI,VAS pain score,PPI score,and serum substance P,neuropeptide Y,neurokinin 1,IL-6,MCP-1,and TNF-αlevels in the two groups were lower as compared with those before treatment;moreover,the observation group yielded decreases in aforementioned pain scores and serum levels of pain-causing factors and inflammatory factors than the control group(all P<005).Conclusion Compared with TCM acupuncture therapy alone,Li medicine hot medicinal compress therapy combined with acupuncture therapy can more effectively alleviate lumbar pain of patients with lumbar disc herniation-caused root sciatica in acute stage,improving related symptoms and curative effects.The mechanism may be related to down-r

关 键 词：根性坐骨神经痛 腰椎间盘突出 黎医药 熨疗法 针刺疗法 疼痛评分 致疼因子 炎症因子 

分 类 号：R681.533[医药卫生—骨科学]