针灸辨证取穴联合刺络放血疗法治疗腰椎间盘突出症患者疗效观察

Effect of Acupuncture and Moxibustion According to Syndrome Differentiation and Acupoint Selection Combined with Blood-Letting Acupuncture on Patients with Lumbar Disc Herniation

目的 观察针灸辨证取穴与刺络放血疗法共同治疗腰椎间盘突出症(LDH)的临床效果。方法 随机数字表法将医院2019年6月—2022年6月收治的82例LDH患者分为两组,对照组41例予以刺络放血疗法,观察组41例在对照组基础上予以针灸辨证取穴。比较两组患者临床治疗效果、腰腿疼痛程度、腰椎功能、炎症水平、不良反应发生情况。结果 观察组治疗总有效率95.12%(39/41)高于对照组75.61%(31/41)(P<0.05);治疗第9 d、治疗第18 d观察组疼痛数字评价量表(NRS)评分低于对照组(P<0.05);治疗后观察组临床体征、主观症状、日常活动受限评分高于对照组(P<0.05);治疗后观察组肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-1β(IL-1β)低于对照组(P<0.05);观察组不良反应发生率7.32%(3/41)与对照组9.76%(4/41)比较差异无统计学意义(P>0.05)。结论 LDH患者应用针灸辨证取穴治疗和刺络放血疗法,能强化治疗效果,改善其疼痛症状和腰椎功能,可减轻患者炎症水平,且安全性较高。

Objective To observe the clinical effect of acupuncture and moxibustion and blood-letting acupuncture on lumbar disc herniation(LDH).Methods Eighty-two cases of LDH patients in the hospital from June 2019 to June 2022 were divided into two groups by random number table method.Forty-one cases in the control group were treated with puncture and bloodletting therapy and the other 41 cases in the observation group were treated with acupuncture and moxibustion differentiation based on the control group.The clinical therapeutic effect,the degree of lumbar pain,lumbar function,inflammation and occurrence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 95.12%(39/41),higher than that of the control group[75.61%(31/41)](P<0.05).The score of numerical rating scale(NRS)in the observation group on day 9 and day 18 was significantly lower than that in the control group(P<0.05).After treatment,the clinical signs,subjective symptoms and restricted daily activity scores of the observation group were higher than those of the control group(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-1β(IL-1β)in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[7.32%(3/41)vs 9.76%(4/41)](P>0.05).Conclusion The application of acupuncture and moxibustion based on syndrome differentiation and blood-letting acupuncture in patients with LDH can strengthen the therapeutic effect,improve the pain symptoms and lumbar function,reduce the inflammatory level of patients,and has high safety.