揿针留针候气联合核心肌力训练治疗腰椎间盘突出症的疗效评价

An evaluation of the efficacy of press-needle and prolonged needling for acu-esthesia combined with core muscle strength training against lumbar disc herniation

目的探讨揿针留针候气联合核心肌力训练治疗气滞血瘀型腰椎间盘突出症(LDH)的疗效及安全性。方法将2019年3~10月入我院骨伤科门诊就诊的60例气滞血瘀型LDH患者随机分为观察组和对照组,每组30例。对照组接受常规腰椎牵引治疗,观察组接受揿针留针候气联合核心肌力训练治疗,比较两组患者治疗前后日本骨科协会(JOA)评分、视觉模拟评分法(VAS)评分、炎性因子(IL-6、TNF-α、NO)水平和不良反应发生情况。结果治疗3周后两组JOA评分均较治疗前升高(P<0.05),且观察组升高更明显(P<0.05)。治疗后两组VAS评分较治疗前下降(P<0.05),观察组评分低于对照组(P<0.05)。治疗后观察组IL-6、TNF-α、NO水平均低于治疗前(P<0.05),且低于同期对照组(P<0.05)。治疗期间两组均未见严重不良反应。结论揿针留针候气联合核心肌力训练治疗气滞血瘀型腰椎间盘突出症疗效显著,安全性高。

Objective To explore the efficacy and safety of press-needle and prolonged needling for acu-esthesia combined with core muscle strength training against lumbar disc herniation(LDH)of qi stagnation and blood stasis type.Methods The 60 LDH patients of qi stagnation and blood stasis type admitted to and treated in the orthopedic clinic of our hospital from March to October 2019 were randomly divided into the observation group and the control group,with 30 patients in each group.The control group received conventional lumbar traction treatment,while the observation group received the treatment of press-needle and prolonged needling for acu-esthesia combined with core muscle strength training.The Japanese orthopedic association(JOA)scores,visual analogue scale(VAS)scores,levels of inflammatory factors(IL-6,TNF-α,NO)and adverse reactions(ADRs)before and after treatment were compared between the two groups.Results After 3 week of treatment,the JOA scores in both groups were higher than those before treatment(P<0.05),and the increase in the observation group was more obvious(P<0.05).After treatment,the VAS scores of the two groups decreased when compared with those before treatment(P<0.05),and the scores of the observation group were lower than those of the control group(P<0.05).After treatment,the levels of IL-6,TNF-αand NO in the observation group were all lower than those before treatment(P<0.05),and lower than those in the control group at the same time(P<0.05).No serious ADR was found in either group during treatment.Conclusion Press-needle and prolonged needling for acu-esthesia combined with core muscle strength training has significant efficacy and sound safety in the treatment of LDH of qi stagnation and blood stasis type.