王涵翰 蒋逸涵 闫朝勃 王玉盼 岳增辉 朱伟

〔摘要〕 目的 探讨采用恢刺电针治疗结合腰部康复训练对腰椎间盘突出症的临床疗效。方法 将63例腰椎间盘突出症患者随机分为试验组（n=32）和对照组（n=31），试验组给予恢刺电针治疗并结合腰部康复训练（改良麦肯基疗法），对照组仅给予腰部康复训练（改良麦肯基疗法）。比较2组患者治疗前后视觉疼痛模拟评分法（visual analogue scale， VAS）、改良日本骨科学会腰痛评分表（improvement japanese orthopacdic association score， M-JOA）问卷评分，检测治疗前后2组患者炎症因子水平，并比较两组患者的临床疗效。结果 临床总有效率试验组为93.75%，对照组为74.19%，两组差异有统计学意义（P<0.05）。治疗后，两组VAS评分及M-JOA评分均较治疗前明显下降（P<0.05或P<0.01）;且试验组VAS评分及M-JOA评分的腰部疼痛、下肢放射痛、麻木、椎旁压痛、步行时间、工作能力方面评分均低于对照组（P<0.05或P<0.01）。治療后，两组血清白细胞介素-1β（interleukin-1β， IL-1β）和白细胞介素-6（interleukin-6， IL-6）水平均较治疗前明显降低（P<0.01）;且试验组显著低于对照组（P<0.01）。结论 恢刺电针结合腰部康复训练可显著提高腰椎间盘突出症患者的临床疗效，在改善患者腰部疼痛、下肢放射痛、麻木、椎旁压痛、步行时间、工作能力及降低血清炎症因子水平方面优于单纯腰部康复训练治疗，值得在临床推广应用。

〔关键词〕 腰椎间盘突出症;恢刺;电针;康复训练;麦肯基疗法

〔中图分类号〕R246       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.07.014

〔Abstract〕 Objective To investigate the clinical effect of Hui-acupuncture and electro-acupuncture combined with lumbar rehabilitation training on lumbar disc herniation. Methods 63 patients with lumbar disc herniation were randomly divided into experimental group （n=32） and control group （n=31）. The experimental group was treated with Hui-acupuncture and electro-acupuncture combined with lumbar rehabilitation training （modified McKenzie therapy）， while the control group was only treated with lumbar rehabilitation training （modified McKenzie therapy）. Visual analogue scale （VAS） and improved Japanese Orthopedic Association score （M-JOA） were compared between the two groups before and after treatment. The levels of inflammatory factors of the two groups were detected before and after treatment， and the clinical efficacy of the two groups was compared. Results The clinical total effective rate was 93.75% in the experimental group and 74.19% in the control group， the difference was statistically significant （P<0.05）. After treatment， the VAS score and M-JOA score of the two groups were significantly lower than those before treatment （P<0.05 or P<0.01）; and the VAS score and M-JOA score of the experimental group were lower than those of the control group in the aspects of lumbar pain， lower limb radiation pain， numbness， paravertebral tenderness， walking time and working ability （P<0.05 or P<0.01）. After treatment， the levels of serum interleukin-1 β （IL-1 β） and interleukin-6 （IL-6） in the two groups were significantly lower than those before treatment （P<0.01）; and the experimental group was significantly lower than the control group （P<0.01）. Conclusion Hui-acupuncture and electro-acupuncture combined with lumbar rehabilitation training can significantly improve the clinical efficacy of patients with lumbar disc herniation. It is superior to simple lumbar rehabilitation training in improving lumbar pain， lower limb radiation pain， numbness， paravertebral tenderness， walking time， working ability and reducing serum inflammatory factor level， which is worthy of clinical application.

〔Keywords〕 lumbar disc herniation; Hui-acupuncture; electro-acupuncture; rehabilitation training; McKenzie therapy

腰椎间盘突出症（lumbar disc herniation， LDH）是临床中引发腰腿痛的常见病因之一[1]，此病是因腰椎间盘退行性病变，又在长期腰部用力不当、外伤劳损等内外力因素作用下，引起纤维环破裂、髓核突出并压迫刺激椎孔内容物，该过程会导致锥体力学结构的破坏并引起自身免疫、炎症因子释放[2]等病理变化，最终引发腰腿部疼痛、麻木等。LDH主要影响的是青壮年人群，该病急性期的疼痛会影响人们正常的工作及生活，导致个人及社会的经济损失[3]。另外，随着人们工作及生活方式的改变，该病发病率不断增加，并呈现年轻化趋势[4]。目前，LDH的治疗方法较多，以是否手术可分为非手术治疗与手术治疗两类。但临床中符合手术指征的比例不高，术后仍存在复发、神经损伤等并发症[5]，因此，患者多期望通过非手术治疗的方式改善病情。……