摘要
目的研究温针灸联合康复训练对腰椎间盘突出症(lumbar disc herniation,LDH)患者经皮椎间孔镜下髓核摘除(percutaneous endoscopic lumbar discectomy,PELD)术后恢复进程的影响。方法将2018年1月—2020年6月医院94例LDH患者采用随机数字表法均分为观察组和对照组各48例,均在PELD术后给予常规治疗和康复训练,时间为3个月,观察组在此基础上加用温针灸进行干预,疗程4周,观察两组围术期指标、视觉模拟法(VAS)疼痛评分、日本骨科协会评估治疗分数(JOA)评分和Oswestry腰椎功能障碍指数(ODI)评分,检测血清P物质(SP)、前列腺素E;(PEG_(2))及五羟色胺(5-HT)水平,并随访术后并发症和不良反应发生情况。结果观察组首次下床活动时间和平均住院时间低于对照组,差异有统计学意义(P<0.05);两组术后VAS评分和ODI评分均明显降低(P<0.05),JOA评分明显升高(P<0.05),观察组术后1个月时VAS和ODI评分低于对照组,JOA评分高于对照组,差异有统计学意义(P<0.05);两组术后1个月时血清SP和PEG_(2)水平均明显降低(P<0.05),两组血清5-HT水平明显升高(P<0.05),且观察组SP和PEG_(2)水平低于对照组,5-HT水平高于对照组,差异有统计学意义(P<0.05)。结论温针灸联合联合康复训练用于LDH患者PELD术后干预有利于减轻局部疼痛和促进腰椎功能,提升患者术后康复速度,其作用机制可能与调节SP、PEG_(2)和5-HT等因子表达水平有关。
Objective To study the effects of needle warming moxibustion combined with rehabilitation training on recovery process of patients with lumbar disc herniation(LDH)after percutaneous endoscopic lumbar discectomy(PELD).Methods From January 2018 to June 2020,94 patients with LDH in the hospital were divided into observation group and control group by the random number table method,with 48 cases in each group.The patients were all given conventional treatment and rehabilitation training after PELD for 3 months,and the observation group was intervened with needle warming moxibustion on this basis for 4 weeks.The perioperative indicators,Visual Analogue Scale(VAS)pain score,evaluation and treatment score of Japanese Orthopaedic Association(JOA)and Oswestry Dysfunction Index(ODI)score were observed in the two groups.The levels of serum substance P(SP),prostaglandin E;(PEG_(2))and 5-hydroxytryptamine(5-HT)were detected,and the occurrence of postoperative complications and adverse reactions were followed up.Results The first ambulation time and average hospital stay in the observation group were lower than those in the control group(P<0.05).The VAS score and ODI score of the two groups after surgery were significantly reduced(P<0.05)while the JOA score was increased significantly(P<0.05),and the VAS score and ODI score of the observation group were lower than those of the control group at 1 month after surgery while the JOA score was higher than that of the control group(P<0.05).The levels of serum SP and PEG_(2)in the two groups at 1 month after surgery were significantly decreased(P<0.05)while the level of serum 5-HT in the two groups was significantly increased(P<0.05),and the levels of SP and PEG_(2)of the observation group were lower than those of the control group while the 5-HT level was higher than that of the control group(P<0.05).Conclusion Needle warming moxibustion combined with rehabilitation training for patients with LDH after PELD is beneficial to alleviate local pain,promote lumbar function and improve the postoperative rehabilitation speed.And its role mechanism may be related to the regulations of expressions levels of SP,PEG_(2)and 5-HT.
作者
叶必宏
叶绿
毛显禹
潘录录
陈炳
宋丰军
王庆来
YE Bihong;YE Lyu;MAO Xianyu;PAN Lulu;CHEN Bing;SONG Fengjun;WANG Qinglai(Wenzhou Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University,Wenzhou 325000,Zhejiang,China;The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)
出处
《中华中医药学刊》
CAS
北大核心
2022年第3期212-215,共4页
Chinese Archives of Traditional Chinese Medicine
基金
浙江省“十三五”中医药(中西医结合)重点学科建设计划(2017-XK-A49)
浙江省公益技术应用研究项目(LGF20H170001)
关键词
腰椎间盘突出症
经皮椎间孔镜髓核摘除术
康复训练
温针灸
腰椎功能
疼痛
生活质量
lumbar disc herniation
percutaneous endoscopic lumbar discectomy
rehabilitation training
needle warming moxibustion
lumbar function
pain
quality of life
