正清风痛宁注射液离子导入配合针刀治疗第3腰椎横突综合征的临床研究

Clinical Study of Zhengqing Fengtongning Injection Iontophoresis Combined with Acupotomy on the Third Lumbar Transverse Process Syndrome

目的观察正清风痛宁注射液离子导入配合针刀疗法治疗第3腰椎横突综合征的临床疗效,并探析治疗机制。方法 113例第3腰椎横突综合征患者随机分为电针组56例和综合治疗组57例,电针组单侧痛者取患侧肾俞、腰阳关、L_1和L_2夹脊穴、委中穴及L_3横突局部压痛点,双侧痛者取以上双侧穴位电针治疗,综合治疗组在电针组治疗基础上采用针刀松解腰背深筋膜法及离子导入法清风痛宁注射液于第3腰横突痛点。两组均治疗2个疗程,共14 d。采用酶联免疫吸附法检测治疗前后患者血清6-酮-前列腺素E1α(6-keto-PGE1α)水平及一氧化氮(NO)含量,观察治疗对患者下肢局部张力及生物力学的影响,采用日本骨科学会下腰痛评分法(JOA)和视觉模拟量表(VAS)进行疗效评价。结果与电针组比,综合治疗组患者血清6-keto-PGE1α、NO、VAS评分均明显低于电针组(P<0.05);腰背部软组织局部张力有明显改善,组织能量吸收比及张力500g位移均较治疗前有所提高;JOA评分和有效率均高于电针组,两组比较差异有统计学意义。结论正清风痛宁注射液离子导入配合针刀综合疗法治疗第3腰椎横突综合征疗效优于电针组。

Objective： To observe the clinical curative effect of Zhengqing Fengtongning Injection iontophoresis combined with acupotomy on the third lumbar transverse process syndrome,and to analyze its mechanism. Methods： A total of 113 patients with third lumbar transverse process syndrome were randomly divided into 56 cases in the electroacupuncture group and 57 in the comprehensive treatment group. Electracupuncture group unilateral pain took ipsilateral Shenshu（BL23） and Yaoyangguan（GV3）, L1 and L2 Jiaji points, Weizhong（BL40） AND L3 transverse local tenderness, pain in patients with bilateral points from above. Loosened the deep fascia of the waist and back by acupotomy combined with Zhengqing Fengtongning Injection iontophoresis at the third lumbar transverse pain point. Two groups were treated for 2 courses of 14 days. ELISA was used before and after treatment to detect the level of serum 6-Keto-PGE1α and the content of NO. The effect of treatment on lower limb local tension and biomechanics was observed. The therapeutic effect was evaluated by the Japanese Department of orthopedics Association low back pain score（JOA） and visual analogue scale（VAS）. Results： In the treatment group,the level of serum 6-keto-PGE1α,the content of NO,and VAS score,which were significantly lower than those in the electroacupuncture group（P〈0.05）. The local tension of the soft tissue in the waist and back was obviously improved. Energy absorption ratio of tissue,and 500 g tension displacement ratio,which were increased compared with those before treatment. JOA score and the efficiency,which were higher than those of acupuncture group;there was significant difference between two groups. Conclusion： The effect of Zhengqing Fengtongning Injection iontophoresis combined with acupotomy on the third lumbar transverse process syndrome is superior to that of electro acupuncture group.