腹式呼吸训练联合短刺法针刺对气滞血瘀型腰椎间盘突出症患者康复效果的影响  

Effect of Abdominal Breathing Training Combined with Short Acupuncture on the Rehabilitation of Patients with Lumbar Disc Herniation of Qi Stagnation and Blood Stasis Type

作　　者：罗红清 唐成剑[1] 周长征[1] 雷建兰[1] 刘采群 LUO Hong-qing;TANG Cheng-jian;ZHOU Chang-zheng;LEI Jian-lan;LIU Cai-qun(Second Department of Spine,The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha,Hunan,410007,China)

机构地区：[1]湖南中医药大学第一附属医院脊柱二科,湖南长沙410007

出　　处：《现代生物医学进展》2023年第20期3929-3934,共6页Progress in Modern Biomedicine

基　　金：湖南省卫生健康委2020年度科研课题项目(20201807)。

摘　　要：目的:探讨腹式呼吸训练联合短刺法针刺对气滞血瘀型腰椎间盘突出症(LDH)患者康复效果的影响。方法:将2020年1月至2022年6月湖南中医药大学第一附属医院收治的478例气滞血瘀型LDH患者,随机数字表法分为两组,对照组239例患者实施短刺法针刺治疗,观察组239例患者行腹式呼吸训练联合短刺法针刺治疗。比较两组治疗效果、治疗前后中医症候评分、肌电值(坐位、直立位、前屈位、后伸位)、疼痛因子水平[前列腺素E_(2)(PGE_(2))、β-内啡肽(β-EP)、5-羟色胺(5-HT)、P物质(SP)]水平、视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)、日本骨科协会评估治疗分数(JOA)评分、腰椎关节活动度(左屈、左旋、右屈、右旋)及安全性。结果:治疗后,两组治疗效果分级经秩和检验差异具有统计学意义(P<0.05),且观察组治疗总有效率显著高于对照组(P<0.05)。治疗后观察组各中医症候评分低于对照组(P<0.05)。治疗后观察组坐位、直立位、前屈位、后伸位肌电值高于对照组(P<0.05)。治疗后观察组疼痛因子PGE_(2)、5-HT、SP水平低于对照组,β-EP水平高于对照组(P<0.05)。治疗后观察组VAS评分、ODI低于对照组,JOA评分高于对照组(P<0.05)。治疗后观察组左屈、左旋、右屈、右旋活动度优于对照组(P<0.05)。两组不良事件发生率比较无显著差异(P>0.05)。结论:腹式呼吸训练联合短刺法针刺可提高气滞血瘀型LDH患者临床疗效,增强患者肌力,改善腰椎功能,恢复关节活动度,同时通过调控疼痛介质水平,减轻患者疼痛症状,且具有较好安全性,值得临床借鉴应用。Objective:To explore the effect of abdominal breathing training combined with short acupuncture on the rehabilitation of patients with lumbar disc herniation(LDH)of qi stagnation and blood stasis type.Methods:From January 2020 to June 2022,478 patients with LDH of qi stagnation and blood stasis type admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine were randomly divided into two groups,239 patients in the control group were treated with short acupuncture,and 239 patients in the observation group were treated with abdominal breathing training combined with short acupuncture.Compare the treatment effect,TCM symptom score before and after treatment,EMG value(seating position,upright position,anteflexion position,extensor position),and the level of pain factor[prostaglandin E_(2)(PGE_(2))β-Endorphin(β-EP),5-hydroxytryptamine(5-HT),substance P(SP)]level,visual analogue scale(VAS)score,Oswestry dysfunction index(ODI),Japanese orthopedic association evaluation treatment score(JOA)score,lumbar joint range of motion(left flexion,left rotation,right flexion,right rotation)and safety.Results:After treatment,there was statistically significant difference in treatment effect grading between the two groups by rank sum test(P<0.05),and the total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the score of TCM symptoms in the observation group was lower than that in the control group(P<0.05).After treatment,the EMG values of seating position,upright position,anteflexion position,extensor position in the observation group were higher than those in the control group(P<0.05).After treatment,the levels of PGE_(2),5-HT and SP in the observation group were lower than those in the control group,β-EP level was higher than that of the control group(P<0.05).After treatment,VAS score and ODI in the observation group were lower than those in the control group,while JOA score was higher than that in the control

关 键 词：腰椎间盘突出症 气滞血瘀型 腹式呼吸训练 短刺针法刺 康复效果 

分 类 号：R681.53[医药卫生—骨科学]