委中刺络放血对腰椎间盘突出症术后综合征的疗效及对凝血的影响

Efficacy Observation of the Weizhong (B40) Bloodletting Puncture in Postoperative Syndrome of Lumbar Intervertebral Disc Protrusion and the Impact on Coagulation

目的:观察委中刺络放血疗法对腰椎术后综合征的治疗效果,同时探讨该法对凝血系统的影响。方法:选取2016年1月至2017年1月广东省第二人民医院收治的腰椎间盘突出症术后综合征患者90例,随机分为对照组和观察组,每组45例。对照组接受腰腹肌功能训练、局部热敷及物理因子理疗,观察组在上述治疗方案基础上于委中穴刺络放血,1次/d,出血量控制在3~5 mL。2组均连续治疗10 d,比较治疗前后2组患者腰痛评定量表(JOA)、改良口述分级评分法(VRS)评分变化,凝血功能指标的水平变化。结果:治疗后2组JOA较治疗前升高,差异有统计学意义(P<0.05),其中观察组在主观症状、体征改善方面较对照组明显,差异有统计学意义(P<0.05)。2组治疗前VRS评分差异无统计学意义(P>0.05),治疗后2组VRS评分均有所改善,其中观察观察组改善优于对照组,差异有统计学意义(P<0.05)。2组治疗后凝血系统均有明显改善,其中观察组优于对照组,差异有统计学意义(P<0.05)。结论:委中刺络放血可明显改善腰椎术后综合征的临床症状及体征,提高患者生命质量,其作用机制可能与改善患者血液流变学状态有关。

Objective： To observe the curative effect of the weizhong （B40） bloodletting puncture in postoperative syndrome of lumbar intervertebral disc protrusion, and simultaneously to discuss the impact on coagulation system. Methods： A total of 90 patients with lumbar intervertebral disc prolapse postoperative syndrome in our hospital from January 2016 to January 2017 were included in the study and randomly divided into control group and the observation group, with 45 cases in each group. The control group had lumbar and abdominal muscles functional training, local hot compress and physiotherapy of physical agents, and the observation group had the weizhong （B40） bloodletting puncture on the basis of the above treatment, once per day. The bleeding volume was controlled in 3 to 5 mL. Both of the two groups had continuous treatment for 10 days. Lumbar pain rating scale （Japanese Orthopaedic Association, JOA）, scores changes of modified verbal rating scale （VRS）, and the index level changes of coagulation function of two groups before and after treatment were compared. Results： 1）After treatment, JOA in the two groups was higher than before treatment, and the differences were with statistically significant （ P 〈0.05）. The improvement of observation group were more obviously than the control group in terms of subjective symptoms and signs, and the differences had statistical significance （ P 〈0.05）.2）the VRS grading of the two groups were with no significant statistical differences before treatment （ P 〉0.05）, and VRS grading of the two groups were both improved after treatment. The improved cases of the observation group was better than that of the control group （ P 〈0.05）. 3）The coagulation system indexes of the two groups were obviously improved after treatment, and the observation group was better than that of control group. The differences were with statistically significant （ P 〈0.05）. Conclusion： Bloodletting puncture of weizhong （B40） can obviously improve the clinical symptoms and signs of lumbar intervertebral disc prolapse postoperative syndrome, improve the life quality of patients. The mechanism may related to the improving of the blood rheology state in patients.