肝气调和针刺法对慢性非特异性腰痛患者疼痛及负性情绪影响研究  

Effect Research of Liver Qi Harmonizing Acupuncture on Pain and Negative Emotion in Patients with Chronic Nonspecific Low Back Pain

作　　者：林文飞 许磊 王超[2] 王轩[2] 殷继超 刘诗若 樊旭[4] LIN Wenfei;XU Lei;WANG Chao;WANG Xuan;YIN Jichao;LIU Shiruo;FAN Xu(Xi’an Hospital of Tranditional Chinese Medicine,Xi’an 710021,Shaanxi,China;Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi,China;Xi’an Health School,Xi’an 710054,Shaanxi,China;Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]西安市中医医院,陕西西安710021 [2]陕西中医药大学,陕西咸阳712046 [3]西安市卫生学校,陕西西安710054 [4]辽宁中医药大学,辽宁沈阳110847

出　　处：《辽宁中医药大学学报》2024年第12期72-76,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划项目(2013CB531700);陕西省科技厅重点研发计划一般项目(2023-YBSF-158,2022SF-173,2022SF-224);陕西省中医药管理局科研能力提升项目(SZY-NLTL-2024-021);辽宁省科技厅联合基金面上项目(2023-MSLH-184);西安市卫健委科研人才项目(2022yb03)。

摘　　要：目的探讨肝气调和针刺法对慢性非特异性腰痛(chronic nonspecific low back pain,CNLBP)患者的临床疗效及负性情绪的影响。方法将80例患者随机分成观察组(40例)与对照组(40例)。对照组予常规针刺治疗(取穴L2~L5夹脊穴、肾俞、大肠俞、腰阳关);观察组在对照组治疗基础上增加肝气调和选穴处方。各组每日治疗1次,连续治疗6 d后休息1 d,共治疗2周。比较两组患者治疗前后Roland-Morris,功能障碍量表(roland-morris disability questionnaire,RMDQ)评分、焦虑量表(self-rating anxiety scale,SAS)评分、抑郁量表(self-rating depression scale,SDS)评分、疼痛灾难指数(pain catastrophizing scale,PCS)评分及血清皮质醇(cortisol,COR)、β-内啡肽(β-endorphin,β-EP)水平。结果治疗后,两组患者RMDQ评分、SAS评分、SDS评分、PCS评分较治疗前均降低(P<0.05),组间比较差异均无统计意义(P>0.05)。两组患者血清COR、β-EP水平较治疗前均升高(P<0.05);且观察组β-EP水平高于对照组(P<0.05),两组患者COR水平比较差异无统计学意义(P>0.05)。随访时,两组患者RMDQ评分、SAS评分、SDS评分、PCS评分较治疗前均降低(P<0.05),且观察组优于对照组(P<0.05)。结论肝气调和针刺法在改善CNLBP患者疼痛的同时,能在一定程度上改善患者的负性情绪,且远期疗效较好,适合临床推广应用。Objective To explore the clinical effect of liver Qi harmony acupuncture on patients with chronic nonspecific low back pain(CNLBP).Methods 80 patients were randomly divided into observation group(40 cases)and control group(40 cases).The control group was treated with routine acupuncture([L2-L5 Jiagi(EX-B2),Shenshu(BL23),Dachangshu(BL25),Yaoyangguan(DU3)];The observation group was given the prescription of regulating liver-Qi acupoints on the basis of the treatment in the control group.Each group received treatment once a day and rested for 1 day after continuous treatment for 6 days,for a total of 2 weeks score.The Roland-Morris disability questionnaire(RMDQ)scores,self-rating anxiety scale(SAS)scores,self-rating depression scale(SDS)scores and pain catastrophizing scale(PCS)scores were compared between the two groups before and after treatment.The serum levels of cortisol(COR)andβ-endorphin(β-EP)were measured before and after treatment.Results After treatment,RMDQ scores,SAS scores,SDS scores and PCS scores were decreased in both groups compared with(P<0.05),there was no difference between two groups(P>0.05).The levels of COR andβ-EP were increased in both groups(P<0.05);The level ofβ-EP in the observation group was higher than that in the control group(P<0.05),before treatment there was no significant difference in COR levels between the two groups(P>0.05).During the follow-up,RMDQ scores,SAS scores,SDS scores and PCS scores were decreased in both groups compared with before treatment(P<0.05),the observation group was better than the control group(P<0.05).Conclusion The liver Qi harmony acupuncture can improve the pain of patients with CNLBP and the negative emotions of patients to a certain extent,and the long-term effect is good,which is suitable for clinical application.

关 键 词：慢性非特异性腰痛 肝主筋 针刺 皮质醇 Β-内啡肽 

分 类 号：R274.34[医药卫生—中医骨伤科学]