针刺激痛点联合威伐光照射治疗产后腰痛的疗效

Curative effect of trigger point acupuncture combined with WIRA irradiation in treatment of postpartum lumbar pain

目的观察针刺激痛点联合威伐光照射治疗产后腰痛的疗效。方法选取该院2017年11月-2019年12月收治的120例产后腰痛患者,采用随机数字表法分为两组各60例。对照组给予威伐光照射治疗,观察组给予针刺激痛点联合威伐光照射治疗,比较两组腰痛程度与腰部功能障碍程度、疗效及血清6-酮前列腺素F1α(6-Keto-PGF1α)、血栓素2 (TXB2)、白细胞介素-1β(IL-1β)、降钙素基因相关肽(CGRP)水平及乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌型肌酸激酶同工酶(CKMM)水平。结果治疗后,两组疼痛视觉模拟评分法(VAS)评分减少,日本骨科协会评估治疗分数(JOA)评分增加,且观察组VAS评分低于对照组,JOA评分高于对照组(均P<0.05);观察组总有效率为96.67%,高于对照组的85.00%(P<0.05);治疗后及两组血清6-Keto-PGF1α水平增加,TXB2、IL-1β、CGRP水平降低,且观察组6-Keto-PGF1α水平高于对照组,TXB2、IL-1β及CGRP水平低于对照组(均P<0.05);治疗后,两组血清LDH、CK、CK-MM2、CK-MM3水平及CK-MM3/CK-MM1均较治疗前降低,CK-MM均较治疗前提升,且观察组血清LDH、CK、CK-MM2、CK-MM3水平及CK-MM3/CK-MM1均低于对照组,CK-MM高于对照组(均P<0.05)。结论针刺激痛点联合威伐光照射治疗产后腰痛效果确切,可明显减轻腰痛程度与腰部功能障碍程度,其机制可能与上调血清6-Keto-PGF1α、CK-MM水平,并下调血清TXB2、IL-1β、CGRP、LDH及CK水平有关。

Objective To observe the curative effect of trigger point acupuncture combined with WIRA irradiation in treatment of postpartum lumbar pain. Methods From November 2017 to December 2019,120 patients with postpartum lumbar pain treated in the Fourth Central Hospital of Tianjin were selected and divided into two groups according to random number table,60 cases in each group. The patients in control group were treated by WIRA irradiation,the patients in observation group were treated by trigger point acupuncture combined with WIRA irradiation. The degrees of postpartum lumbar pain and lumbar dysfunction,curative effects,the levels of serum 6-Keto-PGF1α,thromboxane 2 (TXB2),interleukin-1β (IL-1β),calcitonin gene-related peptide (CGRP),lactic dehydrogenase (LDH),creatine kinase (CK),creatine kinase isoenzyme (CK-MM) in the two groups were compared. Results After treatment,VAS scores in the two groups decreased,JOA scores increased,VAS score in observation group was lower than that in control group,JOA score in observation group was higher than that in control group (P<0. 05). The total effective rate in observation group was 96. 67%,which was statistically significantly higher than that in control group (85. 00%). After treatment,the levels of serum 6-Keto-PGF1α in the two groups increased,the levels of serum TXB2,IL-1β,and CGRP decreased,serum 6-Keto-PGF1α level in observation group was higher than that in control group,the levels of serum TXB2,IL-1β,and CGRP were lower than those in control group (P<0. 05). After treatment,the levels of serum LDH,CK,CK-MM2,CK-MM3,and CK-MM3/CK-MM1 were lower than those before treatment,CK-MM level was higher than that before treatment,the levels of LDH,CK,CK-MM2,CK-MM3,and CK-MM3/CK-MM1 in observation group were lower than those in control group,CK-MM level was higher than that in control group (P<0. 05). Conclusion The curative effect of trigger point acupuncture combined with WIRA irradiation in treatment of postpartum lumbar pain is significant,the therapy can significantly relieve the degrees of postpartum lumbar pain and lumbar dysfunction,which may be correlated with up-regulation of serum 6-Keto-PGF1α and CK-MM levels and down-regulation of serum TXB2,IL-1β,CGRP,LDH,CK levels.