腕踝针联合平衡罐治疗急性腰扭伤临床研究

Clinical Study on Wrist-Ankle Acupuncture Combined with Balance Cupping for Acute Lumbar Sprain

目的:观察腕踝针联合平衡罐治疗急性腰扭伤的临床疗效。方法:将124例急性腰扭伤患者按随机数字表法分为对照组和观察组各62例。对照组给予常规西药治疗,观察组给予腕踝针联合平衡罐治疗,连续治疗7 d。比较2组临床效果、视觉模拟评分法(VAS)评分、腰椎活动度、腰椎功能JOA评分,测定血清血栓素2 (TXB2)、环氧合酶(COX-2)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、肿瘤坏死因子-α (TNF-α)水平。结果:观察组总有效率为91.94%,高于对照组79.03%,差异有统计学意义(P<0.05)。治疗后,2组腰痛VAS评分较治疗前降低(P<0.05),且观察组腰痛VAS评分低于对照组(P<0.05)。治疗后,2组腰椎右旋、左旋、前屈、后伸活动度较治疗前提高(P<0.05),且观察组腰椎右旋、左旋、前屈、后伸活动度高于对照组(P<0.05)。治疗后,2组日常活动受限度、临床体征、自觉症状评分较治疗前升高(P<0.05),且观察组各项评分高于对照组(P<0.05)。治疗后,2组血清TXB2、COX-2、GM-CSF、TNF-α水平较治疗前降低(P<0.05),且观察组血清TXB2、COX-2、GM-CSF、TNF-α水平低于对照组(P<0.05)。结论:腕踝针联合平衡罐治疗急性腰扭伤疗效确切,可显著镇痛,改善腰部活动度,提高腰椎功能,起效可能与调控血清中TXB2、COX-2、GM-CSF、TNF-α等相关因子含量以改善血液微循环、抗炎有关。

Objective:To observe the clinical effect of wrist-ankle acupuncture combined with balance cupping on acute lumbar sprain. Methods:A total of 124 patients with acute lumbar sprain were divided into the control group and the observation group according to the random number table method,with 62 cases in each group. The control group was given routine western medicine, and the observation group was treated with wrist-ankle acupuncture combined with balance cupping. The two groups were treated for7 days. The clinical effects,scores of Visual Analogue Scale(VAS) for pain,lumbar mobility,and scores of Japanese Orthopaedic Association(JOA) for the lumbar function in the two groups were compared. The levels of serum thromboxane B2(TXB2),cyclooxygenase-2(COX-2),granulocyte-macrophage colonystimulating factor(GM-CSF) and tumor necrosis factor-α(TNF-α) in both groups were measured. Results:The total effective rate was 91.94% in the observation group,higher than that of 79.03% in the control group,the difference being significant(P<0.05). After treatment,the scores of VAS for pain in the two groups were decreased when compared with those before treatment(P<0.05),and the score of VAS for pain in the observation group was lower than that in the control group(P<0.05). After treatment, the lumbar mobility of right rotation,left rotation,forward flexion and backward extension in the two groups were increased when compared with that before treatment(P<0.05), and the lumbar mobility of right rotation,left rotation,forward flexion and backward extension in the observation group was higher than that in the control group(P<0.05). After treatment,the scores of limitation of daily activities,clinical signs and subjective symptoms in both groups were increased when compared with those before treatment(P<0.05),and the above three scores in the observation group were higher than those in the control group(P<0.05). After treatment,the levels of serum TXB2,COX-2,GM-CSF and TNF-α in both groups were decreased when compared with those before treatment(P<0.05), and the above four levels in the observation group were lower than those in the control group(P<0.05). Conclusion:The therapy of wristankle acupuncture combined with balance cupping has a definite curative effect on acute lumbar sprain,which can significantly mitigate the pain,improve the lumbar mobility,enhance the lumbar function,and may be related to the improvement of microcirculation of blood and anti-inflammation by regulating the contents of involved factors in serum,including TXB2,COX-2,GM-CSF and TNF-α.