温阳通络针法联合刺络拔罐治疗腰椎间盘突出症疗效及对患者腰椎活动度、血浆β-内啡肽、炎症因子的影响  

Efficacy of Wenyang Tongluo acupuncture combined with pricking and cupping on lumbar disc herniation and its influence on lumbar range of motion,plasmaβ-endorphin and inflammatory factors

作　　者：齐好雯 齐月雯 陈建华 高丽华 QI Haowen;QI Yuewen;CHEN Jianhua;GAO Lihua(Chengde Hospital of Traditional Chinese Medicine,Chengde 067000,China)

机构地区：[1]承德市中医院,河北承德067000 [2]承德医学院附属医院,河北承德067000

出　　处：《陕西中医》2024年第10期1419-1423,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2022282)。

摘　　要：目的:探究温阳通络针法联合刺络拔罐治疗腰椎间盘突出(LDH)的临床疗效及对患者腰椎活动度、血浆β-内啡肽、炎症因子的影响。方法:选取84例LDH患者,按照随机数字表法分为对照组和联合组,各42例,对照组行刺络拔罐治疗,联合组行温阳通络针法联合刺络拔罐治疗。比较两组患者临床疗效、中医症状积分,治疗前后腰椎活动度(前屈、后伸、左右侧屈)、疼痛程度、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶3(MMP-3)]、血浆β-内啡肽(β-EP)及不良反应。结果:联合组治疗总有效率高于对照组(P<0.05);治疗后,两组腰腿疼痛、活动受限、遇寒加重、四肢冰凉症状积分均下降(P<0.05),且治疗后联合组低于对照组(P<0.05);治疗后,两组腰椎前屈、后伸、右侧屈曲、左侧屈曲活动范围均增加(P<0.05),且治疗后联合组高于对照组(P<0.05);治疗后,两组VAS评分均下降(P<0.05),JOA评分均升高(P<0.05),且治疗后组间比较差异具有统计学意义(P<0.05);治疗后,两组IL-6、TNF-α、MMP-3水平均下降(P<0.05),β-EP均升高(P<0.05),且治疗后两组间比较差异具有统计学意义(P<0.05);治疗期间,对照组出现1例皮疹,联合组出现2例局部红肿,1例皮疹,均在2~3 d后自然恢复。结论:温阳通络针法联合刺络拔罐可改善LDH患者的腰椎活动度,降低炎症因子水平,减轻疼痛,抑制病情进展。Objective:To explore the clinical efficacy of combination of Wenyang Tongluo acupuncture and pricking and cupping in the treatment of lumbar disc herniation(LDH)and its influence on lumbar range of motion,plasmaβ-endorphin and inflammatory factors.Methods:A total of 84 patients with LDH were selected and divided into control group(42 cases)and combined group(42 cases)by adopting the random number table method.The control group received pricking and cupping,while the combined group was given Wenyang Tongluo acupuncture combined with pricking and cupping.The clinical efficacy,TCM symptoms scores,lumbar range of motion(forward flexion,back extension,left and right lateral flexion),pain degree,serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),matrix metalloproteinase 3(MMP-3)]and plasmaβ-endorphin(β-EP)before and after treatment and adverse reactions were compared between groups.Results:The combined group had higher total effective rate of treatment(P<0.05).After treatment,the symptoms scores of waist and leg pain,activity limitation,aggravation of cold and cold limbs in the two groups were decreased(P<0.05),and the above scores in combined group after treatment were lower than those in control group(P<0.05).The ranges of motions of lumbar forward flexion,back extension,and right flexion and left flexion were increased in the two groups after treatment(P<0.05),and the ranges of motions in combined group were higher after treatment(P<0.05).After treatment,VAS score in both groups was reduced(P<0.05),while JOA score was enhanced(P<0.05),and after treatment,there were significant differences between groups(P<0.05).The levels of IL-6,TNF-αand MMP-3 in both groups after treatment were declined(P<0.05),while the level ofβ-EP was risen(P<0.05),and significant differences were shown after treatment(P<0.05).During treatment,there was 1 case of skin rash in control group,and there were 2 cases of local redness and swelling and 1 case of skin rash in combined group,and the above cases were rec

关 键 词：腰椎间盘突出 腰椎活动度 温阳通络针 刺络拔罐 炎症因子 β-内啡肽 

分 类 号：R274.34[医药卫生—中医骨伤科学]