浮针结合悬吊训练对腰背肌筋膜炎疗效及血清IL-1β、NLRP3及β-EP表达的影响  

Effect of Fu s Subcutaneous Needling Combined with Sling Exercise Therapy on Lumbar and Back Myofascitis and Its Influence to Serum Expressions of IL-1β,NLRP3 andβ-EP

作　　者：李玉实 朱春燕 王红蕾 张波 LI Yushi;ZHU Chunyan;WANG Honglei;ZHANG Bo(Dongying People's Hospital,Dongying 257091,China)

机构地区：[1]东营市人民医院,山东东营257091

出　　处：《针灸临床杂志》2024年第8期22-26,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：山东省中医药科技项目,编号:2021Q038。

摘　　要：目的:明确浮针结合悬吊训练(SET)技术对腰背肌筋膜炎的临床疗效,并分析其对患者血清中IL-1β、NLRP3及β内啡肽(β-EP)含量的影响。方法:选取在东营市人民医院康复医学科门诊治疗的90例腰背肌筋膜炎患者,对患者采用随机数字表法随机分组,分为浮针组、SET组和浮针联合SET组(简称联合组),各30例。浮针组给予浮针治疗,1次/2 d,SET组给予SET治疗,1次/d,联合组给予浮针联合SET治疗,频率与浮针组及SET组相同。3组治疗以6 d为1个疗程,共治疗2个疗程。在治疗前及治疗后采用VAS量表评分、Oswestry功能障碍评分对患者进行评定,并检测血清中IL-1β、NLRP3及β-EP的含量,进行临床疗效分析。在治疗结束后1个月时采用VAS量表进行随访。结果:经2周治疗后,3组患者VAS及Oswestry评分均较治疗前有明显改善,差异有统计学意义(P<0.05),联合组VAS及Oswestry评分低于浮针组和SET组,差异有统计学意义(P<0.05);联合组总有效率为96.7%(29/30),浮针组为73.3%(22/30),悬吊训练组为80.0%(24/30),联合组高于浮针组和悬吊训练组,差异有统计学意义(P<0.05)。治疗后3组患者血清IL-1β、NLRP3均低于治疗前,差异有统计学意义(P<0.01),β-EP水平高于治疗前,差异有统计学意义(P<0.01),且联合组血清IL-1β、NLRP3含量低于浮针组和SET组,血清β-EP表达高于浮针组和SET组,差异有统计学意义(P<0.01)。3组患者在治疗结束后1个月时VAS评分较治疗结束时均未见明显变化,联合组VAS评分仍低于浮针组和SET组,差异有统计学意义(P<0.05)。结论:浮针结合SET技术对腰背肌筋膜炎疗效确切,可显著改善患者的疼痛及腰椎活动功能,且远期疗效较好,其机制可能与降低血清中IL-1β、NLRP3等炎症因子表达和提高β-EP的表达有关。Objective:To observe the clinical efficacy of Fu s subcutaneous needling combined with sling exercise therapy(SET)in treatment of lumbar and back myofascitis,and to assess its influence to the serum expressions of IL-1β,NLRP3 andβ-EP.Methods:90 patients with lumbar and back myofascitis were randomly divided into the Fu s subcutaneous needling group,the SET group and the combination group,with 30 patients in each group.The Fu s subcutaneous needling group was treated with subcutaneous needling every other day;the SET group was treated with SET,once a day;the combination group was treated with Fu s subcutaneous needling and SET.The treatment duration was two course of 12 d.The clinical efficacy was compared among the three groups after the treatment.The scores of VAS and Oswestry were assessed,and the serum expressions of IL-1β,NLRP3 andβ-EP were detected before and after the treatment in the three groups.The VAS scale was used for follow-up at 1 month after the end of the treatment.Results:After 2 courses of the treatment,the scores of VAS and Oswestry were improved compared with those before the treatment in the three groups(P<0.05),and the scores were lower in the combination group than those in the Fu s subcutaneous group and the SET group(P<0.05).The total effective rate was 96.7%(29/30)in the combination group,which was higher than 80.0%(24/30)in the SET group and 73.3%(22/30)in the Fu s subcutaneous needling group(P<0.05).The serum expressions of IL-1βand NLRP3 were lower(P<0.01),and the serum expression ofβ-EP was higher after the treatment than those before the treatment in the three groups(P<0.01);the serum expressions of IL-1βand NLRP3 were lower(P<0,01),and the serum expression ofβ-EP was higher in the combination group than those in the Fu s subcutaneous needling group and the SET group after the treatment(P<0.01).The VAS score during the follow-up did not show significant changes compared with that at the end of the treatment;however,the VAS was still lower in the combination group than that i

关 键 词：腰背肌筋膜炎 浮针 悬吊训练 VAS Oswestry IL-1β NLRP3 Β-EP 

分 类 号：R246.2[医药卫生—针灸推拿学]