华佗夹脊穴联合腰部核心肌力训练对腰椎间盘突出症患者腰椎功能及血清CD4~+CD8~+水平的影响
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摘要
目的:研究华佗夹脊穴联合腰部核心肌力训练对腰椎间盘突出症(lumbar disc herniation,LDH)患者腰椎功能及T淋巴细胞亚群水平的影响。方法:选取2017年1月至2018年6月在本院就诊的96例LDH患者,按随机数字表法分为对照组和研究组各48例。对照组采用牵引、推拿加常规康复训练治疗,研究组采用华佗夹脊穴联合腰部核心肌力训练治疗,两组均持续治疗4周。比较两组患者临床疗效、治疗前后腰椎功能(ODI及JOA评分)、疼痛程度(VAS评分)、血清T淋巴细胞亚群水平、炎性因子[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]水平及生活质量(SF-36)评分。结果:对照组有效率为79.17%,研究组有效率为95.83%,两组有效率比较,差异有统计学意义(P<0.05);治疗2周、4周后,研究组ODI评分低于对照组,JOA评分高于对照组(P<0.05);治疗2周、4周后,两组VAS评分均低于治疗前,且研究组低于对照组(P<0.05);治疗后两组血清CD3~+、CD4~+、CD4~+/CD8~+水平均高于治疗前,且研究组高于对照组(P<0.05);治疗后两组血清IL-6、TNF-α水平均低于治疗前,且研究组低于对照组(P<0.05);治疗后两组SF-36评分均高于治疗前,且研究组高于对照组(P<0.05)。结论:华佗夹脊穴联合腰部核心肌力训练能有效缓解LDH疼痛,改善其免疫功能,减轻其炎症反应,提高其生活质量。
Objective:To study the influence of Huatuojiaji(Extra)in combination with lumbar core muscle strength training on lumbar function and serum CD4+CD8+level in patients with lumbar disc herniation(LDH).Methods:Ninety-six patients with LDH treated in our hospital from January 2017 to June 2018 were selected and divided into the control group and the research group according to random number table method,with 48 cases in each group.The control group was treated with traction,massage and routine rehabilitation training,while the research group was treated with Huatuojiaji(Extra)combined with lumbar core muscle strength training.Both groups were treated continuously for 4 weeks.The clinical efficacy,lumbar vertebral functions(including ODI and JOA scores),pain degree(VAS scores),serum T lymphocyte subsets,inflammatory factors including interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels and quality of life(SF-36)scores were compared between the two groups before and after treatment.Results:The effective rate of the control group was 79.17%,and that of the researchers was 95.83%.There was a significant difference between the two groups(P<0.05).After 2 and 4 weeks of treatment,the ODI score of the research group was lower than that of the control group,and its JOA score was higher than that of the control group(P<0.05).The VAS scores of the two groups were lower than those before the treatment,and the research group was lower than the control group(P<0.05).After the treatment,the serum levels of CD3~+,CD4~+,CD4~+/CD8~+in the two groups were higher than those before the treatment,and the research group was higher than the control group(P<0.05).The levels of IL-6and TNF-αin both groups were lower than those before the treatment,and the research group was lower than the control group(P<0.05).The SF-36 scores in the two groups after treatment were higher than those before the treatment,and the research group was higher than the control group(P<0.05).Conclusion:Huatuojiaji(Extra)in combination with lumbar core muscle strength training can effectively relieve the pain of LDH patients,improve their immune functions,alleviate the inflammatory reaction and improve their quality of life.
Objective:To study the influence of Huatuojiaji(Extra)in combination with lumbar core muscle strength training on lumbar function and serum CD4+CD8+level in patients with lumbar disc herniation(LDH).Methods:Ninety-six patients with LDH treated in our hospital from January 2017 to June 2018 were selected and divided into the control group and the research group according to random number table method,with 48 cases in each group.The control group was treated with traction,massage and routine rehabilitation training,while the research group was treated with Huatuojiaji(Extra)combined with lumbar core muscle strength training.Both groups were treated continuously for 4 weeks.The clinical efficacy,lumbar vertebral functions(including ODI and JOA scores),pain degree(VAS scores),serum T lymphocyte subsets,inflammatory factors including interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels and quality of life(SF-36)scores were compared between the two groups before and after treatment.Results:The effective rate of the control group was 79.17%,and that of the researchers was 95.83%.There was a significant difference between the two groups(P<0.05).After 2 and 4 weeks of treatment,the ODI score of the research group was lower than that of the control group,and its JOA score was higher than that of the control group(P<0.05).The VAS scores of the two groups were lower than those before the treatment,and the research group was lower than the control group(P<0.05).After the treatment,the serum levels of CD3~+,CD4~+,CD4~+/CD8~+in the two groups were higher than those before the treatment,and the research group was higher than the control group(P<0.05).The levels of IL-6and TNF-αin both groups were lower than those before the treatment,and the research group was lower than the control group(P<0.05).The SF-36 scores in the two groups after treatment were higher than those before the treatment,and the research group was higher than the control group(P<0.05).Conclusion:Huatuojiaji(Extra)in combination with lumbar core muscle strength training can effectively relieve the pain of LDH patients,improve their immune functions,alleviate the inflammatory reaction and improve their quality of life.
引文
[1]胡秋秋,肖宝,孔莲娥.延续护理对非手术治疗腰椎间盘突出症康复的影响[J].湖北中医杂志,2015,37(1):53-54.
[2]李娟.电针华佗夹脊穴配合独活寄生汤加减治疗腰椎间盘突出症的临床分析[J].数理医药学杂志,2016,29(1):121-122.
[3]GRANACHER U,LACROIX A,MUEHLBAUER T,et al.Effects of core instability strength training on trunk muscle strength,spinal mobility,dynamic balance and functional mobility in older adults[J].Gerontology,2013,59(2):105-113.
[4]LEE M,SONG C,JO Y,et al.The effects of core muscle release technique on lumbar spine deformation andlow back pain[J].JPhys Ther Sci,2015,27(5):1519-1522.
[5]余迪霞,吴建贤,翟志敏,等.腰椎间盘突出症患者外周血T淋巴细胞亚群水平变化及其意义[J].安徽医学,2013,34(5):537-542.
[6]伍小敏,吴跃,杜忠举,等.骶管神经阻滞联合腰部核心肌力训练治疗腰椎间盘突出症的疗效观察[J].中华物理医学与康复杂志,2017,39(2):154-156.
[7]侯庆艳,邢其兴,任小雨.中医综合治疗腰椎间盘突出症疗效观察[J].按摩与康复医学,2015,6(11):30-32.
[8]LURIE J D,MOSES R A,TOSTESON A N A,et al.Magnetic Resonance Imaging Predictors of Surgical Outcome in Patients with Lumbar Intervertebral Disc Herniation[J].Spine,2013,38(14):1216-1225.
[9]PASSACANTILLI E,LENZI J,CAPORLINGUA F,et al.Endoscopic interlaminar approach for intracanal L5‐S1 disc herniation:Classification of disc prolapse in relation to learning curve and surgical outcome[J].Asian J Endosc Surg,2015,8(4):445-453.
[10]陈子前,马太平,刁虹.中西医结合治疗腰椎间盘突出症患者的临床疗效观察及对血清炎性因子的影响[J].世界中医药,2017,12(2):299-302.
[11]尹怡红.深刺下腰部华佗夹脊穴配合传统功法训练治疗腰椎间盘突出症的疗效评估[J].针灸临床杂志,2017,33(7):48-50.
[12]张效康,刘敏,唐远军.夹脊穴治疗腰椎间盘突出症398例[J].四川中医,2015,33(11):172-173.
[13]帕提古丽·尼牙孜,古丽娜尔·阿布都克里木.腰部核心肌力训练在腰椎间盘突出症康复治疗中的疗效分析[J].中国伤残医学,2015,23(19):126-127.
[14]申仪.针灸腰段华佗夹脊穴治疗腰椎间盘突出症术后复发的临床研究[J].中国医学创新,2016,13(1):120-123.
[15]钱月芳,金敏娟,方昊.腰部核心肌力训练联合悬吊训练治疗腰椎间盘突出症的疗效观察[J].中华物理医学与康复杂志,2016,38(9):704-706.
[16]王峰川,翁泽鹏,刘景良,等.华佗夹脊穴治疗腰椎间盘突出优化方案及免疫应答机理的研究[J].中国伤残医学,2016,24(17):21-23.
[17]王胜军.华佗夹脊穴治疗腰椎间盘突出症优化方案的评价及对免疫应答机理的探讨[J].中国中医药现代远程教育,2017,15(11):54-55.
[2]李娟.电针华佗夹脊穴配合独活寄生汤加减治疗腰椎间盘突出症的临床分析[J].数理医药学杂志,2016,29(1):121-122.
[3]GRANACHER U,LACROIX A,MUEHLBAUER T,et al.Effects of core instability strength training on trunk muscle strength,spinal mobility,dynamic balance and functional mobility in older adults[J].Gerontology,2013,59(2):105-113.
[4]LEE M,SONG C,JO Y,et al.The effects of core muscle release technique on lumbar spine deformation andlow back pain[J].JPhys Ther Sci,2015,27(5):1519-1522.
[5]余迪霞,吴建贤,翟志敏,等.腰椎间盘突出症患者外周血T淋巴细胞亚群水平变化及其意义[J].安徽医学,2013,34(5):537-542.
[6]伍小敏,吴跃,杜忠举,等.骶管神经阻滞联合腰部核心肌力训练治疗腰椎间盘突出症的疗效观察[J].中华物理医学与康复杂志,2017,39(2):154-156.
[7]侯庆艳,邢其兴,任小雨.中医综合治疗腰椎间盘突出症疗效观察[J].按摩与康复医学,2015,6(11):30-32.
[8]LURIE J D,MOSES R A,TOSTESON A N A,et al.Magnetic Resonance Imaging Predictors of Surgical Outcome in Patients with Lumbar Intervertebral Disc Herniation[J].Spine,2013,38(14):1216-1225.
[9]PASSACANTILLI E,LENZI J,CAPORLINGUA F,et al.Endoscopic interlaminar approach for intracanal L5‐S1 disc herniation:Classification of disc prolapse in relation to learning curve and surgical outcome[J].Asian J Endosc Surg,2015,8(4):445-453.
[10]陈子前,马太平,刁虹.中西医结合治疗腰椎间盘突出症患者的临床疗效观察及对血清炎性因子的影响[J].世界中医药,2017,12(2):299-302.
[11]尹怡红.深刺下腰部华佗夹脊穴配合传统功法训练治疗腰椎间盘突出症的疗效评估[J].针灸临床杂志,2017,33(7):48-50.
[12]张效康,刘敏,唐远军.夹脊穴治疗腰椎间盘突出症398例[J].四川中医,2015,33(11):172-173.
[13]帕提古丽·尼牙孜,古丽娜尔·阿布都克里木.腰部核心肌力训练在腰椎间盘突出症康复治疗中的疗效分析[J].中国伤残医学,2015,23(19):126-127.
[14]申仪.针灸腰段华佗夹脊穴治疗腰椎间盘突出症术后复发的临床研究[J].中国医学创新,2016,13(1):120-123.
[15]钱月芳,金敏娟,方昊.腰部核心肌力训练联合悬吊训练治疗腰椎间盘突出症的疗效观察[J].中华物理医学与康复杂志,2016,38(9):704-706.
[16]王峰川,翁泽鹏,刘景良,等.华佗夹脊穴治疗腰椎间盘突出优化方案及免疫应答机理的研究[J].中国伤残医学,2016,24(17):21-23.
[17]王胜军.华佗夹脊穴治疗腰椎间盘突出症优化方案的评价及对免疫应答机理的探讨[J].中国中医药现代远程教育,2017,15(11):54-55.