穴位针刺疗法联合腰背肌锻炼在慢性非特异性下腰痛患者中的应用

Application of Acupoint Acupuncture Combined with Low Back Muscle Exercise in Patients with Chronic Nonspecific Low Back Pain

目的探讨穴位针刺疗法联合腰背肌锻炼对慢性非特异性下腰痛(CNLBP)患者的临床应用价值,并分析干预前后腰椎各活动度情况。方法选择2019年6月至2021年6月在河南中医药大学第一附属医院康复中心门诊接受治疗的92例CNLBP患者作为研究对象,采用随机数表法分为两组,各46例。两组患者均参照《中国急/慢性非特异性腰背痛诊疗专家共识》接受常规治疗,对照组在此基础上接受腰背肌锻炼,观察组接受穴位针刺疗法联合腰背肌锻炼。比较两组干预前、干预3个月时表面肌电中位频率的斜率(MFs)、腰椎各活动度(屈距、后伸、左侧屈、右侧屈、右侧屈、左旋转、右旋转)及功能障碍[Oswestr功能障碍指数(ODI)]情况。结果干预3个月,两组MFs高于干预前,且观察组高于对照组(P<0.05);干预3个月,两组前屈距离长于干预前,后伸、左侧屈、右侧屈、右侧屈、左旋转、右旋转角度大于干预前,且观察组前屈距离长于对照组,后伸、左侧屈、右侧屈、右侧屈、左旋转、右旋转角度大于对照组(P<0.05);干预3个月,两组ODI评分均低于干预前,且观察组低于对照组(P<0.05)。结论穴位针刺疗法联合腰背肌锻炼能够有效缓解腰部肌肉疲劳,提高CNLBP患者腰椎各活动度,改善功能障碍情况。

Objective To explore the clinical application value of acupoint acupuncture combined with low back muscle exercise in patients with chronic nonspecific low back pain(CNLBP),and to analyze the range of motion of lumbar spine before and after intervention.Methods A total of 92 patients with CNLBP treated in the Rehabilitation Center of the First Affiliated Hospital of Henan University of Traditional Medicine from June 2019 to June 2021 were selected as the research subjects.The patients were divided into two groups by a random number table method,46 cases in each group.Both groups of patients took routine treatment according to the Consensus of Chinese Experts on the Diagnosis and Treatment of Acute/Chronic Nonspecific Low Back Pain,on this basis,the control group took low back muscle exercise,and the observation group took acupoint acupuncture combined with low back muscle exercise.The slope of surface electromygraphy median frequency(MFs),lumbar mobility(flexion distance,extension,left flexion,right flexion,right flexion,left rotation and right rotation)and dysfunction[Oswestr dysfunction index(ODI)]were compared between the two groups before and 3 months after intervention.Results After 3 months of intervention,MFs in both groups was higher than that before intervention,and the observation group was higher with the comparison of the control group(P<0.05).After 3 months of intervention,the flexion distance of both groups was longer than that before intervention,and the angles of extension,left flexion,right flexion,right flexion,left rotation and right rotation were greater than those before intervention(P<0.05).The flexion distance of the observation group was longer than that of the control group,and the angles of extension,left flexion,right flexion,right rotation,left rotation and right rotation were greater than those of the control group(P<0.05).After 3 months of intervention,the ODI scores of both groups were lower than those before intervention,and the observation group was lower with the comparison of the control group(P<0.05).Conclusion Acupoint acupuncture combined with low back muscle exercise can effectively alleviate lumbar muscle fatigue,improve lumbar mobility and improve dysfunction in patients with CNLBP.