侧隐窝注射联合超声下深刺八髎穴治疗腰椎间盘突出症临床研究  

Treatment of Lumbar Disc Herniation by Lateral Recess Injection Combined with Deep Needling of“Baliao”Acupoints under Ultrasound Localization

作　　者：蒋晨浩 张建楠[1,2] 周红梅[1,2] 李荣华 杨慧慧 曹伟[1,2] 刘砂金 蔡靓羽[1,2] JIANG Chenhao;ZHANG Jiannan;ZHOU Hongmei;LI Ronghua;YANG Huihui;CAO Wei;LIU Shajin;CAI Liangyu(Traditional Chinese Medicine Hospital of Wuxi,Nanjing University of Chinese Medicine,Wuxi 214000,China;Nanjing University of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学无锡附属医院,无锡214000 [2]南京中医药大学,南京210023

出　　处：《世界中医药》2025年第2期283-288,共6页World Chinese Medicine

基　　金：国家自然科学基金项目(81973878);江苏省自然科学基金项目(BK20180167);江苏中医药领军人才项目(SLJ0218);无锡市中医药管理局一般项目(ZYKJ202107)。

摘　　要：目的:观察侧隐窝注射联合超声定位下深刺“八髎穴”治疗腰椎间盘突出症的临床疗效。方法:将100例腰椎间盘突出症患者随机分为对照组和观察组,每组50例,对照组采用单纯侧隐窝注射治疗,观察组在对照组基础上联合超声定位下深刺八髎穴治疗,观察2组患者治疗前后的视觉模拟评分法(VAS)、日本骨科协会评估治疗分数(JOA)、血浆血栓烷素B_(2)(TXB_(2))水平、血浆前列腺素E_(2)(PGE_(2))水平、血清肿瘤坏死因子α(TNF-α)水平、核因子κB(NF-κB)蛋白磷酸化水平、Macnab标准来评价疗效。结果:治疗后2组患者VAS评分均低于治疗前,且观察组优于对照组(P<0.05)。2组患者的JOA评分较治疗前升高,且观察组优于对照组(P<0.05)。2组患者炎症介质水平(血浆TXB_(2)、PGE_(2)、TNF-α)低于治疗前,且观察组优于对照组(P<0.05)。2组患者NF-κB蛋白磷酸化水平较治疗前降低,且观察组优于对照组(P<0.05)。治疗后优良率观察组优于对照组(P<0.05)。结论:侧隐窝注射联合超声定位下深刺八髎穴疗效肯定、临床操作简单可复制。Objective:To observe the clinical efficacy of lateral recess injection combined with deep needling of“Baliao”acupoints under ultrasound localization in the treatment of lumbar disc herniation.Methods:A total of 100 patients with lumbar disc herniation were randomly divided into a control group(n=50)and an observation group(n=50).The control group received lateral recess injection therapy alone,while the observation group received additional deep needling of“Baliao”acupoints under ultrasound localization.Clinical efficacy was evaluated using the visual analog scale(VAS),Japanese Orthopedic Association(JOA)score,plasma thromboxane B_(2)(TXB_(2))levels,plasma prostaglandin E_(2)(PGE_(2))levels,serum tumor necrosis factor-α(TNF-α)levels,nuclear factor kappa B(NF-κB)protein phosphorylation levels,and the Macnab criteria before and after treatment.Results:After treatment,both groups showed a significant reduction in VAS scores compared to baseline,with the observation group showing superior improvement(P<0.05).JOA scores increased in both groups,with the observation group demonstrating better outcomes(P<0.05).Levels of inflammatory mediators(plasma TXB_(2),PGE_(2),and TNF-α)decreased in both groups,with greater reductions in the observation group(P<0.05).NF-κB protein phosphorylation levels also decreased in both groups,with the observation group exhibiting a more pronounced decrease(P<0.05).The overall efficacy rate in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:Lateral recess injection combined with deep needling of“Baliao”acupoints under ultrasound localization is an effective and reproducible treatment for lumbar disc herniation,with confirmed efficacy and simple clinical application.

关 键 词：侧隐窝注射 腰椎间盘突出症 超声引导 针刺 八髎穴 炎症介质 NF-κB蛋白磷酸化水平 中西医结合 

分 类 号：R245[医药卫生—针灸推拿学] R274.9[医药卫生—中医临床基础]