[1]齐好雯,齐月雯,陈建华,等.温阳通络针法联合刺络拔罐治疗腰椎间盘突出症疗效及对患者腰椎活动度、血浆β-内啡肽、炎症因子的影响[J].陕西中医,2024,(10):1419-1423.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.028]
　QI Haowen,QI Yuewen,CHEN Jianhua,et al.Efficacy of Wenyang Tongluo acupuncture combined with pricking and cupping on lumbar disc herniation and its influence on lumbar range of motion, plasma β-endorphin and inflammatory factors[J].,2024,(10):1419-1423.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.028]
点击复制

温阳通络针法联合刺络拔罐治疗腰椎间盘突出症疗效及对患者腰椎活动度、血浆β-内啡肽、炎症因子的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年10期
页码:
1419-1423
栏目:
针灸经络
出版日期:
2024-10-05

文章信息/Info

Title:
Efficacy of Wenyang Tongluo acupuncture combined with pricking and cupping on lumbar disc herniation and its influence on lumbar range of motion, plasma β-endorphin and inflammatory factors
作者:
齐好雯1; 齐月雯2; 陈建华1; 高丽华1
(1.承德市中医院,河北 承德 067000; 2.承德医学院附属医院,河北 承德 067000)
Author(s):
QI Haowen; QI Yuewen; CHEN Jianhua; GAO Lihua
(Chengde Hospital of Traditional Chinese Medicine,Chengde 067000,China)
关键词:
腰椎间盘突出;  腰椎活动度;  温阳通络针;  刺络拔罐;  炎症因子;  β-内啡肽
Keywords:
Lumbar disc herniation;  Lumbar range of motion;  Wenyang Tongluo acupuncture;  Pricking and cupping;  Inflammatory factors;  β-endorphin
分类号:
R 274.34
DOI:
DOI:10.3969/j.issn.1000-7369.2024.10.028
文献标志码:
A
摘要:
目的:探究温阳通络针法联合刺络拔罐治疗腰椎间盘突出(LDH)的临床疗效及对患者腰椎活动度、血浆β-内啡肽、炎症因子的影响。方法:选取84例LDH患者,按照随机数字表法分为对照组和联合组,各42例,对照组行刺络拔罐治疗,联合组行温阳通络针法联合刺络拔罐治疗。比较两组患者临床疗效、中医症状积分,治疗前后腰椎活动度(前屈、后伸、左右侧屈)、疼痛程度、血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶3(MMP-3)]、血浆β-内啡肽(β-EP)及不良反应。结果:联合组治疗总有效率高于对照组(P<0.05); 治疗后,两组腰腿疼痛、活动受限、遇寒加重、四肢冰凉症状积分均下降(P<0.05),且治疗后联合组低于对照组(P<0.05); 治疗后,两组腰椎前屈、后伸、右侧屈曲、左侧屈曲活动范围均增加(P<0.05),且治疗后联合组高于对照组(P<0.05); 治疗后,两组VAS评分均下降(P<0.05),JOA评分均升高(P<0.05),且治疗后组间比较差异具有统计学意义(P<0.05); 治疗后,两组IL-6、TNF-α、MMP-3水平均下降(P<0.05),β-EP均升高(P<0.05),且治疗后两组间比较差异具有统计学意义(P<0.05); 治疗期间,对照组出现1例皮疹,联合组出现2例局部红肿,1例皮疹,均在2～3 d后自然恢复。结论:温阳通络针法联合刺络拔罐可改善LDH患者的腰椎活动度,降低炎症因子水平,减轻疼痛,抑制病情进展。
Abstract:
Objective:To explore the clinical efficacy of combination of Wenyang Tongluo acupuncture and pricking and cupping in the treatment of lumbar disc herniation(LDH)and its influence on lumbar range of motion,plasma β-endorphin and inflammatory factors.Methods:A total of 84 patients with LDH were selected and divided into control group(42 cases)and combined group(42 cases)by adopting the random number table method.The control group received pricking and cupping,while the combined group was given Wenyang Tongluo acupuncture combined with pricking and cupping.The clinical efficacy,TCM symptoms scores,lumbar range of motion(forward flexion,back extension,left and right lateral flexion),pain degree,serum inflammatory factors [interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),matrix metalloproteinase 3(MMP-3)] and plasma β-endorphin(β-EP)before and after treatment and adverse reactions were compared between groups.Results:The combined group had higher total effective rate of treatment(P<0.05).After treatment,the symptoms scores of waist and leg pain,activity limitation,aggravation of cold and cold limbs in the two groups were decreased(P<0.05),and the above scores in combined group after treatment were lower than those in control group(P<0.05).The ranges of motions of lumbar forward flexion,back extension,and right flexion and left flexion were increased in the two groups after treatment(P<0.05),and the ranges of motions in combined group were higher after treatment(P<0.05).After treatment,VAS score in both groups was reduced(P<0.05),while JOA score was enhanced(P<0.05),and after treatment,there were significant differences between groups(P<0.05).The levels of IL-6,TNF-α and MMP-3 in both groups after treatment were declined(P<0.05),while the level of β-EP was risen(P<0.05),and significant differences were shown after treatment(P<0.05).During treatment,there was 1 case of skin rash in control group,and there were 2 cases of local redness and swelling and 1 case of skin rash in combined group,and the above cases were recovered naturally after 2-3 days.Conclusion:Wenyang Tongluo acupuncture combined with pricking and cupping can improve lumbar range of motion,reduce inflammatory factors,relieve pain and inhibit disease progression in patients with LDH.

参考文献/References:

[1] 中华医学会骨科学分会脊柱外科学组,中华医学会骨科学分会骨科康复学组.腰椎间盘突出症诊疗指南[J].中华骨科杂志,2020,40(8):477-487.
[2] 王秀廷,李嗣生,孙健,等.椎间孔镜术治疗复发性腰椎间盘突出[J].中国矫形外科杂志,2020,28(11):881-886.
[3] 海龙,穆佐洲.机体炎症水平和氧化应激水平与腰椎间盘突出症椎间孔镜术后残留疼痛相关性研究[J].陕西医学杂志,2022,51(10):1274-1277,1281.
[4] 吴午,谢宝强,曹卓,等.经皮内镜治疗腰椎间盘突出症临床疗效[J].陕西医学杂志,2022,51(1):33-36,47.
[5] 王冬玲,凌春燕,李贵,等.壮腰合剂治疗寒湿痹阻型腰椎间盘突出症临床观察[J].中华中医药学刊,2023,41(9):107-110.
[6] 李吉,杨进,白小军,等.名中医李彦民治疗腰椎间盘突出症经验[J].陕西中医,2023,44(8):1129-1132.
[7] 韩聪,赵耀东,金钰钧,等.经筋理论结合毫针刺法治疗腰椎间盘突出症临床经验[J].中华中医药杂志,2020,35(12):6157-6160.
[8] 黄兹谕,胡万钧,张志伟,等.补肾祛湿汤联合刺络放血治疗腰椎间盘突出症效果分析[J].中华中医药学刊,2022,40(6):174-177.
[9] 韩兴广,徐道明,陆斌.核心肌群训练联合通督温阳针法治疗非特异性腰痛的疗效[J].中国老年学杂志,2017,37(4):961-963.
[10] 国家中医药管理局.中医病证诊断疗效标准[M].北京:中国医药科技出版社,2012:229-230.
[11] 中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,1997:145-147.
[12] 姚卫光,麦晓丹,陈清.视觉模拟疼痛量表在青少年非特异性下腰痛调查中的应用[J].中国学校卫生,2010,31(12):1486-1487.
[13] 孙兵,车晓明.日本骨科协会评估治疗(JOA评分)[J].中华神经外科杂志,2013,29(9):969.
[14] 赵婷婷,赵耀东,蒋梅霞,等.基于《灵枢》解结理论探讨郑氏温通针法治疗腰椎间盘突出症[J].中华中医药杂志,2022,37(6):3036-3039.
[15] 陈博,詹红生,石印玉,等.腰背痛的致病机理及中医学对腰背痛的认识[J].中国中医骨伤科杂志,2010,18(6):62-64.
[16] 张志峰.《诸病源候论》病因学成就探析[J].中医杂志,2011,52(20):1723-1725.
[17] 李洁,张晓辉,李宏九.基于数据挖掘技术探讨平乐正骨治疗腰椎间盘突出症的用药规律[J].中国中医基础医学杂志,2019,25(9):1255-1257.
[18] 梁栋,柏立群.柏立群益气活血通络法治疗气虚血瘀型腰椎间盘突出症临证经验[J].中华中医药杂志,2020,35(3):1296-1299.
[19] 张萌芮,梁超,林明慧,等.刺络放血联合“通脊”电针治疗腰椎间盘突出症坐骨神经痛疗效及对患者功能恢复和疼痛的影响[J].陕西中医,2023,44(8):1141-1144,1149.
[20] 谢卓君,付丽珊,王婉飞.刺血拔罐联合薄氏腹针对老年血瘀型腰椎间盘突出症疼痛及腰椎功能的影响[J].中国老年学杂志,2021,41(4):793-796.
[21] 曹奔,周鑫,任君,等.腰椎间盘突出症筋骨失衡-炎症浸润特征研究[J].中华中医药杂志,2023,38(10):4959-4963.
[22] 朱伟卿,凌卓彦,孙永明,等.Toll样受体4调节硫化氢引起腰椎间盘突出症模型鼠中枢痛敏的机制[J].中华实验外科杂志,2020,37(3):513-516.
[23] 刘艳,刘莹,张绍昆.腰椎间盘突出症微创术后功能锻炼对老年患者血清MMP-3、TNF-α及IL-1β水平的影响[J].中国老年学杂志,2018,38(19):4675-4678.
[24] 陶学顺,余润泽,章玉冰,等.改良经皮椎间孔脊柱内镜技术对老年腰椎间盘突出症患者的疗效[J].中国老年学杂志,2019,39(12):2921-2924.
[25] 宰风雷,邬瑞兰,郑美凤,等.温针灸对腰椎间盘突出症患者血浆β-内啡肽的影响[J].针刺研究,2018,43(8):512-515.

相似文献/References:

[1]张征,章媛,邹佳华.射频热凝靶点消融减压术联合中药穴位注射治疗腰椎间盘突出临床研究*[J].陕西中医,2019,(11):1548.
　ZHANG Zheng,ZHANG Yuan,ZOU Jiahua..Radiofrequency thermocoagulation target ablation and decompression combined with acupoint injection in the treatment of lumbar disc herniation[J].,2019,(10):1548.
[2]张云亮,徐蕴杰△,李 鞠,等.身痛逐瘀汤改良制备黑膏药治疗气滞血瘀型腰椎间盘突出症疗效分析*[J].陕西中医,2020,(4):481.
[3]卢兴军,曾 涛,马道友△.推拿联合腰椎牵引治疗气滞血瘀型腰椎间盘突出症临床研究*[J].陕西中医,2020,(7):986.[doi:DOI:10.3969/j.issn.10007369.2020.07.045]
　LU Xingjun,ZENG Tao,MA Daoyou..Effect of lumbar traction combined with massage in the treatment of lumbar disc herniation with qi stagnation and blood stasis[J].,2020,(10):986.[doi:DOI:10.3969/j.issn.10007369.2020.07.045]
[4]沈志全,孙 娜,王愉鸿.经筋刺法联合定向透药技术治疗气滞血瘀兼阳气虚衰型腰椎间盘突出症临床研究[J].陕西中医,2024,(1):128.[doi:DOI:10.3969/j.issn.1000-7369.2024.01.030]

备注/Memo

备注/Memo:
基金项目:河北省中医药管理局科研计划项目(2022282)
更新日期/Last Update: 2024-10-08