不同针刺时间间隔治疗黄韧带肥厚引起的腰椎狭窄患者效果比较研究

Efficacy Comparison of Acupuncture in Lumbar Spinal Stenosis Patients with the Ligamentum Flavum Hypertrophic Fibrosis at Different Time Intervals

目的:比较不同针刺时间间隔治疗黄韧带增生肥厚引起的腰椎狭窄患者的效果。方法:采用便利抽样法,选择行保守治疗的腰椎狭窄患者129例,采用随机数字表法将患者分为每日1次组43例,每日接受针刺治疗1次,每周5次,两周之间休息2d;隔日1次组43例,隔日接受针刺治疗1次,每周3次,两周之间休息2d;每3日1次组43例,每3日接受针刺治疗1次,每周2次,两周之间休息1d。4周为1个疗程,共治疗3个疗程。分别于治疗前及治疗1、2、3个疗程后,采用Oswestry功能障碍指数(ODI)检测腰椎功能改善状况,以及低切、中切、高切全血黏度测定,另采用酶联免疫吸附法检测纤维蛋白原(FIB)。结果:治疗1个疗程、2个疗程及3个疗程时,每日1次组和隔日1次组ODI评分低于每3日1次组(P<0.05),而每日1次组和隔日1次组ODI评分比较,差异无统计学意义(P>0.05)。治疗前和治疗1个疗程后,3组各血液流变学相关指标比较,差异无统计学意义(P>0.05);治疗2个疗程和3个疗程时,每日1次组和隔日1次组全血低切黏度、中切黏度、高切黏度及FIB低于每3日1次组(P<0.05),而每日1次组和隔日1次组各血液流变学相关指标比较,差异无统计学意义(P>0.05)。结论:每日针刺、隔日针刺治疗黄韧带增生肥厚引起的腰椎狭窄效果优于每3日1次,在保证疗效及安全性的前提下,针刺治疗黄韧带增生肥厚引起的腰椎狭窄的优势间隔时间为隔日1次。

Objective:To compare the effectiveness time of acupuncture in lumbar spinal stenosis patients with the ligamentum flavum hypertrophic fibrosis at different time intervals.Methods:A total of 129 lumbar spinal stenosis patients who receive conservative treatment were selected,and all subjects were divided into the once a day group(n=43)who received acupuncture treatment once a day,five times a week,and rested for 2 days between two weeks;the once every other day group(n=43)who received acupuncture treatment once every other day,three times a week,and rested for 2 days between two weeks;the once every 3 days group(n=43)who received acupuncture treatment once every 3 days,twice a week,and rested for 1 days between two weeks.The 4 weeks were a treatment course,a total of 3 courses.The lumbar function and whole blood viscosity were tested and compared,and the FIB tested by ELISA before treatment,and after the 1,2,3 treatment course.Results:After 1,2,3 treatment course,the GDI score were lower in the once a day group and in the once every other day group than that in the once every 3 days group(P<0.05),the differences were not statistically significant on the ODI score between the once a day group and the once every other day group(P>0.05).There was no statistically significant difference in the comparison of each blood rheology-related index between the 3 groups before and after 1 course of treatment(P>0.05).After 2 and 3 treatment course,the value of whole blood low-cut viscosity,medium-cut viscosity,high-cut viscosity and FIB in the once a day group and in the once every other day group were lower than those in the once every 3 days group(P<0.05),the differences were not statistically significant on each blood rheology related index between the once a day group and the once every other day group(P>0.05).Conclusion:The effect of the once a day and the once every other day on lumbar spinal stenosis caused by ligamentum flavum hypertrophic fibrosis is better than once every 3 days,on the premise of the efficacy and safety,the dominant interval time of acupuncture in lumbar spinal stenosis patients with the ligamentum flavum hypertrophic fibrosis is once every other day.