燔针劫刺联合散寒通痹汤治疗腰椎间盘突出（寒湿痹阻证）临床观察

Clinical observation of Fanzhen Jieci acupuncture combined with Sanhan Tongbi Decoction on lumbar disc herniation (Hanshi Bizu syndrome)

关键词:  腰椎间盘突出症  寒湿痹阻  针刺  燔针劫刺  散寒通痹汤

Key words:  lumbar disc herniation  Hanshi Bizu  acupuncture  Fanzhen Jieci  Sanhan Tongbi Decoction

摘要:

[目的] 探讨燔针劫刺联合散寒通痹汤治疗寒湿痹阻型腰椎间盘突出症（LDH）疗效。[方法] 选择宣城市人民医院2019年1月至2021年10月期间收治的LDH患者106例，按照随机数字表法分为观察组和对照组，每组53例。对照组予以中药散寒通痹汤口服，观察组予以燔针劫刺联合散寒通痹汤治疗，疗程均为4周。比较两组治疗前后疼痛视觉模拟评分（VAS）、日本骨科协会（JOA）下腰痛评分、Oswestry功能障碍指数（ODI）；比较两组腰背肌群肌力；比较两组血清P物质（SP）、β内啡肽（β-EP）、前列腺素E₂（PGE₂）水平；比较两组治疗总有效率。[结果] 治疗后观察组VAS评分、ODI低于对照组（P<0.01），JOA下腰痛评分高于对照组（P<0.01）；腰背肌群前屈、后伸、左旋转、右旋转、左侧曲、右侧屈肌力均高于对照组（P<0.01）；血清SP、PGE₂水平低于对照组（P<0.01），β-EP水平高于对照组（P<0.01），治疗总有效率高于对照组（P<0.05）。[结论] 燔针劫刺联合散寒通痹汤可有效缓解疼痛，增强腰背部肌群力量，改善腰椎功能，调节血清SP、β-EP、PGE₂，治疗寒湿痹阻型LDH效果显著。

Abstract:

[Objective] To investigate the effect of Fanzhen Jieci acupuncture combined with Sanhan Tongbi Decoction on lumbar intervertebral disc herniation(LDH) of Hanshi Bizu syndrome. [Methods] The 106 patients with LDH treated in our hospital from January, 2019 to October, 2021 were randomly divided into observation group and control group, with 53 cases in each group. The control group were treated with traditional Chinese medicine Sanhan Tongbi Decoction orally for 4 weeks, and the observation group were treated with Fanzhen Jieci acupuncture combined with Sanhan Tongbi Decoction for 4 weeks. The pain visual analogue scale (VAS), Japanese Orthopaedic Association (JOA), low back pain score and Oswestry disability index (ODI) were compared between the two groups before and after treatment. The muscle strength of lumbar and dorsal muscles of the two groups was compared. The serum substance P (SP) and β-Endorphins (β-EP), prostaglandin E₂ (PGE₂) levels were compared. The total effective rates of the two groups was compared. [Results] The VAS score and ODI of the observation group were lower than those of the control group (P<0.01), and the JOA of low back pain score was higher than that of the control group (P<0.01). The strength of lumbar dorsal muscle group in flexion, extension, left rotation, right rotation, left flexion and right flexion were higher than those of the control group (P<0.01). The levels of serum SP and PGE₂ were lower than those of the control group (P<0.01). The level of β-EP was higher than that of the control group (P<0.01), and the total effective rate was higher than that of the control group(P<0.05). [Conclusion] Fanzhen Jieci acupuncture combined with Sanhan Tongbi Decoction can effectively relieve pain, enhance the strength of lumbar and back muscles, improve lumbar function and regulate serum SP, β-EP and PGE₂. It is effective in the treatment of LDH of Hanshi Bizu syndrome.