温针灸联合斜圆刃针治疗腰椎间盘突出症的疗效及对血液流变学和血清疼痛递质的影响

摘要 目的：观察温针灸联合斜圆刃针治疗腰椎间盘突出症的疗效及对血液流变学和血清疼痛递质的影响。方法：选取2019年3月~2021年4月我院针灸科收治的118例腰椎间盘突出症患者，经随机数字表法分为观察组（n=59，温针灸联合斜圆刃针治疗）和对照组（n=59，温针灸治疗）。对比两组疗效以及治疗前后日本骨科协会(JOA) 评分、视觉模拟评分法 (VAS) 评分、Oswestry 功能障碍指数（ODI）评分、血液流变学指标和血清疼痛递质[神经肽Y(NPY) 、5-羟色胺 (5-HT) 、P物质(SP)]水平的变化。结果：观察组的临床总有效率为93.22%，高于对照组的77.97%，差异有统计学意义（P<0.05）。治疗2周后，两组VAS、ODI评分降低，且观察组较对照组低；JOA评分升高，且观察组较对照组高（P<0.05）。治疗2周后，两组的全血黏度和血浆黏度均下降，且观察组全血黏度、血浆黏度低于对照组（P<0.05）。两组治疗2周后血清NPY、SP、5-HT水平均降低，且观察组较对照组低（P<0.05）。结论：腰椎间盘突出症采用温针灸联合斜圆刃针治疗可促进患者腰椎功能恢复，调节血液流变学并减少血清疼痛递质的分泌，疗效显著。

Therapeutic Effect of Warm Acupuncture Combined with Oblique Round Blade Acupuncture on Lumbar Disc Herniation and its Effect on Hemorheology and Serum Pain Transmitters

ABSTRACT Objective: To observe the therapeutic effect of warm acupuncture combined with oblique round blade acupuncture on lumbar disc herniation and its effect on hemorheology and serum pain transmitters. Methods: 118 patients with lumbar disc herniation who were treated in the acupuncture department of our hospital from March 2019 to April 2021 were selected, and they were randomly divided into observation group (n=59, treated with warm acupuncture combined with oblique round blade acupuncture) and control group (n=59, treated with warm acupuncture). The therapeutic effect, Japanese Orthopaedic Association Evaluation treatment (JOA) score, Visual analog scale (VAS) score, Oswestry disability index (ODI) score, hemorheology and serum pain transmitters [neuropeptide Y (NPY), serotonin (5-HT), substance P (SP)] before and after treatment were compared between the two groups. Results: The total effective rate of the observation group was 93.22%, which was higher than 77.97% of the control group (P<0.05). 2 weeks after treatment, VAS and ODI scores of the two groups decreased, and the observation group was lower than the control group. JOA score increased, and the observation group was higher than the control group(P<0.05). 2 weeks after treatment, the whole blood viscosity and plasma viscosity in two groups decreased, and the whole blood viscosity and plasma viscosity of the observation group were lower than those of the control group (P<0.05). 2 weeks after treatment, the levels of serum NPY, SP and 5-HT in two groups decreased, and the observation group was lower than the control group (P<0.05). Conclusion: The treatment of lumbar intervertebral disc herniation by warm acupuncture combined with oblique round blade acupuncture can improve the clinical symptoms of patients, promote the recovery of lumbar function, regulate the secretion of blood rheology and serum pain transmitter, effective in treatment.