首页|点线面及整体结合针刺法联合甲钴胺治疗腰椎间盘突出症的疗效研究

点线面及整体结合针刺法联合甲钴胺治疗腰椎间盘突出症的疗效研究

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目的 研究点线面及整体结合针刺法联合甲钴胺治疗腰椎间盘突出症的疗效.方法 选取石家庄市人民医院康复医学二病区2020年6月-2023年4月收治的210例腰椎间盘突出症患者为研究对象,采用简单随机法分为两组.甲钴胺组105例给予甲钴胺治疗,针刺组105例在甲钴胺基础上联合点线面及整体结合针刺法治疗.比较两组视觉模拟(VAS)评分、Oswestry(ODI)评分、日本骨科协会(JOA)评分的差异,检测两组前列腺素E2(PGE2)、5-羟色胺(5-HT)、缺氧诱导因子-1α(HIF-1α)、肿瘤坏死因子-α(TNF-α)及腰部活动范围,统计两组疗效.结果 两组入院时相关评分比较,差异无统计学意义(P>0.05);两组治疗7 d、14 d时VAS评分、ODI评分、中医症状评分均较入院时下降,且针刺组治疗7 d、14 d低于甲钴胺组(P<0.05);两组治疗7 d、14 d时JOA评分均较入院时升高,且针刺组治疗7 d、14 d高于甲钴胺组(P<0.05).两组入院时腰部活动范围比较,差异无统计学意义(P>0.05);针刺组治疗7 d、14 d时腰部伸展、屈曲活动度均较入院时升高,甲钴胺组治疗7 d、14 d时腰部伸展活动度及治疗后14 d腰部屈曲活动度均较入院时升高,且针刺组治疗7 d、14 d高于甲钴胺组(P<0.05);两组入院时及治疗7 d、14 d时腰部侧曲活动度比较,差异无统计学意义(P>0.05).两组入院时PGE2、5-HT、HIF-1α、TNF-α比较,差异无统计学意义(P>0.05);两组治疗7 d、14 d时PGE2、5-HT、HIF-1α、TNF-α均较入院时下降,且针刺组治疗7 d、14 d低于甲钴胺组(P<0.05).针刺组总有效率为92.38%(97/105)高于甲钴胺组的81.90%(86/105),差异有统计学意义(P<0.05).结论 点线面及整体结合针刺法联合甲钴胺治疗腰椎间盘突出症可提高患者腰椎活动度,改善腰椎功能,降低PGE2、5-HT、HIF-1α、TNF-α的表达,提高疗效.
Study on Curative Effect of Acupuncture Combined with Mecobalamine in Treatment of Lumbar Disc Herniation
Objective To study the curative effect of point-line-surface-whole acupuncture combined with mecobalamine on lumbar disc herniation.Methods A total of 210 patients with lumbar disc herniation admitted to the Second ward of Rehabilita-tion Medicine of Shijiazhuang People's Hospital from June.2020 to April 2023 were selected as the study objects and divided into two groups by simple random method.Mecobalamine treatment was given to 105 cases in the mecobalamine group,and acupunc-ture treatment was given to 105 cases in the acupuncture group based on mecobalamine combined with point-line-surface-whole acupuncture.The visual analogue scale(VAS)scores,Oswestry index(ODI)and Japanese Orthopaedic Association(JOA)scores were compared between the two groups.Prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT),hypoxia-inducing fac-tor-1α(HIF-1α),tumor necrosis factor-α(TNF-α)and lumbar range of motion were detected between the two groups.The curative effects of the two groups were analyzed.Results There was no significant difference in relevant scores between the two groups at admission(P>0.05).VAS scores,ODI scores and TCM symptom scores of both groups were decreased on 7 d and 14 d after treatment compared with those at admission,and the scores of the acupuncture group were lower than those of the mecobal-amine group on 7 d and 14 d after treatment(P<0.05).The JOA scores of the two groups were higher on day 7 d and 14 d com-pared with those at admission,and the scores of the acupuncture group were higher on day 7 d and 14 d than those of the mecobal-amine group(P<0.05).There was no significant difference in lumbar motion range between the two groups at admission(P>0.05).The lumbar extension and flexion activity of the acupuncture group at 7 d and 14 d were higher than those at admission,and the lumbar extension and flexion activity of the mecobalamine group at 7 d and 14 d were higher than those at admission,and the lumbar extension and flexion activity of the acupuncture group at 7 d and 14 d were higher than those of the mecobalamine group(P<0.05).There was no significant difference in lumbar lateral flexural motion between the two groups at admission,7 d and 14 d after treatment(P>0.05).There was no significant difference in PGE2,5-HT,HIF-1α or TNF-α between the two groups at admission(P>0.05).The levels of PGE2,5-HT,HIF-1 α and TNF-α in both groups were decreased at 7 d and 14 d after treatment compared with those at admission,and the levels of the acupuncture group were lower than those of the meco-balamine group at 7 d and 14 d after treatment(P<0.05).The total effective rate of the acupuncture group was 92.38%(97/105),higher than that of the mecobalamine group(81.90%(86/105),with statistical difference(P<0.05).Conclusion Point-line-surface-whole acupuncture combined with mecobalamine in the treatment of lumbar disc herniation can improve the lum-bar motion and the lumbar function,reduce the levels of PGE2,5-HT,HIF-1α and TNF-α,and increase the curative effect.

acupuncture methodmecobalaminelumbar disc herniationlumbar spine functioncurative effect

耿雪莲、刘海侠、马怡坤、杨军静、郑丽

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石家庄市人民医院,河北石家庄 050000

石家庄信息工程职业学院,河北石家庄 050000

针刺法 甲钴胺 腰椎间盘突出症 腰椎功能 疗效

2025

辽宁中医杂志
辽宁中医药大学,辽宁省中医药学会

辽宁中医杂志

北大核心
影响因子:0.815
ISSN:1000-1719
年,卷(期):2025.52(1)