小针刀联合热敏灸治疗腰大肌损伤性腰腿痛患者的疗效及对其JOA评分、血清白细胞介素-17、白细胞介素-18水平的影响

Efficacy of Small Needle-knife Combined with Thermal Moxibustion in the Treatment of Lumbar and Leg Pain in Psoas Injury and Its Influence on JOA Score and Serum IL-17 and IL-18 Levels

目的探讨小针刀联合热敏灸治疗腰大肌损伤性腰腿痛患者的疗效及对其日本骨科学会(JOA)评分、血清白细胞介素17(Interleukin-17,IL-17)、白细胞介素-18(Interleukin-18,IL-18)水平的影响。方法选取2020年10月—2022年10月期间赣州市人民医院中医科门诊收治的100例腰大肌损伤性腰腿痛患者,根据患者入院单双号分为小针刀组和联合组,每组各50例。分别给予小针刀治疗和小针刀联合热敏灸治疗,连续治疗1周,共治疗两周。观察比较两组患者临床疗效、腰腿功能评价[JOA量表和Oswestry功能障碍指数问卷表(ODI)]、血清炎性指标[白细胞介素-17(interleukin-17,IL-17)、白细胞介素-18(Interleukin-18,IL-18)、白细胞介素-1β(Interleukin-1β,IL-1β)]、疼痛递质[血清神经肽Y(Neuropeptide Y,NPY)、5-羟色胺(5-Hydroxytryptamine,5-HT)及P物质(Substance P,SP)]水平。结果治疗后联合组临床总有效率94.00%(47/50)明显高于小针刀组78.00%(39/50),差异有统计学意义(P<0.05)。治疗后两组患者JOA量表评分均较治疗前升高,ODI量表评分均较治疗前降低,差异有统计学意义(P<0.05);且联合组JOA量表评分明显高于小针刀组,ODI量表评分明显低于小针刀组,差异有统计学意义(P<0.05)。治疗后两组患者IL-17、IL-18、IL-1β水平均较治疗前降低,差异有统计学意义(P<0.05);且联合组炎性因子水平明显低于小针刀组,差异有统计学意义(P<0.05)。治疗后两组患者NPY、5-HT、SP水平均较治疗前降低,差异有统计学意义(P<0.05);且联合组疼痛递质水平明显低于小针刀组,差异有统计学意义(P<0.05)。结论小针刀联合热敏灸不仅能够促进腰大肌损伤性腰腿痛患者的功能恢复,对于减轻炎症反应,抑制神经疼痛递质也效果显著。

Objective To investigate the efficacy of small needle-knife combined with thermal moxibustion in treating patients with psoas injury-induced lumbar and leg pain and its effects on Japanese Orthopaedic Association(JOA)scores and serum interleukin(IL)-17 and IL-18 levels.Methods A total of 100 outpatients with psoas injury-induced lumbar and leg pain,treated at the Traditional Chinese Medicine Department of Ganzhou People's Hospital from October 2020 to October 2022,were selected and divided into a small needle-knife group and a combined group based on their admission odd and even numbers,with 50 patients in each group.The small needle-knife group received small needle-knife treatment,while the combined group received small needle-knife combined with thermal moxibustion treatment.Both treatments were administered for one week,with a total treatment duration of two weeks.The clinical efficacy,lumbar and leg function evaluation[JOA scale and Oswestry Disability Index(ODI)questionnaire],serum inflammatory markers(IL-17,IL-18,and IL-1β),and pain mediators[serum neuropeptide Y(NPY),5-hydroxytryptamine(5-HT),and substance P(SP)]levels were observed and compared between the two groups.Results After treatment,the combined group had a significantly higher total clinical effective rate of 94.00%(47/50)than the small needle-knife group at 78.00%(39/50)(P<0.05).Both groups showed significantly increased JOA scale scores and decreased ODI scores after treatment(P<0.05),with the combined group showing higher JOA scale scores and lower ODI scores than the small needle-knife group(P<0.05).Levels of IL-17,IL-18,and IL-1βsignificantly decreased in both groups after treatment(P<0.05),with the combined group having lower levels than the small needle-knife group(P<0.05).Levels of NPY,5-HT,and SP also significantly decreased in both groups after treatment(P<0.05),with the combined group showing lower levels than the small needle-knife group(P<0.05).Conclusion Small needle-knife combined with thermal moxibustion can significantly promote functional recovery in patients with psoas injury-induced lumbar and leg pain,reduce inflammation,and inhibit pain mediators effectively.