钩活术治疗气滞血瘀型腰椎间盘突出症的临床观察  

Clinical Observation of Gouhuo Operation in the Treatment of Lumbar Disc Herniation of Qi Stagnation and Blood Stasis Type

作　　者：唐雄 吴宗蔚 TANG Xiong;WU Zongwei(The Orthopedics Hospital of Traditional Chinese Medicine Zhuzhou City,Zhuzhou 412000,China)

机构地区：[1]湖南省株洲市中医伤科医院,湖南株洲412000

出　　处：《中国民族民间医药》2022年第10期96-99,共4页Chinese Journal of Ethnomedicine and Ethnopharmacy

基　　金：2019湖南省中医药管理局科技计划项目(项目号201967)。

摘　　要：目的:观察钩活术治疗气滞血瘀型腰椎间盘突出症患者的临床疗效。方法:选取气滞血瘀型LDH患者120例,随机分为对照组和观察组各60例。对照组给予针刺患侧腰阳关、命名、承山等穴位;观察组予以钩活术治疗。于治疗前后分别采用疼痛视觉模拟量表(VAS)评分和改良日本骨科学会下腰痛评分(M-JOA)进行评分。于治疗前后取血,分离血清,采用ELISA法检测肿瘤坏死因子-α(TNF-α)、白介素1β(IL-1β)表达量。结果:对照组总有效率为76.67%,观察组总有效率为91.67%(P<0.05)。观察组VAS评分较对照组降低更显著(P<0.05),M-JOA评分较对照组升高更为显著(P<0.05)。观察组TNF-α、IL-1β抑制效果较对照组更显著(P<0.05)。结论:钩活术可显著抑制气滞血瘀型LDH患者VAS评分,改善M-JOA评分,其作用机制可能与调控恢复Th1/Th2平衡有关。Objective To observe the clinical effect of Gouhuo operation on lumbar disc herniation(LDH)of Qi stagnation and blood stasis type.Methods A total of 120 patients with LDH of Qi stagnation and blood stasis type were selected and randomly divided into control group(60 cases)and observation group(60 cases).Control group was given acupuncture at Yaoyangguan,Mingming,Chengshan and other acupoints on the affected side.Observation group was treated with Gouhuo operation.Visual Analogue Scale(VAS)and Modified Japanese Orthopaedic Association Scores(M-JOA)were used before and after treatments.Blood was collected before and after treatments,the serum was separated,and tumor necrosis factor was detected by the expression level of-α(TNF-α)and Interleukin-1β(IL-1β)with ELISA.Results There was significant difference between the two groups,the total effective rate was 76.67%in control group and 91.67%in observation group(P<0.05).The VAS scores of observation group were significantly lower than that of control group(P<0.05),and the M-JOA were significantly higher than that of control group(P<0.05).The inhibitory effect of TNF-αand IL-1βin observation group was more significant than that of control group(P<0.05).Conclusion Gouhuo operation can significantly inhibit VAS scores and improve M-JOA scores of patients with LDH of Qi stagnation and blood stasis type.Its mechanism may be related to regulating and restoring the balance of Th1/Th2.

关 键 词：腰椎间盘突出症 钩活术 气滞血瘀型 

分 类 号：R681.3[医药卫生—骨科学]