刺络放血联合“通脊”电针治疗腰椎间盘突出症坐骨神经痛疗效及对患者功能恢复和疼痛的影响

Efficacy of bloodletting combined with “Tongji” electroacupuncture on patients with lumbar disc herniation sciatica and its influence on functional recovery and pain status

目的:探究刺络放血联合“通脊”电针对腰椎间盘突出症(LDH)坐骨神经痛患者的疗效及对功能恢复和疼痛的影响。方法:选取LDH所致的坐骨神经痛气滞血瘀型患者60例,按照随机数字表法分为针刺组和电针组,各30例。电针组予常规电针治疗,针刺组予刺络放血联合“通脊”电针治疗,两组均治疗2周。比较两组临床疗效、中医症状积分、疼痛视觉模拟评分(VAS)、日本骨科协会腰痛评分表(JOA)、Oswestry功能障碍指数评分(ODI)、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、疼痛介质[P物质(SP)、5-羟色胺(5-HT)]。记录两组治疗期间不良反应。结果:针刺组临床总有效率为93.33%,明显高于电针组的73.33%(P<0.05)。治疗后,两组中医主症、次症积分下降,且针刺组治疗后中医主症、次症积分低于电针组(均P<0.05)。治疗后,两组VAS、ODI评分下降,JOA评分上升(均P<0.05);针刺组治疗后VAS、ODI、JOA评分与电针组比较差异有统计学意义(均P<0.05)。治疗后,两组血清IL-6、TNF-α、SP、5-HT水平下降(均P<0.05);且针刺组治疗后上述指标低于电针组(均P<0.05);两组未见明显不良反应。结论:刺络放血联合“通脊”电针可提高LDH坐骨神经痛患者的疗效,缓解其症状,降低炎性因子、疼痛介质水平。

Objective:To explore the efficacy of bloodletting combined with“Tongji”electroacupuncture on patients with lumbar disc herniation(LDH)complicated with sciatica and its influence on the functional recovery and pain status.Methods:60 patients with sciatica caused by LDH of qi stagnation and blood stasis type were selected and divided into acupuncture group and electroacupuncture group according to the random number table method,with 30 cases in each group.The patients in electroacupuncture group were treated with conventional electroacupuncture while the patients in acupuncture group were given bloodletting combined with“Tongji”electroacupuncture,and both groups were treated for 2 weeks.The clinical efficacy,TCM symptoms scores,Visual Analogue Scale(VAS),Japanese Orthopedic Association low back pain score(JOA),Oswestry Disability Index(ODI),inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]and pain mediators[substance P(SP),5-hydroxytryptamine(5-HT)]were compared between the two groups,and the adverse reactions in the two groups during treatment were recorded.Results:After treatment,the clinical effective rate was 93.33%in acupuncture group,which was significantly higher than 73.33%in electroacupuncture group(P<0.05).After treatment,the scores of TCM primary symptoms and secondary syndromes in the two groups were decreased,and the scores in acupuncture group were lower than those in electroacupuncture group(all P<0.05).The VAS score and ODI score in the two groups were declined after treatment,while the JOA score was enhanced(all P<0.05),and the scores in acupuncture group after treatment were significantly different from those in electroacupuncture group(all P<0.05).After treatment,serum levels of IL-6,TNF-α,SP and 5-HT were reduced in the two groups(all P<0.05),and the above indicators after treatment in acupuncture group were lower than those in electroacupuncture group(all P<0.05).There were no obvious adverse reactions in the two groups.Conclusion:Bloodletting combined with“Tongji”electroacupuncture can enhance the efficacy,relieve the symptoms and reduce the levels of inflammatory factors and pain mediators of patients with LDH and sciatica.