电针联合牵引治疗坐骨神经痛的效果及对致痛物质的影响
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摘要
目的研究电针联合牵引治疗腰椎间盘突出所致的坐骨神经痛的效果及对致痛物质5-羟色胺(5-HT)和P物质(SP)的影响。方法将符合纳入标准的坐骨神经痛患者126例随机分为电针组(A组)、牵引组(B组)和电针联合牵引组(C组),每组各42例。3组共同的基础治疗一致。分别于治疗前和治疗3 d、7 d、14 d、21 d后评定疼痛缓解程度(VAS评分)以及M-JOA评分,同时检测患者外周血中相关致痛物质水平,分析生物学指标的变化与疗效的关系。结果 3组患者治疗3 d后VAS评分均有明显降低(P均<0.05),C组治疗14 d、21 d的VAS评分明显低于A、B组(P均<0.05)。3组M-JOA评分在治疗3 d后均开始升高,C组治疗14 d、21 d后M-JOA评分明显高于A、B组(P均<0.05)。3组患者5-HT和SP含量在治疗3 d后均开始降低,而C组在治疗7 d、14 d、21 d时的含量明显低于A、B组(P均<0.05)。结论电针联合牵引治疗坐骨神经痛能更快速显著地缓解疼痛,降低相关致痛物质的水平,值得临床推广应用。
Objective It is to explore the curative effect of electric acupuncture combined with traction on ischioneuralgia induced by prolapse of lumbar intervertebral disc and influence on pain-producing substances hydroxytryptamine( 5-HT) and substance P( SP). Methods 126 patients with ischioneuralgia met with the Inclusion criteria were randomly divided into electric acupuncture group( group A),traction group( group B) and electric acupuncture plus traction group( group C),each group had 42 cases. Group A,group B and group C were respectively treated with electric acupuncture,traction and electric acupuncture plus traction based on basic therapy. The VAS scores and M-JOA scores were evaluated while the changes of correlated pain-producing substances in peripheral blood were determined before treatment and after treatment for 3,7,14 and 21 days,thus to analyze the relationship between the changes of these indexes with curative effect. Results After treatment for 3 days,the VAS scores were all significantly decreased in the three groups,and the scores in group C were significantly lower than those in group A and group B after treatment for 14,21 days( P < 0. 05).The M-JOA scores began to increase in the three groups after treatment for 3 days,and the sores were significantly higher than those in group A and group B after treatment for 14,21 days( P < 0. 05). The contents of 5-HT and SP began to decrease in the three groups after treatment for 3 days,and the contents were significantly lower than those in group A and group B after treatment for 14,21 days( P < 0. 05). Conclusion Electric acupuncture combined with traction could relieve pain and decrease the levels of correlated pain-producing substances more fast and significantly in the treatment of ischioneuralgia,it is worthy of popularization and application.
Objective It is to explore the curative effect of electric acupuncture combined with traction on ischioneuralgia induced by prolapse of lumbar intervertebral disc and influence on pain-producing substances hydroxytryptamine( 5-HT) and substance P( SP). Methods 126 patients with ischioneuralgia met with the Inclusion criteria were randomly divided into electric acupuncture group( group A),traction group( group B) and electric acupuncture plus traction group( group C),each group had 42 cases. Group A,group B and group C were respectively treated with electric acupuncture,traction and electric acupuncture plus traction based on basic therapy. The VAS scores and M-JOA scores were evaluated while the changes of correlated pain-producing substances in peripheral blood were determined before treatment and after treatment for 3,7,14 and 21 days,thus to analyze the relationship between the changes of these indexes with curative effect. Results After treatment for 3 days,the VAS scores were all significantly decreased in the three groups,and the scores in group C were significantly lower than those in group A and group B after treatment for 14,21 days( P < 0. 05).The M-JOA scores began to increase in the three groups after treatment for 3 days,and the sores were significantly higher than those in group A and group B after treatment for 14,21 days( P < 0. 05). The contents of 5-HT and SP began to decrease in the three groups after treatment for 3 days,and the contents were significantly lower than those in group A and group B after treatment for 14,21 days( P < 0. 05). Conclusion Electric acupuncture combined with traction could relieve pain and decrease the levels of correlated pain-producing substances more fast and significantly in the treatment of ischioneuralgia,it is worthy of popularization and application.
引文
[1]杨期东.神经病学[M].北京:人民卫生出版社,2004:240
[2]Aizawa T,Sato T,Sasaki H,et al.Results of surgical treatment for thoracic myelopathy:minimum 2-year follow-up study in 132 patients[J].J Neurosurg Spine,2007,7(1):13-20
[3]孙传兴.临床疾病诊断依据治疗好转标准[M].2版.北京:人民军医出版社,2002:198
[4]郭冬梅,谢淑萍.神经系统疾病[M].北京:中国医药科技出版社,2002:47-49
[5]姜志,李毅中.腰椎间盘突出所致坐骨神经痛发病机制[J].国际骨科学杂志,2010,31(2):102-104
[6]陈美仁,王萍,成钢.温针灸对坐骨神经痛患者痛阈值的影响[J].中国针灸,2005,25(12):831-833
[7]Manzoni GC,Torelli P.Symptomatic treatment of migraine:from scientific evidence to patient management[J].Neurol Sci,2014,35(1):11-15
[8]Humes DJ,Simpson J,Smith J,et al.Visceral hypersensitivity insymptomatic diverticular disease and the role of neuropeptides and low grade inflammation[J].Neurogastroenterol Motil,2012,24(4):318-e163
[2]Aizawa T,Sato T,Sasaki H,et al.Results of surgical treatment for thoracic myelopathy:minimum 2-year follow-up study in 132 patients[J].J Neurosurg Spine,2007,7(1):13-20
[3]孙传兴.临床疾病诊断依据治疗好转标准[M].2版.北京:人民军医出版社,2002:198
[4]郭冬梅,谢淑萍.神经系统疾病[M].北京:中国医药科技出版社,2002:47-49
[5]姜志,李毅中.腰椎间盘突出所致坐骨神经痛发病机制[J].国际骨科学杂志,2010,31(2):102-104
[6]陈美仁,王萍,成钢.温针灸对坐骨神经痛患者痛阈值的影响[J].中国针灸,2005,25(12):831-833
[7]Manzoni GC,Torelli P.Symptomatic treatment of migraine:from scientific evidence to patient management[J].Neurol Sci,2014,35(1):11-15
[8]Humes DJ,Simpson J,Smith J,et al.Visceral hypersensitivity insymptomatic diverticular disease and the role of neuropeptides and low grade inflammation[J].Neurogastroenterol Motil,2012,24(4):318-e163