基于“燔针取痹”探讨内热针治疗寒湿痹阻型腰椎间盘突出症对腰椎功能及疼痛症状改善效果

Improvement Effect of Internal Heat Acupuncture on Lumbar Function and Pain Symptoms in Treatment of LDH of Cold-Dampness Obstruction Based on‘Burnt Needle Removing Bi’

目的:分析基于“燔针取痹”探讨内热针治疗寒湿痹阻型腰椎间盘突出症(LDH)对腰椎功能及疼痛症状改善效果。方法:选定联勤保障部队第900医院中医针灸科、骨科2021年7月—2023年1月就诊的90例寒湿痹阻型LDH患者进行回顾性研究,根据治疗方法的不同将其分为3组,每组30例,西药组给予塞来昔布治疗,内热针组给予内热针治疗,温针灸组给予温针灸治疗,比较3组临床疗效、腰椎活动度、腰椎JOA评分、疼痛视觉模拟评分(VAS)量表、生活质量评分量表(SF-36)、血清炎症因子肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)和不良反应总发生率。结果:内热针组临床总有效率93.33%(28/30),高于温针灸组的70.00%(21/30)、西药组的63.33%(19/30),差异具有统计学意义(P<0.05)。内热针组治疗后腰椎前屈、后伸最大活动度均高于温针灸组、西药组,差异具有统计学意义(P<0.05)。内热针组治疗后腰椎JOA评分、SF-36评分均高于温针灸组、西药组,差异具有统计学意义(P<0.05),内热针组治疗后VAS评分均低于温针灸组、西药组,差异具有统计学意义(P<0.05)。内热针组治疗后血清TNF-α、CRP、IL-6水平均低于温针灸组、西药组,差异具有统计学意义(P<0.05)。不良反应总发生率内热针组3.33%(1/30)、西药组6.67%(2/30)和温针灸组13.33%(4/30)。结论:基于“燔针取痹”给予内热针治疗,可有效缓解寒湿痹阻型LDH患者腰椎疼痛等症状,改善腰椎活动度及功能,减轻炎症反应,提高生活质量且未引发严重不良反应,安全有效。

Objective:To analyze the improvement effect of internal heat acupuncture on lumbar function and pain symptoms in treatment of lumbar intervertebral disc herniation(LDH)of cold-dampness obstruction based on‘burnt needle removing Bi’.Methods:A retrospective study was conducted on 90 patients with LDH of cold-dampness obstruction.The patients were divided into the Western medication group,the internal heat acupuncture group and the needle-warming moxibusiton group,with 30 patients in each group.Clinical efficacy,lumbar motion,scores of JOA,VAS and SF-36,serum inflammatory factors of TNF-α,CRP and IL-6,as well as total incidence of adverse reactions were compared among the three groups.Results:The total effective rate of the internal heat acupuncture group was 93.33%(28/30),which was higher than 70.00%(21/30)of the needle-warming moxibusiton group and 63.33%(19/30)of the Western medication group(P<0.05).The maximum range of motion was higher in the internal heat acupuncture group than that in the needle-warming moxibustion group and the Western medication group(P<0.05).The scores of JOA and SF-36 were higher(P<0.05),and the VAS score was lower in the internal heat acupuncture group than those in the needle-warming moxibustion group and the Western medication group(P<0.05).The serum levels of TNF-α,CRP and IL-6 were lower in the internal heat acupuncture group than those in the needle-warming moxibustion group and the Western medication group(P<0.05).In terms of the total incidence of adverse reactions,it was 3.33%(1/30)in the internal heat acupuncture group,6.67%(2/30)in the Western medication group and 13.33%(4/30)in the needle-warming moxibustion group,in which there were no statistical differences among the three groups(P>0.05).Conclusion:The treatment of internal heat acupuncture based on‘burnt needle removing Bi’can effectively relieve the symptoms of lumbar pain in treatment of LDH of cold-dampness obstruction,it can improve lumbar motion and function,reduce inflammation,improve quality of life,without serious adverse reactions.The therapy is safe and effective.