现代宫廷理筋术结合经筋灸法治疗慢性非特异性下腰痛的临床研究

Clinical Efficacy of Modern Palace Tendon Manipulation Combined with Meridian Moxibustion in the Treatment of Chronic Non-Specific Low Back Pain

目的观察现代宫廷理筋术结合经筋灸法治疗慢性非特异性下腰痛(Chronic non-specific low back pain,CNLBP)的临床价值。方法选取2018年7月—2020年2月期间六安市中医院诊治的CNLBP患者82例,按随机数字表法分为对照组和研究组,每组各41例。两组患者均予以基础康复治疗,研究组加用现代宫廷理筋术结合经筋灸法治疗。治疗4周后,观察比较两组患者临床疗效、指地距离(Finger and floor dis-tance,FFD)、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、视觉模拟量表(Visual analogue scale,VAS)评分、腰背肌静、动态耐力及血清抗氧化指标[过氧化氢酶(catalase,CAT)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)]水平。结果治疗后研究组总有效率为97.37%(37/38)明显高于对照组82.05%(32/39),差异有统计学意义(P<0.05)。治疗后两组患者FFD、ODI、VAS评分均低于治疗前,差异有统计学意义(P<0.05),且研究组FFD、ODI、VAS评分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者静、动态肌耐力均高于治疗前,差异有统计学意义(P<0.05);且研究组静、动态肌耐力均高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CAT、SOD水平均高于治疗前,MDA水平均低于治疗前,差异有统计学意义(P<0.05);且研究组血清CAT、SOD水平高于对照组,MDA水平低于对照组,差异有统计学意义(P<0.05)。结论现代宫廷理筋术结合经筋灸法治疗CNLBP疗效理想,可有效减轻腰部功能障碍及腰痛症状,提升腰肌耐力,并减少氧化应激损伤,值得临床推广。

Objective To observe the clinical efficacy of modern palace tendon manipulation combined with meridian moxibustion in the treatment of chronic non-specific low back pain(CNLBP).Methods Eighty-two CNLBP patients treated in the Lu′an Hospital of Traditional Chinese Medicine during July 2018 to February 2020 were selected and assigned into a control group(n=41)and a study group(n=41)according to the random number table method.Both groups were given basic rehabilitation treatment,and modern palace tendon manipulation combined with meridian moxibustion was added to the study group.The clinical efficacy was compared between the two groups after four weeks of treatment.The Finger-to-Floor Distance(FFD),Oswestry Disability Index(ODI)score,Visual Analogue Scale(VAS)score,lumbar back muscle endurance(static and dynamic),and serum antioxidant indexes[catalase(CAT),superoxide dismutase(SOD),and malondialdehyde(MDA)]were compared between before and after treatment and between the two groups.Results The study group had higher total effective rate[97.37%(37/38)vs.82.05%(32/39),P<0.05]than the control group.After treatment,the FFD,ODI,and VAS scores of patients in both groups declined compared those before treatment and were lower in the study group than in the control group(P<0.05).After treatment,the static and dynamic muscle endurance of both groups increased compared with those before treatment and was higher in the study group than in the control group(P<0.05).The treatments in both groups elevated the CAT and SOD levels and reduced the MDA level(P<0.05).Moreover,the study group had higher CAT and SOD levels and lower MDA level than the control group(P<0.05).Conclusion Modern palace tendon manipulation combined with meridian moxibustion can mitigate waist dysfunctionand low back pain,improve lumbar muscle endurance,and reduce oxidative damage,showing ideal effect on CNLBP and being worthy of clinical promotion.