针灸联合中药熏蒸治疗急性期腰椎间盘突出症疗效观察

Efficacy of Acupuncture Combined with Chinese Medicine Fumigation in the Treatment of Acute Stage Lumbar Disc Herniation

目的:探讨针灸联合中药熏蒸法治疗急性期腰椎间盘突出症的临床疗效。方法:选取2019年1月—2020年6月河南中医药大学第一附属医院收治的68例急性期腰椎间盘突出症患者作为研究对象,采用随机数表法将其分为观察组与对照组,每组各34例。对照组患者接受针灸治疗,观察组患者在针灸治疗的基础上联合中药熏蒸治疗,对比两组患者治疗前后症状改善情况及血清炎性因子水平。结果:治疗前,两组患者Mc Gill疼痛询问量表(MMQ)评分中疼痛感觉评分(PRIA)、疼痛情绪评分(PRIS)、疼痛总分(PRIT)、视觉模拟评分法(VAS)以及现有疼痛强度(PPI)评分比较,差异无统计学意义(t=1.092、1.184、1.206、0.174、0.198,P>0.05);治疗后,观察组患者PRIA、PRIS、PRIT、VAS、PPI评分均明显低于对照组患者,差异有统计学意义(t=3.846、3.096、3.341、3.471、3.020,P<0.05)。治疗前,两组患者腰椎功能障碍指数(ODI)评分中疼痛、单项功能、日常生活能力以及总分比较,差异无统计学意义(t=0.971、1.052、1.174、1.030,P>0.05);治疗后,观察组患者疼痛、单项功能、日常生活能力以及总分均明显低于对照组患者,差异有统计学意义(t=3.096、4.517、4.892、5.274,P<0.05)。治疗前,两组患者血清炎性因子白细胞介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α)以及β-内啡肽(β-EP)水平比较,差异无统计学意义(t=1.546、1.069、1.274,P>0.05);治疗后,观察组患者IL-6、TNF-α水平均明显低于对照组患者,而β-EP水平明显高于对照组患者,差异有统计学意义(t=12.508、9.749、15.609,P<0.05)。治疗后,观察组患者总有效率明显高于对照组患者,差异有统计学意义(χ^(2)=6.969,P<0.05)。结论:采用针灸联合中药熏蒸法可快速、有效改善急性期腰椎间盘突出症患者剧烈腰痛症状,止痛镇痛效果理想且安全可靠,能够有效改善患者腰椎功能障碍以及局部炎性反应。

Objective:To investigate the clinical efficacy of acupuncture combined with herbal fumigation in the treatment of acute stage lumbar disc herniation.Methods:68 patients with acute stage lumbar disc herniation admitted to the hospital from January 2019 to June 2020 were selected as study subjects and were divided into observation and control groups using the random number table method,with 34 cases in each group.The control group received acupuncture treatment and the observation group was treated with acupuncture treatment combined with herbal fumigation.The improvement of symptoms and serum inflammatory factor levels before and after treatment were compared between the two groups.Results:Before treatment,there was no statistically significant difference in the pain perception score (PRIA),pain mood score (PRIS),total pain score (PRIT),visual analog scoring method (VAS),and existing pain intensity (PPI) scores when comparing the Mc Gill Pain Questioning Scale (MMQ) scores of the two groups (t=1.092,1.184,1.206,0.174,0.198,P>0.05).After treatment,the PRIA,PRIS,PRIT,VAS,and PPI scores were significantly lower in the observation group than in the control group,with statistically significant differences (t=3.846,3.096,3.341,3.471,3.020,P0.05).After treatment,pain,single function,daily living ability and total score were significantly lower in the observation group than in the control group,and the difference was statistically significant (t=3.096,4.517,4.892,5.274,P0.05).After treatment,IL-6 and TNF-α levels in the observation group were significantly lower than those in the control patients,while β-EP levels were significantly higher than those in the control group,with statistically significant differences (t=12.508,9.749,15.609,P<0.05).After treatment,the total effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant (χ^(2)=6.969,P<0.05).Conclusion:Acupuncture combined with Chinese medicine fumigation can quickly and effectively improve the symptoms of severe lumbar pain in patients with acute stage lumbar disc herniation,with ideal pain relief and analgesia,and can effectively improve the dysfunction of the lumbar spine and the local inflammatory response of patients.