腹部推拿对腰椎间盘突出症术后患者腰椎功能及血清血栓素B2、前列腺素I2表达的影响

摘要/Abstract

摘要： 目的探讨与分析腹部推拿对腰椎间盘突出症术后患者腰椎功能及血清血栓素B2（TXB2）、前列腺素I2（PGI2）的影响。方法选取2019年4月—2022年2月在新疆生产建设兵团第十三师红星医院诊治的腰椎间盘突出症术后患者88例作为研究对象,根据信封随机分组原则把患者分为传统组与推拿组,各44例。传统组给予常规口服非甾体抗炎药治疗,推拿组在传统组治疗的基础上给予腹部推拿治疗,推拿组与传统组都治疗观察4个疗程,比较两组患者腰椎功能、腰部疼痛、腰椎活动力度及血清TXB2、PGI2表达变化情况。结果治疗后推拿组的总有效率明显高于传统组（P<0.05）。推拿组与传统组治疗后的视觉模拟评分法（VAS）评分与Oswestry功能量表（ODI）评分都明显低于治疗前（P<0.05）,推拿组也明显低于传统组（P<0.05）。推拿组与传统组治疗后的腰椎活动度-后伸、前屈都显著高于治疗前（P<0.05）,推拿组也明显高于传统组（P<0.05）。推拿组与传统组治疗后的血清TXB2值都低于治疗前,PGI2值都高于治疗前（P<0.05）;治疗后推拿组的血清TXB2值低于与传统组,血清PGI2值高于传统组（P<0.05）。结论腹部推拿在腰椎间盘突出症术后患者的应用能提高总体治疗效果,缓解疼痛,改善腰椎功能与腰椎活动度,还有利于患者血清TXB2、PGI2分泌保持平衡。

关键词: 腹部推拿, 腰椎间盘突出症, 疼痛, 腰椎功能, 腰椎活动度

Abstract: Objective To explore and analysis the effect of abdominal massage on lumbar spine function and serum thromboxane B2 (TXB2), prostaglandin I2 (PGI2) in patients with lumbar disc herniation after surgery. Methods From April 2019 to February 2022, 88 patients with postoperative lumbar disc herniation who were diagnosed and treated in the Red Star Hospital of the 13th Division of Xinjiang Production and Construction Corps were selected as the research objects. Accorded to the principle of envelope randomization, the patients were divided into the traditional group and the massage group of 44 cases in each groups. The conventional group was given conventional oral NSAIDs, while the massage group was given abdominal massage therapy on the basis of the traditional group. The massage group and the traditional group were treated and observed for 4 courses, and the lumbar spine function and the expression changes of serum TXB2 and PGI2 were recorded. Results After treatment, the total effective rates of massage group was significantly higher than traditional group (P<0.05). The Visual Analogue Scale (VAS) score and Oswestry Dability Index (ODI) score of the two groups after treatment were significantly lower than those before treatment (P<0.05), and the massage group were also significantly lower than the traditional group (P<0.05). After treatment, the lumbar mobility-posterior extension and anterior flexion in the massage and traditional groups were significantly higher than that before treatment (P<0.05), and the massage group was also significantly higher than that in the traditional group (P<0.05). The serum TXB2 values of the massage group and the traditional group after treatment were lower than those before treatment (P<0.05), and the serum PGI2 values were higher than those before treatment (P<0.05). After treatment, the serum TXB2 value of the massage group was lower than that of the traditional group, and the serum PGI2 value of the massage group was higher than that of the traditional group (P<0.05). ConclusionThe application of abdominal massage in patients with lumbar intervertebral disc herniation can improve the overall therapeutic effect, promote pain relief, improve lumbar spine function and lumbar spine mobility, and also help patients maintain a balance in the secretion of serum TXB2 and PGI2.

Key words: abdominal massage, lumbar disc herniation, pain, lumbar function, lumbar range of motion

中图分类号:

R681.53

刘杨杰, 高英, 何成斌. 腹部推拿对腰椎间盘突出症术后患者腰椎功能及血清血栓素B2、前列腺素I2表达的影响[J]. 中华养生保健, 2023, 41(6): 42-46.

LIU Yang-jie, GAO Ying, HE Cheng-bin. Effects of Abdominal Massage on Lumbar Spine Function and Serum Thromboxane B2, Prostaglandin I2 in Patients with Lumbar Disc Herniation after Operation[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(6): 42-46.

参考文献 21

[1]	李江涛,齐雨.推拿联合针灸治疗血瘀型腰椎间盘突出症的临床疗效观察[J].世界中医药,2020,16(6):920-924.
[2]	雷龙鸣,覃书颖,陈广辉.推拿手法治疗腰椎间盘突出症的生物力学效应机制[J].广西医学,2022,44(12):1397-1401.
[3]	王劲. 如何预防腰椎间盘突出[J].人人健康,2016(9):46.
[4]	陈婷婷,曾宪敏,李安洪.推拿联合针灸治疗腰椎间盘突出症的疗效及对相关炎性因子影响的临床研究[J].贵阳中医学院学报,2019, 41(1):36-41,46.
[5]	黄定权,李树标.辨证推拿治疗腰椎间盘突出症的研究进展[J].现代中西医结合杂志,2018,27(31):3523-3525,3534.
[6]	张维,陈帅,尹宏兵.五步推拿疗法配合脊柱测试评价训练系统(Tergumed)治疗腰椎间盘突出症[J].吉林中医药,2022,42(6):726-728.
[7]	ZHANG J, ZHAI X, WANG X, et al.The Effect of Thunder-Fire Moxibustion on Lumbar Disc Herniation: Study Protocol for a Randomized Controlled Trial[J]. Front Public Health,2022,6(10):930830.
[8]	柴杨. 正脊调曲法联合中药熏蒸、牵引推拿治疗腰椎间盘突出症疗效观察[J].现代中西医结合杂志,2017,26(1):89-91.
[9]	顾非,房敏.推拿治疗腰椎间盘突出症手法规范化与疗效量化标准的研究[J].颈腰痛杂志,2010,31(1):8-11.
[10]	中华医学会骨科学分会脊柱外科学组,中华医学会骨科学分会骨科康复学组.腰椎间盘突出症诊疗指南[J].中华骨科杂志,2020,40(8): 477-487.
[11]	胥少汀,葛宝丰,徐印坎.实用骨科学[M].北京:人民军医出版社,2012:1337-1343.
[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.
[13]	严广斌. 视觉模拟评分法(VAS)[J].中华关节外科杂志(电子版), 2014,8(2):273.
[14]	金伟,徐蓉,贾东奇.手法推拿联合悬吊运动疗法对腰椎间盘突出症患者腰背伸肌群功能及肌肉抗疲劳的影响[J].现代中西医结合杂志,2019,28(25):2772-2776,2796.
[15]	刘俊杰,李洪涛,谭曾德,等.经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症患者的手术效果及术后腰部活动功能评价[J].中国临床医生杂志,2021,49(9):1091-1093.
[16]	张虎林,张华,郭成龙,等.麦肯基疗法配合针灸推拿治疗腰椎间盘突出症伴腰3横突综合征疗效观察[J].现代中西医结合杂志,2016, 25(25):2777-2779.
[17]	王志杰,刘妍妍,黄金勇.推拿联合牵引对腰椎间盘突出患者腰痛程度及炎症因子的影响[J].湖北中医药大学学报,2022,24(3):64-66.
[18]	宋晓磊,丁志敏,张丽红,等.“两针一灸”整合疗法治疗老年腰椎间盘突出症临床观察[J].河南中医,2022,42(4):624-628.
[19]	司晓华,陈迪,车有路,等.腰-骶手法调整治疗腰椎间盘突出症合并骶髂关节紊乱的临床观察[J].中国中医急症,2022,31(3):395-398.
[20]	彭科志,向开维,崔瑾.皮内针配合推拿治疗腰椎间盘突出症疗效观察[J].中国针灸,2008,28(12):894-896.
[21]	吴虹娇,吕立江,吕智桢,等.吕立江应用杠杆定位手法治疗腰椎间盘突出症经验探析[J].浙江中医杂志,2022,57(6):406-408.