温通针法联合独活寄生汤治疗退行性腰椎管狭窄症的疗效及对炎性因子的影响

Effect of Wentong Acupuncture Combined with Duhuo Jisheng Decoction in the Treatment of DLSS and Its Influence to Inflammatory Factors

目的:观察温通针法联合独活寄生汤治疗退行性腰椎管狭窄症的临床疗效及对白细胞介素1α(IL-1α)和肿瘤坏死因子α(TNF-α)的影响。方法:将96例患者随机分为两组,每组各48例,对照组采用脱水、止痛、营养神经对症治疗,实验组采用针灸联合独活寄生汤治疗,连续治疗4周。采用视觉疼痛模拟评分法(VAS)评价治疗前后腰痛程度,日本骨科协会评估治疗分数(JOA)评价治疗前后腰椎功能恢复情况,酶联免疫吸附法(ELISA)测定血清中IL-1α和TNF-α的变化。结果:与治疗前比较,两组患者的腰痛程度明显减轻,临床体征和日常生活明显改善,差异有统计学意义(P <0. 05);实验组与对照组比较,自觉症状和日常生活明显改善,差异有统计学意义(P <0. 05或P <0. 01)。与治疗前比较,两组患者血清中IL-1α和TNF-α的含量明显降低,差异有统计学意义(P <0. 05或P <0. 01);治疗4周后,实验组IL-1α和TNF-α与对照组比较,差异有统计学意义(P <0. 05)。结论:温通针法联合独活寄生汤能缓解退行性腰椎管狭窄症患者的腰痛程度,改善腰椎功能,同时能够降低血清中IL-1α和TNF-α的含量。

Objective： To observe the clinical effect of Wentong acupuncture combined with Duhuo Jisheng Decoction in the treatment of degenerative lumbar spinal stenosis（ DLSS） and its influence to IL-1α and TNF-α. Methods： 96 patients were randomly divided into the observation group（ n = 48） and the control group（ n =48）. The control group was treated with the therapies of dehydration,analgesia and nourishing nerves. The observation group was treated with acupuncture combined with Duhuo Jisheng Decoction for four continuous weeks. VAS was applied to assess the degree of lumbago and JOA was applied to evaluate the functional recovery of lumbar spine before and after the treatment respectively. Serum levels of IL-1α and TNF-α were measured by ELISA method. Results： After the treatment,the degree of lumbago was significantly reduced,as well as clinical signs and daily life were obviously improved in the two groups compared to those before the treatment（ P〈0. 05）; of which the observation group improved more than the control group in terms of the subjective symptoms and daily life（ P〈0. 05,P〈0. 01）. The serum levels of IL-1α and TNF-α were significantly decreased after the treatment in the two groups compared to those before the treatment（ P〈0. 05,P〈0. 01）.After four weeks of treatment,there was statistical difference in the levels of IL-1α and TNF-α between the observation group and the control group（ P〈0. 05）. Conclusion： Wentong acupuncture combined with Duhuo Jisheng Decoction can relieve the degree of lumbago in the patients with DLSS,it can improve lumbar function and reduce the serum contents of IL-1α and TNF-α.