温针灸治疗腰椎间盘突出症的疗效观察及对炎症因子的影响  

Observation on the efficacy of needle-warming moxibustion for lumbar disc herniation and its effect on inflammatory factors

作　　者：邓利萍 彭艳 范小春 DENG Liping;PENG Yan;FAN Xiaochun(Sichuan Nanchong Hospital of Traditional Chinese Medicine South Branch,Nanchong 637000,China;Key Laboratory of Traditional Chinese Medicine for the Prevention and Treatment of Musculoskeletal Diseases,Nanchong 637000,China)

机构地区：[1]四川省南充市中医医院南院区,南充637000 [2]筋骨病中医药防治南充市重点实验室,南充637000

出　　处：《上海针灸杂志》2024年第4期405-410,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：南充市哲学社会科学重点研究基地名老中医医案研究中心2022年度资助项目(YAZX22-ZD-03);南充市中医医院四川省中医药管理局研发资金项目(2021MS374);南充市科技局项目(22YYJCYJ0033)。

摘　　要：目的观察温针灸治疗腰椎间盘突出症的临床疗效及对患者腰椎功能和血清炎症因子水平的影响。方法选取95例腰椎间盘突出症患者,用随机数字表法分为观察组(48例)和对照组(47例)。对照组予常规治疗,观察组在对照组基础上予温针灸治疗。比较两组临床疗效,观察两组治疗前后中医证候积分、Oswestry功能障碍指数(Oswestry disability index,ODI)评分和日本骨科协会(Japanese Orthopaedic Association,JOA)评分的变化,观察两组治疗前后炎症因子[血清白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白介素-1β(interleukin-1β,IL-1β)]以及疼痛介质[血清P物质(substance P,SP)、5-羟色胺(5-hydroxytryptamine,5-HT)和前列素E2(prostaglandin E2,PGE2)]的水平变化。结果观察组总有效率为93.8%,高于对照组的78.7%,差异具有统计学意义(P<0.05)。两组治疗后中医证候积分各项评分、ODI和JOA评分均较治疗前降低(P<0.05),且观察组治疗后上述各项评分均低于对照组(P<0.05)。两组治疗后IL-1β、TNF-α、IL-6、SP、5-HT和PGE2水平均较治疗前降低(P<0.05),且观察组治疗后上述各项指标水平均低于对照组(P<0.05)。结论在常规治疗基础上,温针灸治疗腰椎间盘突出症可提高临床疗效,缓解临床症状,改善腰椎功能,降低炎症因子和疼痛介质的水平。Objective To observe the clinical efficacy of needle-warming moxibustion for lumbar disc herniation and its effect on inflammatory factors.Method Ninety-five patients with lumbar disc herniation were enrolled and allocated,using a random number table,to an observation group(48 cases)and a control group(47 cases).The control group received conventional treatment and the observation group received needle-warming moxibustion in addition.The clinical therapeutic effects were compared between the two groups.The TCM syndrome score,the Oswestry disability index(ODI)score and the Japanese Orthopaedic Association(JOA)score were recorded in the two groups before and after treatment.The levels of inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),substance P(SP),5-hydroxytryptamine(5-HT)and prostaglandin E2(PGE2)]were measured in the two groups before and after treatment.Result The total efficacy rate was 93.8% in the observation group,which was higher than 78.7% in the control group with a statistically significant difference(P<0.05).After treatment,the TCM syndrome scores,the ODI score and the JOA score decreased in the two groups compared with those before treatment(P<0.05)and were lower in the observation group than those in the control group(P<0.05).After treatment,IL-1β,TNF-α,IL-6,SP,5-HT and PGE2 levels decreased in the two groups compared with those before treatment(P<0.05)and were lower in the observation group than those in the control group(P<0.05).Conclusion On the basis of conventional treatment,needle-warming moxibustion can heighten the clinical therapeutic effect,relieve the clinical symptoms,improve lumbar spine function and reduce inflammatory factors and pain mediator levels in treating lumbar disc herniation.

关 键 词：针刺疗法 温针疗法 针药并用 腰椎间盘突出症 腰痛 炎症因子 疼痛介质 

分 类 号：R246.2[医药卫生—针灸推拿学]