摘要
目的探讨针灸联合温经通络汤治疗急性腰椎间盘突出症(LDH)患者的临床效果,并通过检测患者血清差异代谢物(β-隐黄素、丙酮酸、赖氨酸、柠檬酸)水平的变化探讨其作用机制。方法将126例急性LDH患者,随机分为观察组和对照组,每组63例。两组均给予常规保守治疗,观察组同时采用针灸联合温经通络汤治疗,均治疗3周。治疗结束后,对比两组的治疗效果,并比较两组患者治疗前后疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)、日本骨科协会(JOA)评分,以及血清差异代谢物(β-隐黄素、丙酮酸、赖氨酸、柠檬酸)水平。结果观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组的疼痛VAS评分均随治疗时间延长而逐渐降低,且观察组低于对照组;两组JOA量表评分增加,ODI降低,观察组以上评分改善情况均优于对照组(均P<0.05);两组血清β-隐黄素、丙酮酸、赖氨酸、柠檬酸水平均增加,且观察组上述代谢物水平均高于对照组(均P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论在常规保守治疗的基础上,采用针灸联合温经通络汤治疗急性LDH临床效果显著,可有效地改善患者腰椎和下肢功能、缓解腰部疼痛,且无明显不良反应,其作用机制可能与抗炎、抗氧化及改善能量代谢相关。
Objective To explore the clinical efficacy of acupuncture and moxibustion combined with Wenjing Tongluo Decoction for the treatment of patients with acute lumbar disc herniation(LDH),and to investigate its mechanism of action by detecting the changes in serum levels of differential metabolites(β-cryptoxanthin,pyruvic acid,lysine,and citric acid)of the patients.Methods A total of 126 patients with acute LDH were randomly divided into observation group and control group,with 63 cases in each group.Both groups were given conventional expectant treatment,the observation group received acupuncture and moxibustion combined with Wenjing Tongluo Decoction additionally,and all patients were treated for three weeks.After the end of treatment,treatment effects were compared between the two groups,and the Visual Analogue Scale(VAS)pain score,Oswestry Disability Index(ODI)and Japanese Orthopaedic Association(JOA)score,as well as serum differential metabolites(β-cryptoxanthin,pyruvic acid,lysine,and citric acid)levels,were compared between the two groups before and after treatment.Results The overall effective rate for treatment in the observation group was higher than that in the control group(P<0.05).After treatment,VAS pain scores in both groups decreased gradually over time,and the observation group exhibited lower scores than the control group;JOA scale score was higher and ODI was lower in both groups;the observation group was superior to the control group in the improvements of the aforementioned scores(all P<0.05);serum levels ofβ-cryptoxanthin,pyruvic acid,lysine and citric acid were increased in both groups,and the levels of the metabolites mentioned above in the observation group were higher than those in the control group(all P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Based on conventional expectant therapy,acupuncture and moxibustion combined with Wenjing Tongluo Decoction has significant clinical efficacy for th
作者
钮静
杜宗攀
王小斌
NIU Jing;DU Zong-pan;WANG Xiao-bin(Department of Emergency,Beijing Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China;Department of Neurology,Beijing Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China;Department of Orthopedics and Traumatology,Beijing Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China)
出处
《广西医学》
CAS
2021年第19期2306-2310,共5页
Guangxi Medical Journal
基金
北京市大兴区中西医结合医院院级科研课题(DXZXYZ201701)。
关键词
腰椎间盘突出症
针灸
温经通络汤
差异代谢物
腰椎功能
疼痛
Lumbar disc herniation
Acupuncture and moxibustion
Wenjing Tongluo Decoction
Differential metabolites
Lumbar function
Pain
