俞募配穴针灸法联合常规物理疗法治疗非特异性腰痛疗效及对疼痛介质、6-酮-前列腺素1α、血栓素2的影响  

Curative Effect of Acupuncture and Moxibustion Method with Shu-Mu Point Combination Combined with Routine Physical Therapy for Nonspecific Low Back Pain and Its Effect on Pain Mediators,6-Ketone-Prostaglandin 1 α and Thromboxane 2

作　　者：王凡[1] 蒋腾 王晓宇 WANG Fan;JIANG Teng;WANG Xiaoyu

机构地区：[1]南阳市中心医院针灸科,河南南阳473200

出　　处：《新中医》2022年第23期172-176,共5页New Chinese Medicine

基　　金：河南省中医药科学研究专项课题(20-21ZY3031)。

摘　　要：目的:观察俞募配穴针灸法联合常规物理疗法治疗非特异性腰痛(NLBP)的疗效及对疼痛介质、6-酮-前列腺素1α (6-Keto-PGF1α)、血栓素2 (TXB2)的影响。方法:选取116例NLBP患者,按随机数字表法分为对照组及观察组各58例。对照组采取常规物理疗法,观察组在对照组基础上加用俞募配穴针灸法治疗。比较2组临床疗效及复发率,比较2组治疗前后疼痛程度[疼痛视觉模拟评分(VAS)、疼痛分级指数(PRI)、现在疼痛状况(PPI)]评分、疼痛介质[血清β-内啡肽(β-EP)、5-羟色胺(5-HT)、前列腺素E2(PGE2)]、血清6-Keto-PGF1α、TXB2、TXB2/6-Keto-PGF1α指标值、腰腹肌等长收缩值的变化。结果:观察组临床疗效总有效率为91.38%,对照组为77.59%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组VAS、PRI、PPI评分均较治疗前下降(P<0.05),观察组上述3项评分均低于对照组(P<0.05)。治疗后,2组血清β-EP、5-HT、PGE2水平均较治疗前下降(P<0.05);观察组上述3项水平均低于对照组(P<0.05)。治疗后,2组血清6-Keto-PGFlα水平均较治疗前升高,TXB2、TXB2/6-Keto-PGF1α指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,观察组血清6-Keto-PGFlα水平高于对照组,TXB2、TXB2/6-Keto-PGF1α指标值均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组前屈、后伸、右旋、左旋腰腹肌等长收缩值均较治疗前提升(P<0.05),观察组各项腰腹肌等长收缩值均大于对照组(P<0.05)。随访6个月,观察组复发率为20.75%,对照组复发率为40.00%,2组比较,差异有统计学意义(P<0.05)。结论:俞募配穴针灸法联合常规物理疗法治疗NLBP能提高临床疗效,减轻腰痛程度,改善腰部功能,且复发率较低。Objective:To observe the curative effect of acupuncture and moxibustion method with shumu point combination combined with routine physical therapy for nonspecific low back pain(NLBP) and its effect on pain mediators,6-ketone-prostaglandin 1α(6-keto-PGF1α) and thromboxane 2(TXB2).Methods:A total of 116 cases of NLBP patients were divided into the control group and the observation group according to the random number table method,with 58 cases in each group.The control group was treated with routine physical therapy,and the observation group was additionally treated with acupuncture and moxibustion method with shu-mu point combination based on the treatment of the control group.The clinical effects and the recurrence rates in the two groups were compared.The changes in scores of pain degree [Visual Analogue Scale(VAS),Pain Rating Index(PRI) and Present Pain Intensity(PPI)],pain mediators [β-endorphin(β-EP),5-hydroxytryptamine(5-HT) and prostaglandin E2(PGE2) in serum],levels of 6-Keto-PGF1α,TXB2and TXB2/6-Keto-PGF1α in serum and isometric contraction values of lumbar abdominal muscle before and after treatment were compared between the two groups.Results:The total effective rate of clinical effect was 91.38% in the observation group and 77.59% in the control group,the difference being significant(P<0.05).After treatment,the scores of VAS,PRI and PPI in the two groups were decreased when compared with those before treatment(P<0.05),and the above three scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of β-EP,5-HT and PGE2in serum in the two groups were decreased when compared with those before treatment(P<0.05);the levels of β-EP,5-HT and PGE2in serum in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of 6-Keto-PGF1α in serum in the two groups were increased when compared with those before treatment,and the levels of TXB2and TXB2/6-Keto-PGF1α were decreased,differences being significant(P<0.05);t

关 键 词：非特异性腰痛 俞募配穴针灸法 物理疗法 疼痛介质 6-酮-前列腺素1α 血栓素2 

分 类 号：R681.55[医药卫生—骨科学]