针刺联合通络活血方对气滞血瘀型LDH的临床效果及炎症因子的影响

The Clinical Effect of Acupuncture Combined with Tongluo Huoxue Decoction on LDH of Qi Stagnation and Blood Stasis Type and Its Influence on Inflammatory Factors

目的:观察针刺联合通络活血方治疗气滞血瘀型腰椎间盘突出症(LDH)的临床疗效及对相关炎症因子的影响。方法:将60例符合纳入标准的患者随机分为对照组和试验组各30例。对照组采用常规西药治疗,试验组采用针刺联合口服通络活血方治疗。对比观察治疗前后两组患者JOA、VAS、ODI评分,直腿抬高试验,炎症因子等指标,评估两组的疗效。结果:治疗前,两组患者各项指标的组间差异均无统计学意义(P>0.05);治疗后,两组患者VAS、ODI评分较治疗前相比均有所降低(P<0.05),JOA评分均增高(P<0.05);且试验组VAS、ODI评分低于对照组(P<0.05),JOA评分高于对照组(P<0.05)。两组直腿抬高角度均增大(P<0.05),试验组抬高角度大于对照组(P<0.05)。两组患者IL-6、CRP水平均下降(P<0.05);试验组IL-6、CRP水平低于对照组(P<0.05)。试验组总有效率为96.7%,高于对照组的73.3%(P<0.05),不良反应发生率为10.0%,小于对照组的16.7%(P>0.05)。结论:针刺联合通络活血方对于缓解气滞血瘀型LDH患者的临床症状,改善腰椎功能,降低疼痛,降低IL-6、CRP等炎症指标水平,提高疗效方面较单纯使用西药效果更优,值得临床推广。

Objective:To observe the clinical efficacy of acupuncture combined with Tongluo Huoxue Decoction in the treatment of lumbar disc herniation(LDH)of qi stagnation and blood stasis type and its effect on related inflammatory factors.Methods:60 patients who met the inclusion criteria were randomLy divided into control group(n=30)and experimental group(n=30).The control group was treated with conventional western medicine,and the experimental group was treated with acupuncture combined with oral Tongluo Huoxue Decoction.The JOA,VAS,ODI scores,straight leg raising test,inflammatory factors and other indicators were compared between the two groups before and after treatment,and the efficacy of the two groups was evaluated.Results:Before treatment,there was no significant difference in the indexes between the two groups(P>0.05).After treatment,the VAS and ODI scores of the two groups were lower than those before treatment(P<0.05),and the JOA scores were higher(P<0.05).The VAS and ODI scores of the experimental group were lower than those of the control group(P<0.05),and the JOA score was higher than that of the control group(P<0.05).The straight leg elevation angle of the two groups increased(P<0.05),and the elevation angle of the experimental group was greater than that of the control group(P<0.05).The levels of IL-6 and CRP in the two groups decreased(P<0.05).The levels of IL-6 and CRP in the experimental group were lower than those in the control group(P<0.05).The clinical effective rate of the experimental group was 96.7%,which was higher than that of the control group 73.3%(P<0.05).The incidence of adverse reactions was 10.0%,which was lower than that of the control group 16.7%(P>0.05).Conclusion:Acupuncture combined with Tongluo Huoxue Decoction can relieve the clinical symptoms of LDH patients with qi stagnation and blood stasis,improve waist function,reduce pain,reduce the levels of IL-6,CRP and other inflammatory indicators,and improve the curative effect.It is better than the simple use of western medicine,which is worthy of clinical promotion.