银质针导热疗法联合神经阻滞治疗脊柱源性腰痛患者的效果评价

Evaluation of the effect of silver needle heat conduction therapy combined with nerve block in the treatment of spinal-derived low back pain

目的 分析银质针导热疗法联合神经阻滞对脊柱源性腰痛的腰椎功能及肌电图指标的影响。方法 以随机数字表法将我院2021年6月至2023年5月间收治的84例脊柱源性腰痛患者分为2组,各42例。对照组予以神经阻滞治疗,联合组在此基础上加用银质针导热治疗,两组均治疗2周。对比两组疗效、病情相关评分[日本骨科协会制定的腰椎疗效标准(JOA)、视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数问卷表(ODI)]、血清因子[血清转化生长因子-β1(TGF-β1)、白介素-6(IL-6)、γ干扰素(IFNγ)]、肌电图特征(竖脊肌、多裂肌平均振幅)。结果 联合组总有效率(95.24%)高于对照组(78.57%)(P<0.05);治疗1、2周后联合组VAS、ODI低于对照组,JOA高于对照组(P<0.05);治疗1、2周后联合组TGF-β1、IFNγ、IL-6低于对照组(P<0.05);治疗1、2周后联合组竖脊肌、多裂肌平均振幅高于对照组(P<0.05)。结论 银质针导热疗法联合神经阻滞治疗脊柱源性腰痛可通过抑制炎症与提高竖脊肌、多裂肌活动能力,减轻疼痛,改善腰椎功能,效果显著。

Objective To analyze the effects of silver needle heat conduction therapy combined with nerve block on lumbar function and EMG indexes of spinal-derived low back pain.Methods A total of eighty-four patients with spinal origin low back pain admitted to Zhengzhou traditional chinese medicine hospital from June 2021 to May 2023 were divided into two groups with forty-two cases in each group by random number table.The control group was treated with nerve block,and the combined group was treated with silver needle heat conduction.The efficacy,disease-related scores[Japanese Orthopedic Association(JOA),Visual Analogue Pain Scale(VAS),Oswestry Disability Index(ODI)],serum factors[serum transforming growth factor-β1(TGF-β1),interleukin-6(IL-6),and interferon gamma(IFN-γ)],EMG features(mean amplitudes of erector spinalis and multifidus muscles)of the two groups were compared.Results The total effective rate of combined group(95.24%)was higher than that of control group(78.57%)(P<0.05).After 1 and 2 weeks of treatment,VAS and ODI in combination group were lower than those in control group,and JOA was higher than those in control group(P<0.05).After 1 and 2 weeks of treatment,TGF-β1,IFN-γand IL-6 in combination group were lower than those in control group(P<0.05);After 1 and 2 weeks of treatment,the average amplitude of erector spinalis muscle and multifidus muscle in combination group was higher than that in control group(P<0.05).Conclusion Silver needle heat conduction therapy combined with nerve block can reduce pain and improve lumbar function by inhibiting inflammation and improving the activity of erector and multifidus muscles.