灯盏花素穴位注射联合针灸对腰椎间盘突出症患者腰背伸肌群表面肌电指标及血清MMP3、PGE_(2)、IL-1β表达的作用  

Effect of Acupoint Injection with Breviscapin Combined with Acupuncture on Surface Electromyography Indexes of Lumbar and Back Extensor and Levels of Serum MMP3,PGE_(2)and IL-1βin Patients with Lumbar Disc Herniation

作　　者：刘元朗 刘志杰 朱宏飞 LIU Yuanlang;LIU Zhijie;ZHU Hongfei(Optics Valley Hospital,Wuhan Third Hospital,Wuhan 430074,Hubei,China;Xiantao Hospital of Traditional Chinese Medicine,Wuhan 433000,Hubei,China;Hubei Provincial Hospital of Traditional Chinese Medicine,Affiliated Hospital of Hubei University of Traditional Chinese Medicine,Hubei Provincial Academy of Traditional Chinese Medicine,Wuhan 430060,Hubei,China)

机构地区：[1]武汉市第三医院光谷院区,湖北武汉430074 [2]仙桃市中医医院,湖北仙桃433000 [3]湖北省中医院,湖北中医药大学附属医院,湖北省中医药研究院,湖北武汉430060

出　　处：《中华中医药学刊》2024年第5期165-169,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：湖北省中医药管理局中医药科研基金项目(ZY2023F125,ZY2023F011)。

摘　　要：目的探讨灯盏花素穴位注射联合针灸对腰椎间盘突出症(Lumbar disc herniation,LDH)患者腰背伸肌群表面肌电指标及血清基质金属蛋白酶3(Matrix metalloproteinase 3,MMP3)、前列腺素E2(Prostaglandin E_(2),PGE_(2))、白细胞介素-1β(Interleukin-1β,IL-1β)表达的作用。方法应用前瞻性随机对照研究方法选取2020年3月—2022年5月收治的LDH患者186例,以随机数字表法分为观察组(62例)、对照A组(62例)、对照B组(62例)。对照A组予以灯盏花素穴位注射,对照B组予以针灸,观察组予以灯盏花素穴位注射联合针灸,均治疗1个月。比较3组疗效、不良反应与治疗前、治疗1个月后疼痛程度评分(Visual Analogue Scale/Score,VAS)、日本骨科协会下腰痛功能评价表评分(Japanese Orthopaedic Association Scores,JOA)、日常生活能力评分(Barthel,BI)、腰背伸肌群表面肌电指标(积分肌电值、平均功率频率)、血液流变学指标、血清免疫功能指标[免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白M(Immunoglobulin M,IgM)、补体C_(3)]、MMP3、PGE_(2)、IL-1β水平。结果观察组治疗1个月后总有效率93.55%(58/62)高于对照A组7742%(48/62)、对照B组80.65%(50/62)(P<0.05);3组治疗1个月后VAS评分较治疗前降低,且观察组低于对照A组、对照B组,JOA、BI评分与积分肌电值、平均功率频率较治疗前增高,且观察组高于对照A组、对照B组(P<0.05);3组治疗1个月后全血低切黏度、全血高切黏度、血浆黏度、红细胞压积、红细胞聚集指数较治疗前降低,且观察组低于对照A组、对照B组(P<0.05);3组治疗1个月后血清IgG、IgM、补体C_(3)、MMP3、PGE_(2)、IL-1β水平较治疗前降低,且观察组低于对照A组、对照B组(P<0.05);3组治疗期间不良反应发生率相比,差异无统计学意义(P>0.05)。结论应用灯盏花素穴位注射联合针灸治疗LDH可缓解疼痛程度与腰背伸肌群疲劳程度,提升腰背伸肌群肌肉收缩性,改善腰椎功能�Objective To explore the effect of acupoint injection with breviscapin combined with acupuncture on the surface electromyography(EMG)indicators of the lumbar and back extensor muscles and the levels of serum matrix metalloproteinase 3(MMP3),prostaglandin E_(2)(PGE_(2))and interleukin-1β(IL-1β)in patients with lumbar disc herniation(LDH).Methods From March 2020 to May 2022,a total of 186 patients with LDH in the hospital were selected by prospective randomized controlled research methods.They were divided into observation group(62 cases),control group A(62 cases)and control group B(62 cases)by random number table.The control group A was given acupoint injection with breviscapin,the control group B was given acupoint injection with breviscapin and moxibustion,and the observation group was given acupoint injection with compound betamethasone combined with acupuncture.All were treated for 1 month.The efficacy and adverse effects,the pain severity score(VAS),lumbar function score(JOA)and barthel index score(BI),the surface EMG indexes of the waist and back extensors(in⁃tegrated EMG value,frequency of average power),hemorheology indexes and serum immune function indexes[immunoglobulin G(IgG),immunoglobulin M(IgM),complement C_(3)],the levels of MMP3,PGE_(2) and IL-1βbefore and 1 month after treatment of the three groups were compared.Results The total effective rate of the observation group after 1 month of treatment was 93.55%(58/62),higher than 77.42%(48/62)of control group A and 80.65%(50/62)of control group B(P<0.05).The VAS scores of the three groups after 1 month of treatment were lower than those before treatment,and the score of the observation group was lower than that of control group A and control group B.The scores of JOA and BI,integrated EMG value and average power frequency were higher than those before treatment,and the results of the observation group were higher than those of control group A and control group B(P<0.05).After 1 month of treatment in the three groups,the values of whole blood low-s

关 键 词：灯盏花素 穴位注射 针灸 腰椎间盘突出症 腰背伸肌群表面肌电指标 MMP3 PGE_(2) IL-1Β 

分 类 号：R245.95[医药卫生—针灸推拿学] R681.53[医药卫生—中医临床基础]