针刺联合穴位注射对盘源性腰痛患者镇痛效果的临床研究  

Clinical study on analgesic effect of acupuncture combined with point injection in patients with discogenic low back pain

作　　者：曾巧 楚福明 牟子欣 周旗旗 ZENG Qiao;CHU Fuming;MOU Zixin;ZHOU Qiqi(Sichuan Province Orthopedic Hospital,Chengdu 610000,China)

机构地区：[1]Sichuan Province Orthopedic Hospital,Chengdu 610000,China

出　　处：《Journal of Acupuncture and Tuina Science》2024年第4期320-325,共6页针灸推拿医学（英文版）

基　　金：2022年成都市医学科研课题,No.2022092.

摘　　要：目的:观察针刺联合维生素B12穴位注射对盘源性腰痛患者疼痛程度的影响,并分析其可能机制。方法:选取96例盘源性腰痛患者,将其按照随机数字表法分为两组,对照组予以针刺治疗,联合组在对照组基础上加用维生素B12穴位注射。两组均治疗2周。治疗前、治疗1周及2周后比较疼痛视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI)评分;治疗前后比较血清炎性因子[肿瘤坏死因子(TNF)-α和白介素(IL)-6]、血清β-内啡肽(β-EP)以及前列腺素(PG)E2水平。治疗后比较两组不良反应情况及临床疗效。结果:联合组总有效率高于对照组(P<0.05)。联合组治疗1周及治疗2周后的VAS评分及ODI评分均低于同时间点对照组(P<0.05)。联合组治疗后血清TNF-α、IL-6及PGE2水平均低于对照组(P<0.05),血清β-EP水平高于对照组(P<0.05)。两组不良反应总发生率比较无统计学差异(P>0.05)。结论:针刺联合维生素B12穴位注射能减轻盘源性腰痛患者的疼痛程度,促进功能恢复;降低血清TNF-α、IL-6及PGE2水平,提高血清β-EP水平可能是其部分作用机制。Objective:To observe the effect of acupuncture combined with vitamin B12 point injection on pain severity in patients with discogenic low back pain and to analyze its potential mechanisms.Methods:A total of 96 patients with discogenic low back pain were randomly divided into two groups.The control group received acupuncture treatment,while the combined group received vitamin B12 point injection in addition to the identical acupuncture treatment in the control group.Both groups were treated for 2 weeks.The visual analog scale(VAS)and Oswestry disability index(ODI)scores were compared before treatment,after 1 week of treatment,and after 2 weeks of treatment.The levels of such serum inflammatory factors as tumor necrosis factor(TNF)-αand interleukin(IL)-6,serum beta-endorphin(β-EP),and prostaglandin(PG)E2 were compared before and after treatment.Adverse reactions and clinical efficacy were compared between the two groups after treatment.Results:The total effective rate in the combined group was higher than that in the control group(P<0.05).The VAS and ODI scores in the combined group after 1 week and 2 weeks of treatment were lower than those in the control group at the same time point(P<0.05).The levels of TNF-α,IL-6,and PGE2 in the combined group were lower than those in the control group after treatment(P<0.05),while the level ofβ-EP was higher than that in the control group(P<0.05).There was no statistical difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusion:Acupuncture combined with vitamin B12 point injection can alleviate pain and promote functional recovery in patients with discogenic low back pain;reducing the levels of TNF-α,IL-6,and PGE2 and increasing the level ofβ-EP may be part of the mechanism of the therapy.

关 键 词：针刺疗法 水针疗法 椎间盘 腰痛 针刺镇痛 Β-内啡肽 前列腺素 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]