温针灸联合阴络放血治疗腰椎间盘突出症临床研究

Clinical Study on the Treatment of Lumbar Disc Herniation with Warming Needle Moxibustion Combined with Yin-Collateral Bloodletting

目的:观察温针灸联合阴络放血治疗腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效。方法:将102例行椎间孔镜手术的LDH患者按照随机数字表法分为常规组与治疗组,每组各51例。常规组术后给予常规康复治疗,治疗组在常规组治疗的基础上加用温针灸联合阴络放血治疗。比较两组患者的临床疗效及治疗前后日本骨科协会(Japanese orthopaedic association,JOA)评分、改良口述分级评分(verbal rating scale,VRS)、血清内皮素(endothelin,ET)、降钙素基因相关肽(calcitonin gene related protein,CGRP)、5-羟色胺(5-hydroxytryptamine,5-HT)水平、椎间隙高度、腰椎矢状位Cobb角变化情况。结果:治疗组有效率为94.12%,常规组有效率为80.39%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后JOA各维度评分高于本组治疗前,且治疗后治疗组高于常规组,差异具有统计学意义(P<0.05)。两组患者后VRS评分低于本组治疗前,且治疗后治疗组低于常规组,差异具有统计学意义(P<0.05)。两组患者治疗后血清ET、5-HT水平低于治疗前,CGRP高于治疗前,且治疗后组间比较,差异均有统计学意义(P<0.05)。两组患者治疗后椎间隙高度、腰椎矢状位Cobb角高于本组治疗前,差异具有统计学意义(P<0.05),治疗后治疗组高于常规组,但差异无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:温针灸联合阴络放血治疗椎间孔镜术后LDH,可改善患者的临床症状及腰椎功能,缓解疼痛程度,并下可调血清ET、5-HT水平,上调血清β-EP、CGRP水平。

Objective:To observe the clinical efficacy of warming needle moxibustion combined with yin-collateral bloodletting on lumbar disc herniation(LDH).Methods:A total of 102 LDH patients who underwent intervertebral foramen endoscopy surgery were randomly divided into the conventional group and the treatment group according to random number table method,with 51 cases in each group.The conventional group was given routine rehabilitation treatment after operation,while the treatment group was given warming needle moxibustion combined with yin-collateral bloodletting treatment on the basis of the conventional group.The clinical efficacy,and the changes of the Japanese Orthopaedic Association(JOA)score,improved oral rating scale(VRS),serum endothelin(ET),calcitonin gene related protein(CGRP),5-hydroxytryptamine(5-HT)level,intervertebral space height,and lumbar sagittal Cobb angle of the two groups before and after treatment were compared.Results:The effective rate of the treatment group was 94.12%,while that of the conventional group was 80.39%.The difference wafter treatmentas statistically significant(P<0.05).After treatment,the JOA scores in all dimensions of the two groups were higher than those of the same group before treatment,and the treatment group's were higher than those of the conventional group,and all the differences were statistically significant(P<0.05);The VRS scores of the two groups were lower than those of the same group before treatment,and the treatment group's were lower than those of the conventional group,and all the differences were statistically significant(P<0.05);The levels of serum ET and 5-HT in the two groups were lower than those of the same group before treatment,while CGRP was higher than that before treatment,and all the differences were statistically significant(P<0.05);The height of the intervertebral space and the Cobb angle of the lumbar spine in the sagittal position of the two groups of patients were higher than those of the same group before treatment,and all the differences were statistically significant(P<0.05);the treatment group's was higher than that of the conventional group,but the difference was not statistically significant(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Warming needle moxibustion combined with yin-collateral bloodletting can improve the clinical symptoms and lumbar function of patients with LDH after intervertebral foramen endoscopy surgery,relieve pain,down-regulate serum ET and 5-HT levels,and up-regulate serumβ-EP and CGRP levels.