| 摘要: |
| 目的：观察基于“筋膜-经筋轴”理论应用温针联合肾着汤合新定白术汤治疗寒湿痹阻型非特异性下腰痛的临床疗效。方法：将90例寒湿痹阻型非特异性下腰痛患者随机分为中药组、温针组和针药联合组，每组各30例。中药组予以肾着汤合新定白术汤口服治疗，温针组予以温针治疗，针药联合组予以中药组加温针组疗法。比较3组疼痛视觉模拟评分法（Visual Analogue Scale，VAS）评分、Oswestry 功能障碍指数（Oswestry Disability Index，ODI）、腰部关节活动度、白细胞介素-6（interleukin-6，IL-6）、C反应蛋白（C-reactive protein，CRP）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α），并评价临床疗效。结果：总有效率针药联合组为90.00%（27/30），高于中药组的76.67%（23/30）和温针组的73.33%（22/30），差异有统计学意义（P<0.05）。3组患者疼痛VAS评分、ODI、腰部关节活动度、IL-6、CRP、TNF-α均较治疗前有明显改善，且针药联合组改善优于中药组和温针组（P<0.05）。结论：温针联合肾着汤合新定白术汤能有效改善寒湿痹阻型非特异性下腰痛患者的腰骶部疼痛和活动受限，并明显缩短功能障碍的治疗恢复周期，其机制可能与下调血清IL-6、CRP、TNF-α 等炎症介质水平有关。 |
| 关键词: 非特异性下腰痛 寒湿痹阻型 筋膜-经筋轴 温针 肾着汤合新定白术汤 |
| DOI： |
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| Clinical effect of warm acupuncture combined with Shenzhuo Decoction and Xinding Baizhu Decoction in treatment of non-specific low back pain with cold-damp obstruction based on the theory of fascia-meridian sinew axis: An analysis of 30 cases |
| WU Yinjun,YIN Jinyan,XUE Pengfei,WANG Sheng,WEI Xuwang |
| (Jiaxing Hospital of Traditional Chinese Medicine，Jiaxing 314001，Zhejiang，China;Xincheng Street Community Health Service Center，Xiuzhou District，Jiaxing 314001，Zhejiang，China) |
| Abstract: |
| Objective: To investigate the clinical effect of warm acupuncture combined with Shenzhuo Decoction and Xinding Baizhu Decoction in the treatment of non-specific low back pain with cold-damp obstruction based on the theory of fascia-meridian sinew axis. Methods: A total of 90 patients with non-specific low back pain with cold-damp obstruction were randomly divided into traditional Chinese medicine （TCM） group，warm acupuncture group，and acupuncture-medicine therapy group，with 30 patients in each group. The patients in the TCM group were given oral administration of Shenzhuo Decoction and Xinding Baizhu Decoction，those in the warm acupuncture group were given warm acupuncture，and those in the acupuncture-medicine therapy group were given TCM combined with warm acupuncture. The three groups were compared in terms of Visual Analogue Scale （VAS） score，Oswestry Disability Index （ODI），lumbar joint range of motion，interleukin-6 （IL-6），C-reactive protein （CRP），and tumor necrosis factor-α （TNF-α），and clinical outcome was assessed. Results: The acupuncture-medicine therapy group had a significantly higher overall response rate than the TCM group and the warm acupuncture group ［90.00% （27/30） vs 76.67% （23/30） and 73.33%（22/30），P < 0.05］. After treatment，all three groups had improvements in VAS pain score，ODI，lumbar joint range of motion，IL-6，CRP，and TNF-α，and the acupuncture-medicine therapy group had significantly better improvements than the TCM group and the warn acupuncture group （P < 0.05）. Conclusion: Warm acupuncture combined with Shenzhuo Decoction and Xinding Baizhu Decoction can effectively improve lumbosacral pain and limitation of motion in patients with non-specific low back pain with cold-damp obstruction，possibly by downregulating the serum levels of inflammatory factors such as IL-6，CRP，and TNF-α. |
| Key words: non-specific low back pain cold-damp obstruction fascia-meridian sinew axis warm acupuncture Shenzhuo Decoction Xinding Baizhu Decoction |
