注射针刀对椎间盘源性下腰痛患者疼痛程度及炎症反应的影响  

Effect of Acupotomy Injection on Pain Degree and Inflammatory Reaction in Patients with Discogenic Low Back Pain

作　　者：刘建梁[1] 王苗[1] 景福权 赵平[1] 周钰[1] LIU Jianliang;WANG Miao;JING Fuquan;ZHAO Ping;ZHOU Yu(The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830054

出　　处：《针灸临床杂志》2024年第2期41-45,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：新疆维吾尔自治区自然科学基金,编号:2021D01C349。

摘　　要：目的:观察注射针刀治疗对椎间盘源性下腰痛患者的治疗效果。方法:将90例确诊为椎间盘源性下腰痛的病例随机分为注射针刀组、注射组与针刀组各30例,注射针刀组运用注射针刀治疗,注射组给予痛点局部注射治疗,针刀组给予常规小针刀治疗。于3组治疗1个月后评价患者临床疗效,通过观察疼痛直观模拟评分(VAS)、日本骨科学会腰椎疗效评分(JOA)与功能障碍指数(ODI)的变化对3组治疗后局部疼痛和整体症状的改善状况进行评价,抑郁自评量表(SDS)观察3组抑郁状态,并检测3组治疗前后血清中六酮前列腺素F1α(PGF1α)、肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)与白细胞介素-6(IL-6)水平的变化。结果:3组患者治疗前各指标比较差异无统计学意义(P>0.05);治疗结束后,注射针刀组临床疗效优于注射组和针刀组(P<0.05);与注射组、针刀组比较,注射针刀组VAS、ODI与SDS评分明显下降,JOA评分明显提升,差异有统计学意义(P<0.05),血清中PGF1α、TNF-α、IL-1β及IL-6炎症因子水平较注射组和针刀组均有明显下调,差异有统计学意义(P<0.05);注射组VAS、ODI和SDS评分及血清PGF1α、TNF-α、IL-1β及IL-6水平显著低于针刀组,JOA评分较针刀组明显提升,差异有统计学意义(P<0.05)。结论:注射针刀对椎间盘源性下腰痛具有良好的治疗效果,疗效优于局部注射和单纯小针刀治疗,其作用机制可能与降低炎性细胞因子水平、抑制炎症反应相关。Objective:To observe the therapeutic effect of acupotomy injection on patients with discogenic low back pain.Methods:90 cases of discogenic low back pain were randomly divided into the acupotomy injection group,the injection group and the acupotomy group,with 30 cases in each group.The injection group was treated with local injection around pain points,the acupotomy group was treated with conventional acupotomy,and the acupotomy injection group was treated with acupotomy combined with injection.Clinical efficacy was evaluated after one month of treatment in the three groups.The improvements on local pain and overall symptoms were assessed by observing the score changes of VAS,JOA and ODI in the three groups after the treatment.The depression state of the three groups was observed with Self Rating Depression Scale(SDS).The serum levels of hexaketoprostaglandin F1α(PGF1α),tumor necrosis factorα(TNF-α),interleukin-1β(IL-1β)and interleukin-6(IL-6)were detected before and after the treatment in the three groups.Results:There were no statistical differences in the indicators among the three groups before the treatment(P>0.05).After the treatment,the clinical efficacy of the acupotomy injection group was better than that of the injection group and the acupotomy group(P<0.05).Compared with those in the injection group and the acupotomy group,the scores of VAS,ODI and SDS decreased significantly,whereas the score of JOA increased significantly in the acupotomy injection group(P<0.05).The serum levels of PGF1α,TNF-α,IL-1βand IL-6 were significantly lower in the acupotomy injection group than those of the injection group and the acupotomy group(P<0.05).The scores of VAS,ODI and SDS,the serum levels of PGF1α,TNF-α,IL-1βand IL-6 were significantly lower,and the score of JOA was obviously higher in the injection group than those in the acupotomy group(P<0.05).Conclusion:Acupotomy injection has a good therapeutic effect on discogenic low back pain,which is superior to local injection and simple acupotomy treatment.I

关 键 词：椎间盘源性下腰痛 注射针刀 疼痛 炎症反应 

分 类 号：R246.2[医药卫生—针灸推拿学]