夹脊温针与中药熏蒸结合西医常规疗法治疗腰椎间盘突出急性炎症期的临床研究  

Clinical study of warming needle moxibustion of Jiaji and TCM fumigation combined for acute inflammatory period of lumbar disc herniation

作　　者：袁绪文 董海彦 吴月 刘一畅 Yuan Xuwen;Dong Haiyan;Wu Yue;Liu Yichang(Department of Acupuncture,Bozhou City Hospital of Traditional Chinese Medicine,Bozhou 236800,China)

机构地区：[1]亳州市中医院针灸科,亳州236800

出　　处：《国际中医中药杂志》2023年第9期1095-1099,共5页International Journal of Traditional Chinese Medicine

基　　金：安徽省红十字会中医药传承创新发展研究项目(2021ZYYB09)。

摘　　要：目的评价夹脊温针与中药熏蒸结合西医常规疗法对腰椎间盘突出症(LDH)急性炎症期患者的临床疗效。方法随机对照试验研究。选取2019年12月-2021年12月本院140例LDH急性炎症期患者作为观察对象,采用随机数字表法将患者分为2组,每组70例。对照组给予西医常规疗法治疗,观察组在对照组基础上联合夹脊温针与中药熏蒸治疗。2组均连续治疗1个月。分别于治疗前后进行中医证候评分,采用VAS量表评估腰椎疼痛程度,日本骨科协会评估治疗(JOA评分)评估腰椎功能障碍程度,采用ELISA法检测血清CRP、IL-6、TNF-α水平,评价临床疗效。结果观察组总有效率为95.71%(67/70)、对照组为82.86%(58/70),2组比较差异有统计学意义(χ^(2)=6.05,P=0.014)。观察组治疗后中医证候积分[(4.45±1.09)分比(10.67±2.82)分,t=16.85]、VAS评分[(1.54±0.43)分比(3.28±1.04)分,t=12.94]低于对照组(P<0.01),JOA评分中主观感觉[(7.54±2.87)分比(6.24±1.76)分,t=5.72]、体征[(6.76±2.00)分比(4.34±1.67)分,t=7.77]、日常活动受限[(9.56±3.27)分比(7.89±2.97)分,t=3.16]、膀胱功能[(2.88±0.84)分比(2.63±0.64)分,t=2.89]评分及总分[(25.04±7.44)分比(20.35±6.87)分,t=4.63]高于对照组(P<0.01)。观察组治疗后血清IL-6[(18.12±4.23)μg/L比(26.46±4.58)μg/L,t=11.19]、CRP[(18.87±6.07)mg/L比(25.89±5.72)mg/L,t=7.04]、TNF-α[(24.42±5.37)ng/L比(29.45±5.44)ng/L,t=5.51]水平低于对照组(P<0.01)。结论夹脊温针与中药熏蒸结合西医常规疗法可有效缓解LDH急性炎症期患者的腰部疼痛感,降低炎症因子水平,提高临床疗效。Objective To evaluate the clinical efficacy of lumbar spine warming needle moxibustion of Jiaji and Traditional Chinese Medicine(TCM)fumigation combined with conventional western medicine therapy on patients with acute inflammatory period of lumbar disc herniation(LDH).Methods Randomized controlled trial.A total of 140 patients with acute inflammation of LDH in our hospital from December 2019 to December 2021 were selected as observational objects,and the patients meeting the inclusion criteria were divided into 2 groups with 70 patients in each group by random number table method.The control group was treated with conventional western medicine therapy,and the observational group was treated with warming needle moxibustion of Jiaji combined with TCM fumigation on the basis of control group treatment.Both groups received continuous treatment for 1 month.TCM syndrome scores were performed before and after treatment,the degree of lumbar pain was assessed by VAS,the degree of lumbar dysfunction was assessed by Japanese Orthopaedic Association Evaluation Treatment(JOA score),and serum CRP,IL-6 and TNF-αlevels were measured by ELISA.Results The total effective rate was 95.71%(67/70)in the observation group and 82.86%(58/70)in the control group,and there was significant difference between the two groups(χ^(2)=6.05,P=0.014).After treatment,TCM syndrome score[(4.45±1.09)vs.(10.67±2.82),t=16.85],VAS score[(1.54±0.43)vs.(3.28±1.04),t=12.94]lower than those in the control group(P<0.01),subjective feeling[(7.54±2.87)vs.(6.24±1.76),t=5.72],physical signs[(6.76±2.00)vs.(4.34±1.67),t=7.77],limited daily activities[(9.56±3.27)vs.(7.89±2.97),t=3.16],bladder function score[(2.88±0.84)vs.(2.63±0.64),t=2.89]and the total score[(25.04±7.44)vs.(20.35±6.87),t=4.63]were higher than those in the control group(P<0.01).After treatment,serum IL-6[(18.12±4.23)μg/L vs.(26.46±4.58)μg/L,t=11.19],CRP[(18.87±6.07)mg/L vs.(25.89±5.72)mg/L,t=7.04]and TNF-αlevels[(24.42±5.37)ng/L vs.(29.45±5.44)ng/L,t=5.51]were lower than tho

关 键 词：椎间盘移位 腰椎 针刺疗法 温针疗法 熏洗疗法 

分 类 号：R681.53[医药卫生—骨科学]