基于加速康复外科理念观察颊针对后路椎间融合术后早期康复的影响  

Effect of Buccal Acupuncture on Early Rehabilitation after Posterior Lumbar Interbody Fusion Based on the Concept of Enhanced Recovery after Surgery

作　　者：谭建盛 李会斌 赵学千 白春晓[1] 李晋玉[1] 贾育松[1] TAN Jiansheng;LI Huibin;ZHAO Xueqian;BAI Chunxiao;LI Jinyu;JIA Yusong(Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《世界中医药》2023年第7期1014-1018,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(81503601)。

摘　　要：目的:探讨基于加速康复外科理念指导下后路腰椎间融合术后疼痛、功能受限患者颊针治疗的临床效果。方法:选取2020年10月至2021年3月北京中医药大学东直门医院收治的行后路椎间融合术的患者47例作为研究对象进行回顾性研究,按照治法不同分为对照组(n=26)和观察组(n=21)。对照组服用塞来昔布200 mg/次,1次/d;观察组在对照组治疗基础上采用了颊针针刺,30 min/次,1次/d。记录术后第1、3、7天后视觉模拟评分法(VAS)和日本骨科协会(JOA)腰椎功能评分,比较2组白细胞介素6、白细胞计数、中性粒细胞计数、C反应蛋白指标。结果:术后第7天,观察组VAS评分均值明显低于对照组(P<0.05);2组术后第7天的JOA评分差异有统计学意义(P<0.05)。术后第3天,2组白细胞计数(WBC)、中性粒细胞(Neutrophil,NE)占比、C反应蛋白(CRP)、白细胞介素-6(IL-6)指标比较差异有统计学意义(P<0.05);术后第7天的各指标比较中,CRP和IL-6这2项指标比较显示观察组显著低于对照组(P<0.05)。结论:观察组各评分、指标总体上结果优于对照组。颊针治疗能有效改善患者术后疼痛和炎症反应,有助于减轻或消除患者早功能锻炼的身心障碍,符合加速康复外科理念,且便捷廉价取穴方便,值得临床推广应用。Objective:To investigate the clinical effect of buccal acupuncture on the patients with pain and functional limitation after posterior lumbar interbody fusion based on the concept of enhanced recovery after surgery.Methods:The medical records of 47 patients who underwent posterior lumbar interbody fusion in the Dongzhimen Hospital of Beijing University of Chinese Medicine from October 2020 to March 2021 were collected for a retrospective study.The patients were assigned into an observation group(n=26)and a control group(n=21)according to the treatment methods.The control group received celecoxib at a dose of 200 mg/qd,and the observation group additionally received buccal acupuncture at 30 min/qd.The visual analogue scale(VAS)score,Japanese Orthopaedic Association(JOA)score,interleukin-6(IL-6),white blood cell count(WBC),neutrophil count(NE),and C-reactive protein(CRP)were compared between the two groups on days 1,3,and 7 after operation.Results:On day 7 after operation,the mean VAS score of the observation group was lower than that of the control group(P<0.05),and the JOA score was different between the two groups(P<0.05).On day 3 after operation,the WBC,NE,CRP,and IL-6 showed differences between the two groups(P<0.05).On day 7 after operation,the observation group had lower CRP and IL-6 than the control group(P<0.05).Conclusion:The observation group outperformed the control group in restoring the scores and indicators.Buccal acupuncture can effectively alleviate postoperative pain and inflammatory response and helps to reduce or eliminate the physical and mental impairment of patients with early functional exercise.This therapy is in accordance with the concept of enhanced recovery after surgery.Moreover,it is characterized by low cost and simple acupoint selection,and thus is worthy of promotion in clinical practice.

关 键 词：颊针 腰椎间盘突出症 后路腰椎间融合术 加速康复外科 全息针法 炎症 疼痛 早期康复 

分 类 号：R246[医药卫生—针灸推拿学]