通督正脊手法联合温针灸治疗腰椎间盘突出症的临床研究

Curative effect of Tongdu Zhengji manipulation combined with warm acupuncture and moxibustion on lumbar disc herniation and its influences on the recovery of lumbar function and hemorheology

关键词:  腰椎间盘突出症  通督正脊手法  温针灸  腰椎功能  血液流变学

Key words:  lumbar disc herniation  Tongdu Zhengji manipulation  warm acupuncture and moxibustion  lumbar function  hemorheology

摘要:

[目的] 探讨通督正脊手法联合温针灸治疗腰椎间盘突出症（LDH）的疗效及对腰椎功能恢复、血液流变学的影响。[方法] 选取2021年6月—2024年6月就诊于山西省中医院的100例LDH患者，使用随机数字表法随机分为2组，每组各50例。其中针灸组采用温针灸治疗，联合组采用通督正脊手法联合温针灸治疗，疗程均为4周。收集2组基线资料，并观察治疗前、治疗4周后中医证候总积分、临床总有效率变化情况、视觉模拟评分量表（VAS）评分、Oswestry功能障碍评分指数（ODI）评分及日本骨科学会腰椎功能（JOA）评分，采用量角器测量腰部屈伸、伸展及侧屈活动度，采用全自动血液流变仪检测血浆黏度、全血高切黏度、全血低切黏度、红细胞聚集指数。[结果] 联合组总有效率为92.00%，高于针灸组的76.00%（P < 0.05）。治疗4周后，联合组中医证候总积分、VAS评分及ODI评分均低于针灸组（P < 0.05），JOA评分高于针灸组（P < 0.05）。治疗4周后，联合组腰部屈伸、伸展及侧屈活动度均大于针灸组（P < 0.05），血浆黏度、全血高切黏度、全血低切黏度及红细胞聚集指数均低于针灸组（P < 0.05）。[结论] 采用通督正脊手法联合温针灸治疗LDH效果明显，可促进腰椎功能恢复，提高腰部活动度，改善血液流变学。

Abstract:

[Objective]To explore the curative effect of Tongdu Zhengji manipulation combined with warm acupuncture and moxibustion on lumbar disc herniation(LDH)and its influences on the recovery of lumbar function and hemorheology.[Methods]One hundred patients with LDH who visited our hospital from June 2021 to June 2024 were selected and randomly divided into two groups using the random number table method, with 50 cases in each group. The acupuncture group was treated with warm acupuncture, while the combined group was treated with the Tungdu Zhengji technique combined with warm acupuncture. The treatment course was 4 weeks for both groups. Baseline data of the two groups were collected, and changes in the total score of taditional Chinese medicine (TCM)syndromes, total clinical effective rate, Visual Analogue Scale(VAS)score, Oswestry Disability Index(ODI)score, and Japanese Orthopaedic Association(JOA)score for the lumbar spine were observed before and after treatment. The range of motion of lumbar flexion, extension, and lateral flexion was measured with a goniometer, and plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, and red blood cell aggregation index were detected using an automatic blood rheometer.[Results]The total effective rate of the combined group was 92.00%, which was higher than that of the acupuncture and moxibustion group(76.00%, P < 0.05). After treatment, the total TCM syndrome score, VAS score and ODI score of the combined group were all lower than those of the acupuncture group(P < 0.05), while the JOA score was higher than that of the acupuncture group(P < 0.05). After therapy, the combined group had greater lumbar flexion, extension and lateral flexion activities(P < 0.05), and lower plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, and erythrocyte aggregation index than the acupuncture and moxibustion group (P < 0.05).[Conclusion]Tongdu Zhengji manipulation combined with warm acupuncture and moxibustion has obvious effect on LDH. It can promote the recovery of lumbar function, improve lumbar mobility and enhance hemorheology.