温针齐刺法联合穴位埋线治疗腰椎间盘突出症临床观察

Clinical observation on treating lumbar intervertebral disc herniation with needle warming and triple acupuncture combined with acupoint catgut embedding therapy

目的观察温针齐刺法联合穴位埋线治疗腰椎间盘突出症(LDH)的临床疗效。方法将100例LDH患者按照随机数字表法分为2组,治疗组50例予温针齐刺法联合穴位埋线治疗,对照组50例予常规针刺联合电针治疗。2组均治疗1个疗程后统计疗效,比较2组治疗前后疼痛视觉模拟评分(VAS)、日本骨科协会(JOA)下腰痛评分及腰椎Oswetry功能障碍指数(ODI)评分变化情况,比较2组前后血清肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)及IL-6水平变化情况,比较2组治疗前后腰部前屈、后伸及侧屈活动度变化情况。结果治疗组总有效率96.00%(48/50),对照组总有效率84.00%(42/50),治疗组疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后疼痛VAS及ODI评分均明显降低(P<0.05),JOA下腰痛评分均明显升高(P<0.05),且治疗后治疗组各项评分改善均优于对照组(P<0.05)。2组治疗后血清TNF-α、IL-1β及IL-6水平均明显低于本组治疗前(P<0.05),且治疗后治疗组各指标水平均低于对照组(P<0.05)。2组治疗后腰部前屈、后伸及侧屈活动度与本组治疗前比较均明显增加(P<0.05),且治疗组均大于对照组(P<0.05)。结论温针齐刺法联合穴位埋线治疗LDH临床疗效确切,可明显改善患者临床症状,缓解疼痛,改善腰椎功能,提高腰椎活动度,降低TNF-α、IL-1β及IL-6水平,抑制炎性反应,提高临床疗效。

Objective To observe the clinical efficacy of treating lumbar intervertebral disc herniation(LDH)with needle warming and triple acupuncture combined with acupoint catgut embedding therapy.Methods 100 LDH patients were divided into the control group(n=50)and the treatment group(n=50)according to the random number table.Patients in the treatment group were treated with needle warming and triple acupuncture combined with acupoint catgut embedding therapy while the control group with conventional acupuncture combined with electroacupuncture.Patients in the two groups were treated for one cycle.Then the treatment effects were evaluated.The scores of Visual Analogue Scale(VAS),lower back pain in Japanese Orthopaedic Association Score(JOA),and Oswestry Disability Index(ODI)in the two groups were compared before and after treatment.The ranges of motion about lumbar spine translated anteriorly,posteriorly,and laterally in the two groups were compared before and after treatment.And the levels of tumor necrosis factor-α(TNF-α),interleukin 1β(IL-1β),and interleukin 6(IL-6)in the two groups were compared before and after treatment.Results The total effective rate was 96.00%(48/50)in the treatment group while 84.00%(42/50)in the control group.So,the total effective rate in the treatment group was higher than that of the control group(P<0.05).After treatment,the scores of VAS and ODI in the two groups were obviously lower than those results before treatment(P<0.05).And the scores of lower back pain in JOA in the two groups were obvious higher than those results before treatment(P<0.05).And each post-treatment score in the treatment group was higher than that of the control group(P<0.05).After treatment,the levels of TNF-α,IL-1β,and IL-6 in the two groups were obviously lower than those results before treatment(P<0.05).And each post-treatment level in the treatment group was lower than that of the control group(P<0.05).After treatment,the ranges of motion about lumbar spine translated anteriorly,posteriorly,and laterally in the two groups were obviously more increased than those results before treatment(P<0.05).And each range of motion in the treatment group was bigger than that of the control group(P<0.05).Conclusion It has a definite curative effect of treating LDH with needle warming and triple acupuncture combined with acupoint catgut embedding therapy.And this kind of combined therapy can significantly improve the clinical symptoms,relieve the pain,improve the lumbar function,increase the range of lumbar motion,lower the levels of TNF-α,IL-1β,and IL-6,inhibit the inflammatory reactions,and enhance the clinical efficacy.