穴位放血结合调脊电针法治疗腰椎间盘突出症对患者腰部后伸肌力的影响  

Effect of Acupoints Blood-Letting Combined with EA Adjusting Spine on Lumbar Posterior Extension Strength in Treatment of LDH

作　　者：张晓玲 王雷 郭运岭 范鹏[1] 张蕊 ZHANG Xiaoling;WANG Lei;GUO Yunling;FAN Peng;ZHANG Rui(Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市中医医院,河北秦皇岛066000

出　　处：《针灸临床杂志》2023年第7期36-41,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：河北省中医药管理局科研计划项目,编号:2020371。

摘　　要：目的:分析穴位放血结合调脊电针法治疗腰椎间盘突出症患者的临床疗效。方法:选取2020年1月—2021年5月在本院针灸科门诊就诊的腰椎间盘突出症患者80例,以随机数字表法分为A组和B组,每组40例,A组接受常规针刺与电针法治疗,B组接受常规针刺、调脊电针法与穴位放血治疗,两组均治疗2周。观察两组治疗2周后的疗效,比较两组治疗前、治疗2周后的症状积分、疼痛程度、腰椎活动度与腰部后伸肌力及血清肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)与β-内啡肽(β-EP)水平。结果:治疗2周后,B组愈显率87.50%(35/40)高于A组65.00%(26/40),差异有统计学意义(P<0.05)。治疗2周后,两组主观症状、临床体征、日常活动受限度、改良Oswestry功能障碍指数(M-ODI)、视觉模拟评分(VAS)、疼痛分级指数评分及血清TNF-α、IL-1β水平呈降低趋势,且与A组比较,B组较低(P<0.05);两组压痛阈值、腰椎活动度(前屈度、后伸度)与腰部后伸肌力及血清β-EP水平呈升高趋势,且与A组比较,B组较高(P<0.05)。结论:穴位放血结合调脊电针法可有效抑制腰椎间盘突出症患者炎症因子表达、上调β-EP,改善患者腰椎活动度与腰部后伸肌力,有效减轻患者疼痛程度,并解除患者腰椎功能障碍,缓解患者相关临床症状,进而提高疗效。Objective:To analyze the clinical effect of acupoints blood-letting combined with electro-acupuncture(EA)adjusting spine in treatment of lumbar disc herniation(LDH).Methods:80 patients with LDH were randomly divided into group A and group B,with 40 cases in each group.Group A was treated with conventional acupuncture and EA,whereas group B was treated with conventional acupuncture,EA adjusting spine and acupoints blood-letting.Both groups were treated for 2 weeks.Curative effect of the two groups after 2 weeks of treatment was observed;symptoms score,pain degree,lumbar mobility and lumbar posterior extension strength and serum levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)andβ-endorphin(β-EP)were compared between before and after 2 weeks of treatment in the two groups.Results:After 2 weeks of treatment,the effective rate of group B was 87.50%(35/40),which was significantly higher than 65.00%(26/40)of group A(P<0.05).After 2 weeks of treatment,the scores of subjective symptoms,clinical signs,limits of daily activities,improved Oswestry dysfunction index(M-ODI),visual analogue scale(VAS)and pain grading indexes,as well as the serum levels of TNF-αand IL-1βshowed decreasing trends in the two groups;the decreasing changes were more significant in group B than those in group A(P<0.05).The tenderness threshold,lumbar mobility(flexion and extension),lumbar posterior extension strength and the serum level ofβ-EP showed an increasing trend in the two groups after the treatment;the increasing changes were more significant in group B than those in group A(P<0.05).Conclusion:Acupoints blood-letting combined with EA adjusting spine can effectively inhibit expressions of inflammatory factors and up-regulateβ-EP in patients with LDH,it can improve mobility of lumbar spine and the lumbar posterior extension strength,effectively reduce pain,relieve lumbar spine dysfunction,alleviate related clinical symptoms and improve curative effect.

关 键 词：腰椎间盘突出症 调脊 针刺 电针 穴位放血 疼痛 腰椎活动度 

分 类 号：R246.2[医药卫生—针灸推拿学]