腹四穴手法为主配合腰腹肌功能锻炼治疗椎间盘源性腰痛的临床观察

Clinical Curative Effect of Four Points of Abdomen Technique Combined with Waist and Abdominal Muscle Dirigation on Discogenic Low Back Pain and the Influence on Serum TNF-α

目的观察腹四穴手法治疗为主配合腰腹肌功能锻炼治疗椎间盘源性腰痛的临床疗效及对血清肿瘤坏死因子-α(TNF-α)的影响。方法将椎间盘源性腰痛患者260例按随机数字表法分为治疗组和对照组各130例,对照组给予常规治疗手法配合腰腹肌功能锻炼;治疗组给予腹四穴手法治疗为主配合腰腹肌功能锻炼,2周为1疗程。结果治疗前两组患者视觉模拟量表(VAS)评分差异无统计学意义(P>0.05);治疗后两组患者不同时间点VAS评分均较治疗前明显下降(P<0.05);其中治疗后1疗程、治疗后2疗程、治疗后3疗程治疗组VAS评分均显著低于对照组(P<0.05)。治疗前两组患者Oswestry功能指数(ODI)评分差异无统计学意义(P>0.05);治疗后两组患者不同时间点ODI评分均较治疗前明显下降(P<0.05);其中治疗后1疗程、治疗后2疗程、治疗后3疗程治疗组ODI评分均显著低于对照组(P<0.05)。治疗后治疗组与对照组血清TNF-α水平分别为(10.36±2.01)μg/m L、(15.37±2.84)μg/m L,分别低于治疗前的(36.06±5.72)μg/m L、(36.24±4.33)μg/m L(P<0.05);两组比较,治疗组改善更加明显(P<0.05)。结论腹四穴手法治疗为主治疗椎间盘源性腰痛能够明显改善患者的疼痛症状及血清TNF-α水平,本研究将现代医学基础与中医脊柱相关疾病学相联系,治疗方法科学,为以后治疗椎间盘源性腰痛提供循证医学基础。

Objective： To observe clinical curative effect of four points of abdomen technique combined with waist and abdominal muscle dirigation on discogenic low back pain and the influence on serum TNF-α. Methods： 260 cases with discogenic low back pain were divided into the treatment group and the control group according to random number table,each group of 130 cases. The control group was given conventional treatment technique combined with waist and abdominal muscle dirigation;the treatment group was given four points of abdomen technique combined with waist and abdominal muscle dirigation. Two weeks was a course. Results： There was no statistically significant difference in VAS score before treatment in both groups（P 〉 0.05）. After treatment,the VAS scores of the two groups at different time points were significantly lower than those before treatment（P 〈0.05）. After 1 course,2 courses and 3 courses of treatment,the scores of VAS in the treatment group were significantly lower than those in the control group（P 〈 0.05）. Before treatment,there was no significant difference in ODI scores between the two groups（P 〉 0.05）. After treatment,the ODI scores of the two groups at different time points were significantly lower than those before treatment（P 〈 0.05）. After 1 course,2 courses and 3 courses of treatment,the scores of ODI in the treatment group were significantly lower than those in the control group,and the difference was statistically significant（P 〈 0.05）. After treatment,the serum TNF-α levels of the treatment group and the control group were（10.36 ±2.01） mg/m L,（15.37 ±2.84） mg/m L,respectively,lower than those before treatment（36.06±5.72） mg/m L,（36.24±4.33） mg/m L,and the difference was statistically significant（P 〈 0.05）.Compared with the two groups,the treatment group improved more obviously（P 〈 0.05）. Conclusions： Four points of abdomen technique on discogenic low back pain can significantly improve the patient′ s pain symptoms and serum TNF-α. In this study,the basis of modern medicine is related to the spine related diseases of traditional Chinese medicine,and the treatment method is scientific,which provides the evidence based medicine for the treatment of Discogenic low back pain.