循经针刺联合非手术脊柱减压对腰椎间盘突出症腰椎功能及血清TFAR19、Apaf-1的影响  

Influences of Acupuncture Along Meridians Combined with Non-surgical Spinal Decompression on Lumbar Function and Serum TFAR19 and Apaf-1 in Patients with Lumbar Disc Herniation

作　　者：孙文 李江涛[1] 王晓玲[1] SUN Wen;LI Jiangtao;WANG Xiaoling(Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市中医医院,河北秦皇岛066000

出　　处：《辽宁中医药大学学报》2022年第2期93-97,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：秦皇岛市科学技术研究与发展计划项目(202004A115)。

摘　　要：目的探讨循经针刺联合非手术脊柱减压对腰椎间盘突出症腰椎功能及血清TF-1细胞凋亡相关基因19(TFAR19)、凋亡蛋白酶激活因子-1(Apaf-1)的影响。方法选取2018年6月—2020年7月该院收治的94例腰椎间盘突出症患者,随机分为对照组与观察组,各47例。对照组给予非手术脊柱减压治疗,观察组在对照组基础上另给予循经针刺治疗。对比治疗前、治疗3个月后腰椎功能[日本骨科协会腰椎功能(JOA)评分、Oswestry功能障碍指数(ODI)评分]及治疗前、治疗1个月、治疗3个月的腰腿疼痛评分[视觉模拟评分法(VAS)],并比较临床疗效及治疗前、治疗1个月、治疗3个月的椎旁肌肉肌电变化情况,另比较治疗前、治疗3个月后血清TFAR19、Apaf-1水平变化情况及治疗期间不良事件发生情况。结果两组治疗3个月后JOA评分均高于治疗前(P<0.05),观察组治疗3个月后高于对照组(P<0.05);两组治疗3个月后ODI评分均低于治疗前(P<0.05),观察组治疗3个月后低于对照组(P<0.05);两组治疗1个月、3个月的VAS评分均低于治疗前(P<0.05),治疗3个月的VAS评分均低于治疗1个月(P<0.05);观察组治疗1个月、3个月的VAS评分均低于对照组(P<0.05);观察组总有效率高于对照组(P<0.05);两组治疗1个月、3个月的竖脊肌及多裂肌积分肌电值(IEMG)、平均振幅、平均频率斜率均高于治疗前(P<0.05),治疗3个月均高于治疗1个月(P<0.05);观察组治疗1个月、3个月的竖脊肌及多裂肌IEMG、平均振幅、平均频率斜率均高于对照组(P<0.05);两组治疗3个月后血清TFAR19、Apaf-1水平均低于治疗前(P<0.05),观察组治疗3个月后血清TFAR19、Apaf-1水平均低于对照组(P<0.05);两组治疗期间不良事件发生率比较差异无统计学意义(P>0.05)。结论循经针刺联合非手术脊柱减压治疗腰椎间盘突出症患者,可明显减轻患者腰腿疼痛感,改善腰椎功能及椎旁肌肉肌力,提升椎旁肌群稳定性,降低Objective To investigate the influences of acupuncture along meridian combined with nonsurgical spinal decompression on lumbar function and serum TF-1 apoptosis related gene 19(TFAR19)and apoptotic protease activating factor-1(Apaf-1)in patients with lumbar disc herniation. Methods 94 patients with lumbar disc herniation admitted in our hospital from June 2018 to July 2020 were selected and randomly divided into control group and observation group,with 47 cases in each group. The control group was given non-surgical spinal decompression,while the observation group was additionally given acupuncture along meridians on the basis of the control group. The lumbar function [Japanese Orthopedic Association lumbar function(JOA)score,Oswestry disability index(ODI)score] before and after 3 months of treatment and the pain scores of hips and legs(visual analogue scale,VAS)before treatment,1 month after treatment and 3 months after treatment were compared,and the clinical effect and the changes of electromyography of paravertebral muscles before treatment,1 month after treatment and 3 months after treatment were compared,and the changes of serum TFAR19 and Apaf-1 levels before and after 3 months of treatment and the occurrence of adverse events during treatment were also compared.Results The JOA scores of the two groups after 3 months of treatment were higher than those before treatment(P<0.05),which in the observation group after 3 months of treatment was higher than that in the control group(P<0.05). The ODI scores of the two groups after 3 months of treatment were lower than those before treatment(P<0.05),which in the observation group after 3 months of treatment was lower than that in the control group(P<0.05). The VAS score of the two groups at 1 month and 3 months after treatment were lower than those before treatment(P<0.05),of which the two groups at 3 months after treatment were lower than those at 1 month after treatment(P<0.05). The VAS scores of the observation group at 1 month and 3 months after treatment were

关 键 词：循经针刺 非手术脊柱减压 腰椎间盘突出症 腰椎功能 TF-1细胞凋亡相关基因19 凋亡蛋白酶激活因子-1 

分 类 号：R246.9[医药卫生—针灸推拿学] R681.53[医药卫生—中医临床基础]