内热式针灸联合独活寄生汤加味治疗寒湿阻络型腰椎间盘突出症临床研究  

Clinical Study on the Treatment of Lumbar Disc Herniation of Cold-dampness Blocking Collaterals Type withInternal Heating Acupuncture Needle Combined with Modified Duhuo Jisheng Decoction

作　　者：庄瑜 ZHUANG Yu(Department of Pain,Yixing Hospital of Traditional Chinese Medicine,Yixing 214200,China)

机构地区：[1]宜兴市中医医院疼痛科,江苏宜兴214200

出　　处：《中西医结合研究》2024年第3期173-177,共5页Research of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨内热式针灸联合独活寄生汤加味治疗寒湿阻络型腰椎间盘突出症的临床疗效。方法将147例寒湿阻络型腰椎间盘突出症患者按1∶1∶1随机分为针灸组、中药组、针药联合组,每组49例。针灸组予以内热式针灸治疗,中药组予以独活寄生汤加味治疗,针药联合组予以内热式针灸联合独活寄生汤加味治疗。治疗4周后,比较3组临床总有效率、疼痛程度、腰部功能及血清致痛因子水平。结果治疗后,针药联合组总有效率为91.84%,明显高于针灸组的75.51%和中药组的69.39%,差异均有统计学意义(P均<0.05)。针药联合组魁北克腰痛障碍评分量表(Quebec back pain disability scale,QBPDS)、视觉模拟量表(visual analogue scale,VAS)等疼痛程度评分均明显低于针灸组与中药组(P均<0.05);针药联合组Roland-Morris功能障碍调查表(Roland-Morris disability questionnaire,RMDQ)、Oswestry功能障碍指数(Oswestry disability index,ODI)等腰部功能评分均明显低于针灸组与中药组(P均<0.05);针药联合组血清前列腺素E_(2)(prostaglandin E_(2),PGE_(2))、5-羟色胺(5-hydroxytryptamine,5-HT)、P物质(substance P,SP)等致痛因子水平均明显低于针灸组与中药组(P均<0.05)。结论应用内热式针灸联合独活寄生汤加味治疗寒湿阻络型腰椎间盘突出症可增强疗效,促进疼痛症状和腰部功能障碍的改善,并能有效降低血清致痛因子水平。Objective To analyze the therapeutic effect of internal heating acupuncture needle combined with modified Duhuo Jisheng decoction on lumbar disc herniation of cold-dampness blocking collaterals type.Methods A total of 147 patients with lumbar disc herniation of cold-dampness blocking collaterals type were randomly divided into the acupuncture group,traditional Chinese medicine group,and the combination of acupuncture and traditional Chinese medicine group according to 1∶1∶1,with 49 cases in each group.The acupuncture group was treated with internal heating acupuncture needle,the traditional Chinese medicine group was treated with modified Duhuo Jisheng decoction,and the combination of acupuncture and traditional Chinese medicine group was treated with internal heating acupuncture needle combined with modified Duhuo Jisheng decoction.After four weeks of treatment,the clinical total effective rate,degree of pain,lumbar function and serum levels of pain-inducing factors were compared among the three groups.Results After treatment,the total effective rate of the combination of acupuncture and traditional Chinese medicine group was 91.84%,which was significantly higher than the 75.51%of the acupuncture group and the 69.39%of the traditional Chinese medicine group(all P<0.05).The pain scores of Quebec back pain disability scale(QBPDS)and visual analogue scale(VAS)in the combination group were significantly lower than those of the acupuncture group and the traditional Chinese medicine group(all P<0.05).The waist function scores of Roland-Morris disability questionnaire(RMDQ)and Oswestry disability index(ODI)in the combination group were significantly lower than those in the acupuncture group and the traditional Chinese medicine group(all P<0.05).The serum levels of pain-inducing factors such as prostaglandin E_(2)(PGE_(2)),5-hydroxytryptamine(5-HT)and substance P(SP)in the combination group were significantly lower than those in the acupuncture group and traditional Chinese medicine group(all P<0.05).Conclusion The

关 键 词：腰椎间盘突出症 内热式针灸 独活寄生汤 致痛因子 

分 类 号：R274.9[医药卫生—中西医结合]