主客原络配穴针刺联合推拿治疗第三腰椎横突综合征的临床观察

Clinical observation of acupuncture with host-guest combination using Yuan-Primordial and Luo-Connecting points plus Tuina for the third lumbar transverse process syndrome

目的:观察主客原络配穴针刺联合推拿对第三腰椎横突综合征的影响.方法:共选择第三腰椎横突综合征患者88例,根据随机数字表法分为观察组与对照组,每组44例,对照组接受推拿治疗,观察组在对照组干预基础上加用主客原络配穴针刺治疗.治疗后比较两组临床疗效,观察体征评分、Roland-Morris功能障碍调查表(RMDQ)评分、Oswestry功能障碍指数量表(ODI)评分、魁北克腰痛残障量表(QBPDS)评分及疼痛因子[包括血清前列腺素(PG)E2、神经肽Y(NPY)和基质金属蛋白酶-3(MMP-3)]的变化情况.结果:治疗后,观察组总有效率为93.2%,高于对照组的75.0%,组间差异有统计学意义(P<0.05).两组体征评分、各腰痛量表评分及血清疼痛因子水平均较本组治疗前降低(P<0.05),且观察组低于对照组(P<0.05).结论:主客原络配穴针刺联合推拿治疗第三腰椎横突综合征疗效肯定,能改善患者体征,减轻腰部疼痛,降低血清疼痛因子水平.

Objective:To observe the effects of acupuncture at Yuan-Primordial and Luo-Connecting points by host-guest combination plus Tuina(Chinese therapeutic massage)on the third lumbar transverse process syndrome.Methods:A total of 88 patients with the third lumbar transverse process syndrome were selected and divided into an observation group and a control group according to the random number table method,with 44 cases in each group.The control group was treated with Tuina,and the observation group was treated with additional acupuncture at Yuan-Primordial and Luo-Connecting points by host-guest combination.The clinical efficacy of the two groups was compared after treatment.The changes in the scores of physical signs,Roland-Morris disability questionnaire(RMDQ),Oswestry disability index(ODI),Quebec back pain disability scale(QBPDS),and pain factors[including serum prostaglandin(PG)E2,neuropeptide Y(NPY),and matrix metalloproteinase-3(MMP-3)]were observed.Results:After treatment,the total effective rate in the observation group was 93.2%,higher than 75.0%in the control group;the difference between the two groups was statistically significant(P<0.05).Compared with those before treatment,the scores of physical signs and each low back pain scale,and the levels of serum pain factors in the two groups were decreased(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).Conclusion:Acupuncture at Yuan-Primordial and Luo-Connecting points by host-guest combination plus Tuina is effective in the treatment of the third lumbar transverse process syndrome;it can improve the patient’s physical signs,relieve low back pain,and reduce the levels of serum pain factors.