循经针刺联合刺络放血治疗血瘀型腰椎间盘突出症患者的疗效观察  

Observing the Efficacy of Meridian-Based A cupuncture Combined with Bloodlet-ting Therapy in Treating Patients with Blood Stasis Type Lumbar Disc Herniation

作　　者：齐好雯 陈建华 高丽华 齐月雯 QI Hao-wen;CHEN Jian-hua;GAO Li-hua;QI Yue-wen(Department of Acupuncture-Moxibustion and Tuina,Chengde Hospital of Traditional Chinese Medicine,Chengde Hebei 067000;Department of Endocrinology,Chengde Hospital of Traditional Chinese Medicine,Chengde Hebei 067000;Department of Gastroenterology,Affiliated Hospital of Chengde Medical University,Chengde Hebei 067000)

机构地区：[1]承德市中医院针灸推拿科,河北承德067000 [2]承德市中医院内科,河北承德067000 [3]承德医学院附属医院消化内科,河北承德067000

出　　处：《世界中西医结合杂志》2024年第7期1377-1381,1387,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2022282)。

摘　　要：目的探讨循经针刺联合刺络放血治疗血瘀型腰椎间盘突出症患者临床疗效。方法选取2021年10月-2022年10月期间承德市中医院收治的腰椎间盘突出症患者80例,按照随机数字表法分为对照组和观察组,每组各40例。对照组采用常规针刺法,观察组采用循经针刺联合刺络放血治疗,连续治疗4周。观察比较两组患者临床疗效、不良反应情况,治疗前后中医证候积分、日本骨科协会(Japanese orthopaedic association scores,JOA)评分、视觉模拟评分(Visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、血清炎性因子水平[白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白介素-1β(Interleukin-1β,IL-1β)、C反应蛋白(C-reactive protein,CRP)]水平。结果治疗后两组患者腰腿疼痛如针刺、下肢放射痛、腰部活动受限、腰膝沉重、下肢麻木评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者JOA评分均较治疗前升高,VAS、ODI评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组JOA评分明显高于对照组,VAS、ODI评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IL-6、TNF-α、IL-1β、CRP水平均较治疗前明显降低,差异有统计学意义(P<0.05),且观察组血清炎性因子水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组总有效率92.50%(37/40)明显高于对照组75.00%(30/40),差异有统计学意义(P<0.05)。治疗期间,两组患者均无晕针、断针、滞针、皮下血肿、感染等针刺或刺络放血等不良事件发生。结论循经针刺联合刺络放血治疗腰椎间盘突出症(血瘀证)疗效显著,能够抑制炎症反应,减轻腰腿疼痛等不适症状,促进腰椎功能恢复。Objective To explore the clinical efficacy of meridian-based acupuncture combined with bloodletting acupuncture therapy in treating patients with blood stasis type lumbar disc herniation.Methods 80 patients with lumbar disc herniation admitted to Chengde Hospital of Traditional Chinese Medicine from October 2021 to October 2022 were selected.They were divided into a control and an observation group using the random number table method,with 40 patients in each group.The control group was treated with conventional acupuncture,while the observation group was treated with meridian-based acupuncture combined with bloodletting acupuncture therapy.The treatment lasted for four weeks.The clinical efficacy,adverse reactions,traditional Chinese medicine(TCM)syndrome scores,Japanese Orthopedic Association(JOA)scores,visual analog scale(VAS)scores,Oswestry disability index(ODI)scores,and serum inflammatory factor levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),C-reactive protein(CRP)]were observed and compared before and after treatment.Results After treatment,the scores of lower back and leg pain,acupuncture,lower limb radiating pain,limited lumbar activity,heaviness in the lower back and knees,and lower limb numbness in both groups were significantly reduced compared to before treatment,with a statistically significant difference(P<0.05);the TCM syndrome scores in the observation group were significantly lower than those in the control group,with a statistically significant difference(P<0.05).The JOA scores in both groups increased significantly after treatment,while the VAS and ODI scores decreased significantly compared to before treatment,with a statistically significant difference(P<0.05);the JOA scores in the observation group were significantly higher than those in the control group,and the VAS and ODI scores were significantly lower,with a statistically significant difference(P<0.05).After treatment,the levels of IL-6,TNF-α,IL-1β,and CRP in both groups decreased significantly co

关 键 词：腰椎间盘突出症 血瘀证 循经针刺法 刺络放血 血清炎性因子 腰椎功能 

分 类 号：R245.31[医药卫生—针灸推拿学] R681.53[医药卫生—中医临床基础]