针刺结合独活寄生汤治疗腰椎间盘突出症急性期临床观察

目的观察针刺“王氏腰痛八针”结合独活寄生汤治疗腰椎间盘突出症急性期的临床疗效。方法将2017年1月—2019年5月北京中医医院顺义医院治疗的72例腰椎间盘突出症急性期患者随机分为观察组和对照组,每组36例。对照组予以布洛芬缓释胶囊口服;观察组在对照组治疗基础上加用针刺结合独活寄生汤口服治疗,2组均连续治疗2周。比较2组治疗前和治疗2周、3个月随访时JOA下腰痛评分、疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数评分(ODI),检测治疗前后2组胫神经和腓总神经运动传导速度、炎性因子水平,并比较2组治疗后的临床疗效。结果2组治疗后及随访时JOA评分、VAS评分、ODI评分均较治疗前有明显改善(P均<0.05),且观察组在治疗后及随访时上述评分改善程度更为显著(P均<0.05);2组治疗后胫神经和腓总神经运动传导速度均较治疗前显著加快(P均<0.05),且观察组显著快于对照组(P均<0.05);2组治疗后血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均较治疗前明显降低(P均<0.05),且观察组显著低于对照组(P均<0.05)。观察组总有效率为94.4%(34/36),高于对照组的80.6%(29/36),差异有统计学意义(P<0.05)。结论针刺“王氏腰痛八针”结合独活寄生汤治疗可显著改善腰椎间盘突出症急性期患者的临床症状和腰椎功能,减轻疼痛,改善神经传导速度,降低相关炎性因子水平,并具有较好的远期疗效。

Clinical observation on acupuncture combined with Duhuo Jisheng Decoction on acute lumbar disc herniation

Objective It is to observe the clinical efficacy of acupuncture“Wang’s lumbago eight needles”combined with Duhuo Jisheng Decoction in the treatment of acute lumbar disc herniation.Methods A total of 72 patients with acute lumbar disc herniation treated in Shunyi District Hospital of Traditional Chinese Medicine from January 2017 to May 2019 were randomly divided into observation group and control group,with 36 cases in each group.The control group was given ibuprofen sustained-release capsule orally;the observation group was treated with acupuncture combined with Duhuo Jisheng Decoction based on the control group,both groups were continuously treated for 2 weeks.The JOA low back pain score,visual analogue scale(VAS)score,Oswestry disability index(ODI)before treatment and after 2 weeks of treatment and 3 months of follow up were compared between the two groups,the motor conduction velocity of tibial nerve and common peroneal nerve,and levels of inflammatory factors were detected before and after treatment,the clinical curative effects were compared between the two groups.Results The JOA score,VAS score and ODI score of the two groups after treatment and follow-up were significantly improved compared with before treatment(all P<0.05),the improvement of the above scores in the observation group after treatment and follow-up was more significant(all P<0.05);the motor conduction velocity of tibial nerve and common peroneal nerve of the two groups after treatment were significantly faster than those before treatment(all P<0.05),and the observation group was faster than the control group(all P<0.05);the levels of serum IL-1β,IL-6 and TNF-α after treatment were significantly lower than those before treatment in the two groups(all P<0.05),and the observation group was significantly lower than the control group(all P<0.05).The total effective rate of the observation group was 94.4%(34/36),which was higher than 80.6%(29/36)of the control group(P<0.05).Conclusion Acupuncture with“Wang’s lumbago eight needles”combined with Duhuo Jisheng Decoction can significantly improve the clinical symptoms and lumbar function,relieve pain,improve nerve conduction velocity,reduce the level of related inflammatory factors,and has a good long-term effect in patients with acute lumbar disc herniation.