摘要
目的探讨浮针疗法联合热敏灸对气滞血瘀型腰痛患者关节活动范围、中医证候积分及疼痛评分的影响。方法选取2020年1月至2023年4月于赣南医学院第三附属医院就诊的80例气滞血瘀型腰痛患者作为研究对象,根据治疗方法不同分为浮针组(n=26)、热敏灸组(n=24)与联合组(n=30)。浮针组给予以单纯浮针疗法治疗,热敏灸组予以单纯热敏灸治疗,联合组予以浮针疗法联合热敏灸治疗。比较3组临床疗效、中医证候积分、视觉模拟评分法(visual analogue scale,VAS)、日本骨科协会(Japanese Orthopaedic Association,JOA)、腰部活动度范围、血清指标[白细胞介素1β(interleukin-1β,IL-1β)、血清5-羟色胺(serum 5-hydroxytryptamine,5-HT)、P物质(P substance,SP)]水平及不良反应发生率。结果3组临床疗效比较差异有统计学意义(P<0.05);联合组治疗总有效率高于热敏灸组,差异有统计学意义(P<0.05)。治疗后,3组沉痛缠绵、疼痛拒按、沉重乏力积分均低于治疗前,且联合组低于浮针组、热敏灸组,差异有统计学意义(P<0.05)。治疗后,3组VAS评分均低于治疗前,JOA评分均高于治疗前,联合组VAS评分低于浮针组和热敏灸组,JOA评分高于浮针组和热敏灸组,差异有统计学意义(P<0.05)。治疗1、2周,3组ODI评分低于前一时间点,联合组低于浮针组和热敏灸组,差异有统计学意义(P<0.05)。治疗后,3组腰部屈曲、伸展和侧屈活动度均大于治疗前,且联合组大于浮针组和热敏灸组,差异有统计学意义(P<0.05)。治疗后,3组IL-1β、5-HT、SP水平均低于治疗前,且联合组低于浮针组和热敏灸组,差异有统计学意义(P<0.05)。3组不良反应发生率比较差异无统计学意义。结论相较于单纯浮针或热敏灸疗法,浮针联合热敏灸治疗气滞血瘀型腰痛疗效显著,能有效改善患者临床症状、减轻疼痛程度、提升腰椎功能活动度,且安全性良好。
Objective To explore the effects of floating needle therapy combined with heat-sensitive moxibustion on range of motion,scores of Traditional Chinese Medicine symptoms and pain in patients with lumbago of qi stagnation blood stasis type.Methods A total of 80 patients with low back pain of qi stagnation and blood stasis type who were treated in the Third Affiliated Hospital of Gannan Medical University from January 2020 to April 2023 were selected as the research subjects,they were divided into the floating needle group(n=26),the heat-sensitive moxibustion group(n=24)and the combined group(n=30)according to the different treatment methods.The floating needle group was treated with pure floating needle therapy,the heat-sensitive moxibustion group was treated with pure heat-sensitive moxibustion,and the combined group was treated with the combination of floating needle therapy and heat-sensitive moxibustion.The clinical efficacy,Traditional Chinese Medicine syndrome scores,visual analogue scale(VAS),Japanese Orthopaedic Association(JOA)score,range of lumbar motion,serum indexes interleukin-1β[IL-1β],serum 5-hydroxytryptamine[5-HT],substance P[SP]levels,and the incidence of adverse reactions were compared among the three groups.Results There were statistically significant differences in clinical efficacy among the three groups(P<0.05);the total effective rate in the combined group was higher than that in the heat-sensitive moxibustion group,and the difference was statistically significant(P<0.05).After treatment,the scores of persistent pain,pain with tenderness,and heaviness and weakness of the three groups were all lower than those before treatment,and the scores in the combined group were lower than those in the floating needle group and the heat-sensitive moxibustion group,and the differences were statistically significant(P<0.05).After treatment,the VAS scores of the three groups were lower than those before treatment,and the JOA scores were higher than those before treatment,the VAS score in the combined group was lower than those in the floating needle group and the heat-sensitive moxibustion group,and the JOA score in the combined group was higher than those in the floating needle group and the heat-sensitive moxibustion group,and the differences were statistically significants(P<0.05).At 1 and 2 weeks after treatment,the ODI scores of the three groups were lower than those at the previous time points,and the combined group was lower than the floating needle group and the heat-sensitive moxibustion group,and the differences were statistically significant(P<0.05).After treatment,the ranges of lumbar flexion,extension,and lateral flexion of the three groups were all greater than those before treatment,and the combined group were greater than the floating needle group and the heat-sensitive moxibustion group,and the differences were statistically significant(P<0.05).After treatment,the levels of IL-1β,5-HT,and SP of the three groups were all lower than those before treatment,and the combined group were lower than the floating needle group and the heat-sensitive moxibustion group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions among the three groups.Conclusion Compared with simple floating needle or heat-sensitive moxibustion therapy,floating needle combined with heat-sensitive moxibustion has a significant effect on low back pain of qi stagnation and blood stasis type,which can effectively improve the clinical symptoms of patients,reduce the degree of pain,improve the functional activity of lumbar spine,and has good safety.
作者
郭景华
黄金梅
钟惠珍
GUO Jinghua;HUANG Jinmei;ZHONG Huizhen(Department of Traditional Chinese Medicine,The Third Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi,341000,China)
出处
《当代医学》
2024年第27期41-46,共6页
Contemporary Medicine
关键词
浮针疗法
热敏灸
气滞血瘀型腰痛
关节活动范围
中医证候积分
Floating needle therapy
Heat-sensitive moxibustion
Qi stagnation blood stasis type
Range of motion
Traditional Chinese Medicine syndrome score
