王宜娅++王宜娜　　刘丽秀　程继伟

[摘要] 目的 觀察腕踝针用于治疗慢性腰肌劳损的疗效，并探讨其可能的机制。 方法 选择某单位门诊体检分析报告显示患有慢性腰肌劳损的90例患者，随机分为腕踝针组和普通组，每组45例。腕踝针组，皮下留针3 d；普通组采用物理按摩的方法治疗，每次治疗持续20 min，每日2次，持续治疗3 d。观察比较两组患者治疗后总有效率、疼痛评分、压痛评分及功能障碍评分；比较两组患者治疗前后血清β-内啡肽的水平。 结果 腕踝针组总有效率为93.3%，普通组总有效率为71.1%，两组差异具有统计学意义（P<0.05）；治疗后，腕踝针组的疼痛评分较普通组明显降低，两组差异具有统计学意义（P<0.01）；与治疗前相比，两组治疗后的压痛评分及功能障碍评分降低（P<0.05）；与治疗前相比，腕踝针组治疗后血清β-内啡肽的水平明显升高，且明显高于治疗后的普通组，差异具有统计学意义（P<0.01），而普通组治疗前后血清中β-内啡肽水平差异不具有统计学意义（P>0.05）。 结论 对患有腰肌劳损的患者实施腕踝针治疗优于物理按摩治疗，可有效缓解疼痛，改善临床症状，临床效果良好，其可能与提高了血清中β-内啡肽的水平有关。

[关键词] 腕踝针；β-内啡肽；慢性腰肌劳损；疼痛；针刺镇痛

[中图分类号] R246.2 [文献标识码] A [文章编号] 1673-9701（2017）03-0022-04

A study on wrist-ankle acupuncture in treatment of lumbar muscle strain by increasing serum β-endorphin level

WANG Yiya1 WANG Yina2 LIU Lixiu2 CHENG Jiwei3

1.Medical Department，People's Liberation Army NO.113 Hospital， Ningbo 315040， China； 2.Department of Emergency，People's Liberation Army NO.113 Hospital， Ningbo 315040， China； 3.Orthopedic Center， People's Liberation Army NO.113 Hospital， Ningbo 315040， China

[Abstract] Objective To observe the effect of wrist- ankle acupuncture on chronic lumbar muscle strain and to explore its possible mechanism. Methods A total of 90 cases of chronic lumbar muscle strain showed by outpatient examination report of certain unit were selected and randomly divided into wrist-ankle acupuncture group and common group，with 45 cases in each group.Wrist-ankle acupuncture group was given subcutaneous needle for 3 days， and common group was treated with physical massage method， with each treatment for 20 min， 2 times a day， and continuous treatment for 3 days. The total effective rate， pain score， tenderness score and dysfunction score were compared between the two groups after treatment. The levels of serum β-endorphin were compared between the two groups before and after treatment. Results The total effective rate was 93.3% in the wrist and ankle acupuncture group and 71.1% in the general group. The difference between the two groups was statistically significant（P<0.05）. After treatment， the pain score of the wrist and ankle acupuncture group was significantly lower than that of the common group，and the difference was significant（P<0.01）. Compared with before treatment， the scores of pain scores and dysfunction scores of the two groups decreased（P<0.05）. The level of serum β-endorphin in the wrist-ankle acupuncture group significantly increased compared with before treatment， and was obviousley higher than that in the control group， and the difference was significant（P<0.01）. There was no significant difference in serum β-endorphin level between the two groups before and after treatment（P>0.05）. Conclusions The implementation of in patients with lumbar muscle strain，which can relieve pain and improve clinical symptoms， is better than physical massage therapy. The wrist and ankle acupuncture has a good clinical effect， which may be related to the improvement of serum β-endorphin.

[Key words] Wrist-ankle acupuncture； β-endorphin； Chronic lumbar muscle lesion； Pain； Acupuncture analgesia

腰肌劳损是指因为腰背部肌肉、筋膜、韧带等软组织的慢性损伤，导致的局部无菌性炎症，从而引起腰背部一侧或两侧的弥漫性疼痛的临床综合征[1]。一般认为长期不正确的姿势和负重，使肌肉长期处于疲劳状态，平衡失调，力量不足，使得韧带、筋膜挫伤，甚至出现局部的组织液渗出和微血管破裂，蔓延到邻近肌间隙后形成瘢痕组织，最终导致局部粘连、变性、甚至肌肉萎缩，分布于肌肉组织中的神经纤维受到病变组织的压迫、刺激、甚至部分神经末梢被破坏，产生疼痛感[2]。

腕踝针是一种我国传统的针刺疗法，主要根据体表症状选择针刺部位进行皮下刺激，以缓解疼痛。……