针刺联合椎间孔镜治疗对腰椎间盘突出症患者疼痛介质、神经功能及应激反应的影响

Effect of acupuncture combined with transforaminal endoscopic therapy on pain mediators,neural function and stress response in patients with lumbar disc herniation

目的:探讨针刺联合椎间孔镜治疗对腰椎间盘突出症患者疼痛介质、神经功能及应激反应的影响。方法:收集在本院接受治疗的腰椎间盘突出症患者118例,经随机数表法分为对照组、观察组各59例。对照组接受椎间孔镜治疗,观察组接受针刺联合椎间孔镜治疗。对比两组治疗前后疼痛介质、神经功能及应激反应的差异。结果:治疗前,两组血清中疼痛介质含量、下肢神经传导速度、血清应激激素含量的差异无统计学意义(P>0.05)。治疗后,两组血清中PGE2、5-HT、NO、Cor、INS、NE的含量低于治疗前,血清中β-EP的含量以及胫神经MCV、腓总神经MCV、腓浅神经SCV、腓肠神经SCV的水平高于治疗前,且观察组血清中PGE2、5-HT、NO、Cor、INS、NE的含量低于对照组,血清中β-EP的含量以及胫神经MCV、腓总神经MCV、腓浅神经SCV、腓肠神经SCV的水平高于对照组。结论:腰椎间盘突出症患者接受针刺联合椎间孔镜治疗,可有效减轻疼痛、抑制应激反应,优化下肢神经功能。

Objective:To study the effect of acupuncture combined with transforaminal endoscopic therapy on pain mediators,neural function and stress response in patients with lumbar disc herniation.Methods:A total of118patients with lumbar disc herniation who were treated in the hospital between January2015and January2017were collected and divided into control group(n=59)and observation group(n=59)by random number table method.The control group received transforaminal endoscopic therapy,and the observation group received acupuncture combined with transforaminal endoscopic therapy.The differences in the pain mediators,neural function and stress response were compared between the two groups before and after treatment.Results:Before treatment,the differences in serum pain mediator contents,lower limb nerve conduction velocity and serum stress hormone contents were not statistically significant between the two groups(P>0.05).After treatment,serum PGE2,5HT,NO,Cor,INS and NE contents of both groups of patients were lower than those before treatment while serumβEP contents as well as tibial nerve MCV,common peroneal nerve MCV,superficial peroneal nerve SCV and sural nerve SCV levels were higher than those before treatment,and serum PGE2,5HT,NO,Cor,INS and NE contents of observation group were lower than those of control group while serumβEP content as well as tibial nerve MCV,common peroneal nerve MCV,superficial peroneal nerve SCV and sural nerve SCV levels was higher than those of control group.Conclusion:Acupuncture combined with transforaminal endoscopic therapy can effectively alleviate the pain,inhibit the stress response and optimize the neural function of lower limbs in patients with lumbar disc herniation.