温针灸联合硬膜外阻滞治疗腰椎间盘突出症临床研究  

Clinical Study of Warm Acupuncture Combined with Epidural Block in Treatment of Lumbar Disc Herniation

作　　者：张立亭 姚鑫 田晶 张文 韩迎春[2] ZHANG Liting;YAO Xin;TIAN Jing;ZHANG Wen;HAN Yingchun(Shaanxi Provincial Forest Industry Staff Hospital,Xi'an 710300,China;Baoji People s Hospital,Shaanxi Baoji 721000,China)

机构地区：[1]陕西省森林工业职工医院,陕西西安710300 [2]陕西省宝鸡市人民医院,陕西宝鸡721000

出　　处：《现代中医药》2023年第2期69-74,共6页Modern Chinese Medicine

基　　金：陕西省科技厅重点研发计划项目(2019SF-257)。

摘　　要：目的探究温针灸联合硬膜外阻滞治疗腰椎间盘突出症(Lumbar disc herniation,LDH)的临床疗效。方法纳入LDH患者88例,随机分为对照组(44例,硬膜外阻滞)、治疗组(44例,硬膜外阻滞+温针灸),评估治疗效果,测量比较治疗前及治疗后患者凝血功能、血清炎性因子、神经递质水平,评估患者疼痛及功能障碍情况。结果治疗组总有效率显著高于对照组(P<0.05);治疗后治疗组活化部分凝血酶原时间(aPTT)、凝血酶原时间(PT)均显著长于对照组(P<0.05);治疗后治疗组血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平显著低于对照组(P<0.05);治疗后治疗组血清前列腺素E2(PGE2)、5-羟色胺(5-HT)水平显著低于对照组(P<0.05);治疗后治疗组视觉模拟量表(VAS)评分、Oswestry功能障碍指数问卷表(ODI)评分均显著低于对照组(P<0.05)。结论给予LDH患者温针灸联合硬膜外阻滞治疗可显著改善其凝血功能,促进炎症缓解,下调血清疼痛介质水平,减轻疼痛并改善患者腰椎功能障碍,整体疗效显著。Objective To explore the clinical effect of warm acupuncture combined with epidural block in the treatment of lumbar disc herniation.Methods 88 patients with lumbar disc herniation were randomly divided into control group(44 cases,epidural block)and treatment group(44 cases,epidural block+warm acupuncture)to evaluate the treatment effect,measure and compare the blood coagulation function,serum inflammatory factors,neurotransmitter levels,and evaluate the pain and dysfunction of patients before and after treatment.Results The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05);After treatment,the activated partial prothrombin time(aPTT)and prothrombin time(PT)in the treatment group were significantly longer than those in the control group(P<0.05);Serum tumor necrosis factor(TNF-α)in treatment group after treatment、the level of interleukin-6(IL-6)was significantly lower than that of the control group(P<0.05);After treatment,the serum levels of PGE2 and 5-HT in the treatment group were significantly lower than those in the control group(P<0.05);After treatment,the scores of VAS and ODI in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Warm acupuncture combined with epidural block can significantly improve the blood coagulation function of patients with lumbar disc herniation,promote inflammation relief,lower the level of serum pain mediators,reduce pain and improve the lumbar dysfunction of patients.The overall effect is significant.

关 键 词：腰椎间盘突出症 硬膜外阻滞治疗 温针灸 炎性因子 凝血功能 神经递质 

分 类 号：R245.31[医药卫生—针灸推拿学]