[1]刘鹏民,王文彪,杨来福,等.体外冲击波联合艾灸治疗腰椎小关节源性腰痛疗效观察[J].新乡医学院学报,2023,40(9):829-833.[doi:10.7683/xxyxyxb.2023.09.005]
　LIU Pengmin,WANG Wenbiao,YANG Laifu,et al.Curative effect of extracorporeal shock wave combined with moxibustion in the treatment of lumbar facet-derived low back pain[J].Journal of Xinxiang Medical University,2023,40(9):829-833.[doi:10.7683/xxyxyxb.2023.09.005]
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体外冲击波联合艾灸治疗腰椎小关节源性腰痛疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年9
页码:
829-833
栏目:
临床研究
出版日期:
2023-09-05

文章信息/Info

Title:
Curative effect of extracorporeal shock wave combined with moxibustion in the treatment of lumbar facet-derived low back pain
作者:
刘鹏民; 王文彪; 杨来福; 朱景维; 李辉; 张玲玲; 曹一升
（新乡医学院第一附属医院康复医学科，河南　卫辉　453100）
Author(s):
LIU Pengmin; WANG Wenbiao; YANG Laifu; ZHU Jingwei; LI Hui; ZHANG Lingling; CAO Yisheng
(Department of Rehabilitation Medicine,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
小关节源性腰痛; 体外冲击波; 艾灸
Keywords:
facet-derived low back pain; extracorporeal shock wave; moxibustion
分类号:
R681.5
DOI:
10.7683/xxyxyxb.2023.09.005
文献标志码:
A
摘要:
目的　探讨体外冲击波联合艾灸治疗腰椎小关节源性腰痛的疗效。
方法　选择2020年1月至2022年7月新乡医学院第一附属医院收治的90例腰椎小关节源性腰痛患者为研究对象，采用随机数字表法将患者分为冲击波治疗组、艾灸治疗组、联合治疗组，每组30例。冲击波治疗组患者在腰痛处给予体外冲击波治疗；艾灸治疗组患者在腰痛处给予艾灸治疗；联合治疗组患者在腰痛处给予体外冲击波治疗和艾灸治疗。分别于治疗前及治疗1、2、3、4周后，采用疼痛视觉模拟评分法(VAS) 评估3组患者的腰痛程度，日本骨科协会评估治疗（JOA）评分评估3组患者腰部功能障碍情况，Oswestry功能障碍指数（ODI）评估3组患者腰椎功能改善程度。
结果　治疗前，3组患者VAS、JOA和ODI评分比较差异无统计学意义(P>0.05)。治疗1、2、3、4周后，联合治疗组患者的VAS、JOA评分显著低于冲击波治疗组和艾灸治疗组，ODI评分显著高于冲击波治疗组和艾灸治疗组(P<0.05)；冲击波治疗组与艾灸治疗组患者的VAS、JOA和ODI评分比较差异无统计学意义(P>0.05)。3组患者治疗1、2、3、4周后的VAS和JOA评分显著低于治疗前，ODI评分显著高于治疗前(P<0.05)。
结论　体外冲击波及艾灸均可减轻腰椎小关节源性腰痛，改善腰椎功能；体外冲击波与艾灸联合治疗较单一治疗效果更佳。
Abstract:
Objective　To explore the curative effect of extracorporeal shock wave combined with moxibustion in the treatment of lumbar facet-derived low back pain.
Methods　A total of 90 patients with lumbar facet-derived low back pain admitted to the First Affiliated Hospital of Xinxiang Medical University from January 2020 to July 2022 were selected as the research objects,and they were randomly divided into shock wave treatment group,moxibustion treatment group and combined treatment group,with 30 cases in each group.The patients in the shock wave treatment group were treated with extracorporeal shock wave at the site of low back pain;the patients in the moxibustion treatment group were treated with moxibustion at the location of low back pain;the patients in the combined treatment group were treated with extracorporeal shock wave and moxibustion at the site of low back pain.Before treatment and after 1,2,3 and 4 weeks of treatment,the degree of low back pain of patients in the three groups was evaluated by using the visual analogue scale (VAS),the lumbar dysfunction of patients in the three groups was evaluated by using Japanese Orthopedic Association (JOA) score,and the improvement of lumbar function of patients in the three groups was evaluated by using Oswestry disability index (ODI).
Results　Before treatment,there was no statistically significant difference in VAS,JOA and ODI scores of patients among the three groups (P>0.05).After 1,2,3 and 4 weeks of treatment,the VAS and JOA scores of patients in the combined treatment group were significantly lower than those in the shock wave treatment group and moxibustion treatment group,the ODI score was significantly higher than that in the shock wave treatment group and moxibustion treatment group (P<0.05);there was no statistically significant difference in VAS,JOA and ODI scores of patients between the shock wave treatment group and the moxibustion treatment group (P>0.05).After 1,2,3 and 4 weeks of treatment,the VAS and JOA scores of patients were significantly lower than those before treatment,the ODI score was significantly higher than that before treatment in the three groups(P<0.05).
Conclusion　Extracorporeal shock wave and moxibustion can both relieve lumbar facet-derived low back pain and improve lumbar function.Extracorporeal shock wave combined with moxibustion treatment is more effective than single treatment of extracorporeal shock wave and moxibustion.

参考文献/References:

［1］　张家立,王东洋,伍亮,等.腰椎关节突关节源性腰痛诊疗的研究进展［J］.中国全科医学,2016,19(6):729-732.
ZHANG J L,WANG D Y,WU L,et al.Research progress on the diagnosis and treatment of lumbar zygapophysial joint pain［J］.Chin General Pract,2016,19(6):729-732.
［2］　岳寿伟.腰痛的评估与康复治疗进展［J］.中国康复医学杂志,2017,32(2):136-139.
YUE S W.Progress of evaluation and rehabilitation treatment for low back pain［J］.Chin J Rehabil Med,2017,32(2):136-139.
［3］　黄俊,江蔚,王明俊.冲击波联合物理疗法对非特异性下腰痛康复的临床观察［J］.颈腰痛杂志,2019,40(4):508-509.
HUANG J,JIANG W,WANG M J.Clinical observation of shock wave combined with physical therapy for rehabilitation of non-specific low back pain［J］.J Cervic Lumb,2019,40 (4):508-509.
［4］　李祖虹,李洁,朱耀刚,等.体外冲击波治疗慢性非特异性下背痛的疗效观察［J］.中华物理医学与康复杂志,2019,41(7):501-503.
LI Z H,LI J,ZHU Y G,et al.Effect of extracorporeal shock wave therapy on chronic nonspecific low back pain［J］.Chin J Phys Med Rehabil,2019,41 (7):501-503.
［5］　吴坤,刘彧,董玉茹,等.体外冲击波疗法治疗急性亚急性非特异性下腰痛的临床研究［J］.中华灾害救援医学,2016,4(2):81-84.
WU K,LIU Y,DONG Y R,et al.Clinical trial of extracorporeal shock wave therapy on acute subacute nonspecific low back pain［J］.Chin J Disast Med,2016,4(2):81-84.
［6］　周迪远,陶惠红,杨耀琴,等.体外冲击波对肌肉骨骼痛症的抗炎镇痛机制［J］.实用骨科杂志,2017,23(7):618-621,625.
ZHOU D Y,TAO H H,YANG Y Q,et al.Anti-inflammatory and analgesic mechanism of extracorporeal shock wave on musculoskeletal pain［J］.J Pract Orthopaed,2017,23(7):618-621,625.
［7］　CHEN Y T,YANG C C,SUN C K,et al.Extracorporeal shock wave therapy ameliorates cyclophosphamide-induced rat acute interstitial cystitis though inhibiting inflammation and oxidative stress-in vitro and in vivo experiment studies［J］.Am J Transl Res,2014,6(6):631-648.
［8］　黄雪莉,方云添,郑亚珠.艾灸治疗肾虚型腰痛病的疗效观察［J］.光明中医,2016,31(2):246-248.
HUANG X L,FANG Y T,ZHENG Y Z.Clinical observation on moxa-wooi moxibustion in the treatment of lumbago of kidney deficiency［J］.Guangming J Chin Med,2016,31(2):246-248.
［9］　周纯袆,蔡慧芳,周燕,等.麦粒灸结合腰部推拿治疗老年肾虚型腰痛疗效观察［J］.山西中医,2016,32(3):31-32.
ZHOU C H,CAI H F,ZHOU Y,et al.Observation on the curative effect of wheat moxibustion combined with waist massage on elderly kidney deficiency type low back pain［J］.Shanxi J TCM,2016,32(3):31-32.
［10］　詹玉林,范家伦.腰椎小关节病的诊断与治疗［J］.中国矫形外科杂志,2002,10(8):822-823.
ZHAN Y L,FAN J L.Diagnosis and treatment of lumbar microarthropathy［J］.Orthopaed J China,2002,10(8):822-823.
［11］　严广斌.视觉模拟评分法［J］.中华关节外科杂志(电子版),2014,8(2):273.
YAN G B.Visual analog scoring［J］.Chin J Joint Surg (Electr Ed),2014,8(2):273.
［12］　程继伟,王振林,刘伟,等.Oswestry功能障碍指数的改良及信度和效度检验［J］.中国脊柱脊髓杂志,2017,27(3):235-241.
CHENG J W,WANG Z L,LIU W,et al.Improvement of oswestry disability index and its test of reliability and validity［J］.Chin J Spine Spinal Cord,2017,27(3):235-241.
［13］　杨剑,康建平,冯大雄,等.IL-1和IL-6的表达增强且与盘源性下腰痛改良日本骨科学会(mJOA)评分负相关［J］.细胞与分子免疫学杂志,2016,32(1):88-91．
YANG J,KANG J P,FENG D X,et al.Increased IL-1 and IL-6 expressions are negatively correlated with modified Japanese Orthopedic Association (mJOA) scores of discogenic low back pain［J］.Chin J Cell Mol Immunol,2016,32 (1):88-91.
［14］　SURI P,MIYAKOSHI A,HUNTER D J,et al.Does lumbar spinal degeneration begin with the anterior structures? A study of the observed epidemiology in a community-based population［J］.BMC Musculoskelet Disord Volume,2011,12:202.
［15］　MANCHIKANTI L,HIRSCH J A,KAYE A D,et al.Cervical zygapophysial (facet) joint pain:effectiveness of interventional management strategies［J］.Postgrad Med,2016,128(1):54-68.
［16］　KIM J S,ALI M H,WYDRA F,et al.Characterization of degenerative human facet joints and facet joint capsular tissues［J］.Osteoarthritis Cartilage,2015,23(12):2242-2251.
［17］　BERESFORD Z M,KENDALL R W,WILLICK S E.Lumbar facet syndromes［J］.Curr Sports Med Rep,2010,9(1):50-56.
［18］　寇文丽.体外冲击波应用进展［J］.中国医学创新,2017,14(34):139-142.
KOU W L.Advances of extracorporeal shock wave therapy［J］.Med Inn Chin,2017,14(34):139-142.
［19］　OCHIAI N,OHTORI S,SASHO T,et al.Extracorporeal shock wave therapy improves motor dysfunction and pain originating from knee osteoarthritis in rats［J］.Osteoarthritis Cartilage,2007,15(9):1093-1096．
［20］　ROMEO P,LAVANGA V,PAGANI D,et al.Extracorporeal shock wave therapy in musculoskeletal disorders:a review［J］.Med Prince Pract,2014,23(1):7-13.
［21］　陈影,彭雪梅,吴东南,等.艾灸盒温灸治疗肾虚型腰痛临床疗效观察［J］.中医临床研究,2020,12(31):59-61.
CHEN Y,PENG X M,WU D N,et al.Clinical observation on treating lumbago of the Shenxu type by moxibustion box［J］.Clin J Chin Med,2019,12(31):59-61.
［22］　王玲玲.艾灸的特点及温通效应［J］.中国针灸,2011,31(10):865-868.
WANG L L.Characteristics of moxibustion and its warming-dredging effect［J］.Chin Acupunct Moxibust,2011,31(10):865-868.
［23］　吕鹏,张承舜,尹海燕,等.艾灸温热刺激的研究现状［J］.成都中医药大学学报,2017,40(1):95-98.
LYU P,ZHANG C S,YIN H Y.Thermal effect of moxibustion［J］.J Chengdu Univ TCM,2017,40(1):95-98.

更新日期/Last Update: 2023-09-05