三维平衡正脊手法配合针灸治疗腰椎间盘突出症临床研究
|
摘要
目的 :观察三维平衡正脊手法配合针灸治疗腰椎间盘突出症的临床疗效及患者血清白细胞介素-6(IL-6)、降钙素基因相关肽(CGRP)水平的变化。方法:将确诊患者73例随机分组,治疗组37例给予三维平衡正脊手法配合针灸治疗,对照组36例给予单纯针灸治疗。治疗1个月后观察疗效,对两组治疗前后疼痛等症状变化进行量化评分,包括视觉疼痛量表(VAS)及下腰痛日本骨科学会(JOA)量表评分,并用酶联免疫吸附法(ELISA)检测血清IL-6及CGRP的表达情况。结果:治疗组总有效率94.59%优于对照组77.78%(P<0.05);两组治疗后VAS值均较治疗前明显降低(P<0.05),且治疗组优于对照组(P<0.05);两组治疗后JOA值均明显高于治疗前(P<0.05),且治疗组优于对照组(P<0.05);两组患者治疗前血清IL-6及CGRP水平均明显高于健康组,两组治疗后均较治疗前明显降低(P<0.05),且治疗组两项指标的改善较对照组更显著(P<0.05)。结论:三维平衡正脊手法配合针灸治疗腰椎间盘突出症,通过调节炎症介质IL-6及CGRP的表达,能够有效改善患者的疼痛症状及腰部功能。
Objective:To observe the clinical efficacy of three-dimensional equilibrium chiropractic therapy combined with acupuncture on lumbar intervertebral disc herniation(LIDH) and the influence on serum interleukin 6(IL-6) and calcitonin gene-related peptide(CGRP) levels. Methods:Seventy-three LIDH patients were randomized into two groups:the treatment group(n= 37) was given three-dimensional equilibrium chiropractic therapy combined with acupuncture,while the control group(n= 36) was only treated with acupuncture. After one-month treatment,the curative effects were observed and the scores of pain and other symptoms were quantified according to visual acuity scale(VAS) and Japanese Orthopaedic Association(JOA) Lower Back Pain Scale. Furthermore,enzyme linked immunosorbent assay(ELISA) was used to detect serum IL-6 and CGRP levels. Results:The overall curative effect in the treatment group(94.59%) was significantly greater than that in the control group(77.78%)(P<0.05). VAS score in both groups were significantly lower than those before treatment(P<0.05),and the VAS score in the treatment group was better than that in the control group(P<0.05). JOA scores in both groups were significantly higher than those before treatment(P <0.05),and in the treatment group they were better than those in the control group(P<0.05). Before treatment,the serum IL-6 and CGRP levels in both groups were markedly higher than those in the healthy group(P <0.05). After treatment the serum IL-6 and CGRP levels in both groups decreased significantly compared with before treatment(P<0.05),and in the treatment group they were better than those in the control group(P <0.05). Conclusion:Three-dimensional equilibrium chiropractic therapy combined with acupuncture could effectively relieve the pain symptoms and improve lumbar functions of LIDH patients via regulating inflammatory cytokine IL-6 and CGRP.
Objective:To observe the clinical efficacy of three-dimensional equilibrium chiropractic therapy combined with acupuncture on lumbar intervertebral disc herniation(LIDH) and the influence on serum interleukin 6(IL-6) and calcitonin gene-related peptide(CGRP) levels. Methods:Seventy-three LIDH patients were randomized into two groups:the treatment group(n= 37) was given three-dimensional equilibrium chiropractic therapy combined with acupuncture,while the control group(n= 36) was only treated with acupuncture. After one-month treatment,the curative effects were observed and the scores of pain and other symptoms were quantified according to visual acuity scale(VAS) and Japanese Orthopaedic Association(JOA) Lower Back Pain Scale. Furthermore,enzyme linked immunosorbent assay(ELISA) was used to detect serum IL-6 and CGRP levels. Results:The overall curative effect in the treatment group(94.59%) was significantly greater than that in the control group(77.78%)(P<0.05). VAS score in both groups were significantly lower than those before treatment(P<0.05),and the VAS score in the treatment group was better than that in the control group(P<0.05). JOA scores in both groups were significantly higher than those before treatment(P <0.05),and in the treatment group they were better than those in the control group(P<0.05). Before treatment,the serum IL-6 and CGRP levels in both groups were markedly higher than those in the healthy group(P <0.05). After treatment the serum IL-6 and CGRP levels in both groups decreased significantly compared with before treatment(P<0.05),and in the treatment group they were better than those in the control group(P <0.05). Conclusion:Three-dimensional equilibrium chiropractic therapy combined with acupuncture could effectively relieve the pain symptoms and improve lumbar functions of LIDH patients via regulating inflammatory cytokine IL-6 and CGRP.
引文
[1]PEDERSEN L M,SCHISTAD E,JACOBSEN L M,et al.Serum levels of the pro-inflammatory interleukins 6(IL-6)and-8(IL-8)in patients with lumbar radicular pain due to disc herniation:A 12-month prospective study[J].Brain Behav Immun,2015,46:132-136.
[2]SATO M,INAGE K,SAKUMA Y,et al.Anti-RANKL antibodies decrease CGRP expression in dorsal root ganglion neurons innervating injured lumbar intervertebral discs in rats[J].Eur Spine J,2015,24(9):2017-2022.
[3]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,1994:201-202.
[4]师彬,孙国栋.三维平衡正脊技术-治疗脊柱及脊柱相关病[M].济南:山东大学出版社,2009:273.
[5]陈伟峰.针灸治疗腰椎间盘突出症的研究进展[J].针灸经络,2006,19(5):35-37.
[6]OHTORI S,INOUE G,KOSHI T,et al.Characteristics of sensory dorsal root ganglia neurons innervating the lumbar vertebral body in rats[J].J Pain,2007,8(6):483-488.
[7]TAKEUCHI H,KAWAGUCHI S,OHWADA O,et al.Plasma neuropeptides in patients undergoing lumbar discectomy[J].Spine,2007,32(2):79-84.
[8]CHOUSSAT R,MONTALESCOT G,COLLET J,et al.Effect of prior exposure to Chlamydia pneumoniae,Helicobacter pylori,or cytomegalovirus on the degree of inflammation and one-year prognosis of patients with unstable angina pectoris or non-Q-wave acute myocardial infarction[J].Am J Cardiol,2000,86(4):379-384.
[2]SATO M,INAGE K,SAKUMA Y,et al.Anti-RANKL antibodies decrease CGRP expression in dorsal root ganglion neurons innervating injured lumbar intervertebral discs in rats[J].Eur Spine J,2015,24(9):2017-2022.
[3]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,1994:201-202.
[4]师彬,孙国栋.三维平衡正脊技术-治疗脊柱及脊柱相关病[M].济南:山东大学出版社,2009:273.
[5]陈伟峰.针灸治疗腰椎间盘突出症的研究进展[J].针灸经络,2006,19(5):35-37.
[6]OHTORI S,INOUE G,KOSHI T,et al.Characteristics of sensory dorsal root ganglia neurons innervating the lumbar vertebral body in rats[J].J Pain,2007,8(6):483-488.
[7]TAKEUCHI H,KAWAGUCHI S,OHWADA O,et al.Plasma neuropeptides in patients undergoing lumbar discectomy[J].Spine,2007,32(2):79-84.
[8]CHOUSSAT R,MONTALESCOT G,COLLET J,et al.Effect of prior exposure to Chlamydia pneumoniae,Helicobacter pylori,or cytomegalovirus on the degree of inflammation and one-year prognosis of patients with unstable angina pectoris or non-Q-wave acute myocardial infarction[J].Am J Cardiol,2000,86(4):379-384.