针灸辅助督脉活血汤在退行性腰椎管狭窄症患者中的应用

Application of acupuncture and moxibustion assisted Dumai Huoxue Decoction in patients with degenerative lumbar spinal stenosis

目的:探讨针灸辅助督脉活血汤治疗退行性腰椎管狭窄症患者的临床效果。方法:选取2020年10月~2021年10月我院收治的96例气虚血瘀型退行性腰椎管狭窄症患者作为研究对象。所有患者采用随机双盲法分为参照组和研究组,各48例。两组均接受常规治疗,参照组采用针灸辅助治疗,研究组在参照组的基础上增加督脉活血汤治疗。比较两组临床疗效、治疗前、治疗8 w后视觉模拟评分量表(Visual simulation score,VAS)、功能障碍指数量表(Oswestry disability index,ODI)、腰椎功能评分量表(Japanese Orthopaedic Association,JOA)评分、间歇性跛行评分、无痛行走距离、血液流变学指标(全血低切黏度、全血高切黏度、纤维蛋白原、红细胞比容)、血清炎性因子水平。结果:研究组临床总有效率明显高于参照组(P<0.05)。治疗后,两组VAS评分、ODI评分、间歇性跛行评分明显降低,且研究组低于参照组(P<0.05);两组JOA评分明显升高,且研究组高于参照组(P<0.05);两组无痛行走距离明显增大,且研究组大于参照组(P<0.05);两组全血低切、高切黏度、红细胞比容、纤维蛋白原指标及血清白细胞介素-1β(Interleukin-1β,IL-1β)、肿瘤坏死因子-α(Ttumor necrosis factor-α,TNF-α)、白细胞介素-1α(Interleukin-1α,IL-1α)、降钙素原(Procalcitonin,PCT)水平明显降低,且研究组低于参照组(P<0.05)。结论:针灸辅助督脉活血汤治疗退行性腰椎管狭窄症疗效确切,可有效缓解临床症状及疼痛程度,恢复腰椎功能,改善血液微循环及机体炎症状态。

Objective:To investigate the clinical effect of acupuncture and moxibustion assisted with Dumai Huoxue Decoction in treatment of degenerative lumbar spinal stenosis.Methods:From October 2020 to October 2021,96 patients with degenerative lumbar spinal stenosis and qi deficiency and blood stasis type admitted to our hospital were selected as research objects.All patients were randomly divided into the reference group and the research group with 48 cases each.Both groups received routine treatment.The reference group was treated with acupuncture and moxibustion.The research group was treated with Dumai Huoxue Decoction on the basis of the reference group.The clinical efficacy,visual simulation score(VAS),dysfunction index(ODI),Japanese Orthopaedic Association(JOA)score,intermittent claudication score,pain free walking distance,hemorheology indexes(whole blood low shear viscosity,whole blood high shear viscosity,fibrinogen,hematocrit),and serum levels of inflammatory factors were compared between two groups.Results:The total clinical effective rate of the research group was significantly higher than that of the reference group(P<0.05).After treatment,VAS score,ODI score and intermittent claudication score were decreased significantly in the two groups,which were lower in the research group than those in the reference group(P<0.05);the JOA scores was increased significantly in the two groups,which was significantly higher in the research group than that in the control group(P<0.05);the pain free walking distance was significantly increased in the two groups,which was greater in the research group than that in the reference group(P<0.05);whole blood low shear,high shear viscosity,hematocrit,fibrinogen index and serum levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-1α(IL-1α),procalcitonin(PCT)were decreased significantly in the two groups,which were significantly lower in the research group than those in the reference group(P<0.05).Conclusion:Acupuncture and moxibustion assisted with Dmai Huoxue Decoction is effective in treatment of degenerative lumbar spinal stenosis.It can effectively relieve clinical symptoms and pain,restore lumbar function,and improve blood microcirculation and body inflammation.