调督理筋针法联合腰部核心肌力训练对腰椎间盘突出症患者腰椎功能、腰背肌力学效应和血清炎性因子的影响

Effects of Tiaodu Lijin Acupuncture Combined with Lumbar Core Muscle Strength Training on Lumbar Function,Lumbar Back Muscle Mechanical Effect and Serum Inflammatory Factors in Patients with Lumbar Disc Herniation

目的:探讨调督理筋针法联合腰部核心肌力训练对腰椎间盘突出症患者腰椎功能、腰背肌力学效应和血清炎性因子的影响。方法:选取湖南中医药大学第二附属医院于2020年6月-2022年3月期间收治的120例腰椎间盘突出症(LDH)患者,按照随机数字表法将患者分为对照组(腰部核心肌力训练,60例)和观察组(调督理筋针法联合腰部核心肌力训练,60例)。对比两组疗效、疼痛及腰椎功能指标、腰背肌力学效应和血清炎性因子的情况。结果:与对照组相比,观察组临床总有效率更高(P<0.05)。观察组治疗15 d后日本矫形外科学会(JOA)评分高于对照组,疼痛视觉模拟评分(VAS)评分低于对照组(P<0.05)。观察组治疗15 d后屈曲过程表面肌电值(AEMG)、屈伸松弛比(FRR)低于对照组,伸直过程AEMG高于对照组(P<0.05)。观察组治疗15 d后白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、C反应蛋白(CRP)低于对照组(P<0.05)。结论:腰部核心肌力训练联合调督理筋针法治疗LDH,可减轻疼痛症状,改善腰背肌力学效应并降低血清炎性因子水平,促进腰椎功能恢复。

Objective:To investigate the effect of Tiaodu Lijin acupuncture combined with lumbar core muscle strength training on lumbar function,lumbar back muscle mechanical effect and serum inflammatory factors in patients with lumbar disc herniation.Methods:120 patients with Lumbar discheriation(LDH)who were admitted to The Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine from June 2020 to March 2022 were selected,and they were randomly divided into control group(lumbar core muscle strength training,60 cases)and observation group(Tiaodu Lijin acupuncture combined with lumbar core muscle strength training,60 cases).The curative effect,pain and lumbar function indexes,lumbar back muscle mechanical effect and serum inflammatory factors were compared between the two groups.Results:Compared with the control group,the total clinical effective rate of the observation group was higher(P<0.05).15 d after treatment,the Japanese Orthopaedic Association(JOA)score of the observation group was higher than that of the control group,and the visual analogue scale(VAS)score was lower than that of the control group(P<0.05).15d after treatment,the buckling process averaged electromyography(AEMG),flexion/extension relaxation ratio(FRR)of the observation group were lower than those of the control group,and the straightening process AEMG were higher than those of the control group(P<0.05).15 d after treatment,the interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and C-reactive protein(CRP)of the observation group were lower than those of the control group(P<0.05).Conclusion:Tiaodu Lijin acupuncture combined with lumbar core muscle strength training in the treatment of LDH can reduce pain symptoms,improve the lumbar back muscle mechanical effect,reduce the level of serum inflammatory factors,and promote the recovery of lumbar function.