基于俞募配穴法针灸结合康复治疗非特异性腰痛的临床疗效(1)
摘要 目的：探討俞募配穴法联合康复训练对非特异性腰痛的临床疗效，并对其部分作用机制进行分析。方法：选取2013年3月至2016年4月河南省省直第一医院收治的非特异性腰痛患者100例，随机分为对照组和观察组，每组50例。取同期健康体检者50例作为健康对照组。对照组及观察组非特异性腰痛均接受核心肌群康复训练法及物理治疗康复训练，观察组在常规训练基础上采用俞募配穴法进行针刺，2组均使用电针仪通电，疏密波条件下留针30 min。2组患者治疗前后均测评McGILL评分、JOA腰痛疾患疗效评分、Oswestry功能障碍指数评分、腰腹肌等长收缩值，同时检测3组受试人员外周血β-内啡肽(β-EP)。结果：2组治疗后McGILL评分、JOA腰痛疾患疗效评分、Oswestry功能障碍指数评分均较治疗前明显改善，与治疗前比较，差异有统计学意义( P <0.05)，其中观察组改善的趋势更为明显，与对照组治疗后比较，差异有统计学意义( P <0.05)。治疗后2组腰腹肌等长收缩值明显高于治疗前( P <0.05)，其中治疗后观察组数值明显优于对照组( P <0.05)。2组非特异性腰痛患者治疗前β-EP均明显高于健康对照组，干预后2组β-EP均一定程度下调，其中观察组下降的更为明显与对照组治疗后比较( P <0.05)。结论：俞募配穴法联合康复训练可明显缓解非特异性腰痛的临床不适，其作用机制可能与下调机体β-EP水平有关。
关键词 腰痛;非特异性;俞募配穴;康复训练;核心肌群训练;临床疗效;机制;β-内啡肽
Clinical Study on Curative Effects of Nonspecific Low Back Pain Based on Back-shu and Front-mu Matching Acupoints Method of Acupuncture Combined with Rehabilitation Treatment
Sha Shuya 1， Zhang Ming 2， Meng Qingliang 3
(1 Department of Rehabilitation， the First Hospital of Henan Province， Zhengzhou 450000， China; 2 Department of Rehabilitation， the First Affiliated Hospital of Henan University of Traditional Chinese Medicine， Zhengzhou 450099， China; 3 Department of Rheumatology， Chinese Academy of Traditional Chinese Medicine， Zhengzhou 450002， China)
Abstract Objective： To investigate the clinical curative effects of back-shu and front-mu matching acupoints combined rehabilitation training on nonspecific low back pain， and to analyze part of mechanism of action. Methods： A total of 100 nonspecific low back pain patients in our hospital during March 2013 to April 2016 included into the study， were randomly divided into the control group and the observation group， with 50 cases in each group.50 cases of healthy examined people in the corresponding period were selected as healthy controls.The two groups of nonspecific low back pain accepted core muscle training.The observation group had back-shu and front-mu matching acupoints method.Both of the two groups had electric acupuncture apparatus， retained needle under the condition of dilatational wave for 30 min.McGILL grade， JOA lumbago disease curative effect， Oswestry disability index scores， waist abdominal muscle isometric contraction value of two groups were measured before and after treatment with.Meanwhile， peripheral blood beta-endorphin (β-EP) concentration changes of three groups were detected. Results： 1) McGILL grade， JOA lumbago disease curative effect， Oswestry disability index scores were improved obviously after treatment in the two groups when compared with before the treatment ( P <0.05).The improvement trend of the observation group was more significant compared with the control group after treatment ( P <0.05).2) Lumbar abdominal muscle isometric contraction value in the two groups was significantly higher after treatment than before treatment ( P <0.05)， and the numerical of the observation group was significantly better than that of control group after treatment ( P <0.05).3) β-EP concentrations of the two groups of patients with nonspecific low back pain were significantly higher than that of healthy controls before treatment， and the β-EP concentrations of the two groups down-regulated to a certain extent after intervention.The decreased of the observe group were more significantly compared with the control group after treatment ( P <0.05). Conclusion： Back-shu and front-mu matching acupoints combined rehabilitation training can obviously alleviate the clinical discomfort of nonspecific low back pain， and its mechanism may be related to down-regulation of β-EP concentration of the body., http://www.100md.com(沙书娅 张铭 孟庆良)
关键词 腰痛;非特异性;俞募配穴;康复训练;核心肌群训练;临床疗效;机制;β-内啡肽
Clinical Study on Curative Effects of Nonspecific Low Back Pain Based on Back-shu and Front-mu Matching Acupoints Method of Acupuncture Combined with Rehabilitation Treatment
Sha Shuya 1， Zhang Ming 2， Meng Qingliang 3
(1 Department of Rehabilitation， the First Hospital of Henan Province， Zhengzhou 450000， China; 2 Department of Rehabilitation， the First Affiliated Hospital of Henan University of Traditional Chinese Medicine， Zhengzhou 450099， China; 3 Department of Rheumatology， Chinese Academy of Traditional Chinese Medicine， Zhengzhou 450002， China)
Abstract Objective： To investigate the clinical curative effects of back-shu and front-mu matching acupoints combined rehabilitation training on nonspecific low back pain， and to analyze part of mechanism of action. Methods： A total of 100 nonspecific low back pain patients in our hospital during March 2013 to April 2016 included into the study， were randomly divided into the control group and the observation group， with 50 cases in each group.50 cases of healthy examined people in the corresponding period were selected as healthy controls.The two groups of nonspecific low back pain accepted core muscle training.The observation group had back-shu and front-mu matching acupoints method.Both of the two groups had electric acupuncture apparatus， retained needle under the condition of dilatational wave for 30 min.McGILL grade， JOA lumbago disease curative effect， Oswestry disability index scores， waist abdominal muscle isometric contraction value of two groups were measured before and after treatment with.Meanwhile， peripheral blood beta-endorphin (β-EP) concentration changes of three groups were detected. Results： 1) McGILL grade， JOA lumbago disease curative effect， Oswestry disability index scores were improved obviously after treatment in the two groups when compared with before the treatment ( P <0.05).The improvement trend of the observation group was more significant compared with the control group after treatment ( P <0.05).2) Lumbar abdominal muscle isometric contraction value in the two groups was significantly higher after treatment than before treatment ( P <0.05)， and the numerical of the observation group was significantly better than that of control group after treatment ( P <0.05).3) β-EP concentrations of the two groups of patients with nonspecific low back pain were significantly higher than that of healthy controls before treatment， and the β-EP concentrations of the two groups down-regulated to a certain extent after intervention.The decreased of the observe group were more significantly compared with the control group after treatment ( P <0.05). Conclusion： Back-shu and front-mu matching acupoints combined rehabilitation training can obviously alleviate the clinical discomfort of nonspecific low back pain， and its mechanism may be related to down-regulation of β-EP concentration of the body., http://www.100md.com(沙书娅 张铭 孟庆良)
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