| 杠杆定位手法结合脉冲电场对腰椎间盘突出症患者镇痛效应及IL-1β、TNF-α的影响 |
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投稿时间：2020-06-09
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| 作者 | Author | 单位 | Address | E-Mail |
| 吕立江 |
LYU Li-jiang |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China |
731577158@qq.com |
| 毛凌宇 |
MAO Ling-yu |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China |
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| 李景虎 |
LI Jing-hu |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China |
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| 杨超 |
YANG Chao |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China |
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| 王玮娃 |
WANG Wei-wa |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China |
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| 王晟 |
WANG Sheng |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China |
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| 刘鼎 |
LIU Ding |
浙江中医药大学第三临床医学院, 浙江 杭州 310053 |
The Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第8期，第780-784页 |
| DOI：10.12200/j.issn.1003-0034.2021.08.017 |
| 基金项目:国家自然科学基金项目（编号：81273866，81774442）；国家临床重点专科建设项目-推拿科[编号：国卫医发（2013）42]；浙江省重大疾病中医药防治中心项目（编号：浙中医药2018-9） |
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中文摘要:
目的：观察杠杆定位手法结合脉冲电场对腰椎间盘突出症患者的镇痛效应及血清中白细胞介素-1β（interleukin-1β，IL-1β），肿瘤坏死因子（tumor necrosis factor-α，TNF-α）影响。
方法：2018年1月至2019年3月纳入58例腰椎间盘突出症患者进行研究，将58例患者用数字表法随机分为观察组和对照组。观察组29例，其中男16例，女13例，年龄（38.03±11.29）岁，采用杠杆定位手法结合脉冲电场治疗。对照组29例，其中男17例，女12例，年龄（38.21±9.16）岁，采用脉冲电场治疗。两组患者每周均治疗3次，隔1 d治疗1次，3次为1个疗程，治疗2个疗程后，采用疼痛数字评分法（numeric rating scales，NRS）对两组患者治疗前后进行评分；同时对治疗前后血清中IL-1β和TNF-α浓度进行测量。
结果：观察组和对照组治疗前NRS评分分别是4.21±1.76，4.66±1.61，治疗后分别为1.28±0.84，2.10±1.35，治疗后观察组NRS评分明显低于对照组（P<0.05）。治疗后两组患者的IL-1β和TNF-α浓度均有变低（P<0.05），观察组和对照组治疗前IL-1β分别为（119.01±69.65）、（112.23±78.43） pg/ml，治疗后分别为（59.78±36.60）、（77.51±40.46） pg/ml；观察组和对照组治疗前TNF-α分别为（1.68±1.13）、（1.74±0.70） pg/ml，治疗后分别为（1.14±0.56）、（1.45±0.58） pg/ml，观察组IL-1β、TNF-α变化均优于对照组（P<0.05）。
结论：杠杆定位手法结合脉冲电场对腰椎间盘突出症患者有较好的镇痛效应，并对腰椎间盘突出症患者的血清IL-1β和TNF-α浓度有明显影响，可作为指导临床的依据，但杠杆定位手法结合脉冲电场的协同作用及对临床治疗的指南还需要进一步研究。 |
| 【关键词】腰椎 椎间盘移位 手法,骨科 脉冲电场 镇痛 白细胞介素-1β 肿瘤坏死因子-α |
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| Lever positioning manipulation combined with pulsed electric field on the analgesic effect of patients with lumbar disc herniation and its influence on IL-1β and TNF-α |
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ABSTRACT
Objective: To observe the analgesic effect of lever positioning manipulation combined with pulsed electric field on patients with lumbar disc herniation and the influence on serum IL-1β and TNF-α.
Methods: From January 2018 to March 2019,58 patients with lumbar disc herniation were included in the study,which were randomly divided into observation group and control group by digital table method. Observation group of 29 cases,including 16 males and 13 females,aged (38.03±11.29) years old,were treated with lever positioning manipulation combined with pulsed electric field. The 29 cases in control group,including 17 males and 12 females,aged (38.21±9.16) years old,were treated with pulsed electric field. Both groups of patients were treated 3 times a week,once every other day,3 times as a course of treatment. After 2 courses of treatment,the two groups of patients were scored before and after treatment by the numeric rating scales (NRS);at the same time,the serum levels of IL-1β and TNF-α were measured before and after treatment.
Results: The NRS scores of observation group and control group were 4.21±1.76,4.66±1.61 before treatment,and 1.28±0.84,2.10±1.35 after treatment,respectively. The NRS scores of the observation group after treatment was significantly lower than that of the control group (P<0.05). After treatment,the concentrations of IL-1β and TNF-α in both groups became lower(P<0.05). The levels of IL-1β in observation group and control group before treatment were (119.01±69.65),(112.23±78.43) pg/ml,and after treatment were(59.78±36.60),(77.51±40.46) pg/ml,respectively. The levels of TNF-α in observation group and control group before treatment were (1.68±1.13),(1.74±0.70) pg/ml,and after treatment were(1.14±0.56),(1.45±0.58) pg/ml,respectively. The change of IL-1β and TNF-α in observation group was better than that in control group(P<0.05).
Conclusion: The lever positioning manipulation combined with pulsed electric field has a good analgesic effect on patients with lumbar disc herniation,and it has a significant impact on the patient's serum IL-1β and TNF-α concentration,which can be used as a clinical guide. However,the synergistic effect of lever positioning technique combined with pulsed electric field and guidelines for clinical treatment need further research. |
| KEY WORDS Lumbar vertebrae Intervertebral disc displacement Manipulation,Orthopedic Pulsed electric field Analgesia Interleukin-1β Tumor necrosis factor-α |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吕立江,毛凌宇,李景虎,杨超,王玮娃,王晟,刘鼎.杠杆定位手法结合脉冲电场对腰椎间盘突出症患者镇痛效应及IL-1β、TNF-α的影响[J].中国骨伤,2021,34(8):780~784 |
| 英文格式: | LYU Li-jiang,MAO Ling-yu,LI Jing-hu,YANG Chao,WANG Wei-wa,WANG Sheng,LIU Ding.Lever positioning manipulation combined with pulsed electric field on the analgesic effect of patients with lumbar disc herniation and its influence on IL-1β and TNF-α[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(8):780~784 |
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