基于动作模式调整理论的运动针灸治疗非特异性下腰痛的效果观察

Effect of motor acupuncture based on movement pattern adjustment theory in the treatment of non-specific low back pain

目的探讨基于动作模式调整理论的运动针灸治疗非特异性下腰痛(NLBP)对患者Oswestry功能障碍指数(ODI)、改良日本骨科学会(JOA)评分及预后的影响。方法将2020年3月—2023年3月本院收治的98例NLBP患者随机分为对照组和观察组,每组49例。对照组给予腰椎骨盆节律训练治疗,观察组给予基于动作模式调整理论的运动针灸治疗,观察2组治疗前后视觉模拟评分法(VAS)评分、ODI、改良JOA评分、腰部肌电信号[肌肉伸展时最大肌电值与腰椎最大屈曲时肌电值的比值(EXT/MVF)、肌肉屈曲时最大肌电值与腰椎最大屈曲时肌电值的比值(FLEX/MVF)]、血清炎性因子[白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)],并比较2组临床疗效和3个月复发率。结果治疗2周后,观察组VAS评分、ODI低于对照组,改良JOA评分高于对照组,差异有统计学意义(P<0.05)。治疗2周后,观察组竖脊、多裂肌表面EXT/MVF、FLEX/MVF高于对照组,差异有统计学意义(P<0.05)。治疗2周后,观察组血清IL-6、IL-1β、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。观察组治疗有效率高于对照组,治疗3个月后的复发率低于对照组,差异有统计学意义(P<0.05)。结论基于动作模式调整理论的运动针灸对NLBP的疗效显著,可有效缓解患者疼痛,提高腰椎功能,减轻炎症反应,且预后较好,不易复发。

Objective To explore the effects of motor acupuncture based on movement pattern adjustment theory on Oswestry Disability Index(ODI),modified Japanese Orthopedic Association(JOA)score and the prognosis in patients with non-specific low back pain(NLBP).Methods A total of 98 patients with NLBP who were admitted to the hospital from March 2020 to March 2023 were randomly divided into control group and observation group,with 49 patients in each group.The control group received lumbar and pelvic rhythm training,while the observation group received motor acupuncture based on movement pattern adjustment theory.The Visual Analogue Scale(VAS)score,ODI score,JOA score,low back electromyographic signals[the ratio of maximum EMG during extension to maximum EMG during maximum voluntary flexion(EXT/MVF)and the ratio of maximum EMG during flexion to maximum EMG during maximum voluntary flexion(FLEX/MVF)],and serum inflammatory factors[interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α]in both groups were observed before and after treatment.Clinical efficacy and 3-month recurrence rate were compared between the two groups.Results After 2 weeks of treatment,VAS score and ODI score of the observation group were lower than those of the control group,and JOA score was higher than that of the control group(P<0.05).EXT/MVF and FLEX/MVF of the erector spinae and multifidus muscle in the observation group were higher than those in the control group(P<0.05).Serum IL-6,IL-1βand TNF-αlevels two weeks after treatment in the observation group were lower than those in the control group(P<0.05).The effective rate of the observation group was higher,and 3-month recurrence rate of the observation group was lower than that of the control group(P<0.05).Conclusion Motor acupuncture based on movement pattern adjustment theory can achieve significant therapeutic effect in treating NLBP,which can effectively alleviate pain,improve lumbar function,and reduce inflammatory reactions,with good prognosis and a low recurrence rate.