通元针法结合隔姜灸治疗慢性腰肌劳损(寒湿型)疗效及对疼痛因子、表面肌电图的影响  

Effects of Tongyuan acupuncture method combined with Ginger-separated moxibustion on pain factors and surface electromyogram in the treatment of chronic lumbar muscle strain(cold-dampness type)

作　　者：冯轶 杨燕冰 张姬[2] 徐玉萍[3] FENG Yi;YANG Yanbing;ZHANG Ji(Department of geriatrics,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai200010,China;Outpatient service,Dongfang South Campus Affiliated to Tongji University in Shanghai,Shanghai200233,China)

机构地区：[1]上海中医药大学附属曙光医院老年科,上海200010 [2]上海同济大学附属东方南院门诊,上海200233 [3]上海中医药大学附属曙光医院护理部,上海200010

出　　处：《四川中医》2023年第3期189-192,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：上海市卫生健康委员会科研项目(编号:20214Y0033)。

摘　　要：目的:探究通元针法结合隔姜灸治疗慢性腰肌劳损(寒湿型)的效果及对疼痛因子、表面肌电图的影响。方法:选取我院117例慢性腰肌劳损(寒湿型)患者为研究对象,1∶1简单随机分为联合组和对照组,两组患者均给予西药双氯芬酸二乙胺乳胶剂治疗,对照组(n=58)在此基础上给予隔姜灸治疗,联合组(n=59)在对照组的基础上加用通元针法治疗,治疗4周后比较两组临床疗效,治疗前后中医证候积分、腰椎功能[腰椎Oswestry功能障碍指数(ODI)评分法、视觉模拟评分法(VAS)]、腰椎表面肌电图指标[平均肌电波幅(AEMG)、平均功率频率(MPF)、中位频率斜率(MFs)]及血清疼痛因子[前列腺素E2(PGE_(2))、神经肽Y(NPY)、P物质(SP)、β内啡肽(β-EP)]水平变化情况。结果:联合组临床有效率为96.61%,显著高于对照组的86.21%,差异有统计学意义(P<0.05);治疗4周后,两组中医证候积分、VAS、ODI评分均显著下降(P<0.05),肌电图指标AEMG、MPF、MFs均显著升高(P<0.05),血清PGE_(2)、NPY、SP水平均显著降低(P<0.05),β-EP水平均显著升高(P<0.05),且上述指标组间对比,差异具有统计学意义(P<0.05)。结论:通元针法结合隔姜灸治疗寒湿型慢性腰肌劳损可显著缓解患者临床症状、减轻腰椎疼痛和功能障碍,改善竖脊肌肌张力,临床应用效果理想。Objective:To explore the efficacy of Tongyuan acupuncture method combined with ginger-separated moxibustion on chronic lumbar muscle strain(cold-dampness type)and its effects on pain factors and surface electromyogram.Methods:117patients with chronic lumbar muscle strain(cold-dampness type)in the hospital were selected as the research subjects,and were randomly divided into combined group and control group at a 1:1ratio.Both groups were treated with western medicine diclofenac diethylamide emulsion,and the control group(n=58)was given ginger-separated moxibustion on this basis while the combined group(n=59)was additionally given Tongyuan acupuncture method on the basis of the control group.The clinical efficacy was compared between the two groups after 4weeks of treatment.Before and after treatment,scores of TCM syndromes,lumbar function[lumbar Oswestry Disability Index(ODI),Visual Analogue Scale(VAS)],lumbar surface electromyogram indicators[average electromyographic amplitude(AEMG),mean power frequency(MPF),median frequency slope(MFs)]and serum pain factors[serum prostaglandin E2(PGE_(2)),neuropeptide Y(NPY),substance P(SP),β-endorphin(β-EP)]were compared between the two groups.Results:The clinical effective rate of the combined group was 96.61%,which was significantly higher than that of the control group(P<0.05).After 4weeks of treatment,the TCM syndromes scores,VAS score and ODI score in both groups were significantly decreased(P<0.05)while the electromyogram indexs of AEMG,MPF and MFs were significantly increased(P<0.05),and serum PGE_(2),NPY and SP levels were significantly reduced(P<0.05)whileβ-EP level was significantly enhanced(P<0.05),and the differences were statistically significant when comparing the above indexes between groups(P<0.05).Conclusion:Tongyuan acupuncture method combined with ginger-separated moxibustion in the treatment of chronic lumbar muscle strain(cold-dampness type)can significantly relieve clinical symptoms,reduce lumbar spine pain and dysfunction,improve the muscle tension of

关 键 词：慢性腰肌劳损 通元针 隔姜灸 腰椎功能 疼痛因子 肌电图 

分 类 号：R246.2[医药卫生—针灸推拿学]