针灸辅助分期功能锻炼对腰椎间盘突出症康复的影响  

Influence of acupuncture and moxibustion assisted by staged functional exercise on the rehabilitation of lumbar intervertebral disc herniation

作　　者：王鼎暄 田明波[2] Wang Dingxuan;Tian Mingbo(Department of Spinal Surgery,Zhengzhou Traditional Chinese Medicine Orthopedic Hospital,Henan 450000,China;不详)

机构地区：[1]郑州中医骨伤病医院脊柱科,450000 [2]郑州人民医院骨科

出　　处：《山西医药杂志》2025年第1期12-16,共5页Shanxi Medical Journal

基　　金：郑州市中医药青苗人才培养项目(郑卫中管函〔2024〕7号)。

摘　　要：目的观察针灸辅助分期功能锻炼对腰椎间盘突出症(LDH)康复的影响。方法本研究为前瞻性研究,纳入郑州中医骨伤病医院2021年12月至2022年12月收治的109例LDH患者为研究对象,通过计算机随机分组法将其分为训练组(54例)和针灸组(55例),2组患者均接受经皮椎间孔镜下髓核摘除术(PELD)治疗,训练组术后实施分期功能锻炼,针灸组术后实施中医针灸联合分期功能锻炼,所有患者开展为期1年随访,比较2组患者的炎症因子变化,疼痛改善情况,以及腰椎结构、功能恢复情况。结果在不同治疗方案下,针灸组的肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)、基质外金属蛋白酶-3(MMP-3)分别为(10.4±2.2)ng/ml、(3.2±0.4)pg/ml、(25±5)ng/ml,均低于训练组[(12.4±3.6)ng/ml、(4.1±1.3)pg/ml、(29±5)ng/ml];针灸组的P物质(SP)、Β内啡肽(BEP)、视觉模拟疼痛量表(VAS)评分分别为(10.4±2.4)ng/L、(46±10)pg/ml、(3.7±0.3)分,均低于训练组[(12.5±3.3)ng/L、(51±10)pg/ml、(4.4±1.3)分];针灸组的伤椎后凸角、Cobb角分别为(12.4±3.3)°、(10.3±2.4)°,均低于训练组[(15.6±3.6)°、(12.3±3.4)°];针灸组随访第6个月、12个月后的Oswestry功能障碍指数(ODI)评分分别为(36±5)分、(32±5)分,均低于训练组[(39±6)分、(35±6)分];日本骨科协会治疗分数(JOA)评分分别为(20±5)分、(23±5)分,均高于训练组[(18±3)分、(20±5)分],差异均具有统计学意义(P<0.05)。结论针灸辅助分期功能锻炼能缓解LDH患者的炎症反应及疼痛情况,对促进患者腰椎结构及功能恢复均有重要意义。Objective To observe the effect of acupuncture and moxibustion assisted by staged functional exercise on the rehabilitation of LDH.Methods This study is a prospective study.A total of 109 LDH patients from our hospital from December 2021 to December 2022 were selected and classified into training group(54 cases)and acupuncture and moxibustion group(55 cases)by computer random grouping method.Both groups received PELD treatment.The training group were treadted with staged functional exercise after surgery,and the acupuncture and moxibustion group were treadted with TCM acupuncture and moxibustion combined staged functional exercise after surgery.All patients were followed up for one year,the inflammatory factors,improvement in pain,and recovery of lumbar spine structure and function between two groups of patients were compared.Results TNF-α,IL-1βand MMP-3 levels in the acupuncture and moxibustion group under different treatment schemes were(10.4±2.2)ng/ml,(3.2±0.4)pg/ml,and(25±5)ng/ml,which were lower than those in the training group[(12.4±3.6)ng/ml,(4.1±1.3)pg/ml,(29±5)ng/ml].The SP,B-EP and VAS scores in the acupuncture and moxibustion group were(10.4±2.4)ng/L,(46±10)pg/ml and(3.7±0.3)points,which were lower than those in the training group[(12.5±3.3)ng/L,(51±10)pg/ml and(4.4±1.3)points].The kyphosis angle and Cobb angle of injured vertebra in the acupuncture and moxibustion group were(12.4±3.3)°and(10.3±2.4)°,which were lower than those in the training group[(15.6±3.6)°and(12.3±3.4)°].The ODI scores of the acupuncture and moxibustion group after 6 months and 12 months of treatment were(36±5)and(32±5),which were lower than those of the training group[(39±6)and(35±6)].The JOA scores were(20±5),and(23±5),which were higher than those in the training group[(18±3),and(20±5)](P<0.05).Conclusion Acupuncture and moxibustion combined with staged functional exercise can alleviate inflammatory reaction and pain in patients with LDH,which is of great significance in promoting the recovery of lu

关 键 词：腰椎间盘突出症 分期功能锻炼 针灸 腰椎结构 腰椎功能 

分 类 号：R246.9[医药卫生—针灸推拿学]