子午流注纳子法穴位贴敷治疗腰椎骨质增生性腰痛临床观察

Clinical Observations on Acupoint Application Based on Zi Wu Liu Zhu Na Zi Method for Lumbago due to Lumbar Vertebral Hyperosteogeny

目的观察子午流注纳子法穴位贴敷治疗腰椎骨质增生性腰痛肝肾不足证的效果,及其对血清硬骨素(SOST)、Dickkopf-1(DKK1)水平的影响。方法将104例腰椎骨质增生性腰痛患者随机分为观察组和对照组,每组52例。两组患者均进行牵引疗法,对照组口服腰痛宁胶囊,观察组在对照组的基础上采用子午流注纳子法穴位贴敷治疗。比较两组治疗前后腰功能Oswestry功能障碍指数问卷表(ODI)评分、X线摄片检查评分、疼痛视觉模拟量表(VAS)评分、疼痛分级指数(PRI)评分、现时疼痛强度(PPI)评分、临床疗效以及血清SOST、DKK1水平。结果两组患者治疗后ODI、X线摄片评分减少,且观察组ODI、X线摄片评分低于对照组,差异均有统计学意义(P<0.01)。两组治疗后简化McGill量表(VAS、PRI、PPI)评分下降,且观察组治疗后简化McGill量表(VAS、PRI、PPI)评分低于对照组,差异均有统计学意义(P<0.01)。观察组总有效率(94.2%)显著高于对照组(P<0.05)。两组治疗后血清SOST、DKK1含量升高,且观察组血清SOST、DKK1水平高于对照组,差异均有统计学意义(P<0.01)。结论在常规治疗基础上子午流注纳子法穴位贴敷治疗腰椎骨质增生性腰痛肝肾不足证的疗效显著,且可上调血清SOST、DKK1水平。

Objective To investigate the efficacy of acupoint application based on Zi Wu Liu Zhu Na Zi method (midnight-noon ebb-flow method) for liver-kidney deficiency in lumbago due to lumbar vertebral hyperosteogeny and its effect on serum sclerostin (SOST) and Dickkopf-1(DKK1) levels. Method One hundred and four patients with lumbago due to lumbar vertebral hyperosteogeny were randomized to observation and control groups, 52 cases each. Both groups received traction therapy. The control group received oral administration of Yaotongning Capsules and the observation group, acupoint application based on Zi Wu Liu Zhu Na Zi method in addition. The Oswestry Dability Index (ODI) scores, X-ray scores, the Visual Analogue Scale (VAS) scores, the Pain Rating Index (PRI) scores, the Present Pain Intensity (PPI) scores, the clinical therapeutic effects and serum SOST and DKK1 levels were compared between the two groups before and after treatment. Result After treatment, the ODI score and the X-ray score decreased in the two groups of patients and were lower in the observation group than in the control group with statistically significant differences (P<0.01). After treatment, the simplified McGill scales (VAS, PRI and PPI) scores decreased in the two groups and were lower in the observation group than in the control group with statistically significant differences (P< 0.01). The total efficacy rate in the observation group (94.2%) was significantly higher than that in the control group (P<0.05). After treatment, serum SOST and DKK1 levels increased in the two groups and were higher in the observation group than in the control group with statistically significant differences (P<0.01). Conclusion Conventional treatment plus acupoint application based on Zi Wu Liu Zhu Na Zi method has a marked therapeutic effect on liver-kidney deficiency in lumbago due to lumbar vertebral hyperosteogeny. It can upregulate serum SOST and DKK1 levels.