血清疼痛介质及炎症因子在腰椎间盘突出症急性期患者康复治疗前后的变化

目的 探讨血清疼痛介质及炎症因子在腰椎间盘突出症急性期患者康复治疗前后的变化。方法 选择2017年1月～2018年12月就诊的LDH急性期患者50例作为观察组。观察组患者予以卧床休息、避免腰部剧烈活动、腰椎骨盆牵引、针刺、理疗和推拿等康复措施,连用7 d。观察患者治疗前和治疗7 d后血清疼痛介质[多巴胺(DA)、去甲肾上腺素(NE)和5-羟色胺(5-HT)]及炎症因子[白介素-6(IL-6)、IL-8和IL-10]水平变化。另取体检中心健康体检者30例作为对照组。比较两组血清DA、NE、5-HT、IL-6、IL-8和IL-10水平。结果 观察组患者血清DA、NE和5-HT水平明显高于对照组(P0.01);治疗7 d后,观察组患者血清DA、NE和5-HT水平较治疗前明显下降(P0.05)。观察组患者血清IL-6、IL-8水平明显高于对照组,IL-10水平明显低于对照组(P0.01);治疗7 d后,观察组患者血清IL-6和IL-8水平较治疗前明显下降,IL-10水平较治疗前明显上升(P0.05)。结论LDH急性期存在血清疼痛介质DA、NE和5-HT水平异常升高,其水平的变化可作为LDH急性期治疗疗效随访和预后评估的敏感血清指标;同时LDH急性期存在促炎症/抗炎症因子网络水平紊乱,血清IL-6、IL-8水平的异常升高,血清IL-10水平异常下降,其水平的变化亦可作为LDH急性期疗效随访和预后评估的敏感血清指标。

Changes of serum pain mediators and inflammatory factors in patients with acute lumbar disc herniation before and after rehabilitation treatment

Objective To investigate the changes of serum pain mediators and inflammatory factors before and after rehabilitation treatment in patients with acute lumbar disc herniation.Methods 50 patients with acute LDH from January 2017 to December 2018 were enrolled as observation group.They were given rest in bed,avoiding lumbar violent activities,lumbar pelvic traction,acupuncture,physiotherapy and massage,etc.,for 7 days.The changes of serum pain mediators including dopamine(DA),norepinephrine(NE) and serotonin(5-HT),and inflammatory factors including interleukin-6(IL-6),IL-8 and IL-10 before and at 7 days after treatment in the observation group were observed.Another 30 healthy subjects in the physical examination center were used as the control group.Serum levels of DA,NE,5-HT,IL-6,IL-8 and IL-10 were compared between two group.Results The levels of serum DA,NE and 5-HT in the observation group were significantly higher than those in the control group(P<0.01).In the observation group,the levels of serum DA,NE and 5-HT after 7 days of treatment were significantly lower than those before treatment(P<0.05).The levels of serum IL-6 and IL-8 in the observation group were significantly higher than those in the control group,and the level of IL-10 in the observation group was significantly lower than that in the control group(P<0.01).After 7 days of treatment,the serum levels of IL-6 and IL-8 in the observation group were higher than those before treatment,and the level of IL-10 decreased significantly compared with that before treatment(P<0.05).Conclusion The levels of serum pain mediators including DA,NE and 5-HT are abnormally elevated in the acute phase of LDH.The changes of serum levels can be used as sensitive serum indicators for the follow-up and prognosis evaluation of acute LDH treatment.Meanwhile,there is pro-inflammatory/anti-inflammatory factor network level disorder,abnormal rise of serum IL-6 and IL-8,and abnormal decrease of serum IL-10 in the acute phase of LDH.The change can also be used as a sensitive serum index for follow-up and prognosis evaluation of acute LDH treatment.