拨筋针治疗急性复发期腰背肌筋膜炎的临床研究  

Efficacy of Tendon-pulling Acupuncture in the Treatment of Acute Recurrent Lumbar Myofasciitis

作　　者：钟贻凯 孙刚毅 宋宝 井夫杰[1] Zhong Yikai;Sun Gangyi;Song Bao;Jing Fujie(Shandong University of Traditional Chinese Medicine,Shandong,Jinan 250014,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250014

出　　处：《中国中医急症》2022年第11期1937-1940,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：山东省卫生健康委员会齐鲁医派中医学术流派传承项目(L20210932198417)。

摘　　要：目的 观察拨筋针治疗急性复发期腰背肌筋膜炎的临床疗效。方法 将60例急性复发期腰背肌筋膜炎患者用随机数表法分为对照组与观察组各30例。对照组采取针刺激痛点治疗,观察组采用拨筋针治疗,2周治疗结束后进行比较,分别记录3、7、14 d视觉模拟评分表(VAS)、Oswestry功能障碍指数(ODI)的评分及治疗前后血清中P物质(SP)、白细胞介素-1β(IL-1β)、β-内啡肽(β-EP)的水平。结果 2周治疗结束后,对照组和观察组各有1例患者因工作地点变动无法继续治疗,实际完成58例。对照组总有效率为82.76%,观察组总有效率为93.10%,两组比较差异有统计学意义(P<0.05);治疗后两组VAS、ODI评分均改善(P<0.05),观察组评分改善更显著(P<0.05);治疗后两组SP、IL-1β降低,β-EP升高,观察组比对照组改善更显著(P<0.05)。对所有患者进行3个月的随访,对照组复发率41.67%,观察组复发率为7.41%,结果表明观察组复发率明显低于对照组(P<0.05)。结论 拨筋针治疗急性复发期腰背肌筋膜炎疗效确切,可下调炎性介质IL-1β、兴奋性神经递质SP,上调抑制性神经递质β-EP。Objective:To observe the clinical efficacy of tendon-pulling acupuncture in the treatment of acute recurrent lumbar myofasciitis. Methods:Patients who met the inclusion and exclusion criteria were randomly divided into the control group and the observation group by random number table method,with 30 cases in each group. The control group was treated with acupuncture to stimulate pain points,and the observation group was treated with tendon-pulling acupuncture. The two groups were compared after 2 weeks of treatment,and the scores of visual analog scale(VAS)and oswestry disability index(ODI) were recorded on 3、7、14 days respectively. The serum levels of substance P(SP),interleukin-1β(IL-1β),and β-endorphin(β-EP) before and after treatment were also recorded. Results:After the 2-week treatment,one patient in the control group and the observation group could not continue the treatment due to the change of work place,and 58 cases were actually completed.The total effective rate in the control group was 82.76%,and the total effective rate in the observation group was 93.10%,and the difference between the two groups was statistically significant(P< 0.05);the VAS and ODI scores in both groups improved after treatment(P< 0.05),and the observation group improved more significantly(P<0.05);after treatment,the SP and IL-1β levels in both groups decreased,the β-EP level increased,and the observation group decreased and increased more significantly than the control group(P< 0.05). All patients were followed for 3 months.The recurrence rate of the observation group was 41.67%,and the recurrence rate of the observation group was 7.41%;the results showed that the recurrence rate of the observation group was significantly lower than that of the control group(P< 0.05). Conclusion:Tendon-pulling acupuncture is effective in the treatment of acute recurrent lumbarmyofasciitis. It can down-regulate the inflammatory mediator IL-1β and excitatory neurotransmitter SP,and up-regulate the inhibitory neurotransmitter β-EP.

关 键 词：腰背肌筋膜炎 经筋病 激痛点 拨筋针法 

分 类 号：R685[医药卫生—骨科学]