| 引用本文:毕圣洁1，郑文贤1，林建忠1，吴素华2.耳穴联合腰夹脊穴对椎间盘源性腰痛急性发作的即刻效应[J].世界中医药,2017,(12):. |
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| 耳穴联合腰夹脊穴对椎间盘源性腰痛急性发作的即刻效应 |
| Observation on Immediate Effects of Auricular Acupuncture Combined with Lumbar Jiaji Points on Acute Discogenic Low Back Pain |
| 投稿时间：2017-03-05 |
| DOI：10.3969/j.issn.1673-7202.2017.12.055 |
| 中文关键词: 耳穴 腰夹脊穴 椎间盘源性腰痛 急性发作 即刻效应 |
| English Keywords:Auricular points, Lumbar Jiaji (EX-B2), Acute discogenic low back pain, Immediate effect |
| 基金项目:2014年建设中医药强省立项资助科研课题(20141147） |
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| 中文摘要: |
| 目的：观察运用耳穴联合腰夹脊穴治疗椎间盘源性腰痛急性发作的即刻效应，为临床治疗腰痛提供新思路。方法：选取于2016年1月至2016年12月前来中国人民解放军第九五医院康复医学科就诊的急性腰痛患者，根据诊断及纳入标准确诊为腰椎间盘源性疼痛者共90例。所选患者按照就诊的先后顺序，分别纳入观察组和对照组，每组45例。对照组采用普通针刺腰部夹脊穴，观察组在对照组腰夹脊穴针刺的基础上加以磁珠贴压耳穴治疗。分别记录患者治疗前、治疗后30 min的McGILL评分、JOA腰痛疾患疗效评分、Oswestry功能障碍指数评分。同时采用酶联免疫吸附试验对2组患者治疗前及治疗后30 min的外周血液进行五羟色胺（5-HT）、β-内啡肽（β-EP）水平进行检测。结果：2组患者治疗前McGILL、JOA腰痛疾患疗效评分和Oswestry功能障碍指数评分比较，差异无统计学意义（P>0.05），在治疗后2组评分较治疗前均有得到改善，但观察组明显优于对照组，差异有统计学意义（P<0.05）。2组患者治疗前血液中的5-HT水平比较，差异无统计学意义（P>0.05），干预治疗后2组患者的5-HT水平均得到明显升高，观察组优于对照组（P<0.05）。2组患者治疗前血液中的β-EP水平比较，差异无统计学意义（P>0.05），干预治疗后发现2组患者的β-EP水平均得到明显降低，观察组较对照组下降幅度更大（P<0.05）。结论：耳穴联合腰夹脊穴治疗椎间盘源性腰痛，其急性发作期的即时效应显示能改善患者疼痛/整体症状和肢体功能，其起效机制可能与5-HT、β-EP的改变有关。 |
| English Summary: |
| To observe the immediate effects of auricular acupuncture combined with lumbar Jiaji points (EX-B2) in the treatment of acute lumbar discogenic pain, and to provide new ideas for clinical treatment of lumbago. Methods:A total of 90 patients with acute lumbar pain who were admitted to our hospital from January 2016 to December 2016 were enrolled in this study. In accordance with the order of treatment, the selected patients were divided into observation group and control group, 45 cases in each group. There were no statistical differences in age, gender, course of disease of two groups (P>0.05), which meant they were comparable. The control group was treated with normal acupuncture in Jiaji (EX-B2), and the observation group was added magnetic auricular plaster treatment based on control group. The McGILL scores, JOA score of low back pain and Oswestry disability index score of patients 30 min before and after treatment were recorded respectively. Enzyme linked immunosorbent assay (Elisa) was used to detect the concentrations of five HT (5-HT) and beta endorphin (β-EP) in the peripheral blood of the patients 30 min before and after treatment. Results:The differences in McGILL, JOA low back pain score and Oswestry disability index score efficacy of two groups before and after treatment were not statistically significant (P>0.05), which meant they were comparable. After treatment, the scores showed improvement after treatment, but the score of the observation group was significantly better than the control group with statistically significant difference (P<0.05). Before treatment, the difference in 5-HT content in the blood of two groups were not statistically significant (P>0.05). After treatment, 5-HT of two groups was found significantly increased, and that in treatment group was better than in control group (P<0.05). Before treatment, the difference in beta-EP content of two groups were not statistically significant (P>0.05). After treatment, it was found that beta-EP contents of two groups were significantly decreased, and the decrease in observation group was larger than that in the control group (P<0.05). Conclusion:For Auricular points combined lumbar Jiaji point (EX-B2) in the treatment of discogenic low back pain, the immediate effect of the acute exacerbation of patients showed that it can improve the overall symptoms and pain/limb function, and the effect and possible mechanism might be related with 5-HT and beta-EP changes. |
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