夹脊电针配合盐酸青藤碱注射液穴注射治疗骨质疏松骨折下腰痛的临床研究
|
摘要
目的观察夹脊电针配合盐酸青藤碱注射液夹脊穴穴位注射治疗骨质疏松骨折下腰痛的临床疗效。方法将患者99例遵照随机数字表法分为对照组49例和治疗组50例,对照组采用夹脊穴电针加肌肉注射依降钙素加口服钙尔奇碳酸钙d3,治疗组在对照组基础上夹脊穴注射盐酸青藤碱注射液。采用视觉模拟量表(VAS)和改良Oswestry功能障碍指数(ODI)分析疗效,取患者同组治疗前后外周血,采用酶联免疫吸附(ELISA)法检测白介素-1β(IL-1β)及骨保护素(OPG)。结果经3周治疗,治疗组患者外周血OPG较对照组明显升高(P<0.05),IL-1β含量及VAS、ODI评分均较对照组降低(P<0.05),治疗组有效率为86.00%,高于对照组的65.31%(P<0.05)。结论夹脊电针配合盐酸青藤碱穴注射治疗骨质疏松骨折下腰痛临床疗效优于单纯夹脊电针治疗。
Objective: To investigate the therapeutic mechanism and clinical efficacy of Jiaji electro-acupuncture combined with acupoint injection of Sinomenine Hydrochloride Injection on low back pain in osteoporotic fracture. Methods: 99 cases with low back pain in osteoporotic fracture were randomly divided into the control group(49 cases) and treatment group(50 cases). The control group received Jiaji electro-acupuncture plus intravenous injection of elcatonin + oral Caltrate D3 calcium carbonate. The treatment group on the basis received Jiaji point injection of Sinomenine Hydrochloride Injection. VAS and modified ODI were used to take curative effect analysis.Before and after treatment,peripheral blood was taken from the same group,and detected by ELISA for the detection of IL-1β and OPG. Results: After 3 weeks′ treatment,OPG of peripheral blood in the treatment group was significantly higher than that of the control group(P < 0.05). The content of IL-1β and scores of VAS and ODI were lower than those of the control group(P < 0.05);the efficiency of the treatment group was 86%,higher than that of the control group(65.3%)(P < 0.05). Conclusion: Jiaji electroacupuncture combined with Sinomenine Hydrochloride Injectionon low back pain in osteoporotic fracture has a better clinical effect than that of simple Jiaji acupuncture.
Objective: To investigate the therapeutic mechanism and clinical efficacy of Jiaji electro-acupuncture combined with acupoint injection of Sinomenine Hydrochloride Injection on low back pain in osteoporotic fracture. Methods: 99 cases with low back pain in osteoporotic fracture were randomly divided into the control group(49 cases) and treatment group(50 cases). The control group received Jiaji electro-acupuncture plus intravenous injection of elcatonin + oral Caltrate D3 calcium carbonate. The treatment group on the basis received Jiaji point injection of Sinomenine Hydrochloride Injection. VAS and modified ODI were used to take curative effect analysis.Before and after treatment,peripheral blood was taken from the same group,and detected by ELISA for the detection of IL-1β and OPG. Results: After 3 weeks′ treatment,OPG of peripheral blood in the treatment group was significantly higher than that of the control group(P < 0.05). The content of IL-1β and scores of VAS and ODI were lower than those of the control group(P < 0.05);the efficiency of the treatment group was 86%,higher than that of the control group(65.3%)(P < 0.05). Conclusion: Jiaji electroacupuncture combined with Sinomenine Hydrochloride Injectionon low back pain in osteoporotic fracture has a better clinical effect than that of simple Jiaji acupuncture.
引文
[1]刘晓伟,孙凌蓉,夏殷,等.针灸联合自拟补肾壮骨汤改善骨质疏松症疼痛的临床观察[J].中国中医急症,2015,24(2):303-305.
[2]尹东武,冯文顺,李朝军,等.自拟补肾活血方配合口服钙剂与维生素D治疗老年性骨质疏松症临床研究[J].国际中医中药杂志,2016,22(3):220-223.
[3]单建林,张阳,单忠林,等.胸腰段椎体压缩性骨折中下腰痛症状观察及机制分析[J].脊柱外科杂志,2015,12(1):33-36.
[4]朱肖菊,王晓杰,迟梦雅,等.针刺结合健康管理对高寒地区老年人群骨质疏松症的干预研究[J].针灸临床杂志,2015,31(4):4-6.
[5]梁粤,皮敏,谢柱,等.邵氏点穴位注射复方盐酸青藤碱注射液治疗慢性脊神经后支源性下腰痛临床观察[J].新中医,2014,13(1):154-157.
[6]陈静,雷南伟,刘金凤,等.夹脊电针结合局部A型肉毒素注射治疗慢性腰痛的临床观察[J].针灸临床杂志,2016,32(4):4-6.
[7]张智海,刘忠厚,李娜,等.中国人骨质疏松症诊断标准专家共识(第3稿·2014版)[J].中国骨质疏松杂志,2014,20(9):1007-1010.
[8]王启才.针灸治疗学[M].北京:中国中医药出版社,2007:60-61.
[9]胡波,徐秋玲,李健强,等.以视觉模拟量表评价电针镇痛的累积效应[J].国际中医中药杂志,2013,12(4):343-344.
[10]Fritz JM,Irrgang JJ.A com parison of a modified oswestry low back pain disability questionnaire and the quebec back pain disability scale[J].Phys Ther,2001,81(2):776-788.
[11]邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南(骨质疏松性骨折诊断及治疗原则)[J].中国骨与关节外科,2015,8(5):371-374.
[12]李晖.老年性骨质疏松骨折研究进展[J].世界最新医学信息文摘:电子版,2016,16(48):39-40.
[13]王盛明,陈成,黄夕斌,等.骨质疏松性椎体压缩骨折经皮椎体成形术后残留下腰痛的原因分析[J].吉林医学,2014,35(30):6751-6752.
[14]陈颖,李金艳,肖兵,等.骨质疏松症的针灸临床研究特点概述[J].上海针灸杂志,2014,33(3):274-277.
[15]郑洁,罗浩,王瑞辉,等.青藤碱降低兔膝骨关节炎模型脂联素含量及其受体表达[J].基础医学与临床,2015,35(3):399-400.
[16]王涛,王永胜,刘志斌,等.白细胞介素、转化生长因子在骨质疏松性股骨骨折患者中的诊断意义[J].中国实验诊断学,2014,32(8):1328-1330.
[17]姚志涛,阿布都合·肯亚如拜克,李伟东,等.骨形态发生蛋白、成纤维细胞生长因子1、胰岛素样生长因子1、白细胞介素-1β、白细胞介素-6以及转化生长因子-β在髁状突囊内骨折中的表现和机制[J].中华实验外科杂志,2016,22(9):2183-2185.
[18]杨惠琴,陈礼荣.青藤碱对膝骨性关节炎兔关节液及血清白细胞介素l含量的影响[J].中西医结合学报,2008,6(12):1275-1279.
[19]Wagner D,Fahrleitner-Pammer A.Levels of osteoprotegerin(OPG)and receptor activator for nuclear factor kappa B ligand(RANKL)in serum:are they of any help[J].Wien Med Wochenschr,2010,160(17-18):452-457.
[20]李炳奇,王平,冯荣,等.阻力针合并电针治疗机械性下腰痛的疗效观察[J].中国中医骨伤科杂志,2015,10(12):54-56.
[21]李树成,邓聪,卢佩斯,等.电针配合多壮温针灸治疗骨质疏松症腰痛疗效观察[J].按摩与康复医学,2014,5(4):59-60.
[22]丁从珠,姚瑶,方芸,等.青藤碱对胶原诱导的关节炎大鼠血清OPG/RANKL、l L-17含量的影响[J].南京中医药大学学报,2012,28(4):330-333.
[23]姚瑶,葛卫红.青风藤醇提物与青藤碱治疗胶原诱导关节炎大鼠药效的比较研究[J].药学与临床研究,2014,22(1):25-28.
[2]尹东武,冯文顺,李朝军,等.自拟补肾活血方配合口服钙剂与维生素D治疗老年性骨质疏松症临床研究[J].国际中医中药杂志,2016,22(3):220-223.
[3]单建林,张阳,单忠林,等.胸腰段椎体压缩性骨折中下腰痛症状观察及机制分析[J].脊柱外科杂志,2015,12(1):33-36.
[4]朱肖菊,王晓杰,迟梦雅,等.针刺结合健康管理对高寒地区老年人群骨质疏松症的干预研究[J].针灸临床杂志,2015,31(4):4-6.
[5]梁粤,皮敏,谢柱,等.邵氏点穴位注射复方盐酸青藤碱注射液治疗慢性脊神经后支源性下腰痛临床观察[J].新中医,2014,13(1):154-157.
[6]陈静,雷南伟,刘金凤,等.夹脊电针结合局部A型肉毒素注射治疗慢性腰痛的临床观察[J].针灸临床杂志,2016,32(4):4-6.
[7]张智海,刘忠厚,李娜,等.中国人骨质疏松症诊断标准专家共识(第3稿·2014版)[J].中国骨质疏松杂志,2014,20(9):1007-1010.
[8]王启才.针灸治疗学[M].北京:中国中医药出版社,2007:60-61.
[9]胡波,徐秋玲,李健强,等.以视觉模拟量表评价电针镇痛的累积效应[J].国际中医中药杂志,2013,12(4):343-344.
[10]Fritz JM,Irrgang JJ.A com parison of a modified oswestry low back pain disability questionnaire and the quebec back pain disability scale[J].Phys Ther,2001,81(2):776-788.
[11]邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南(骨质疏松性骨折诊断及治疗原则)[J].中国骨与关节外科,2015,8(5):371-374.
[12]李晖.老年性骨质疏松骨折研究进展[J].世界最新医学信息文摘:电子版,2016,16(48):39-40.
[13]王盛明,陈成,黄夕斌,等.骨质疏松性椎体压缩骨折经皮椎体成形术后残留下腰痛的原因分析[J].吉林医学,2014,35(30):6751-6752.
[14]陈颖,李金艳,肖兵,等.骨质疏松症的针灸临床研究特点概述[J].上海针灸杂志,2014,33(3):274-277.
[15]郑洁,罗浩,王瑞辉,等.青藤碱降低兔膝骨关节炎模型脂联素含量及其受体表达[J].基础医学与临床,2015,35(3):399-400.
[16]王涛,王永胜,刘志斌,等.白细胞介素、转化生长因子在骨质疏松性股骨骨折患者中的诊断意义[J].中国实验诊断学,2014,32(8):1328-1330.
[17]姚志涛,阿布都合·肯亚如拜克,李伟东,等.骨形态发生蛋白、成纤维细胞生长因子1、胰岛素样生长因子1、白细胞介素-1β、白细胞介素-6以及转化生长因子-β在髁状突囊内骨折中的表现和机制[J].中华实验外科杂志,2016,22(9):2183-2185.
[18]杨惠琴,陈礼荣.青藤碱对膝骨性关节炎兔关节液及血清白细胞介素l含量的影响[J].中西医结合学报,2008,6(12):1275-1279.
[19]Wagner D,Fahrleitner-Pammer A.Levels of osteoprotegerin(OPG)and receptor activator for nuclear factor kappa B ligand(RANKL)in serum:are they of any help[J].Wien Med Wochenschr,2010,160(17-18):452-457.
[20]李炳奇,王平,冯荣,等.阻力针合并电针治疗机械性下腰痛的疗效观察[J].中国中医骨伤科杂志,2015,10(12):54-56.
[21]李树成,邓聪,卢佩斯,等.电针配合多壮温针灸治疗骨质疏松症腰痛疗效观察[J].按摩与康复医学,2014,5(4):59-60.
[22]丁从珠,姚瑶,方芸,等.青藤碱对胶原诱导的关节炎大鼠血清OPG/RANKL、l L-17含量的影响[J].南京中医药大学学报,2012,28(4):330-333.
[23]姚瑶,葛卫红.青风藤醇提物与青藤碱治疗胶原诱导关节炎大鼠药效的比较研究[J].药学与临床研究,2014,22(1):25-28.