止痛利湿膏配合横竖针刺对腰椎间盘突出患者中医症候评分及MRI影像学疗效的影响

Effects of Zhitong Lishi Ointment combined with crossed acupuncture on scores of TCM symptoms and MRI efficacy in patients with lumbar disc herniation

目的:探讨止痛利湿膏配合横竖针刺对腰椎间盘突出(LDH)患者中医症候评分及MRI影像学疗效的影响。方法:选取2021年1月~2022年12月本院收治的82例LDH患者,将其随机分为A组(n=41)和B组(n=41)。B组患者采用卧床休息、功能锻炼和塞来昔布胶囊治疗,A组在B组基础上采用止痛利湿膏配合横竖针刺治疗,均持续治疗8周。评估两组临床疗效、中医症候及不良反应;比较两组治疗前后疼痛反应、腰椎功能和生活质量指标[疼痛视觉模拟(VAS)评分、日本骨科协会腰痛评分量表(JOA)评分、生存质量测定量表简表(QOL-BREF)评分]及MRI影像学疗效(突出物矢径、水平面突出物面积、椎间隙高度和硬膜囊平均横截面积)。结果:A组治疗总有效率显著高于B组(P<0.05);A组治疗后中医症候评分、VAS评分、JOA评分和QOL-BREF评分改善均显著高于B组(P<0.05);A组治疗后突出物矢径、水平面突出物面积、椎间隙高度和硬膜囊平均横截面积改善均显著高于B组(P<0.05);两组治疗期间不良反应发生率无显著差异(P>0.05)。结论:止痛利湿膏配合横竖针刺可改善LDH患者中医症候评分,提高MRI影像学疗效,安全性好。

Objective:To explore the effects of Zhitong Lishi Ointment combined with crossed acupuncture on scores of TCM symptoms and MRI efficacy in patients with lumbar disc herniation(LDH).Methods:A total of 82patients with LDH admitted to the hospital were enrolled and randomly divided into group A(n=41)and group B(n=41)between January 2021and December 2022.The group B was treated with bed rest,functional exercise and celecoxib capsules,while group A was additionally treated with Zhitong Lishi Ointment combined with crossed acupuncture.All were treated for 8weeks.The clinical efficacy,TCM symptoms and adverse reactions in the two groups were evaluated.The pain response,lumbar function and quality of life indexes[visual analogue scale(VAS),Japanese Orthopaedic Association Low Back Pain Rating Scale(JOA),quality of life BREF(QOLBREF)]and MRI efficacy(vector diameter of protrusion,protrusion area in horizontal plane,intervertebral height,mean cross-sectional area of dural cyst)were compared between the two groups before and after treatment.Results:The total response rate of treatment in group A was significantly higher than that in group B(P<0.05).After treatment,improvement of TCM symptoms,VAS,JOA and QOL-BREF scores in group A was significantly greater than that in group B(P<0.05),and improvement of vector diameter of protrusion,protrusion area in horizontal plane,intervertebral height and mean cross-sectional area of dural cyst was significantly greater than that in group B(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion:Zhitong Lishi Ointment combined with crossed acupuncture can improve TCM symptoms and MRI efficacy in LDH patients,with good safety.