中医推拿联合牵引治疗腰椎间盘突出症疗效及其对患者肌电图、血清IL-1β、TNF-α和血浆TXB2的影响

Curative effect of traditional Chinese massage combined with traction in the treatment of lumbar disc herniation and the effect on electromyogram,serum IL-1β,TNF-α and plasma TXB2

目的评价中医推拿联合牵引治疗腰椎间盘突出症疗效。方法选取该院2016年5月至2018年9月收治的腰椎间盘突出症患者60例为研究对象,分为观察组(n=30)和对照组(n=30)。对照组行牵引治疗,观察组行中医推拿+牵引治疗。比较两组治疗前后中医综合治疗疗效、视觉模拟评分(VAS)、日本骨科协会评分(JOA)、平均功率频率(MPF)、积分肌电值(IEMG)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)和血栓素(TXB2)的变化情况。结果观察组治疗总有效率显著高于对照组(P<0.05);治疗后,观察组VAS显著低于对照组,JOA显著高于对照组(P<0.05);治疗前,两组左右两侧MPF和IEMG比较,差异有统计学差异(P<0.05);治疗后,观察组左右两侧MPF和IEMG比较,差异无统计学意义(P>0.05),对照组左右两侧比较,差异有统计学意义(P<0.05);治疗后,观察组IL-1β、TNF-α和TXB2水平显著低于对照组(P<0.05);两组均无不良反应发生。结论中医推拿联合牵引治疗腰椎间盘突出症疗效显著,可改善患者表面肌电图,降低IL-1β、TNF-α和TXB2水平。

Objective To evaluate the curative effect of traditional Chinese massage combined with traction in the treatment of lumbar disc herniation.Methods 60 patients with lumbar disc herniation who were admitted in hospital from May 2016 to September 2018 were enrolled in the study.They were divided into the observation group(n=30)and the control group(n=30).The control group was treated with traction while the observation group was treated with traditional Chinese massage combined with traction.Curative effect of traditional Chinese medicine comprehensive treatment,changes in scores of visual analogue scale(VAS),Japanese orthopedic association scores(JOA),mean power frequency(MPF),integrated electromyography(IEMG),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and plasma trombxane B2(TXB2)before and after treatment were compared between the two groups.Results The comprehensive response rate of traditional Chinese massage in the observation group was significantly higher than that in the control group(P<0.05).After treatment,VAS of the observation group was significantly lower than that of the control group,while JOA was significantly higher than that of the control group(P<0.05).Before treatment,there were significant differences in MPF and IEMG between the left side and right side in the two groups(P<0.05).After treatment,there was no significant difference in MPF and IEMG between the left side and right side in the observation group(P>0.05),while there were significant differences in the above indexes between the two sides in the control group(P<0.05).After treatment,the levels of IL-1β,TNF-αand TXB2 in the observation group were significantly lower than those in the control group(P<0.05).No adverse reactions occurred in either group.Conclusion The effect of Chinese massage combined with traction treatment is significant for the treatment of lumbar disc herniation,which can improve the surface EMG,reduce the levels of IL-1β,TNF-αand TXB2.