Influence of herbal cake-partitioned moxibustion on lumbar functions and inflammatory factors in patients with lumbar disc herniation due to kidney deficiency and blood stasis

隔药饼灸对肾虚血瘀腰椎间盘突出症腰椎功能及炎症因子的影响

Objective To observe the efficacy of herbal cake-partitioned moxibustion for lumbar disc herniation(LDH)due to kidney deficiency and blood stasis and observe the influence of this method on lumbar functions and inflammatory factors in patients with this condition.Methods A total of 120 LDH patients who met the inclusion criteria were randomly divided into three groups,including a herbal cake-partitioned moxibustion group,a flour cake-partitioned moxibustion group,and a Western medication group,with 40 patients in each group.The patients in the Western medication group were treated with diflunisal tablets,0.5 g per dose,2 doses a day.Those in the herbal cake-partitioned moxibustion group were treated with additional herbal cake-partitioned moxibustion group at Back-Shu Points and Jiaji(EX-B2)Points once a day.Those in the flour cake-partitioned moxibustion group were treated with the same methods as in the herbal cake-partitioned moxibustion group,except that the herbal cake was replaced by a flour cake.All the patients were treated for 10 d.After treatment,the scores of the visual analog scale(VAS)and Japanese Orthopaedic Association(JOA)and the changes of the interleukin(IL)-6,tumor necrosis factor(TNF)-α,and substance P(SP)levels were observed,and the efficacy was evaluated.Results After treatment,the VAS score and the levels of IL-6,TNF-α,and SP were lower than those before treatment,and the JOA score was higher than that before treatment in the three groups,indicating intra-group statistical significance(P<0.05).The VAS score and the levels of IL-6,TNF-α,and SP of the herbal cake-partitioned moxibustion group were lower than those of the flour cake-partitioned moxibustion group and the Western medication group,while the JOA score of the herbal cake-partitioned moxibustion group was higher than that of the other two groups,indicating inter-group statistical significance(P<0.05).The total effective rate of the herbal cake-partitioned moxibustion group was 92.5%,higher than that of the flour cake-partitioned moxibustion group(80.0%)and the Western medication group(72.5%),indicating inter-group statistical significance(P<0.05).Conclusion On the basis of Western oral medication,additional herbal cake-partitioned moxibustion can alleviate the pain and improve the lumbar functions in patients with LDH due to kidney deficiency and blood stasis.The efficacy of the integrated method is better than that of either flour cake-partitioned moxibustion or Western medication alone,which may be related to the reduction of serum inflammatory factors.

目的观察隔药饼灸治疗肾虚血瘀腰椎间盘突出症(LDH)的临床疗效及其对腰椎功能和炎症因子的影响.方法将120例符合纳入标准的LDH患者按随机数字表法分为隔药饼灸组、隔面饼灸组和西药组,每组40例.西药组予口服二氟尼柳片,0.5 g/次,2次/d.隔药饼灸组在此基础上加用隔药饼灸背俞穴和夹脊穴,1次/d.隔面饼灸组操作同隔药饼灸组,仅将药饼换成面饼.三组均治疗10 d.治疗后观察视觉模拟量表(VAS)评分、日本骨科协会(JOA)评分及血清白介素(IL)-6、肿瘤坏死因子(TNF)-α及P物质水平变化,并评价临床疗效.结果治疗后,三组患者VAS评分,血清IL-6、TNF-α及P物质水平均较本组治疗前下降,JOA评分均较本组治疗前升高,组内差异均有统计学意义(P<0.05).隔药饼灸组VAS评分及血清IL-6、TNF-α及P物质水平低于隔面饼灸组及西药组,而JOA评分高于隔面饼灸组及西药组,组间差异均有统计学意义(P<0.05).隔药饼灸组的总有效率为92.5%,高于隔面饼灸组的80.0%和西药组的72.5%,组间差异均有统计学意义(P<0.05).结论在口服西药基础上加用隔药饼灸能减轻肾虚血瘀LDH患者疼痛,改善腰椎功能,疗效优于隔面饼灸和单独西药治疗,其作用机制可能与降低血清炎症因子水平有关.