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密集型温针斜刺与传统循经针刺治疗血瘀型腰椎间盘突出症的临床疗效比较

Comparison of clinical efficacy between intensive warm needle oblique acupuncture and traditional acupuncture along meridians in treatment of lumbardisc herniation with blood stasis syndrome

    摘要
  • 摘要:
      目的  比较密集型温针斜刺与传统循经针刺治疗血瘀型腰椎间盘突出症的临床疗效。
      方法  将120例腰椎间盘突出症患者随机分为观察组(60例)和对照组(60例)。对照组采用传统循经针刺进行治疗，根据症状表现不同分为胆经型、膀胱经型和混合型，分别选取相应穴位进行针刺。观察组患者采用密集型温针斜刺治疗，在腰夹脊穴和压痛点进行密集多针斜刺，得气后增加艾柱行灸法。2组患者均留针30 min/次, 1次/d, 每周6次, 1周为1个疗程，连续治疗3个疗程。比较2组患者治疗前后中医证候评分、日本骨科协会(JOA)下腰痛评价量表评分、疼痛介质前列腺素E2(PGE2)、环氧合酶-2(COX-2)和5-羟色胺(5-HT)水平、血液流变学指标(血浆黏度、全血高切黏度、全血低切黏度和红细胞聚集指数)水平，记录临床疗效和复发情况。
      结果  观察组治疗后中医证候评分低于对照组, JOA评分高于对照组，差异有统计学意义(P < 0.05); 观察组治疗后PGE2、5-HT、COX-2水平低于对照组，血浆黏度、高切全血黏度、低切全血黏度、红细胞聚集指数低于对照组，差异有统计学意义(P < 0.05); 观察组治疗总有效率高于对照组，复发率低于对照组，差异有统计学意义(P < 0.05)。
      结论  密集型温针斜刺相比于传统循经针刺可以更有效地降低中医证候评分，提高JOA评分，降低疼痛介质水平和血液流变学指标水平，改善患者腰部疼痛症状，提升治疗有效率，并减少复发。

     

    Abstract:
      Objective  To compare the clinical efficacy of intensive warm needle oblique acupuncture and traditional acupuncture along meridian in the treatment of blood stasis lumbar type of disc herniation.
      Methods  A total of 120 patients with lumbar disc herniation were randomly divided into observation group (60 cases) and control group (60 cases). The patients in the control group were treated with traditional acupuncture along the meridians, and were divided into gall meridian type, bladder meridian type and mixed type according to the symptoms. Patients in the observation group were treated with intensive warm needle oblique needling, and intensive multi-needle oblique needling was conducted at lumbar Jiaji point and tenderness point, and moxibustion method of moxa column was added after qi sensation. All patients were treated 30 minutes per time, 1 time per day, 6 times per week. One course was lasted for 1 week, and the treatment was lasted for 3 courses. The traditional Chinese medicine(TCM) symptom score, Japanese Orthopaedic Association(JOA) Low Back Pain Scale score, pain mediator prostaglandin E2(PGE2), cyclooxygenase-2(COX-2), 5-hydroxytryptamine(5-HT) levels and hemorheology indexes (plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity and erythrocyte aggregation index) were compared between two groups before and after treatment, and the clinical efficacy and recurrence were recorded.
      Results  TCM syndrome score of the observation group was lower than that of the control group, and the JOA score was higher than that of the control group (P < 0.05). The levels of PGE2, 5-HT and COX-2 in the observation group were lower than those in the control group, and the plasma viscosity, high shear whole blood viscosity, low shear whole blood viscosity and erythrocyte aggregation index in the observation group were lower than those in the control group (P < 0.05). The total effective rate of the observation group was higher than that of the control group, and the recurrence rate in the observation group was lower than that in the control group (P < 0.05).
      Conclusion  Compared with traditional acupuncture along meridians, intensive warm needle oblique needling can effectively reduce TCM syndrome score, improve JOA score, reduce pain medium level and hemorheology indexes, improve symptoms of waist pain, improve treatment efficiency and reduce recurrence.

     

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