通督温阳针灸法联合自拟补肾通痹汤治疗腰椎间盘突出症的疗效及对血清生化指标的影响

Effect of Tongdu Wenyang Acupuncture and Moxibustion on Treatment of Lumbar Intervertebral Disc Herniation and Its Effect on Serum Biochemical Indexes

目的:通督温阳针灸法联合自拟补肾通痹汤治疗腰椎间盘突出症(LDH)的疗效及对血清生化指标的影响。方法:将120例LDH患者随机分为观察组(60例)及对照组(60例),两组均首先接受常规西医基础治疗,对照组在其基础上给予通督温阳针灸法治疗,观察组在对照组基础上加用自拟补肾通痹汤治疗,疗程为12周。观察两组的临床疗效,并记录两组治疗前后疼痛、下肢肌电图、腰椎功能、日常独立活动能力及血清生化指标的变化情况。结果:观察组治疗总有效率(91. 67%)高于对照组(73. 33%),两组比较差异具有统计学意义(P <0. 05);两组治疗后疼痛视觉模拟评分(VAS)分级和平均分值均有显著改善,观察组的改善情况优于对照组(均P <0. 05);两组治疗后股神经、腓神经、胫神经感觉传导速度(SCV)、运动传导速度(MCV)均显著增高,动作电位的潜伏期减低,观察组治疗后SCV、MCV高于对照组,而动作电位的潜伏期低于对照组(均P <0. 05);两组治疗后日本骨科协会(JOA)腰椎功能评分、Barthel指数(BI)评分分级及平均分值均显著改善,观察组的改善情况显著优于对照组(均P <0. 05);两组治疗后血清IL-6、TNF-α、MCP-1、MAD水平显著降低,SOD、GSH-Px水平显著升高,观察组治疗后的上述指标均优于对照组(均P <0. 05)。结论:通督温阳针灸法联合自拟补肾通痹汤治疗LDH的临床疗效佳,能够显著缓解患者疼痛、促进下肢神经功能恢复,从而提高腰椎功能和日常独立活动能力,其机制可能与其有效调节机体炎性反应和氧化应激反应有关。

Objective:To study the effect of the treatment of Tongdu Wenyang acupuncture and moxibusion combined with Bushen Tongbi Decoction in the treatment of lumbar intervertebral disc herniation(LDH)and the effect on serum biochemical indexes.Methods:A total of 120 patients with LDH were randomly divided into observation group(60 cases)and control group(60 cases).Two groups were treated with routine western medicine.First,the control group on the basis was given Tongdu Wenyang acupuncture and moxibusion method treatment.The observation group additionally used Bushen Tongbi Decoction.The treatment lasted for 12 weeks.The clinical efficacy of the two groups was observed,and the changes of the pain,lower extremity electromyography,lumbar function,daily independent activity and serum biochemical index were recorded in the two groups.Results:The total effective rate(91.67%)was higher than that of the control group(73.33%),and the difference between the two groups was statistically significant(P<0.05).The visual analogue score(VAS)and average score of the two groups were significantly improved after treatment,and the improvement of observation group was better than that in the control group(P<0.05).Two groups’posterior divisions nerve,peroneal nerve,tibial nerve sensory conduction velocity(SCV)and motor conduction velocity(MCV)were significantly increased.The observation group’s SCV and MCV were higher than those of the control group after treatment.The incubation period of the action potential was lower than that of the control group(P<0.05).In the two groups,the lumbar function score of the Japanese orthopaedic association(JOA),the grading of the Barthel index(BI)and the average score were significantly improved,and the improvement of observation group was significantly better than that in the control group(P<0.05).After treatment,serum IL-6,TNF-alpha,MCP-1 and MAD levels were significantly reduced,and the levels of SOD and GSH-Px increased significantly.The above indexes after treatment were all better than those of the control group(P<0.05).Conclusion:Tongdu Wenyang acupuncture and moxibustion method combined with Bushen Tongbi Decoction has clinical curative effect on LDH and can significantly relieve patients’pain,promote the nerve root function recovery,and thus improving the lumbar vertebral function and daily activities independently,effectively regulating the body’s inflammatory reaction and the mechanism may be related to oxidative stress.