基于调神止痛理论针推结合治疗腰椎间盘突出症临床研究  

Clinical Study on Combination of Acupuncture and Massage Based on Spirit-Regulating and Pain-Relieving Theory for Lumbar Disc Herniation

作　　者：牛耕 蒋西玲 王文斌 李东海 NIU Geng;JIANG Xiling;WANG Wenbin;LI Donghai

机构地区：[1]南阳市第二人民医院中医科,河南南阳473000 [2]南阳市第二人民医院疼痛科,河南南阳473000 [3]南阳市中心医院骨科,河南南阳473009

出　　处：《新中医》2022年第24期153-157,共5页New Chinese Medicine

基　　金：河南省医学科技攻关计划项目(2018020988)。

摘　　要：目的:基于调神止痛理论研究针推结合治疗腰椎间盘突出症的临床疗效。方法:将74例腰椎间盘突出症患者按照随机数字表法分为2组各37例。2组均卧床休息4周并给予非甾体类消炎镇痛药物治疗。对照组基于调神止痛理论给予镇痛法、移痛法、消痛法的推拿治疗。观察组在对照组治疗方案的基础上加用基于调神止痛理论选穴的针刺治疗。观察2组临床疗效、疼痛视觉模拟评分法(VAS)评分、临床症状评分、血清炎症因子肿瘤坏死因子-α (TNF-α)及白细胞介素-1β (IL-1β)、匹兹堡睡眠质量指数(PSQI)评分。结果:临床疗效总有效率观察组89.19%高于对照组59.46%(P<0.05)。治疗后,2组疼痛VAS评分、临床症状评分、血清炎症因子水平TNF-α、IL-1β、PSQI评分均较同组治疗前显著下降,且观察组下降更明显,差异均有统计学意义(P<0.05)。结论:基于调神止痛理论针推结合治疗腰椎间盘突出症,可显著改善患者临床症状,降低炎症因子水平,缓解疼痛感,改善患者睡眠,促进康复。Objective:To observe the clinical efect of combination of acupuncture and massage based on spirit-regulating and pain-relieving theory for lumbar disc herniation. Methods:A total of 74 cases of patients with lumbar disc herniation complicated with insomnia were divided into two groups according to the random number table method, with 37 cases in each group. Both groups were kept in bed for four weeks and treated with non-steroidal anti-inflammatory analgesic drugs. Based on spirit-regulating and pain-relieving theory, the control group was given massage therapy including analgesic method, painshifting method and pain-relieving method. The observation group was additionally given acupuncture treatment with point selection based on spirit-regulating and pain-relieving theory. The clinical effects,Visual Analogue Scale(VAS) scores, clinical symptom scores, inflammatory factors in serum including tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β), and Pittsburgh Sleep Quality Index(PSQI)scores in the two groups were observed. Results:The the observation group total clinical effective rate was89.19% and in the control group was 59.46%,the difference being significant(P<0.05). After treatment,the VAS scores of pain,clinical symptom scores,levels of inflammatory factors in serum including TNF-αand IL-1β,and PSQI scores were significantly decreased when compared with those before treatment,and the decrease in the observation group was more significant, differences being significant(P<0.05).Conclusion: Based on spirit-regulating and pain-relieving theory, the combination of acupuncture and massage for lumbar disc herniation can significantly improve clinical symptoms and sleep,reduce levels of inflammatory factors,relieve pain and promote rehabilitation.

关 键 词：腰椎间盘突出症 调神止痛 针推结合 疼痛 炎症因子 匹兹堡睡眠质量指数 

分 类 号：R681.53[医药卫生—骨科学]