超短波联合夹脊穴针刺治疗寒湿证腰椎间盘突出症的疗效评价

Therapeutic effect evaluation of ultrashort wave combined with Jiaji points acupuncture on lumbar disc herniation of cold dampness syndrome

目的探究超短波联合夹脊穴针刺治疗寒湿证腰椎间盘突出症(LDH)的疗效及对患者血清疼痛介质及血液循环的影响。方法选择2019年12月至2021年10月于南阳市中医院就诊治疗的180例寒湿证LDH患者,根据治疗方法不同,分为对照组(超短波)、观察组(超短波、夹脊穴针刺),各90例,并比较两组治疗临床疗效,及治疗前、治疗后14 d、治疗后21 d中医证候积分、VAS评分、疼痛介质[5-羟色胺(5-HT)、前列腺素E2(PGE2)、神经生长因子(NGF)]、血液流变学指标(纤维蛋白原、血浆黏度、红细胞聚集指数)、炎性因子[白细胞介素(IL)-17、肿瘤坏死因子(TNF)-α、基质金属蛋白酶(MMP)-3、IL-6]。结果治疗后观察组总有效率92.22%高于对照组80.00%(P<0.05);治疗后14 d、治疗后21 d观察组中医证候积分、VAS评分均低于对照组(P<0.05);治疗后14 d、治疗后21 d观察组5-HT、PGE2、NGF均低于对照组(P<0.05);治疗后14 d、治疗后21 d观察组纤维蛋白原、血浆黏度、红细胞聚集指数均低于对照组(P<0.05);治疗后14 d、治疗后21 d观察组IL-17、TNF-α、MMP-3、IL-6表达水平均低于对照组(P<0.05)。结论超短波联合夹脊穴针刺治疗寒湿证LDH效果明显,且能改善患者血清疼痛介质及血液循环,减轻炎性因子表达。

Objective To explore the therapeutic effect of ultrashort wave combined with Jiaji acupuncture on lumbar disc herniation(LDH)of cold dampness syndrome and its influence on serum pain medium and blood circulation.Methods 180 cases of cold dampness syndrome LDH patients treated in Nanyang Traditional Chinese Medicine Hospital from December 2019 to October 2021 were selected and divided into control group(ultrashort wave)and observation group(ultrashort wave,Jiaji points acupuncture)according to different treatment methods,with90 cases each.The clinical effects of the two groups were compared,as well as TCM syndrome scores,VAS scores,pain mediators[5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2),nerve growth factor(NGF)],blood rheology indicators(fibrinogen,plasma viscosity,erythrocyte aggregation index),inflammatory factors[interleukin(IL)-17,tumor necrosis factor(TNF)-α,Matrix metalloproteinase(MMP)-3,IL-6]before treatment,14 days after treatment,and 21days after treatment.Results After treatment,the total effective rate of the observation group was 92.22%higher than that of the control group 80.00%(P<0.05);The TCM syndrome score and VAS score in the observation group were lower than those in the control group 14 days and 21 days after treatment(P<0.05);5-HT,PGE2 and NGF in the observation group were lower than those in the control group 14 days and 21 days after treatment(P<0.05);The fibrinogen,plasma viscosity and erythrocyte aggregation index in the observation group were lower than those in the control group 14 days and 21 days after treatment(P<0.05);The expression levels of IL-17,TNF-α,MMP-3,IL-6in the observation group 14 days and 21 days after treatment were lower than those in the control group(P<0.05).Conclusion Ultrashort wave combined with Jiaji points acupuncture has obvious effect on cold dampness syndrome LDH,and can improve the patient’s serum pain medium and blood circulation,and reduce the expression of inflammatory factors.