隔药饼灸对腰椎间盘突出症患者腰腿痛功能及血浆P物质的影响

目的:观察隔药饼灸配合针刺对腰椎间盘突出症患者腰腿痛功能的改善作用及对血浆P物质的影响。方法:将114例腰椎间盘突出症腰腿痛患者随机分为治疗组58例和对照组56例,治疗组采用针刺配合隔药饼灸夹脊、环跳、承山、昆仑等穴,对照组采用针刺配合隔面饼灸相同穴位,每日治疗1次,共治疗10次。观察治疗前后患者腰腿痛功能、下腰痛(JOA)积分、视觉模拟评分(VAS),测定血浆P物质含量。结果:两组治疗前后各项临床症状评分较治疗前均明显改善(P0.01,P0.05)。两组患者治疗后临床症状积分比较,腰腿痛功能积分(P0.05)、JOA积分(P0.05)、VAS(P0.01),差异均有统计学意义,治疗组均优于对照组。两组治疗后JOA改善率比较,治疗组优于对照组(P0.05)。两组患者临床治愈率比较,治疗组优于对照组(P0.01)。治疗后两组血浆P物质含量比较,治疗组低于对照组(P0.05)。结论:针刺加隔药饼灸对腰椎间盘突出症腰腿痛改善作用优于隔面饼灸。

Effect of Medicinal-cake-separated Moxibustion on Functional Activity of Back-leg and Plasma Substance P Level in Patients with Lumbar Disc Herniation

Objective To observe the effect of medicinal-cake-separated moxibustion combined with acupuncture on back-leg activities and plasma substance P(SP)levels in patients with lumbar disc herniation,so as to reveal its mechanism underlying pain relief.Methods A total of 114 patients with lumbar disc herniation were randomly divided into control group(n=56)and treatment group(n=58)according to a random digits table.Patients of the control group were treated by manual acupuncture stimulation of main acupoints Jiaji(EX-B 2),Huantiao(GB 30,affected side),Chengshan(BL 57,affected side),Kunlun(BL 60,affected side),and supplemented acupoints Yanglingquan(GB 34),Weizhong(BL 40)and Zusanli(ST 36)in combination with wheat-flour-cake separated moxibustion at the main acupoints,and patients of the treatment group were treated by medicinal-cake[Chuanwu(Radix Aconiti),Caowu(Radix Aconiti Kusnezoffii),Ruxiang(Olibanum),etc.]-separated moxibustion in combination with manual acupuncture stimulation of the same acupoints mentioned above.Acupuncture treatment was conducted for 30 min,followed by moxibustion for 15 min.The treatment was given once daily for 10 days.The patients' back-leg functional activity ability was assessed using straight-leg raising test,and the pain state assessed using visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA)scores,respectively.The therapeutic effect was evaluated by using"Criteria for Diagnosis and Outcome Evaluation of Clinical Disorders or Syndromes of Chinese Medicine"issued in 1994 and plasma SP content was detected by radioimmunoassay.Results After the therapy,the back-leg activity score and JOA score of both groups were significantly higher than those of pre-treatment in the same one group(P<0.05,P<0.01),and those of the treatment group were significantly higher than those of the control group(P<0.05).The VAS score of the treatment group was remarkably lower than that of the control group(P<0.01).After the treatment,the plasma SP content was markedly lower in the treatment group than in the control group(P<0.05).Conclusion Medicinal-cake-separated moxibustion therapy can ameliorate pain severity and functional activity of the back-leg pain patients with lumbar disc hernia,which may be related to its effect in reducing blood SP level.