针刺夹脊穴结合腰椎牵引治疗腰椎间盘突出症疗效及对腰椎功能、炎性因子的影响

Curative Effect of Acupuncture at Jiaji Acupoint Combined with Lumbar Traction in Treatment of Lumbar Disc Herniation and Effects on Lumbar Vertebral Function and Inflammatory Factors

目的:探讨针刺夹脊穴结合腰椎牵引治疗腰椎间盘突出症的临床疗效及对患者腰椎功能、炎性因子的影响。方法:选取103例腰椎间盘突出症患者作为研究对象,按随机数字表法将其分成对照组51例与治疗组52例。对照组给予腰椎牵引治疗;治疗组在对照组基础上加针刺夹脊穴治疗。对比两组治疗前后疼痛视觉模拟评分(visual analogue scale,VAS)、日本骨科协会下腰疼功能评价(Japanese orthopaedic association,JOA)、腰椎功能障碍指数(oswestry disability index,ODI)评分、中医证候积分和腰椎活动度,各炎性因子C反应蛋白、白介素-6、肿瘤坏死因子-α水平,并分析两组临床疗效。结果:相比对照组,治疗组有效率更高(96.15%vs 82.35%)(P<0.05);治疗前两组VAS评分、JOA和ODI评分比较无差异(P>0.05);治疗后两组VAS、ODI评分均降低、JOA评分升高,且相比对照组,治疗组治疗后VAS、ODI评分更低、JOA评分更高(P<0.05);治疗后两组中医证候积分均降低、腰椎活动度均升高(P<0.05),且相比对照组,治疗组治疗后中医证候积分更低,腰椎活动度更高(P<0.05);治疗后两组各炎性因子水平均降低,且相比对照组,治疗组治疗后血清中C反应蛋白、白细胞介素-6、肿瘤坏死因子-α水平更低(P<0.05)。结论:针对腰椎间盘突出症患者采取针刺夹脊穴结合腰椎牵引治疗能获得较佳的临床疗效,能降低患者疼痛,改善腰椎功能和症状,提高腰椎活动度,抑制炎性因子表达,值得应用及推广。

Objective:To investigate the clinical efficacy of acupuncture at Jiaji acupoint combined with lumbar traction in the treatment of lumbar disc herniation and its effect on lumbar spine function and inflammatory factors.Methods:A total of 103 patients with lumbar intervertebral disc herniation who were treated in our hospital from January 2017 to July 2018 were selected as the research objects,and they were divided into a control group of 51 cases and a treatment group of 52 cases according to the random number table method.The control group was given lumbar traction therapy;the treatment group was given acupuncture at Jiaji acupoint on the basis of the control group.The pain visual analogue scale(VAS),Japanese Orthopaedic Association lower back pain function evaluation(JOA),Oswestry disability index(ODI)score,TCM symptom score and lumbar spine mobility,the levels of various inflammatory factors C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and the clinical efficacy of the two groups was analyzed.Results:Compared with the control group,the total effective rate of the treatment group was higher(96.15%vs 82.35%)(P<0.05);there was no difference in the VAS,JOA and ODI scores between the two groups before treatment(P>0.05);Compared with the control group,the VAS and ODI scores in the treatment group were lower,and the JOA scores were higher in the treatment group(P<0.05).The mobility of the lumbar spine was increased(P<0.05),and compared with the control group,the TCM symptom score was lower in the treatment group after treatment,and the mobility of the lumbar spine was higher(P<0.05);the levels of inflammatory factors in the two groups were decreased after treatment,and compared with the control group,the levels of CRP,IL-6 and TNF-αin the treatment group were lower after treatment(P<0.05).Conclusion:Acupuncture at Jiaji acupoint combined with lumbar traction therapy for patients with lumbar disc herniation can achieve better clinical curative effect,can reduce pain,improve lumbar spine function and symptoms,improve lumbar spine mobility,and inhibit the expression of inflammatory factors,which is worthy of application and promotion.