活络逐瘀汤联合电针治疗腰椎间盘突出症血瘀证的疗效及对患者腰屈伸功能、肌电图和疼痛因子的影响  

Curative effect of Huoluo Zhuyu Decoction combined with electroacupuncture for lumbar disc herniation of blood stasis syndrome and how it impacts on flexion and extension function of lumbar,electromyography and pain mediator

作　　者：陈勇 骆卓琦 闫红霞 李建兵 韦荣宝 唐汉秋 CHEN Yong;LUO Zhuoqi;YAN Hongxia;LI Jianbing;WEI Rongbao;TANG Hanqiu(Wuzhou Hospital of Traditional Chinese Medicine,Wuzhou,Guangxi 543001)

机构地区：[1]广西壮族自治区梧州市中医医院针灸科,广西梧州543001

出　　处：《河北中医》2022年第3期383-387,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区中医药管理局科技项目(编号:GZLC16-64)。

摘　　要：目的观察活络逐瘀汤联合电针治疗腰椎间盘突出症血瘀证的疗效及对患者腰屈伸功能、肌电图和疼痛因子的影响。方法选取广西壮族自治区梧州市中医医院针灸科腰椎间盘突出症血瘀证门诊患者128例,按照随机数字表法分为对照组和观察组,各64例。在常规牵引治疗基础上,对照组采用电针治疗,观察组采用电针加活络逐瘀汤治疗,连续治疗20 d。观察2组治疗后腰屈伸功能变化及对肌电图和疼痛介质的影响,比较2组疗效。结果观察组总有效率95.31%(61/64),对照组总有效率76.56%(49/64),观察组疗效优于对照组(P<0.05)。治疗后观察组日本骨科协会评估治疗分数(JOA)下腰痛评分、McGill疼痛评定表评分均优于对照组(P<0.05),腰椎前屈、后伸功能评分高于对照组(P<0.05)。治疗后2组血清疼痛介质β-内啡肽(β-EP)水平较本组治疗前升高,前列腺素E_(2)(PGE_(2))、5-羟色胺(5-HT)较治疗前降低(P<0.05),且观察组治疗后β-EP高于对照组,PGE_(2)、5-HT低于对照组(P<0.05)。治疗后2组双侧伸肌群的积分肌电值(IEMG)、平均功率频率(MPF)均较本组治疗前增加(P<0.05),且观察组治疗后IEMG高于对照组(P<0.05)。结论活络逐瘀汤联合电针治疗腰椎间盘突出症血瘀证临床疗效确切,可有效提高患者腰椎功能前屈、后伸活动度,减轻疼痛程度,并明显改善患者腰椎肌肉的生理活动。Objective To observe the curative effect of Huoluo Zhuyu Decoction combined with electroacupuncture for lumbar disc herniation(LDH)of blood stasis syndrome and how it impacts on flexion and extension function of lumbar,electromyography(EMG)and pain mediator.Methods Totally 128 LDH patients(blood stasis syndrome)admitted to Department of Acupuncture and Moxibustion,Wuzhou Hospital of Traditional Chinese Medicine were randomly divided into the control group(n=64)and the observation group(n=64).In addition conventional traction therapy,the control group received electroacupuncture,and the observation group received Huoluo Zhuyu Decoction combined with electroacupuncture.A 20-day treatment was performed to compare the changes of flexion and extension function of lumbar,EMG and pain mediator;the curative effect was assessed.Results The overall effective rate was 95.31%(61/64)in the observation group,higher than that of 76.56%(49/64)in the control group(P<0.05).Compared with the control group,japanese orthopaedic association(JOA)score for low back pain,short-form McGill pain questionnaire(SF-MPQ)in the observation group were better(P<0.05),scores of lumbar flexion and extension were higher(P<0.05).After treatment,beta-endorphin(β-EP)in groups was increased(P<0.05),which was increased in the observation group than the control group(P<0.05);prostaglandin E_(2)(PGE_(2))and 5-hydroxytryptamine(5-HT)in groups were decreased(P<0.05),the observation group was more prevalent(P<0.05);integrated EMG(IEMG)of bilateral extensor groups and mean power frequency(MPF)in groups were increased(P<0.05),improvement of IEMG in the observation group were significantly better(P<0.05).Conclusion For LDH patients(blood stasis syndrome),Huoluo Zhuyu Decoction combined with electroacupuncture has a definite curative effect,which can effectively improve the activity of lumbar flexion and extension,relieve pain,and significantly improve the physiological activity of lumbar muscles.

关 键 词：椎间盘移位 腰椎 血瘀 活血祛瘀 电针 针刺疗法:中药疗法 

分 类 号：R246.223[医药卫生—针灸推拿学] R681.533.1[医药卫生—中医临床基础]