“金钩钓鱼针法”联合身痛逐瘀汤治疗腰椎间盘突出症急性期疗效观察及机制研究
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摘要
目的观察"金钩钓鱼针法"联合身痛逐瘀汤治疗腰椎间盘突出症(LDH)急性期的疗效及机制。方法将90例LDH急性期患者按照随机数字表法分为2组,对照组45例采用"金钩钓鱼针法"治疗,治疗组45例在对照组治疗基础上加身痛逐瘀汤治疗。2组均治疗30 d,比较2组临床疗效。检测并比较2组治疗前后血清丙二醛(MDA)、超氧化物歧化酶(SOD)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、基质金属蛋白酶3(MMP-3)及6-酮-前列腺素F_(1α)(6-K-PGF_(1α))水平变化和疼痛视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分变化。结果治疗组临床疗效优于对照组(P<0.05),总有效率(93.33%)高于对照组(80.00%,P<0.05)。治疗后,2组MDA水平均较本组治疗前降低(P<0.05),SOD升高(P<0.05),且治疗组MDA低于对照组(P<0.05),SOD高于对照组(P<0.05)。治疗后,2组TNF-α及IL-6水平均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,2组MMP-3水平均较本组治疗前降低(P<0.05),6-K-PGF_(1α)升高(P<0.05),且治疗组MMP-3水平低于对照组(P<0.05),6-K-PGF_(1α)高于对照组(P<0.05)。治疗后,2组疼痛VAS及ODI评分均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。结论 "金钩钓鱼针法"联合身痛逐瘀汤治疗LDH急性期疗效确切,改善氧化应激、无菌性炎性反应、结缔组织损伤及血液循环可能是其作用机制。
Objective To observe effect observation and mechanism study of "Gold hook fishing acupuncture" combined with Shentong Zhuyu decoction in the treatment of acute lumbar disc herniation(LDH). Methods 90 patients with acute LDH were divided into two groups according to the random number table method. 45 cases in control group were treated by "Gold hook fishing acupuncture". 45 cases in treatment group were treated by Shentong Zhuyu decoction on the basis of the control group. Both groups were treated for 30 days, and the clinical efficacy of the two groups was compared. The level changes of serum malondialdehyde(MDA), superoxide dismutase(SOD), tumor necrosis factor-α(TNF-α), interleukin 6(IL-6), matrix metalloproteinase 3(MMP-3), and 6-keto prostaglandin F_(1α)(6-K-PGF_(1α)) were detected and compared in the two groups before and after treatment, and the changes of pain visual simulation score(VAS) and Oswestry disability index(ODI) score between the two groups were compared. Results The clinical efficacy of the treatment group was better than that of the control group(P<0.05), and the total effective rate(93.33%) was higher than that of the control group(80.00%, P<0.05). After treatment, the MDA levels of the two groups were lower than those before the treatment(P<0.05), the SOD were increased(P<0.05), and the MDA of the treatment group was lower than the control group(P<0.05), and the SOD was higher than the control group(P<0.05). After treatment, the TNF-α and IL-6 levels in both groups were lower than those before treatment(P<0.05), and those in the treatment group were lower than those in the control group(P<0.05). The levels of MMP-3 in the two groups were lower than those in the group before treatment(P<0.05), the 6-K-PGF_(1α) was increased(P<0.05), and the level of MMP-3 in the treatment group was lower than that in the control group(P<0.05). The 6-K-PGF_(1α) was higher than the control group(P<0.05). After treatment, the VAS and ODI scores of the two groups were lower than those before the treatment(P<0.05), and the treatment group was lower than the control group(P<0.05). Conclusion "Gold hook fishing acupuncture" combined with Shentong Zhuyu decoction in the treatment of acute LDH treatment is worthy of recognition, Its mechanism may be to improve oxidative stress, aseptic inflammatory response, connective tissue damage and blood circulation.
Objective To observe effect observation and mechanism study of "Gold hook fishing acupuncture" combined with Shentong Zhuyu decoction in the treatment of acute lumbar disc herniation(LDH). Methods 90 patients with acute LDH were divided into two groups according to the random number table method. 45 cases in control group were treated by "Gold hook fishing acupuncture". 45 cases in treatment group were treated by Shentong Zhuyu decoction on the basis of the control group. Both groups were treated for 30 days, and the clinical efficacy of the two groups was compared. The level changes of serum malondialdehyde(MDA), superoxide dismutase(SOD), tumor necrosis factor-α(TNF-α), interleukin 6(IL-6), matrix metalloproteinase 3(MMP-3), and 6-keto prostaglandin F_(1α)(6-K-PGF_(1α)) were detected and compared in the two groups before and after treatment, and the changes of pain visual simulation score(VAS) and Oswestry disability index(ODI) score between the two groups were compared. Results The clinical efficacy of the treatment group was better than that of the control group(P<0.05), and the total effective rate(93.33%) was higher than that of the control group(80.00%, P<0.05). After treatment, the MDA levels of the two groups were lower than those before the treatment(P<0.05), the SOD were increased(P<0.05), and the MDA of the treatment group was lower than the control group(P<0.05), and the SOD was higher than the control group(P<0.05). After treatment, the TNF-α and IL-6 levels in both groups were lower than those before treatment(P<0.05), and those in the treatment group were lower than those in the control group(P<0.05). The levels of MMP-3 in the two groups were lower than those in the group before treatment(P<0.05), the 6-K-PGF_(1α) was increased(P<0.05), and the level of MMP-3 in the treatment group was lower than that in the control group(P<0.05). The 6-K-PGF_(1α) was higher than the control group(P<0.05). After treatment, the VAS and ODI scores of the two groups were lower than those before the treatment(P<0.05), and the treatment group was lower than the control group(P<0.05). Conclusion "Gold hook fishing acupuncture" combined with Shentong Zhuyu decoction in the treatment of acute LDH treatment is worthy of recognition, Its mechanism may be to improve oxidative stress, aseptic inflammatory response, connective tissue damage and blood circulation.
引文
[1] 张兆振,杨豪,郭会卿,等.腰椎间盘突出症的国内外研究进展[J].风湿病与关节炎,2013,2(6):70-73.
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[3] 盛雪燕,朱田田,邢家铭,等.郑氏“金钩钓鱼”针法治疗肩关节周围炎临床随机对照研究[J].中国中医药信息杂志,2016,23(3):12-15.
[4] 刘朝圣.熊继柏教授运用身痛逐瘀汤治疗重度腰椎间盘突出症60例临床观察[J].湖南中医药大学学报,2014,34(1):34-36.
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[8] 刘绮,麦明泉,肖灵君,等.中文版Oswestry功能障碍指数评定慢性腰痛患者的反应度研究[J].中国康复医学杂志,2010,25(7):621-624.
[9] 郑红波.腰椎间盘突出症保守治疗的临床研究进展[J].世界中西医结合杂志,2013,8(11):1186-1188.
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[11] 孙润洁,田亮,方晓丽,等.“金钩钓鱼”针法结合Bobath技术治疗脑卒中后上肢痉挛状态的临床研究[J].中国针灸,2017,37(4):372-376.
[12] 刘灿,刘伟.身痛逐瘀汤[M].北京:中国医药科技出版社,2013:87-99.
[13] 王洪伟,李长青,周跃.腰椎间盘突出症疼痛发生机制的研究进展[J].中国矫形外科杂志,2011,19(7):568-571.
[14] 王永贵,刘江涛,庄正陵,等.丹红注射液联合复方倍他米松穴位注射治疗腰椎间盘突出症疗效及对血清BMP-2、TGF-β1、SOD、MDA的影响[J].现代中西医结合杂志,2017,26(19):56-58.
[15] 晁满香,李建军,许昌泰,等.腰椎间盘突出症伴疼痛患者血清细胞因子的改变[J].现代检验医学杂志,2018,33(2):19-22.
[16] 曹金梅,李秋宇,陈先菊,等.温阳通络胶囊合用腰八针温针灸对腰椎间盘突出症患者改良JOA评分、SOD和MDA的影响[J].按摩与康复医学,2013,4(12):63-65.
[17] 韩建军,李菊梅,丁文元,等.腰椎间盘突出程度与间盘组织肿瘤坏死因子α水平的关系[J].中国组织工程研究与临床康复,2008,12(33):6462-6465.
[18] 刘潮坚,蔡拉加,石昭宏,等.腰椎间盘突出物中TNF-α、IL-1、IL-6的表达与神经根性疼痛的相关性研究[J].临床医学工程,2011,18(7):987-988,991.
[19] 魏春,徐杰.腰椎间盘突出症患者外周血白细胞介素-1β、前列腺素E2及基质金属蛋白酶-3水平变化[J].新乡医学院学报,2017,34(1):76-78.
[20] 李伟,裴久国,莫锐芳,等.针刀整体松解术配合手法治疗对腰椎间盘突出症患者血清6-酮-前列腺素F1α的影响[J].湖北中医药大学学报,2016,18(3):44-46.
[2] 李华南,王金贵,丛德毓,等.中医综合治疗方案治疗腰椎间盘突出症多中心随机对照研究[J].中医杂志,2015,56(21):1840-1844.
[3] 盛雪燕,朱田田,邢家铭,等.郑氏“金钩钓鱼”针法治疗肩关节周围炎临床随机对照研究[J].中国中医药信息杂志,2016,23(3):12-15.
[4] 刘朝圣.熊继柏教授运用身痛逐瘀汤治疗重度腰椎间盘突出症60例临床观察[J].湖南中医药大学学报,2014,34(1):34-36.
[5] 康明海.腰椎间盘突出症的诊断与治疗[J].中国医药指南,2011,9(26):42-43.
[6] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:243-265.
[7] 宗行万之助.疼痛的估价:用特殊的视觉模拟评分法作参考(VAS)[J].疼痛学杂志,1994,2(4):153.
[8] 刘绮,麦明泉,肖灵君,等.中文版Oswestry功能障碍指数评定慢性腰痛患者的反应度研究[J].中国康复医学杂志,2010,25(7):621-624.
[9] 郑红波.腰椎间盘突出症保守治疗的临床研究进展[J].世界中西医结合杂志,2013,8(11):1186-1188.
[10] 朱博雯,张星华,孙润洁,等.郑氏“金钩钓鱼针法”治疗腰椎间盘突出症临床观察[J].中国针灸,2016,36(4):355-358.
[11] 孙润洁,田亮,方晓丽,等.“金钩钓鱼”针法结合Bobath技术治疗脑卒中后上肢痉挛状态的临床研究[J].中国针灸,2017,37(4):372-376.
[12] 刘灿,刘伟.身痛逐瘀汤[M].北京:中国医药科技出版社,2013:87-99.
[13] 王洪伟,李长青,周跃.腰椎间盘突出症疼痛发生机制的研究进展[J].中国矫形外科杂志,2011,19(7):568-571.
[14] 王永贵,刘江涛,庄正陵,等.丹红注射液联合复方倍他米松穴位注射治疗腰椎间盘突出症疗效及对血清BMP-2、TGF-β1、SOD、MDA的影响[J].现代中西医结合杂志,2017,26(19):56-58.
[15] 晁满香,李建军,许昌泰,等.腰椎间盘突出症伴疼痛患者血清细胞因子的改变[J].现代检验医学杂志,2018,33(2):19-22.
[16] 曹金梅,李秋宇,陈先菊,等.温阳通络胶囊合用腰八针温针灸对腰椎间盘突出症患者改良JOA评分、SOD和MDA的影响[J].按摩与康复医学,2013,4(12):63-65.
[17] 韩建军,李菊梅,丁文元,等.腰椎间盘突出程度与间盘组织肿瘤坏死因子α水平的关系[J].中国组织工程研究与临床康复,2008,12(33):6462-6465.
[18] 刘潮坚,蔡拉加,石昭宏,等.腰椎间盘突出物中TNF-α、IL-1、IL-6的表达与神经根性疼痛的相关性研究[J].临床医学工程,2011,18(7):987-988,991.
[19] 魏春,徐杰.腰椎间盘突出症患者外周血白细胞介素-1β、前列腺素E2及基质金属蛋白酶-3水平变化[J].新乡医学院学报,2017,34(1):76-78.
[20] 李伟,裴久国,莫锐芳,等.针刀整体松解术配合手法治疗对腰椎间盘突出症患者血清6-酮-前列腺素F1α的影响[J].湖北中医药大学学报,2016,18(3):44-46.