腰三针联合神经松动术对腰椎间盘突出症急性期患者血清TNF-α、IL-1β、IL-6水平及腰椎功能的影响  

Effects of Lumbar Triple Needling Combined with Nerve Mobilization on Serum Levels of TNF-α,IL-1β,IL-6 and Lumbar Function in Patients with Acute Lumbar Disc Herniation

作　　者：张幻真 林志刚 陈乐春 蒋晶晶 陈进城 江煜 陈水金 ZHANG Huan-zhen;LIN Zhi-gang;CHEN Le-chun;JIANG Jing-jing;CHEN Jin-cheng;JIANG Yu;CHEN Shui-jin(Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital,Fujian Fuzhou 350003,CHINA;Fujian Key Laboratory of Rehabilitation Technology,Fujian Fuzhou 350003,CHINA)

机构地区：[1]福建中医药大学附属康复医院,福建福州350003 [2]福建省康复技术重点实验室,福建福州350003

出　　处：《按摩与康复医学》2023年第8期1-4,共4页Chinese Manipulation and Rehabilitation Medicine

基　　金：国家自然科学基金(82105039);福建省自然科学基金(2022J01881);福建省教育厅课题(JAT200224)。

摘　　要：目的:观察腰三针联合神经松动术对腰椎间盘突出症急性期患者腰腿部疼痛和腰椎功能的临床疗效,并探讨其潜在的作用机制。方法:将60例符合条件的患者随机分为观察组和对照组各30例。两组均予基础治疗,观察组采用腰三针联合神经松动术+口服双氯芬酸钠双释放肠溶胶囊干预,对照组采用口服双氯芬酸钠双释放肠溶胶囊治疗,连续治疗14天。观察治疗前、后两组患者血清TNF-α、IL-1β、IL-6水平、疼痛视觉模拟量表(VAS)、下腰痛功能量表(JOA)变化情况。结果:两组基线条件在治疗前具有可比性(P>0.05)。经治疗,两组血清TNF-α、IL-1β、IL-6水平,VAS评分均较治疗前下降(P<0.05),JOA评分较治疗前均升高(P<0.05);观察组在下调血清TNF-α、IL-1β、IL-6水平和VAS分值方面明显优于照组(P<0.05);观察组较对照组更能显著地提升腰椎功能(P<0.05)。观察组治疗前后VAS、JOA、TNF-α差值大于对照组(P<0.05);IL-1β、IL-6差值不明显(P>0.05)。观察组的临床总有效率显著优于对照组(P<0.05)。结论:腰三针联合神经松动术能显著下调腰椎间盘突出症急性期患者血清TNF-α、IL-1β、IL-6水平,在发挥镇痛效应和恢复腰椎功能方面颇具优势,值得临床推广并深入机制探讨。Objective:To observe the clinical effect of lumbar triple needling combined with nerve mobilization on low back pain and lumbar function in patients with acute lumbar disc herniation,and to explore its potential mechanism.Methods:A total of 60 eligible patients were randomly divided into an observation group and a control group,30 cases in each group.Both groups were given basic treatment.The observation group was treated with lumbar triple needling combined with nerve mobilization and western medicine intervention,and the control group was treated with western medicine intervention.The two groups were treated continuously for 14 days.The levels of serum TNF-α,IL-1βand IL-6,the scores of visual analogue scale(VAS)and Japanese Orthopaedic Association Scores(JOA)were observed before and after treatment.Results:Baseline conditions were comparable between the two groups before treatment(P<0.05).After treatment,the levels of serum TNF-α,IL-1βand IL-6 and the scores of VAS in two groups were lower than those before treatment(P<0.05),JOA scores were higher than those before treatment(P<0.05);the observation group was significantly better than the control group in reducing serum levels of TNF-α,IL-1β,IL-6 and VAS score(P<0.05);compared with the control group,the observation group could significantly improve lumbar function(P<0.05).The differences of VAS score,JOA score and TNF-αbefore and after treatment in the observation group were greater than those in the control group(P<0.05),while the differences of IL-1βand IL-6 were not significant(P>0.05).The clinical total effective rate of the observation group was significantly better than that of the control group(P<0.05).Conclusion:Lumbar triple needling combined with nerve mobilization can significantly reduce the serum levels of TNF-α,IL-1βand IL-6 in patients with acute lumbar disc herniation,and has advantages in analgesic effect and recovery of lumbar function,which is worthy of clinical promotion and indepth mechanism exploration.

关 键 词：腰椎间盘突出症 急性期 腰三针 神经松动术 炎症因子 功能 

分 类 号：R681.53[医药卫生—骨科学]