化瘀理筋针刺法联合中药热奄包对腰椎间盘突出症的治疗效果

王照平; 何嘉; 杨亚军; 王立娜; 王辉

doi:10.16766/j.cnki.issn.1674-4152.003491

化瘀理筋针刺法联合中药热奄包对腰椎间盘突出症的治疗效果

doi: 10.16766/j.cnki.issn.1674-4152.003491

1.
唐山市丰润区人民医院骨一科，河北唐山 064000
2.
唐山市丰润区人民医院骨三科
3.
唐山市丰润区中医医院外科，河北唐山 064000

基金项目:

河北省2022年度中医药类科研计划课题 2022559

详细信息

通讯作者:
王照平，E-mail：13933384719@163.com

中图分类号: R681.53 R245.31
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- 被引次数: 0
出版历程
- 收稿日期: 2024-02-18
- 网络出版日期: 2024-07-20

Therapeutic effect on the treatment of lumbar intervertebral disc herniation with the acupuncture method of Huayu Lijin combined with the traditional Chinese medicine Reyan Bao

1.
Department of Orthopedics, Tangshan Fengrun People's Hospital, Tangshan City, Tangshan, Hebei 064000, China

摘要

摘要: 目的探讨化瘀理筋针刺法联合中药热奄包治疗腰椎间盘突出症的临床效果及对患者疼痛、腰椎功能及炎症水平的影响。方法选取2020年6月-2022年6月唐山市丰润区人民医院收治的80例腰椎间盘突出症患者, 采用随机数字表法将患者分为化瘀理筋针刺法组与联合组, 每组40例, 化瘀理筋针刺法组给予化瘀理筋针刺法治疗, 联合组给予化瘀理筋针刺法配合中药热奄包治疗。以2周为1个疗程, 2组均治疗2个疗程。比较2组临床疗效及治疗前后腰椎功能、疼痛程度、肌电图及促炎因子水平变化。结果联合组总有效率为92.50%(37/40), 化瘀理筋针刺法组总有效率为70.00%(28/40), 差异有统计学意义(P < 0.05)。联合组治疗后Oswestry功能障碍指数低于化瘀理筋针刺法组, 差异均有统计学意义(P < 0.05)。联合组治疗后2周、1个月及3个月VAS评分低于化瘀理筋针刺法组, 差异均有统计学意义(P < 0.05)。联合组治疗后左侧平均功率频率(MPF)、右侧MPF、左侧积分肌电值(EMG)、右侧EMG均高于化瘀理筋针刺法组, 差异均有统计学意义(P < 0.05)。联合组治疗后血清IL-23、前列腺素E2水平低于化瘀理筋针刺法组, 差异均有统计学意义(P < 0.05)。结论化瘀理筋针刺法配合中药热奄包可有效缓解腰椎间盘突出症患者腰椎疼痛, 改善腰椎功能及腰背伸肌群肌电图指标, 减轻机体炎症反应, 值得推广应用。
- 化瘀理筋针刺法 /
- 中药热奄包 /
- 腰椎间盘突出症 /
- 腰椎功能 /
- 肌电图
Abstract: Objective To study the clinical efficacy of the Huayu Lijin acupuncture method combined with traditional Chinese medicine Reyan Bao in the treatment of lumbar disc herniation, and to evaluate the effects of this therapy on the degree of pain, lumbar function, and inflammatory response in patients. Methods A total of 80 patients with lumbar disc herniation admitted to Tangshan Fengrun People's Hospital in Tangshan City from June 2020 to June 2022 were randomly divided into two groups using a random number table method: the Huayu Lijin acupuncture group and the combination group, with 40 cases in each group.The Huayu Lijin acupuncture group received treatment with the Huayu Lijin acupuncture method, while the combination group received treatment with the Huayu Lijin acupuncture method combined with traditional Chinese medicine heat therapy.Both groups were treated for 2 weeks as a course of treatment, with 2 courses of treatment.The therapeutic effects, the changes in lumbar spine function, pain level, electromyography, and pro-inflammatory factor levels between two groups before and after treatment were compared. Results The total effective rate of the combined group was 92.50%(37/40), the total effective rate of the Huayu Lijin acupuncture group was 70.00%(28/40), and the difference was statistically significant (P < 0.05).After treatment, the Oswestry disability index of the combined group was lower than that of the Huayu Lijin acupuncture group (P < 0.05).After 2 weeks, 1 month, and 3 months of treatment, the VAS scores of the combination group were lower than that of the Huayu Lijin acupuncture group (P < 0.05).After combined treatment, the left mean power frequency (MPF), right MPF, left electromyographic (EMG), and right EMG in the combination group were higher than those in the Huayu Lijin acupuncture group (P < 0.05).After treatment, the serum levels of IL-23 and prostaglandin E2 in the combination group were lower than those in the Huayu Lijin acupuncture group (P < 0.05). Conclusion For patients with lumbar disc herniation, the acupuncture method of Huayu Lijin combined with traditional Chinese medicine Reyan Bao has a prominent effect in treating lumbar disc herniation.It can effectively alleviate lumbar pain, improve lumbar function and electromyographic indicators of the lumbar extensor muscle group, reduce body inflammatory reactions, and is worthy of promotion and application.
- Acupuncture method of Huayu Lijin /
- Traditional Chinese medicine Reyan Bao /
- Lumbar disc herniation /
- Lumbar function /
- Electromyogram

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表 1 2组腰椎间盘突出症患者临床效果比较[例(%)]

Table 1. Comparison of clinical outcomes for two groups of patients with lumbar disc herniation[cases(%)]

组别	例数	治愈	好转	未愈	总有效
联合组	40	21(52.50)	16(40.00)	3(7.50)	37(92.50)
化瘀理筋针刺法组	40	10(25.00)	18(45.00)	12(30.00)	28(70.00)
统计量		4.126^a			6.646^b
P值		0.005			0.020
注：^a为Z值，^b为χ²值。

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表 2 2组腰椎间盘突出症患者治疗前后ODI、JOA评分比较(x ±s，分)

Table 2. Comparison of ODI and JOA scores in two groups of patients with lumbar disc herniation before and after treatment (x ±s, points)

组别	例数	ODI评分		JOA评分
组别	例数	治疗前	治疗后	治疗前	治疗后
联合组	40	25.87±5.83	11.42±3.29^b	14.28±4.31	22.84±5.97^b
化瘀理筋针刺法组	40	24.15±5.59	16.61±4.24^b	13.92±4.12	18.01±4.74^b
统计量		1.347^a	7.362^c	0.382^a	9.114^c
P值		0.105	< 0.001	0.674	< 0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP < 0.05。

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表 3 2组腰椎间盘突出症患者不同时间点VAS评分比较(x ±s，分)

Table 3. Comparison of VAS scores at different time points in two groups of patients with lumbar disc herniation (x ±s, points)

组别	例数	治疗前	治疗2周	治疗1个月	治疗3个月	F值	P值
联合组	40	6.17±0.46	2.28±0.37^ac	1.61±0.31^ab	0.82±0.25^abc	29.436	< 0.001
化瘀理筋针刺法组	40	6.35±0.50	3.59±0.41^ac	2.53±0.34^ab	1.45±0.27^abc	31.532	< 0.001
F值		0.745	15.002	12.646	10.828
P值		0.312	< 0.001	< 0.001	< 0.001
注：与同组治疗前比较，^aP < 0.05；与治疗2周比较，^bP < 0.05；与治疗1个月比较，^cP < 0.05。

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表 4 2组腰椎间盘突出症患者治疗前后肌电图相关指标比较(x ±s)

Table 4. Comparison of electromyography-related indicators before and after treatment in two groups of patients with lumbar disc herniation (x ±s)

组别	例数	左侧MPF(Hz)		右侧MPF(Hz)		左侧EMG(μV×s)		右侧EMG(μV×s)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
联合组	40	38.45±4.06	47.81±6.78^b	35.27±4.72	45.72±5.97^b	106.38±10.69	132.86±12.35^b	95.31±9.86	124.73±11.54^b
化瘀理筋针刺法组	40	39.26±5.86	42.59±6.15^b	35.08±4.45	39.62±4.34^b	107.24±10.73	121.56±11.29^b	94.86±10.25	112.57±11.27^b
统计量		0.719^a	7.117^c	0.185^a	9.404^c	0.359^a	10.252^c	0.200^a	12.215^c
P值		0.362	< 0.001	0.924	< 0.001	0.708	< 0.001	0.845	< 0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP < 0.05。

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表 5 2组腰椎间盘突出症患者治疗前后血清IL-23、PGE2水平比较(x ±s，ng/mL)

Table 5. Comparison of serum IL-23 and PGE2 levels before and after treatment in two groups of patients with lumbar disc herniation (x ±s, ng/mL)

组别	例数	IL-23		PGE2
组别	例数	治疗前	治疗后	治疗前	治疗后
联合组	40	59.27±9.72	29.52±8.52^b	372.69±22.06	263.81±15.39^b
化瘀理筋针刺法组	40	58.63±9.16	47.38±8.94^b	375.58±20.25	314.29±17.78^b
统计量		0.303^a	15.225^c	0.610^a	21.442^c
P值		0.735	< 0.001	0.452	< 0.001
注：^a为t值，^c为F值。与同组治疗前比较，^bP < 0.05。

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