温经通络推拿法联合温针灸治疗瘀血阻滞型腰椎间盘突出症临床研究

Clinical Study on Tuina Method of Warming the Channels and Unblocking the Collaterals Combined with Warming-Needle Moxibustion for Lumbar Disc Herniation of Blood Stasis Obstruction Type

目的:观察温经通络推拿法联合温针灸治疗瘀血阻滞型腰椎间盘突出症(LDH)的疗效。方法:选取112例瘀血阻滞型LDH患者,按随机数字表法分为观察组及对照组各56例,经过剔除,最终2组各纳入54例。对照组给予温针灸治疗,观察组给予温经通络推拿法联合温针灸治疗。比较2组临床疗效,比较2组治疗前后腰椎功能[Oswestry功能障碍指数(ODI)、腰椎功能评估(JOA)]、疼痛程度[疼痛视觉模拟评分法(VAS)]、腰椎活动度及血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平的变化。结果:观察组、对照组临床疗效总有效率分别为96.30%、85.19%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组JOA评分均较治疗前上升(P<0.05),ODI评分、VAS评分均较治疗前下降(P<0.05);观察组JOA评分高于对照组(P<0.05),ODI、VAS评分均低于对照组(P<0.05)。治疗后,2组腰椎屈伸、侧屈及旋转活动度均较治疗前增大(P<0.05),观察组上述3项活动度均大于对照组(P<0.05)。治疗后,2组IL-6、TNF-α水平均较治疗前下降(P<0.05),观察组上述2项水平均低于对照组(P<0.05)。结论:温经通络推拿法联合温针灸治疗瘀血阻滞型LDH疗效确切,可有效缓解疼痛程度,改善腰椎功能及腰椎活动度,减轻炎症反应。

Objective:To observe the curative effect of tuina method of warming the channels and unblocking the collaterals combined with warming-needle moxibustion on lumbar disc herniation(LDH)of blood stasis obstruction type.Methods:A total of 112 cases of LDH patients of blood stasis obstruction type were selected and divided into the observation group and the control group according to the random number table method,56 cases in each group,respectively.After exclusion,54 cases were included in each group.The control group was treated with warming-needle moxibustion,and the observation group was treated with tuina method of warming the channels and unblocking the collaterals combined with warming-needle moxibustion.The clinical effects were compared between the two groups.The changes in lumbar spine function[Oswestry Dysfunction Index(ODI),and Japanese Orthopaedic Association(JOA)],pain severity[Visual Analogue Scale(VAS)of Pain],as well as levels of lumbar mobility,and serum inflammatory factors[interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]were compared before and after treatment between the two groups.Results:The total effective rates in the observation group and the control group were 96.30%and 85.19%,respectively,the difference being significant(P<0.05).After treatment,the JOA scores of both groups were raised when compared with those before treatment(P<0.05),and the ODI and VAS scores were declined when compared with those before treatment(P<0.05);the JOA score in the observation group was higher than that in the control group(P<0.05),and the ODI and VAS scores were lower than those in the control group(P<0.05).After treatment,the range of motion of lumbar flexion and extension,lateral flexion,and rotation in both groups were increased when compared with those before treatment(P<0.05),and the observation group had higher levels of these three activities than the control group(P<0.05).After treatment,the levels of IL-6 and TNF-αin the two groups were decreased when compared with those before treatment(P<0.05),and the above two levels in the observation group were lower than those in the control group(P<0.05).Conclusion:Tuina method of warming the channels and unblocking the collaterals combined with warming-needle moxibustion is effective in treating LDH of blood stasis obstruction type,which can effectively relieve pain,improve lumbar function and lumbar mobility,and reduce inflammatory reactions.