腰痛舒痹方联合温针灸治疗风寒湿痹型腰椎间盘突出症临床研究

Clinical Study on Yaotong Shubi Prescription Combined with Warming-Needle Moxibustion for Lumbar Disc Herniation of Wind-Cold-Damp Obstruction Type

目的:观察腰痛舒痹方联合温针灸治疗腰椎间盘突出症的临床疗效及对血清中炎症介质白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)表达的影响。方法:选取腰椎间盘突出症患者90例,采用随机数字表法分为中药组、针灸组、联合组各30例。中药组给予腰痛舒痹方治疗,针灸组给予温针灸治疗,联合组给予腰痛舒痹方联合温针灸治疗,疗程6周。评价3组临床疗效,比较3组治疗前后视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分,并检测血清IL-1β、TNF-α水平。结果:联合组总有效率高于中药组和针灸组(P<0.05)。治疗后,3组VAS评分、ODI指数均较治疗前降低(P<0.05);且联合组VAS评分、ODI指数均低于中药组和针灸组(P<0.05)。治疗后,3组IL-1β、TNF-α水平均较治疗前降低(P<0.05),且联合组IL-1β、TNF-α水平均低于中药组和针灸组(P<0.05)。结论:腰痛舒痹方联合温针灸治疗风寒湿痹型腰椎间盘突出症可提高临床疗效,减轻患者疼痛,改善腰部活动度,降低血清中炎症因子的表达,提高患者生活自理能力。

Objective:To observe the clinical effect of the therapy of Yaotong Shubi Prescription combined with warming-needle moxibustion on lumbar disc herniation and its influence on the levels of serum inflammatory mediators interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α).Methods:A total of 90 patients with lumbar disc herniation were selected and divided into the Chinese medicine group,the acupuncture and moxibustion group and the combination group by random number table method,with 30 cases in each group.The Chinese medicine group was treated with Yaotong Shubi Prescription;the acupuncture and moxibustion group was treated with warming-needle moxibustion,and the combination group was treated with Yaotong Shubi Prescription combined with warming-needle moxibustion.The treatment course was 6 weeks.The clinical effects were evaluated in the three groups;the scores of Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)were compared before and after treatment among the three groups,and levels of serum IL-1βand TNF-αwere detected.Results:The total effective rate in the combination group was higher than those in the Chinese medicine group and the acupuncture and moxibustion group(P<0.05).After treatment,the VAS scores and ODI indexes in the three groups were decreased when compared with those before treatment(P<0.05);the VAS score and ODI index in the combination group were lower than those in the Chinese medicine group and the acupuncture and moxibustion group(P<0.05).After treatment,the levels of IL-1βand TNF-αin the three groups were decreased when compared with those before treatment(P<0.05),and the levels of IL-1βand TNF-αin the combination group were lower than those in the Chinese medicine group and acupuncture and moxibustion group(P<0.05).Conclusion:The therapy of Yaotong Shubi Prescription combined with warming-needle moxibustion can improve clinical effects,relieve pain,improve lumbar mobility,reduce the expression of inflammatory factors in serum,and improve patients'self-care ability.