针刺郄穴治疗腰椎间盘突出症的疗效及对腰椎功能和血液流变学的影响

Clinical Efficacy of Needling Xi-Cleft Points and Its Influence on Lumbar Function and Hemorheology in Treatment of Lumbar Disc Herniation

目的:探究针刺郄穴治疗腰椎间盘突出症的疗效及对腰椎功能和血液流变学的影响。方法:选取80例腰椎间盘突出患者,按随机数字表法分为观察组和对照组,每组各40例。对照组患者采用常规针刺治疗,观察组则采用针刺郄穴治疗,1次/天,30天为1个疗程,2个疗程后统计两组临床疗效;检测并比较两组治疗前后疼痛指标、腰椎功能指标、血清炎性因子水平及血流变指标变化。结果:治疗后观察组临床总有效率高达95%,较对照组的70%显著升高(P<0.01);与治疗前比较,治疗后两组患者VAS评分显著降低(P<0.05或P<0.01),JOA评分显著升高(P<0.01),且治疗后两组间差异显著(P<0.05或P<0.01);与治疗前比较,治疗后两组血清IL-1β、IL-6水平显著降低,且观察组显著低于对照组(P<0.01);与治疗前比较,治疗后两组患者红细胞比积、血沉方程K值、红细胞聚集指数及观察组全血高/低切黏度明显降低(P<0.01),且观察组上述血流变指标均较对照组明显降低(P<0.05或P<0.01)。结论:针刺郄穴可效降低腰椎间盘突出症患者血清炎性因子水平,缓解疼痛症状,并可显著调节患者血流变学指标,降低血液黏度,促进患者腰椎功能恢复,临床疗效显著由于常规针刺治疗。

Objective： To explore the clinical efficacy of needling Xi-cleft points and its influence on lumbar function and hemorheology in treatment of lumbar disc herniation（ LDH）. Methods： 80 LDH patients were randomly divided into the observation group（ n = 40） and the control group（ n = 40）. The control group was treated with conventional acupuncture; whereas the observation group was treated with needling Xi-cleft points; the treatment was once per day for 60 d. Clinical efficacy,the changes of pain,lumbar function,serum inflammatory factors and hemorheology were detected and compared before and after treatment in the two groups. Results： The clinical total effective rate reached up to 95% in the observation group,which was significantly higher than 70% in the control group（ P〈0. 01）. The VAS score decreased significantly（ P〈0. 05,P〈0. 01）,and the JOA score increased significantly（ P〈0. 01） after treatment in the two groups; the difference between the two groups were statistically significant（ P〈0. 05,P〈0. 01）. The serum levels of IL-1β and IL-6 reduced significantly after treatment in the two groups,and the reduction of the observation group was more significant than that of the control group（ P〈0. 01）. The hematocrit,equation K value of erythrocyte sedimentation rate,and erythrocyte aggregation index of the two groups,as well as the whole blood high/low shear viscosity of the observation group decreased significantly（ P〈0. 01）,and the above hemorheology indexes were greatly lower in the observation group than those in the control group（ P〈0. 05,P〈0. 01）. Conclusion： Needling Xi-cleft points can reduce the serum levels of inflammatory factors in LDH patients,it can alleviate the pain,regualte the hemorheology indexes,reduce blood viscosity,and promote the recovery of lumbar function.Its clinical efficacy is superior to the conventional acupuncture.