针刺天柱穴对血瘀型腰椎间盘突出症疼痛的疗效

Effects of Acupuncture at Tianzhu on Lumbar Disc Herniation of Blood Stasis Type

目的观察针刺天柱穴对血瘀型腰椎间盘突出症患者的疗效。方法 2013年10月~2015年10月,108例血瘀型腰椎间盘突出症患者按就诊顺序分为观察组（n=53）和对照组（n=55）。观察组采用天柱穴为主针刺配合推拿治疗,对照组单采用推拿治疗,共4周。观察两组的临床疗效、下腰痛日本骨科协会（JOA）评分改善率,治疗前后评定视觉模拟评分（VAS）,测量血清白细胞介素-6（IL-6）含量。结果治疗后,两组患者VAS、IL-6含量显著低于治疗前（t〉4.220,P〈0.001）。观察组较对照组更低（t〉3.745,P〈0.001）;观察组总有效率94.34%,优于对照组（81.82%,χ^2=3.997,P=0.046）;治疗后JOA改善率比较,观察组优良率90.57%,优于对照组（76.36%,χ^2=3.920,P=0.048）。结论在推拿基础上针刺天柱穴能进一步减轻血瘀型腰椎间盘突出症患者腰腿痛,改善其功能,提高疗效,可能与降低IL-6含量有关。

Objective To observe the effect of acupuncture at Tianzhu（BL10） on Blood Stasis Type lumbar disc herniation（LDH）.Methods From October, 2013 to October, 2015, 108 LDH cases were randomized into observation group（n=53） and control group（n=55）in accordance with the order of visiting. The observation group received Tuina and acupuncture mainly at Tianzhu, while the control group only received Tuina, for four weeks. The clinical efficacy and improvement of Japanese Orthopaedic Association（JOA） scores were recorded, and the Visual Analogue Scale（VAS） and serum levels of interleukin-6（IL-6） were measured before and after treatment. Results The VAS score and IL-6 content decreased in both groups after treatment（t4.220, P〈0.001）, and decreased more in the observation group than in the control group（t3.745, P〈0.001）. The total effective rate was 94.34% in the observation group, more than 81.82% in the control group（χ^2=3.997, P=0.046）. The incidence of impromvement of JOA scores was 90.57% in the observation group, more than 76.36% in the control group（χ^2=3.920, P=0.048）. Conclusion Acupuncture at Tianzhu based on Tuina is more effective on Blood Stasis Type lumbar disc herniation, in term of pain and function, which may relate with decrease of the level of IL-6.