| 摘要: |
| 目的：观察针灸联合手法复位治疗肝肾亏虚型退行性腰椎滑脱症（degenerative lumbar
spondylolisthesis， DLS）的临床疗效。方法：选取肝肾亏虚型DLS 患者100 例，将其随机分为治疗组和对照
组，每组各50 例。对照组采用手法复位治疗，治疗组在对照组基础上联合针灸治疗，2 组均连续治疗4 周。比
较2 组治疗前后疼痛视觉模拟量表（Visual Analogue Scale， VAS）评分、日本骨科协会评估治疗分数（Japanese
Orthopaedic Association Scores， JOA）、Oswestry 功能障碍指数（Oswestry Disability Index， ODI）、多裂肌形态学
指标（L4/5椎间隙、L5 椎体中央、L5/S1椎间隙水平横截面积）、血清炎症因子［ 白细胞介素-6（Interleukin-6，
IL-6）、肿瘤坏死因子-α（Tumor Necrosis Factor-alpha， TNF-α）、C 反应蛋白（C-reactive protein，CRP）］、
生活质量评分（Short Form 36， SF-36），并评价临床疗效，记录不良反应发生情况。结果：总有效率治疗组为
96.0%（48/50），对照组为84.0%（42/50），2 组比较，差异有统计学意义（P <0.05）；2 组VAS 评分、JOA 评分、
ODI 指数、多裂肌形态学指标、血清炎症因子、SF-36 评分治疗前后组内比较及治疗后组间比较，差异均有统
计学意义（P <0.05）；不良反应发生率治疗组为6.0%（3/50），对照组为4.0%（2/50），2 组比较，差异无统计学
意义（P >0.05）。结论：针灸联合手法复位治疗肝肾亏虚型DLS 可有效减轻患者疼痛，改善腰椎功能与多裂肌
形态，降低炎症反应，提升生活质量，且疗效优于单用手法复位，安全性良好。 |
| 关键词: 退行性腰椎滑脱症 肝肾亏虚型 针灸 手法复位 疼痛 功能障碍 炎症因子 |
| DOI： |
|
|
| Clinical effect of acupuncture combined with manual reduction in treatment of degenerative lumbarspondylolisthesis with deficiency of liver and kidney: An analysis of 50 cases |
| YE Maolin,ZHAO Mingyu,MA Jiangtao,ZHAO Qi |
| (Luoyang Orthopedic-Traumatological Hospital, Henan Provincial Orthopedic Hospital, Zhengzhou 450016,
Henan, China）) |
| Abstract: |
| Objective: To investigate the clinical effect of acupuncture combined with manual reduction in the treatment
of degenerative lumbar spondylolisthesis （DLS） with deficiency of liver and kidney. Methods: A total of 100 DLS
patients with deficiency of liver and kidney were enrolled and randomly divided into treatment group and control group, with 50 patients in each group. The patients in the control group received manual reduction, while those in the treatment group
received acupuncture combined with manual reduction, and the course of treatment was 4 consecutive weeks for both groups.
The two groups were compared in terms of Visual Analogue Scale （VAS） pain score, Japanese Orthopaedic Association
（JOA） score, Oswestry Disability Index （ODI）, morphological indicators of the multifidus muscle （cross-sectional
areas at the L4/5 intervertebral space, the center of the L5 vertebral body, and the L5/S1 intervertebral space）, serum inflammatory
factors （interleukin-6［IL-6］, tumor necrosis factor-α［TNF-α］, and C-reactive protein［CRP］）,
and quality of life score based on 36-Item Short-Form Health Survey （SF-36）. Clinical outcome was assessed, and
adverse reactions were recorded. Results: There was a significant difference in overall response rate between the treatment
group and the control group ［96.0% （48/50） vs 84.0% （42/50）, P < 0.05］. After treatment, both groups had
significant changes in VAS score, JOA score, ODI, morphological indicators of the multifidus muscle, serum inflammatory
factors, and SF-36 score, and there were significant differences in these indicators between the two groups after treatment
（P < 0.05）. There was no significant difference in the incidence rate of adverse reactions between the treatment group and
the control group ［6.0% （3/50） vs 4.0% （2/50）, P > 0.05］. Conclusion: In the treatment of DLS with deficiency of
liver and kidney, acupuncture combined with manual reduction can effectively alleviate pain, improve lumbar function and
the morphology of the multifidus muscle, reduce inflammatory response, and enhance quality of life, with a better effect than
manual reduction alone and a favorable safety profile. |
| Key words: degenerative lumbar spondylolisthesis deficiency of liver and kidney acupuncture manual reduction pain dysfunction inflammatory factors |
