化瘀理筋针刺法对腰椎间盘突出症瘀血阻滞型患者血清PGE2、IL-23、MMP-9及腰椎功能的影响  

Clinical study on the effects of acupuncture for removing blood stasis and regulating tendons on serum PGE2,IL-23,MMP-9 and lumbar function in patients with lumbar disc herniation(blood stasis block type)

作　　者：赖智君 刘利涛 李志敏 林慧 倪湘 LAI Zhi-jun;LIU Li-tao;LI Zhi-min;LIN Hui;NI Xiang(Haikou Hospital of Traditional Chinese Medicine,Haikou 570203,China)

机构地区：[1]海口市中医医院,海口570203 [2]海口中医医院文明中分院,海口570203

出　　处：《中华中医药杂志》2022年第12期7540-7542,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：海南省自然科学基金青年基金项目(No.820QN425)。

摘　　要：目的:探讨化瘀理筋针刺法对腰椎间盘突出症瘀血阻滞型治疗作用。方法:所有腰椎间盘突出症患者均于2018年9月至2021年1月在海口市中医医院就诊,并随机分为两组,每组59例,对照组采用西医常规治疗,观察组联合化瘀理筋针刺法治疗,疗程4周,比较治疗前后两组血清前列腺素E2(PGE2)、白介素-23(IL-23)、基质金属蛋白酶-9(MMP-9)、环氧合酶2(COX-2)、转化生长因子-β1(TGF-β1)、腰椎功能障碍指数(ODI)评分、疼痛视觉模拟量表(VAS)评分、腰椎功能(JOA)评分。结果:治疗后,两组血清PGE2、IL-23、MMP-9、COX-2、TGF-β1水平及ODI评分、VAS评分均较治疗前显著降低(P<0.01),JOA评分显著升高(P<0.01),且观察组各指标改善均优于对照组(P<0.01)。两组不良反应总发生率比较差异无统计学意义。结论:对于腰椎间盘突出症瘀血阻滞型患者而言联合化瘀理筋针刺法具有临床可行性。Objective:To investigate the therapeutic effect of removing blood stasis and regulating tendons by acupuncture on the stasis-blocked type of lumbar intervertebral disc herniation.Methods:All patients with lumbar disc herniation with blood stasis and blockage were seen in Haikou Hospital of Traditional Chinese Medicine from September 2018 to January 2021,and were randomly divided into two groups of 59 cases each,the control group was treated with conventional Western medicine,the observation group was treated with the combination of chemosynthesis and tendon acupuncture method for 4 weeks,comparing the serum prostaglandin E2(PGE2),interleukin-23(IL-23),matrix metalloproteinase-9(MMP-9),cyclooxygenase 2(COX-2),transforming growth factor-β1(TGF-β1),lumbar dysfunction index(ODI)score,visual analogue scale(VAS)score of pain,and Japanese orthopaedic association(JOA)score between the two groups before and after treatment.Results:After treatment,serum PGE2,IL-23,MMP-9,COX-2,TGF-β1 levels and ODI score and VAS score in both groups were significantly lower(P<0.01)and JOA score was significantly higher(P<0.01)than before treatment,and the improvement of all indexes in the observation group was better than that in the control group(P<0.01);the difference in adverse effects between the two groups was not statistically significant.Conclusion:For patients with lumbar intervertebral disc herniation with blood stasis and blood blockage,the combination of stasis and tendon treatment with acupuncture is clinically feasible.

关 键 词：化瘀理筋针刺法 腰椎间盘突出症 瘀血阻滞型 疼痛介质 炎症因子 腰椎功能 临床疗效 

分 类 号：R274.9[医药卫生—中西医结合]