摘要
【目的】观察温针灸治疗寒湿痹阻型腰椎间盘突出症的临床疗效。【方法】将96例寒湿痹阻型腰椎间盘突出症患者随机分为观察组和对照组,每组各48例,对照组给予康复疗法联合西药治疗,观察组在对照组治疗的基础上联合温针灸治疗。2组均治疗4周。治疗1个月后,评价2组临床疗效,观察2组患者治疗前后疼痛视觉模拟量表(VAS)评分和日本骨科协会评估治疗分数(JOA)评分的变化情况,以及血清前列腺素E2(PGE2)、转化生长因子β1(TGF-β1)以及血清肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、β-内啡肽(β-EP)的情况。比较2组患者治疗前后腓总神经传导速度(CPNMCV)、胫神经传导速度(NTMCV)的变化情况。并评价2组不良反应的发生情况。【结果】(1)治疗后,2组患者的IL-1β、TNF-α、β-EP水平明显改善(P<0.05),且观察组在改善IL-1β、TNF-α、β-EP水平方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的TGF-β1、PGE2水平明显改善(P<0.05),且观察组在改善TGF-β1、PGE2水平方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的VAS、JOA评分明显改善(P<0.05),且观察组在改善VAS、JOA评分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的CPNMCV、NTMCV水平明显改善(P<0.05),且观察组在改善CPNMCV、NTMCV水平方面明显优于对照组,差异有统计学意义(P<0.05)。(5)观察组总有效率为93.75%(45/48),对照组为75.00%(36/48)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(6)观察组不良反应总发生率为14.58%(7/48),对照组为16.67%(8/48),2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】温针灸治疗寒湿痹阻型腰椎间盘突出症,能明显减轻患者的疼痛症状,改善患者的腰椎功能,疗效显著。
Objective To observe the clinical efficacy of warming-needle moxibustionin treating lumbar disc herniation(LDH)of cold-damp obstructing blockage type.Methods Ninety-six patients with cold-damp obstructing blockage type of LDH were randomly divided into the observation group and the control group,with 48 patients in each group.The control group was given rehabilitation therapy combined with western medicine,while the observation group was treated with warming-needle moxibustionin based on the treatment of the control group.Both groups were treated for 4 weeks of treatment.After 1 month of treatment,the clinical efficacy of the two groups was evaluated,and the changes in Visual Analogue Scale(VAS)scores of pain and Japanese Orthopaedic Association(JOA)scores were observed before and after treatment,as well as the changes in serum prostaglandin E2(PGE2),transforming growth factorβ1(TGF-β1),serum tumour necrosis factorα(TNF-α),interleukin-1β(IL-1β)andβ-endorphin(β-EP).The changes of common peroneal nerve motor conduction velocity(CPNMCV)and tibial nerve conduction velocity(NTMCV)were compared between the two groups before and after treatment.And the occurrence of adverse reactions in the two groups were evaluated.Results(1)After treatment,the levels of IL-1β,TNF-αandβ-EP of the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the levels of IL-1β,TNF-αandβ-EP,and the difference was statistically significant(P<0.05).(2)After treatment,the TGF-β1 and PGE2 levels of patients in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the levels of TGF-β1 and PGE2,and the difference was statistically significant(P<0.05).(3)After treatment,the VAS and JOA scores of the patients in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the VAS and JOA scores,and the difference was statistically significant(P<0.05).(4)After treatment,the CPNMCV and NTMCV levels of patients in the two groups significantly were improved(P<0.05),and the observation group was significantly superior to the control group in improving CPNMCV and NTMCV levels,and the difference was statistically significant(P<0.05).(5)The total effective rate was 93.75%(45/48)in the observation group and 75.00%(36/48)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).(6)The total incidence of adverse reactions in the observation group was 14.58%(7/48)and 16.67%(8/48)in the control group,and the difference was insignificant between the two groups(P>0.05).Conclusion Warming-needle moxibustionin exerts certain effect in treating cold-damp obstructing blockage type of LDH.It can significantly reduce the patient’s pain symptoms and improve the patient’s lumbar spine function.
作者
张燕珍
梁超
陈少萍
ZHANG Yan-Zhen;LIANG Chao;CHEN Shao-Ping(Haikou Hospital of Traditional Chinese Medicine,Haikou 570216 Hainan,China)
出处
《广州中医药大学学报》
CAS
2023年第12期3084-3090,共7页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
海南省卫生计生行业科研资助项目(编号:18A200123)
海南省临床医学中心扶持学科资助项目。
关键词
温针灸
腰椎间盘突出症
寒湿痹阻型
运动神经传导功能
临床观察
warming-needle moxibustionin
lumbar disc herniation
cold-damp obstructing blockage type
motor nerve conduction function
clinical observation
作者简介
张燕珍(1984-),女,主治中医师,E-mail:zhangyz1497@163.com。
