筋膜内热针联合薏仁蠲痹汤治疗腰椎间盘突出症的临床研究  

Clinical Study of Intrafascial Thermal Needle Therapy Combined with Yiren Juanbi Decoction in the Treatment of Lumbar Disc Herniation

作　　者：杜一鹏 赵玉鑫 DU Yi-peng;ZHAO Yu-xin(Second Department of Acupuncture and Massage,Shangqiu 476000,China;Department of Orthopedics,Shangqiu Traditional Chinese Medicine Hospital,Shangqiu 476000,China)

机构地区：[1]商丘市中医院,针灸推拿二科,商丘476000 [2]商丘市中医院,骨科,商丘476000

出　　处：《中国合理用药探索》2025年第2期105-110,共6页Chinese Journal of Rational Drug Use

基　　金：2022年河南省中医药科学研究专项课题(2022ZY1204)。

摘　　要：目的:探讨筋膜内热针联合薏仁蠲痹汤对腰椎间盘突出症(LDH)的治疗效果。方法:选取2021年1月3日~2023年6月19日期间某院收治的123例LDH患者作为研究对象,采用随机数字表法分为A组、B组、C组,每组41例。A组患者给予筋膜内热针治疗,B组患者给予薏仁蠲痹汤治疗,C组患者给予筋膜内热针联合薏仁蠲痹汤治疗,均治疗4周。比较三组患者疼痛情况[视觉模拟评分法(VAS)]、腰椎功能[日本骨科协会(JOA)评分]、腰椎活动度、血小板P-选择素(CD62P)、前列腺素E2(PGE_(2))、临床疗效及不良反应发生情况。结果:治疗后,三组患者VAS评分均降低,且C组低于A组和B组(P<0.05);JOA评分均升高,且C组高于A组和B组(P<0.05);腰椎前屈、伸展、侧屈、旋转的范围均升高,且C组高于A组和B组(P<0.05);CD62P、PGE_(2)水平均降低,且C组低于A组和B组(P<0.05)。C组患者治疗总有效率高于A组和B组(P<0.05)。三组患者不良反应总发生率比较无统计学差异(P>0.05)。结论:筋膜内热针联合薏仁蠲痹汤治疗LDH患者临床疗效较佳,可显著改善腰椎功能、腰椎活动度,缓解患者疼痛,调节CD62P、PGE_(2)水平,且不增加不良反应的发生风险。Objective:To explore the efficacy of intrafascial thermal needle therapy combined with Yiren Juanbi decoction in the treatment of lumbar disc herniation(LDH).Methods:A total of 123 patients with LDH admitted to a hospital from January 3,2021 to June 19,2023 were selected and divided into group A,group B and group C using the random number table method,with 41 patients in each group.Group A was treated with intrafascial thermal needle therapy,group B was treated with Yiren Juanbi decoction,and group C was treated with intrafascial thermal needle therapy combined with Yiren Juanbi decoction,all were treated for 4 weeks.The pain condition[visual analogue scale(VAS)],lumbar spine function[Japanese Orthopaedics Association(JOA)score],lumbar spine mobility,platelet P-selectin(CD62P),prostaglandin E2(PGE_(2)),clinical efficacy and adverse reactions were compared among the three groups.Results:After treatment,the VAS score was decreased in the three groups,and lower in group C than in group A and group B(P<0.05).The JOA score was increased in the three groups,and was higher in group C than in group A and group B(P<0.05).The range of mobility including lumber anteflexion,extension,lateral flexion and rotation was increased in the three groups,and were higher in group C than in group A and group B(P<0.05).The levels of CD62P and PGE_(2) were decreased in the three groups,and were lower in group C than in group A and group B(P<0.05).The total response rate in group C was higher as compared with group A and group B(P<0.05).No statistically significant difference was observed in the total incidence of adverse reactions among the three groups during the study(P>0.05).Conclusion:Intrafascial thermal needle therapy combined with Yiren Juanbi decoction has a better efficacy in the treatment of LDH,which can significantly improve the lumbar function and lumbar mobility,relieve pain,regulate the levels of CD62P and PGE_(2),without increasing the risk of adverse reactions.

关 键 词：筋膜内热针 薏仁蠲痹汤 腰椎间盘突出症 临床疗效 腰椎功能 

分 类 号：R681.53[医药卫生—骨科学]