神经触激术结合理筋手法治疗腰椎间盘突出症的临床效果及对神经肽类物质的影响研究  

Study on the Clinical Effect of Nerve Stimulation Combined with Tendon-regulating Manipulation in Patients with Lumbar Disc Herniation and Influence on Neuropeptide Substances

作　　者：李寒露 吕佳 刘玉欢 李松明 LI Hanlu;LYU Jia;LIU Yuhuan;LI Songming(Acupuncture and Massage Center,the Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine,Changchun 130117,China;不详)

机构地区：[1]长春中医药大学附属第三临床医院针灸推拿中心,吉林长春130117

出　　处：《中国医学创新》2024年第36期5-9,共5页Medical Innovation of China

基　　金：吉林省卫生健康科技能力提升项目(2022JC075)。

摘　　要：目的:探究神经触激术结合理筋手法治疗腰椎间盘突出症的临床效果及对神经肽类物质的影响。方法:将2023年1月—2024年2月长春中医药大学附属第三临床医院的100例腰椎间盘突出症患者根据随机数字表法分为对照组50例和观察组50例。对照组进行神经触激术治疗,观察组则进行神经触激术结合理筋手法治疗。比较两组的腰椎间盘突出症治疗总有效率、治疗前后的疼痛情况[视觉模拟评分法(VAS评分)]、腰椎功能情况[日本骨科协会腰痛评分(JOA评分)]及神经肽类物质[β-内啡肽(β-EP)、强啡肽A(Dyn-A)及P物质(SP)]。结果:观察组的腰椎间盘突出症治疗总有效率显著高于对照组,差异有统计学意义(P<0.05),治疗前两组的VAS评分、JOA评分及神经肽类物质比较,差异均无统计学意义(P>0.05),治疗2周及4周后观察组的VAS评分构成均显著优于对照组,JOA评分、β-EP及Dyn-A均显著高于对照组,SP均显著低于对照组,差异均有统计学意义(P<0.05)。结论:神经触激术结合理筋手法治疗腰椎间盘突出症的临床效果较好,可有效改善机体的不适感,对神经肽类物质的表达也有较好的调控作用,因此在腰椎间盘突出症患者中的应用价值较高。Objective:To investigate the clinical effect of nerve stimulation combined with tendon-regulating manipulation in patients with lumbar disc herniation and influence on neuropeptide substances.Method:A total of 100 patients with lumbar disc herniation in the Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine from January 2023 to February 2024 were divided into control group(50 cases)and observation group(50 cases)by the method of random number table.The control group was treated with nerve stimulation,the observation group was treated with nerve stimulation combined with tendon-regulating manipulation.Then the total effective rates for lumbar disc herniation, the pain state [visual analogue scale (VAS score)], lumbar spine function state [Japanese orthopaedic association score (JOA score)] and neuropeptide substances [β-endorphin (β-EP), dynorphin A (Dyn-A) and P-substance (SP)] before and after the treatment of two groups were compared. Result: The total effective rate for lumbar disc herniation of observation group was significantly higher than that of control group, the difference was statistically significant (P<0.05), the VAS score, JOA score and neuropeptide substances of two groups before the treatment were compared, the differences were not statistically significant (P>0.05), at second and forth week after the treatment, the composition of VAS score of observation group were significantly better than those of control group, the JOA scores, β-EP and Dyn-A were significantly higher than those of control group, the SP were significantly lower than those of control group, the differences were statistically significant (P<0.05). Conclusion: The clinical effect of nerve stimulation combined with tendon-regulating manipulation in patients with lumbar disc herniation is better, and it can effectively improve the discomfort and regulate the expression of neuropeptide substances of patients, so its application value in the patients with lumbar disc herniation is higher.

关 键 词：神经触激术 理筋手法 腰椎间盘突出症 神经肽类物质 

分 类 号：R681.53[医药卫生—骨科学]