针刺联合关节错缝复位术治疗腰椎间盘突出症急性期疗效及对患者疼痛和腰椎功能康复的影响  

Curative effect of acupuncture combined with joint dislocation reduction and its influences on pain and recovery of lumbar function in patients with acute lumbar disc herniation

作　　者：陶龙 蒋涛 孙培养 倪璐 陈飞 郭庆军 吴志东 王坤 桂美琳 何雨霞 TAO Long;JIANG Tao;SUN Peiyang;NI Lu;CHEN Fei;GUO Qingjun;WU Zhidong;WANG Kun;GUI Meilin;HE Yuxia(Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230061,China)

机构地区：[1]安徽中药大学第二附属医院,安徽合肥230061

出　　处：《陕西中医》2024年第1期124-127,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：第七批全国老中医药专家学术经验继承工作项目[国中医药人教函(2022)76号];安徽省“十四五”省级中医优势特色专科-推拿科项目[皖中医药服务秘(2021)71号];第五批全国中医临床优秀人才研修项目[国中医药人教函(2022)1号]。

摘　　要：目的:探究针刺联合关节错缝复位术治疗腰椎间盘突出症(LDH)急性期患者的治疗效果。方法:选取84例LDH急性期患者,随机分为观察组和对照组,两组各42例。对照组行关节错缝复位术,观察组在此基础上联合针刺法治疗。观察两组治疗后的疗效和住院时间、治疗前后疼痛(VAS)和腰椎功能评分、中医证候、腰部活动度、疼痛介质[5-羟色胺(5-HT)、前列腺素E2(PGE2)和P物质(SP)]水平和不良反应发生情况。结果:治疗后,与对照组比较,观察组VAS评分较低、JOA评分较高(P<0.05);治疗后,与对照组比较,观察组胸腹胀满、腰膝无力两项积分较低(P<0.05);治疗后,两组患者腰部屈曲、伸展和侧屈活动范围比较均有所升高,观察组高于对照组(P<0.05);两组患者疼痛介质5-HT、PGE2和SP水平比较均有所降低,观察组低于对照组(P<0.05);观察组住院时间短于对照组(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:采用针刺联合关节错缝复位术治疗LDH急性期患者,其疗效良好,能提高患者腰椎功能,减轻患者疼痛程度和中医证候,缩短患者住院时间,且安全性良好。Objective:To explore the curative effect of acupuncture combined with joint dislocation reduction and its influences on pain and recovery of lumbar function in patients with acute lumbar disc herniation(LDH).Methods:A total of 84 patients with acute LDH were enrolled and randomly divided into observation group(42 cases,joint dislocation reduction+acupuncture)and control group(42 cases,joint dislocation reduction).The curative effect and hospitalization time after treatment,scores of visual analogue scale(VAS),lumbar function and TCM syndromes before and after treatment,lumbar range of motion,levels of pain mediators(5-hydroxytryptamine[5-HT],prostaglandin E2[PGE2],substance P[SP])and the occurrence of adverse reactions in the two groups were observed.Results:After treatment,VAS score was decreased in both groups,which was lower in observation group than control group,while JOA score was increased,which was higher in observation group than control group(P<0.05).After treatment,scores of TCM syndromes(abdominal distension,waist-leg weakness)were decreased in both groups,which were lower in observation group than control group(P<0.05).After treatment,range of motion values(lumbar flexion,extension,lateral flexion)were increased in both groups,which were greater in observation group than control group(P<0.05).After treatment,levels of 5-HT,PGE2 and SP were decreased in both groups,which were lower in observation group than control group(P<0.05).The hospitalization time was shorter in observation group than control group(P<0.05),but the difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05).Conclusion:Acupuncture combined with joint dislocation reduction has good curative effect in patients with acute LDH,which can improve lumbar function,relieve pain and TCM syndromes,and shorten hospitalization time,with good safety.

关 键 词：腰椎间盘突出症 关节错缝复位术 针刺 急性期 疼痛 腰椎功能 

分 类 号：R658.53[医药卫生—外科学]