针刺郄穴为主配合中药介入治疗血瘀型腰椎间盘突出症30例临床研究

Clinical Study on Acupuncture at Xi Xue(Cleft Points) Combined with Injection of Chinese Medicine for Treatment of 30 Cases of Lumbar Intervertebral Disc Prolapse of Blood Stasis Type

目的:观察针刺郄穴为主配合中药介入治疗血瘀型腰椎间盘突出症的临床疗效及作用机理。方法:将60例患者随机分为治疗组与对照组各30例。治疗组针刺L4-S1夹脊穴、外丘、委中、侠溪等特定穴,配合葛根素注射液介入治疗;对照组常规针刺配合阿是穴常规注射葛根素注射液。同时观察两组治疗前后白介素6(IL-6)及血液动力学变化。结果:治疗组总体疗效明显优于对照组(P<0.05),且疗程明显短于对照组(P<0.01);两组治疗后积分、疼痛VAS法积分、直腿抬高试验积分与治疗前比较均有显著改善,且治疗组直腿抬高试验积分、总积分改善优于对照组(P<0.05);两组外周血IL-6水平、红细胞比积、血沉方程K值、全血比黏度高切均有改善,且治疗组治疗后红细胞比积、血沉方程K值、IL-6水平改善明显优于对照组(P<0.05或P<0.01)。结论:治疗组改善症状体征、日常生活能力,疼痛减轻程度等优于对照组,其作用机理可能与改善IL-6水平及血液动力学指标,从而消除神经根炎症有关。

Objeetive：To observe clinical therapeutic effect and mechanisms of acupuncture at Xi Xue （cleft points） combined with injection of Chinese medicine for treatment of 30 cases of lumbar intervertebral disc prolapse of blood stasis type. Methods： 60 cases were randomly divided into a treatment group and a control group, 30 cases in each. Patients of the treatment group were treated with acupuncture at L4-S1 Jiaji points（EX-B2） ,Waiqiu（GB 36） ,Weizhong（BL 40） ,Xiaxi（GB 43） ,combined with injection of Puerarin Injectio,and the control group were given routine acupuncture combined with injection of Puerarin Injectio into Ashi points. Changes of interleukin-6 （IL-6） and hemorheologic indexes before and after treatment were investigated in the two groups. Results,In the treatment group,total therapeutic effect was significantly superior to （P〈0. 05） and the therapeutic course was significantly shorter（P〈0.01） than that in the control group. After treatment the total score,the pain score for VAS,and the cumulative score for straight leg raising test in both groups improved significantly,and the improvement of the score for straight leg raising test and the total score in the treatment group was significantly superior to that in the control group（P〈0. 05）. IL-6 level, red blood cell ratio,K value of blood sedimentation equation,whole blood high shearing specific viscosity were improved after treatment in both groups,and improvement of red blood cell ratio,K value of blood sedimentation,IL- 6 level in the treatment group was superior to that in the control group （P〈0. 05 or P〈0. 01）. Conelusion：The treatment group was superior to the control group in improvement of symptoms and signs ,daily living ability ,and the degree of pain alleviation, and the mechanism is possibly related with improvement of IL-6 level and hemorheologic indexes leading to elimination of radiculoneuritis.