针刺后溪-环跳对穴联合透灸疗法治疗寒湿型腰椎间盘突出症临床研究

Clinical Study on Acupuncture at Couplet Point of Houxi and Huantiao Combined with Penetrating Moxibustion Therapy for Lumbar Disc Herniation of Cold-Damp Type

目的:观察针刺后溪-环跳对穴联合透灸疗法治疗寒湿型腰椎间盘突出症的效果。方法:将60例寒湿型腰椎间盘突出症患者随机分为3组各20例,对照1组采用针刺后溪-环跳对穴治疗,对照2组采用单纯透灸疗法治疗,治疗组采用针刺后溪-环跳对穴联合透灸疗法治疗,3组均以10 d为1个疗程,连续治疗3个疗程。治疗前后评定日本骨科协会评估治疗分数(JOA评分)、腰部疼痛视觉模拟评分法(VAS)评分,检测血清白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)水平以及腰部红外热像图变化温度,比较3组的治疗效果,观察治疗的安全性。结果:治疗3个疗程后,治疗组总有效率95.00%,高于对照1组、对照2组的总有效率,差异均有统计学意义(P<0.05)。3组JOA评分比较,差异有统计学意义(P<0.05)。治疗组JOA评分高于其他两组,差异均有统计学意义(P<0.05);对照1组JOA评分与对照2组比较,差异无统计学意义(P>0.05)。3组腰部疼痛VAS评分比较,差异有统计学意义(P<0.05)。治疗组VAS评分低于其他两组,差异均有统计学意义(P<0.05);对照1组VAS评分与对照2组比较,差异无统计学意义(P>0.05)。3组血清IL-6、hs-CRP水平比较,差异均有统计学意义(P<0.05)。治疗组血清IL-6、hs-CRP水平均低于其他两组,差异均有统计学意义(P<0.05);对照1组血清IL-6、hs-CRP水平与对照2组比较,差异均无统计学意义(P>0.05)。3组腰部红外热像图温度值、温差值比较,差异均有统计学意义(P<0.05)。治疗组腰部红外热像图温度值、温差值均高于其他两组,差异均有统计学意义(P<0.05);对照1组腰部红外热像图温度值、温差值与对照2组比较,差异均无统计学意义(P>0.05)。3组患者在治疗过程中均未发生不良反应事件。结论:针刺后溪-环跳对穴联合透灸疗法治疗寒湿型腰椎间盘突出症具有较好的临床效果,可有效减轻炎症程度、缓解腰部疼痛,提升患者的生活质量,明显提升腰部温度,两者具有协同效应。

Objective:To observe the curative effect of acupuncture at couplet point of Houxi(SI3)and Huantiao(GB30)combined with penetrating moxibustion therapy on lumber disc herniation of cold-damp type.Methods:A total of 60 patients with lumber disc herniation of cold-damp type were randomly divided into three groups,with 20 cases in each group.The control group 1 was treated with acupuncture at the couplet point of Houxi and Huantiao,the control group 2 was treated with penetrating moxibustion therapy alone,and the treatment group was given acupuncture at couplet point of Houxi and Huantiao combined with penetrating moxibustion therapy.The three groups were treated for 3 courses of treatment,with 10 days as a course of treatment.Before and after treatment,the scores of Japanese Orthopaedic Association(JOA)for treatment evaluation,and Visual Analogue Scale(VAS)for low back pain were evaluated,and the levels of interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)as well as the changing temperature of infrared thermography of the lumbar were detected.The curative effects in the three groups were compared and the safety of treatment was observed.Results:After 3 courses of treatment,the total effective rate was 95.00%in the treatment group,higher than that in the control group 1 and the control group 2,the difference being significant(P<0.05).Comparing the JOA scores in the three groups,the difference was significant(P<0.05).The JOA score in the treatment group was higher than that in the other two groups,differences being significant(P<0.05);there was no significant difference being found in the comparison of JOA scores between the control group 1 and the control group 2(P>0.05).Comparing the VAS scores in the three groups,the difference was significant(P<0.05).The VAS score in the treatment group was lower than that in the other two groups,differences being significant(P<0.05);there was no significant difference being found in the comparison of VAS scores between the control group 1 and the control group 2(P>0.05).Comparing the levels of serum IL-6 and hs-CRP in the three groups,the difference was significant(P<0.05).The levels of serum IL-6 and hs-CRP in the treatment group were lower than those in the other two groups,differences being significant(P<0.05);there was no significant difference being found in the comparisons of levels of serum IL-6 and hs-CRP between the control group 1 and the control group 2(P>0.05).Comparing the temperature and temperature difference of infrared thermography of the lumbar in the three groups,the difference were significant(P<0.05).The temperature and temperature difference of infrared thermography of the lumbar in the treatment group were higher than those in the other two groups,differences being significant(P<0.05);there were no significant difference being found in the comparison of temperature and temperature difference of infrared thermography of the lumbar between the control group 1 and the control group 2(P>0.05).No adverse reactions occurred in the treatment of the three groups.Conclusion:Acupuncture at couplet point of Houxi and Huantiao combined with penetrating moxibustion therapy has a good clinical effect on lumber disc herniation of cold-damp type,which can effectively reduce the degree of inflammatory symptoms,mitigate the low back pain,improve the quality of life of patients,and obviously increase the temperature of the lumbar with a synergetic effect.