俞募配穴对椎间盘源性腰痛急性发作的即刻效应观察∗

摘要

目的：观察俞募配穴对椎间盘源性腰痛急性发作的即刻效应及探析部分治疗机制。方法收集90例患者纳入研究，随机将患者分为对照组及观察组。对照组针刺腰部夹脊穴，将压痛明显的两组穴位通以电针仪装置，疏密波条件下留针30 min；观察组采用俞募配穴法进行针刺，合并臀部及下肢痛者加用环跳穴和阳陵泉穴。针刺操作方法与针具和对照组相同。比较两组临床疗效的差异、治疗前和治疗后1、4、24 h简易McGill疼痛评分、Oswestry功能障碍指数的变化以判定即时疗效，同时检测两组治疗前后血清IL-1的浓度的变化。结果1）俞募配穴组在治疗后1 h及4 h的症状缓解率高于常规取穴组（P<0.01或P<0.05）；治疗后24 h两组临床症状缓解率无差别；2）俞募配穴组在治疗后1 h及4 h的McGill疼痛评分及Oswestry功能障碍指数评分均低于常规取穴组（P<0.01或P<0.05）；治疗后24 h两组无差别；3）两组患者治疗前IL-1表达无明显差异；治疗后1 h，两组血清IL-1浓度均有所下调，其中观察组与对照组比较下调的趋势更为明显（P<0.05）；4）使用Pearson法进行分析后发现IL-1水平与McGill疼痛评分及Oswestry功能障碍指数评分均呈正相关关系。结论俞募配穴法可以快速改善椎间盘源性腰痛急性发作患者的临床症状，其治疗机制可能与下调患者外周血清IL-1的浓度有关。%Objective:To observe the immediate effect of acupuncturing Shu point combined with Mu point on acute discogenic back pain and to analyse the mechanism. Methods:90 patients were divided into two groups. Control group were treated with Huatuojiaji point acupuncture,while the treatment group were treated with acu⁃puncturing Shu point combined with Mu point. Clinical effect and 1,4,24 hous McGill scors,Oswestry were ob⁃serve. And the level of IL-1 before and after treament were detected. Results:1)The symptom remission rate of treatment group was higher than that of control group after 1 and 4 hours treatment(P<0.05 or P<0.01),while the diffenence between two groups were without statistical significance after 24 hours(P>0.05). 2)The scores of McGill and index of Oswestry were lower than those of control group after 1 and 4 hours treatment(P<0.05 or P<0.01),while without statistical significance after 24 hours(P>0.05). 3)The level of IL-I of both groups re⁃duced after 1 hour treatment,and the treatemt group did more remarkably(P<0.05). 4)The level of IL-1 are positive correlated with scores of McGill and index of Oswestry. Conclusion:Acupuncturing Shu point com⁃bined with Mu point can quickly improve the symptom of acute acute discogenic back pain,and its mechanism may relate to reducing the level of IL-1.