针灸推拿联合腰椎牵引对老年腰椎间盘突出症患者血清TGF-β_1、PGE_2、IL-6水平的影响

Effect of Acupuncture and Massage Combined with Lumbar Traction on Serum Levels of TGF-β_1,PGE_2 and IL-6 in Elderly Patients with Lumbar Disc Herniation

目的:研究针灸推拿联合腰椎牵引对老年腰椎间盘突出症患者血清转化生长因子-β_1(transforming growth factor-β_1,TGF-β_1)、前列腺素E_2(prostaglandin E_2,PGE_2)及白细胞介素-6(interleukin-6,IL-6)水平变化的影响。方法:选择老年腰椎间盘突出症患者170例,采用随机数字表法分为对照组和试验组,每组各85例。对照组患者采用腰椎牵引治疗,试验组患者加用针灸推拿治疗。比较两组患者的临床疗效、疼痛视觉模拟评分法评分(vsual analogue scale,VAS)、日本骨科协会下腰痛功能评价表评分(Japanese orthopaedic association,JOA)和TGF-β_1、PGE_2、IL-6水平。结果:试验组患者有效率为95.29%,对照组患者有效率为81.18%,试验组临床疗效优于对照组,差异有统计学意义(P<0.05)。两组患者治疗前VAS相近(P>0.05),试验组患者治疗后1周、2周、3周VAS均明显低于同期对照组,差异有统计学意义(P<0.05)。两组患者治疗前JOA相近(P>0.05),试验组患者治疗后1周、2周、3周JOA均明显高于同期对照组,差异有统计学意义(P<0.05)。试验组患者的IL-6、PGE_2、TGF-β_1水平均明显低于对照组,差异有统计学意义(P<0.05)。结论:老年腰椎间盘突出症患者采用针灸推拿联合腰椎牵引的疗效较好,可以减轻疼痛程度,提高腰椎功能,改善免疫因子水平及血清疼痛物质相关水平。

Objective： To study the effects of acupuncture and massage combined with lumbar traction on serum TGF-β1,PGE2 and IL-6 levels in elderly patients with lumbar disc herniation. Methods： A total of 170 elderly patients with lumbar disc herniation were selected and randomly divided into control group and experimental group(with 85 patients in each group）. The control group was treated with lumbar traction,while the experimental group was treated with acupuncture and massage. The clinical efficacy,painual visual analogue scale(VAS） score,Japanese orthopaedic association(JOA） score,and transforming growth factor-β1(TGF-β1）,prostaglandin E2(PGE2） and interleukin-6(IL-6） levels were compared between the two groups of patients. Results： The effective rate was 95. 29% in the experimental group and that was 81. 18% in the control group. The clinical efficacy of the experimental group was better than that of the control group,and the difference was statistically significant(P 〈 0. 05）. The VAS before treatment was similar between the two groups(P 〉 0. 05）. The VAS at 1 week,2 weeks,and 3 weeks after treatment in the experimental group was significantly lower than that in the control group,and the difference was statistically significant(P 〈 0. 05）. The JOA before treatment was similar between the two groups(P 〉 0. 05）. The JOA at 1 week,2 weeks,and 3 weeks after treatment in the experimental group was significantly higher than that in the control group at the same time(P 〈 0. 05）. The levels of IL-6,PGE2 and TGF-β1 in the experimental group were lower than those in the control group,and the difference was statistically significant(P 〈 0. 05）. Conclusion： The effect of acupuncture and massage combined with lumbar traction in elderly patients with lumbar disc herniation is significantly better,which can relieve pain,improve lumbar function,improve immunity factor levels and levels of the related serum pain substances.