一指禅推法联合中药热敷治疗腰椎间盘突出症的临床疗效观察

Clinical Treatment of Lumbar Intervertebral Disc Herniation by Uinone-Finger-Pushing Manipulation Combined with Chinese Medicine Hot Compress

目的 探讨一指禅推法联合中药热敷对腰椎间盘突出症所致腰腿痛患者疼痛程度及氧化应激的影响。方法 选取2019年1月—2021年6月期间安徽中医药大学附属太和中医院收治的腰椎间盘突出症所致腰腿痛患者100例,按随机数字表法分为对照组50例和观察组50例。对照组单纯给予中药热敷;观察组在此基础上加用一指禅推法治疗,1次/d。治疗2周后,观察比较两组患者临床疗效,治疗前后中医证候积分、Oswestry功能障碍指数问卷表(Oswestry Dability Index, ODI)评分、视觉模拟评分法(Visual Analogue Scale/Score, VAS)评分、氧化应激指标[血清丙二醛(Malondialdehyde, MDA)、谷胱甘肽过氧化物酶(Glutathione peroxidase, GSH-PX)、超氧化物歧化酶(Superoxide Dismutase, SOD)]的变化。结果 治疗2周后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分较对照组明显降低,差异有统计学意义(P<0.05)。治疗2周后两组患者VAS评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组VAS评分较对照组明显降低,差异有统计学意义(P<0.05)。治疗2周后两组患者ODI评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组ODI评分较对照组明显降低,差异有统计学意义(P<0.05)。治疗2周后两组患者血清MDA水平均较治疗前降低,SOD、GSH-PX水平较治疗前升高,差异有统计学意义(P<0.05);且观察组血清MDA水平均较对照组明显降低,SOD、GSH-PX水平较对照组明显升高,差异有统计学意义(P<0.05)。治疗后观察组患者临床总有效率96.00%(48/50)明显高于对照组80.00%(40/50),差异有统计学意义(P<0.05)。结论 一指禅推法联合中药热敷能明显提高腰椎间盘突出症致腰腿痛的疗效,改善临床症状,减轻疼痛程度及氧化应激状态,促进关节功能恢复。

Objective To investigate the effect of uinone-finger-pushing manipulation combined with Chinese medicine hot compress on the pain in waist and lower extremities(WLEP)induced by lumbar intervertebral disc herniation(LIDH)in patients and the oxidative stress.Methods A total of 100 patients with WLEP caused by LIDH who were treated in Taihe Hospital of Traditional Chinese Medicine,Anhui University of Chinese Medicine,from January 2019 to June 2021 were included and randomized into control group(n=50)and observation group(n=50)with the random number table method.The control group was treated only by hot compress of Chinese medicine,and the observation group by hot compress of Chinese medicine and uinone-finger-pushing manipulation(once/day).After two weeks of treatment,the clinical efficacy in the two groups was evaluated,and the changes of traditional Chinese medicine(TCM)syndrome score,Oswestry Disability Index(ODI)score,visual analog scale(VAS)score,and oxidative stress indexes[malondialdehyde(MDA),glutathione peroxidase(GSH-PX),and superoxide dismutase(SOD)]were compared between the two groups before and after treatment.Results After two weeks of treatment,the TCM syndrome score was lower than that before treatment in both groups(P<0.05),and the score was lower in the observation group than in the control group(P<0.05).After 2 weeks of treatment,the VAS score was lower than that before treatment in both groups(P<0.05),and the score in the observation group was lower than that in the control group(P < 0.05).After 2 weeks of treatment,the ODI score was lowerthan that before treatment in the two groups(P <0.05),and the score of the observation group was lower than that of thecontrol group(P <0.05).After treatment,the level of serum MDA was lower than that before treatment and the levels ofSOD and GSH - PX were higher than those before treatment in the two groups(P <0.05).In addition,the serum MDA level in the observation group was lower than that in the control group,and the levels of SOD and GSH - PX were higher thanthose in the control group(P < 0.05).After treatment,the total effective rate in the observation group was 96.00% (48/50),as compared with the 80.00%(40/50)in the control group(P <0.05).Conclusion Uinone - finger - pushing manipulation combined with Chinese medicine hot compress has remarkable effect on the WLEP caused by LIDH,which canalleviate the clinical symptoms,pain,and oxidative stress and thus promote the recovery of joint function.