经验方联合小针刀治疗腰椎间盘突出症临床研究

Clinical Study on Proved Prescription Combined with Acupotomy for Lumbar Disc Herniation

目的:观察经验方联合小针刀治疗腰椎间盘突出症的临床疗效。方法:筛选2022年12月—2023年10月接受治疗的腰椎间盘突出症患者,共82例。根据随机数字表法分为2组各41例。对照组予小针刀治疗;观察组采用小针刀联合自拟经验方内服治疗。2组均连续观察4周。比较2组疼痛视觉模拟评分法(VAS)评分、日本骨科协会(JOA)评分、腰椎活动度、血清高迁移率族蛋白B1(HMGB1)、白细胞介素-1β(IL-1β)、核因子-κB(NF-κB)水平。结果:治疗2周后、治疗4周后,2组疼痛VAS评分较治疗前均明显降低,观察组疼痛VAS评分较对照组同期评分均降低,差异均有统计学意义(P<0.05)。治疗2周后、治疗4周后,2组JOA评分较治疗前均升高,观察组JOA评分高于对照组同期评分,差异均有统计学意义(P<0.05)。治疗4周后,2组腰椎活动度相关指标较治疗前明显升高,观察组腰椎活动度相关指标较对照组升高,差异均有统计学意义(P<0.05)。治疗4周后,2组血清HMGB1、IL-1β、NF-κB水平均较治疗前明显下降,观察组上述各项指标均低于对照组,差异均有统计学意义(P<0.05)。治疗4周后,临床疗效观察组总有效率97.56%,高于对照组80.49%,差异均有统计学意义(P<0.05)。结论:经验方联合小针刀治疗腰椎间盘突出症能降低血清HMGB1、IL-1β、NF-κB水平,减缓疼痛,改善腰椎功能,临床效果良好。

Objective:To observe the clinical effect of the combination use of proved prescription and acupotomy on lumbar disc herniation.Methods:A total of 82 patients with lumbar disc herniation who were given treatment from December 2022 to October 2023 were screened.They were divided into the control group and the observation group by the random number table method,with 41 cases in each group.The control group was treated with acupotomy;the observation group was treated with acupotomy combined with self-made proved prescription.Both groups were observed for four weeks.The scores of Visual Analogue Scale(VAS)of pain and Japanese Orthopaedic Association(JOA),lumbar range of motion,and the levels of serum high mobility group protein B1(HMGB1),interleukin-1β(IL-1β)and nuclear factor-κB (NF-κB)were compared between the two groups.Results:After two weeks and four weeks of treatment,the VAS scores of pain in the two groups were significantly lower than those before treatment,and the VAS score of pain in the observation group was lower than that in the control group at the same time,differences being significant(P<0.05).After two weeks and four weeks of treatment,the JOA scores in the two groups were higher than those before treatment,and the JOA score in the observation group was higher than that in the control group at the same time,differences being significant(P<0.05).After four weeks of treatment,the indexes of lumbar range of motion in the two groups were significantly higher than those before treatment,and the indexes of lumbar range of motion in the observation group were higher than those in the control group,differences being significant(P<0.05).After four weeks of treatment,the levels of serum HMGB1,IL-1βand NF-κB in the two groups were significantly reduced when compared with those before treatment,and the above three levels in the observation group were lower than those in the control group,differences being significant(P<0.05).After four weeks of treatment,the total effective rate was 97.56%in the observation group,higher than that of 80.49%in the control group,differences being significant(P<0.05).Conclusion:The combination use of proved prescription and acupotomy can reduce the levels of serum HMGB1,IL-1βand NF-κB of patients with lumbar disc herniation,mitigate the pain,and improve the lumbar function with great clinical effect.