循经推拿刮痧法防治腰背痛的机制研究

Clinical Study on Prevention and Treatment of Low Back Pain by Massage and Scraping along Meridian

目的:探讨腰背痛患者使用循经推拿刮痧法治疗的效果及其致痛物质含量的变化。方法:选取腰背痛患者60例,随机分为对照组、推法组和刮痧组,每组20例,分别给予不同的推拿处理方法。比较各组患者的总体疗效及致痛物质含量的变化。结果:治疗前3组VAS评分、ODI指数、IL-6、TNF-α、SP比较,差异均无统计学意义(P>0.05);3组治疗后VAS评分、ODI指数、IL-6、TNF-α、SP与组内治疗前比较,差异均有统计学意义(P<0.05);与对照组治疗后比较,推法组及刮痧组的VAS评分、ODI指数、IL-6、TNF-α、SP均显著下降(P<0.05);治疗后推法组VAS评分、ODI指数、IL-6、TNF-α、SP与刮痧组比较,差异均无统计学意义(P>0.05)。结论:推法与刮痧法均能有效降低腰背痛患者的VAS评分及ODI指数,改善腰背痛患者的疼痛与功能障碍,其作用机制与降低致痛物质的表达,改善局部的炎症反应有关。

Objective: To investigate the therapeutic effect and the change of pain induced substance in patients with low back pain treated with massage and scrapping along meridian method. Methods: Sixty patients with low back pain were randomly divided into control group, massage group and scraping group, 20 cases in each group. Each group was given different manipulation methods. The overall curative effect and the change of the content of pain-causing substances in each group were compared. Results: There was no significant difference in VAS scores, ODI indexes, IL-6, TNF-αand SP among the three groups before treatment(P>0.05);after treatment, VAS scores, ODI indexes, IL-6, TNF-αand SP in the three groups were significantly different from those before treatment(P<0.05);after treatment, VAS scores, ODI indexes, IL-6, TNF-α and SP in the pushing group and scraping group were significantly lower than those in the control group(P<0.05). There was no significant difference in VAS scores, ODI indexes, IL-6, TNF-α, SP between pushing group and scraping group after treatment(P>0.05). Conclusion: Both massage and scrapping method can effectively reduce the VAS scores and ODI indexes of patients with low back pain, and improve the pain and dysfunction of patients with low back pain. Its mechanism is related to reducing the expression of pain-causing substances and improving local inflammatory response.