内热针联合体外冲击波对腰背肌筋膜炎疗效及血清SP和TNF-α水平的影响

The Effect of Internal Heat Acupuncture Combined with Extracorporeal Shock Wave on the Curative Effect of Back Myofasciitis and Serum SP and TNF-α Levels

目的评价内热针联合体外冲击波治疗腰背肌筋膜炎的效果及其对P物质(SP)、血清肿瘤坏死因子(TNF)-α水平的影响。方法回顾性分析2018年1月—2019年12月在该院收治的100例腰背肌筋膜炎患者的临床资料,根据治疗方法的不同分为对照组与观察组,每组50例。对照组行单纯体外冲击波治疗,观察组在对照组治疗基础上联合内热针治疗,连续治疗4周后,比较两组视觉模拟评分(VAS)评分,Oswestry功能障碍指数(ODI)、改良日本骨科协会(JOA)评分、Zung氏焦虑自评量表(SAS)以及血清SP、TNF-α水平。结果两组在治疗前各项指标差异无统计学意义(P>0.05);经过4周治疗后,两组VAS、ODI、SAS评分及血清SP、TNF-α水平均较治疗前降低,差异有统计学意义(P<0.05),JOA评分较治疗前升高,差异有统计学意义(P<0.05),且观察组各项指标均明显优于对照组,差异有统计学意义(P<0.05),观察组总有效率为96%,对照组80%,观察组显著高于对照组,差异有统计学意义(χ^2=6.061,P=0.014)。结论内热针联合冲击波治疗腰背肌筋膜炎效果优于单纯体外冲击波治疗,同时可下调血清SP和TNF-α水平,具有良好的临床应用前景。

Objective To evaluate the effect of internal heat acupuncture combined with extracorporeal shock wave in the treatment of low back myofasciitis and its effect on substance P(SP) and serum tumor necrosis factor(TNF)-α levels. Methods A retrospective analysis of the clinical data of 100 patients with low back myofasciitis who were admitted to the hospital from January 2018 to December 2019. According to the different treatment methods, they were divided into control group and observation group. 50 cases in each group. The control group received simple extracorporeal shock wave therapy, and the observation group was combined with internal heat acupuncture on the basis of the control group. After 4 weeks of continuous treatment, the two groups were compared with visual analogue scale(VAS) scores, Oswestry dysfunction index(ODI), and modified Japanese Orthopaedic Association(JOA) score, Zung’s Self-rating Anxiety Scale(SAS), and serum SP and TNF-α levels. Results There was no statistically significant difference in indicators between the two groups before treatment(P>0.05). After 4 weeks of treatment, the scores of VAS,ODI, SAS and serum SP and TNF-α levels in the two groups were lower than before treatment, the difference was statistically significant(P <0.05). The JOA score was higher than before treatment, the difference was statistically significant(P<0.05), and all the indicators of the observation group were significantly better than those of the control group, the difference was statistically significant(P<0.05). The total effective rate of the observation group was 96%, and the control group was 80%. The observation group was significantly higher In the control group, the difference was statistically significant(χ^2=6.061,P =0.014).Conclusion The effect of internal heat acupuncture combined with shock wave in the treatment of low back myofasciitis is better than that of extracorporeal shock wave therapy alone. At the same time, it can lower serum SP and TNF-α levels, which has a good clinical application prospect.