针灸联合推拿治疗腰椎间盘突出症的效果评价

Effect Evaluation of Acupuncture Combined with Tuina in Treatment of Lumbar Disc Herniation

目的探讨针灸联合推拿治疗腰椎间盘突出症的临床效果。方法以随机数字表法将60例2021年7月—2022年7月晋中市中医院收治的腰椎间盘突出症患者分为研究组(常规推拿+针灸)和对照组(常规推拿),各30例。两组均治疗10 d。比较两组各项指标。结果对照组治疗后临床总有效率低于研究组;研究组各项的临床症状的消失时间均短于对照组;治疗后两组视觉模拟评分(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)、P物质(substance P,SP)、前列腺素E2(prostaglandin E2,PGE2)及神经肽Y(neuropeptide Y,NPY)水平均低于治疗前,且对照组高于观察组;两组日本骨科协会(Japanese Orthopedics Association,JOA)评分、直腿抬高角度、血清白细胞介素-4(interleukin-4,IL-4)、白细胞介素-10(interleukin-10,IL-10)水平均高于治疗前,且对照组低于观察组(P<0.05)。结论针灸联合推拿治疗可显著缓解腰椎间盘突出症患者腰腿疼痛等症状、肢体疼痛及功能障碍,抑制炎症反应,疗效显著。

Objective To investigate the clinical effect of acupuncture combined with Tuina in the treatment of lumbar disc herniation.Methods Sixty patients with lumbar disc herniation admitted to the hospital from July 2021 to July 2022 were divided into the study group(conventional Tuina+acupuncture)and the control group(conventional Tuina)with 30 cases each by random number table method.Both groups were treated for 10 d.The indicators of both groups were compared.Results The total effective after treatment rate of the control group was lower than that of the study group.The disappearance time of clinical symptoms in the study group was shorter than that in the control group.After treatment,the scores of visual analogue scale(VAS),Oswestry disability index(ODI),the levels of serum tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),substance P(SP),prostaglandin E2(PGE2)and neuropeptide Y(NPY)in both groups were lower than those before,and the levels of the control group were higher than those of the observation group.The score of Japanese Orthopedics Association(JOA),straight leg lifting height,the levels of serum IL-4 and IL-10 in both groups were higher than those before treatment,and the levels of the control group were lower than those of the observation group(P<0.05).Conclusion Acupuncture and moxibustion combined with Tuina can significantly relieve the symptoms of lumbar disc herniation,such as leg pain,limb pain and dysfunction,inhibit inflammatory response and have a significant effect.