【摘要】 目的 观察温针灸结合骨伤按摩的中医药综合疗法治疗中老年腰椎间盘突出症(LDH)的临床疗效。方法前瞻性选取2019年6月至2020年6月在廊坊市中医医院骨伤科纳入227例LDH患者，按照随机数字表法，将其分为观察组(n=114)和对照组(n=113)。对照组接受常规的中药治疗，观察组在对照组基础上给予温针灸结合骨伤按摩的中医药综合疗法。比较两组临床有效率、腰腿痛程度改善情况、腰椎功能、下肢功能、脊柱稳定性和血清炎症因子[白细胞介素(IL)-6、IL-10、超敏C反应蛋白(hs-CRP)]的变化。结果 治疗后，观察组患者的有效率93.86%，高于对照组(76.11%)，差异有统计学意义(P <0.05)。治疗后，观察组患者视觉模拟评分(VAS)、Osweatry功能障碍指数(ODI)评分为(2.77±0.93)、(4.48±3.85)分，低于对照组[(3.04±0.96)、(9.86±4.31)分]，直腿抬高角度为(78.25±10.24)°，高于对照组[(66.43±8.38)°]，差异均有统计学意义(P <0.05)。治疗后，观察组腰椎曲度、腰椎倾斜角和平均腰间隙高度为(1.82±0.49)°、(31.63±4.02)°、(12.41±1.32) mm，均显著高于对照组[(1.60±0.41)°、(28.91±3.77)°、(10.35±1.43) mm]，差异均有统计学意义(P <0.05)。观察组患者血清IL-6、hs-CRP水平为(103.82±6.92) pg/mL、(8.04±1.85) mg/L，显著低于对照组[(124.74±8.56) pg/m L、(10.24±2.58) mg/L],IL-10为(79.39±5.78) pg/m L，显著高于对照组[(62.45±5.03) pg/m L]，差异均有统计意义(P <0.05)。结论 温针灸结合骨伤按摩的中医综合疗法对腰椎间盘突出症患者的治疗提高了临床疗效，值得临床推广。更多还原

【Abstract】 Objective To investigate the therapeutic effect of warming moxibustion combined with bone injury massage on middle-aged and elderly lumbar disc herniation. Methods From June 2019 to June 2020,227 patients with LDH were prospectively enrolled in the Department of orthopedics and traumatology of Langfang Traditional Chinese Medicine Hospital. According to the random number table method,they were divided into observation group( n = 114) and control group( n = 113). The control group was given traditional Chinese medicine,and the observation group was was given warming moxibustion combined with bone injury massage on the basis of the control group. The clinical effective rate,the improvement of low back and leg pain,lumbar function,lower limb function,spinal stability and inflammatory factors[interleukin( IL)-6,IL-10,high-sensitivity C-reactive protein( hs-CRP) ]were compared between the two groups. Results After treatment,the effective rate of the observation group was 93. 86%,which was higher than that of the control group( 76. 11%),and the difference was statistically significant( P < 0. 05). After treatment,the visual analogue scale( VAS) and Oswestry disability index( ODI) scores in the observation group were( 2. 77 ± 0. 93),( 4. 48 ± 3. 85) points,which were lower than those in the control group [( 3. 04 ± 0. 96),( 9. 86 ± 4. 31) points],and the straight leg raising angle was( 78. 25 ± 10. 24) °,which was higher than the control group [( 66. 43 ± 8. 38) °],the differences were statistically significant( P < 0. 05). The lumbar curvature,lumbar inclination angle and average lumbar space height in the observation group were( 1.82 ± 0. 49) °,( 31. 63 ± 4. 02) °,( 12. 41 ± 1. 32) mm,which were significantly higher than those in the control group[( 1. 60 ± 0. 41) °,( 28.91 ± 3. 77) °,( 10. 35 ± 1. 43) mm],the differences were statistically significant( P < 0. 05). The serum levels of IL-6 and hs-CRP in the observation group were( 103. 82 ± 6. 92) pg/m L,( 8. 04 ± 1. 85) mg/L,which were significantly lower than those in the control group [( 124. 74± 8. 56) pg/m L,( 10. 24 ± 2. 58) mg/L],IL-10 was( 79. 39 ± 5. 78) pg/m L,which was significantly higher than that in the control group[( 62. 45 ± 5. 03) pg/m L],and the differences were statistically significant( P < 0. 05). Conclusion Warming moxibustion combined with bone injury massage can improve the clinical efficacy and thus is worthy of clinical application.更多还原