钩活术联合红花注射液穴位注射治疗腰椎间盘突出症及对患者IL-6、NO的影响

Efficacy of hooking therapy and safflower injection on lumbar disc herniation and the impact on IL-6 and NO in the patients

目的：探讨钩活术联合红花注射液穴位注射治疗腰椎间盘突出症的临床疗效及作用机制。方法：将60例腰椎间盘突出症患者按1∶1的比例随机分为观察组和对照组,每组30例。对照组采用红花注射液穴位注射,取穴为腰三穴,每日1次,7次为一疗程,共2个疗程。观察组在局麻下采用巨钩针对腰三穴进行钩治,然后于腰三穴注射红花注射液,6~7天治疗1次,若疗效不满意,可行第2次治疗。观察两组患者治疗前后疼痛视觉模拟量表（VAS）、改良日本骨科学会下腰痛评分法（M-JOA）评分,并进行临床疗效评定。检测两组患者治疗前后外周血白细胞介素-6（IL-6）、一氧化氮（NO）水平。结果：两组患者治疗后疼痛VAS评分及M-JOA评分均较治疗前明显改善（均P〈0.01）,观察组较对照组改善更为明显（均P〈0.01）;观察组愈显率为76.7%（23/30）,总有效率为96.7%（29/30）,均优于对照组的43.3%（13/30）、70.0%（21/30,均P〈0.05）。治疗后,两组患者外周血IL-6、NO含量均较治疗前降低（均P〈0.01）,且观察组上述指标的改变较对照组更为明显（均P〈0.01）。结论：钩活术联合红花注射液穴位注射可明显改善腰椎间盘突出症疼痛及临床症状,其作用机制与降低外周血炎性因子IL-6、NO含量有关。

Objective To explore the clinical efficacy and the effect mechanism of hooking therapy and safflower injection in the treatment of lumbar disc herniation （LDH）, Methods Sixty patients of LDH were randomized into an observation group and a control group at ratio of 1 to 1, 30 cases in each one. In the control group, safflower injection was applied to three points of lumbar region, once a day. Seven treatments made one session, and totally 2 sessions were required. In the observation group, under local anesthesia, the big hook needle was used to stimulate the three points of lumbar region first, followed by the safflower injection, once every 6 to 7 days, If the efficacy was not satisfactory enough, the second treatment was given. The visual analogue scale （VAS） and the modified Japanese Orthopaedic Association （M-JOA） scores were observed before and after treatment in the patients of the two groups and the clinical efficacy was evaluated. The levels of peripheral interleukin-6 （IL-6） and nitric oxide （NO） were determined. Results VAS and M-JOA scores were all improved apparently after treatment as compared with those before treatment in the patients of the two groups （both P〈0.01）. The improvements in the observation group were much more obvious than those in the control group （both P（0.01）. In the Observation group, the curative and remarkably effective rate was 76.7% （23/30） and the total effective rate was 96.7% （29/ 30）, better than 43.3~ （13/30） and 70.0% （21/30） in the control group separately （both P〈0.05）. After treatment, the levels of IL-6 and NO were all reduced as compared with those before treatment in the two groups （both P〈0.01）. The above indices were changed more obviously in the observation group as compared with those in the control group （both P〈0.01）. Conclusion The combined therapy of hooking therapy and safflower injection apparently relieves pain and clinical symptoms of LDH. The effect mechanism is relevant with reducing the levels of IL-6 and NO in the peripheral blood.