循经针刺联合身痛逐瘀汤治疗腰椎间盘突出症气滞血瘀证疗效研究

Clinical study on meridian acupuncture combined with Shentong Zhuyu decoction in treatment of lumbar disc herniation

目的:观察循经针刺联合身痛逐瘀汤治疗腰椎间盘突出症(LDH)气滞血瘀证的临床疗效。方法:选择LDH气滞血瘀证患者110例,按照随机数字表法分为治疗组(55例)和对照组(55例)。对照组予以中药身痛逐瘀汤口服,治疗组在对照组用药基础上予以循经针刺,两组疗程均为8周。比较两组治疗前后疼痛视觉模拟评分(VAS)、日本骨科协会评估治疗分数(JOA)、Oswestry功能障碍指数(ODI)评分、总有效率以及血清炎症因子水平、致痛物质水平、凋亡相关因子水平。结果:治疗后,与对照组比较,治疗组VAS、ODI评分和血清IL-1β、TNF-α、SP、NPY、Caspase-3、TFAR19、Apaf-1水平均降低(P<0.01),JOA评分升高(P<0.01)。治疗组总有效率高于对照组(P<0.05)。结论:循经针刺联合身痛逐瘀汤可降低血清Caspase-3、TFAR19、Apaf-1水平,减轻炎症反应,减少致痛物质分泌,缓解疼痛,改善腰椎功能。

Objective:To observe effect of meridian acupuncture combined with Shentong Zhuyu decoction on lumbar disc herniation(LDH)Qizhi Xueyu syndrome.Methods:110 LDH patients with Qizhi Xueyu syndrome were randomly divided into treatment group(55 cases)and control group(55 cases).The control group were treated with Shentong Zhuyu decoction,and the treatment group treated with meridian acupuncture on the basis of the control group.The course of treatment was for eight weeks.Before and after treatment,Visual analogue scale(VAS),Japanese orthopaedic association assessment treatment score(JOA),oswestry dysfunction index(ODI)score,total effective rates were compared between the two groups.Before and after treatment,the levels of serum inflammatory factor,pain causing substances,apoptosis related factors were compared between the two groups.Results:After treatment,compared with the control group,VAS,ODI score and serum IL-1β,TNF-α,SP,NPY,Caspase-3,TFAR19,Apaf-1 levels in the treatment group decreased(P<0.01),JOA score increased(P<0.01).The total effective rate in the treatment group was higher than that in the control group(P<0.05).Conclusion:Acupuncture combined with Shentong Zhuyu decoction can reduce the levels of serum Caspase-3,TFAR19 and Apaf-1,reduce inflammatory reaction,reduce secretion of pain substances,relieve pain,improve lumbar function.