Yang Shuo, Yang Xiao-fang, Jiang Yu, Xiang Kai-wei, Li Hai-yu
Zhen Ci Yan Jiu. 2014 Dec;39(6):491-5.
To observe the effect of medicinal-cake-separated moxibustion combined with acupuncture on back-leg activities and plasma substance P (SP) levels in patients with lumbar disc herniation, so as to reveal its mechanism underlying pain relief.
A total of 114 patients with lumbar disc herniation were randomly divided into control group (n=56) and treatment group (n=58) according to a random digits table. Patients of the control group were treated by manual acupuncture stimulation of main acupoints Jiaji (EX-B 2), Huantiao (GB 30, affected side), Chengshan (BL 57, affected side), Kunlun (BL 60, affected side), and supplemented acupoints Yanglingquan (GB 34), Weizhong (BL 40) and Zusanli (ST 36) in combination with wheat-flour-cake separated moxibustion at the main acupoints, and patients of the treatment group were treated by medicinal-cake [Chuanwu (Radix Aconiti), Caowu (Radix Aconiti Kusnezoffii), Ruxiang (Olibanum), etc. ]-separated moxibustion in combination with manual acupuncture stimulation of the same acupoints mentioned above. Acupuncture treatment was conducted for 30 min, followed by moxibustion for 15 min. The treatment was given once daily for 10 days. The patients' back-leg functional activity ability was assessed using straight-leg raising test, and the pain state assessed using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores, respectively. The therapeutic effect was evaluated by using "Crite- ria for Diagnosis and Outcome Evaluation of Clinical Disorders or Syndromes of Chinese Medicine" issued in 1994 and plasma SP content was detected by radioimmunoassay.
After the therapy, the back-leg activity score and JOA score of both groups were significantly higher than those of pre-treatment in the same one group (P<0. 05, P<0. 01), and those of the treatment group were significantly higher than those of the control group (P<0.05). The VAS score of the treatment group was re- markably lower than that of the control group (P<0. 01). After the treatment, the plasma SP content was markedly lower in the treatment group than in the control group (.P<0O. 05 ) .
Medicinal-cake-separated moxibustion therapy can ame- liorate pain severity and functional activity of the back-leg pain patients with lumbar disc hernia, which may be related to its effect in reducing blood SP level.
观察隔药饼灸联合针刺对腰椎间盘突出症患者腰腿部活动及血浆P物质（SP）水平的影响，以揭示其缓解疼痛的机制。
将114例腰椎间盘突出症患者按随机数字表法随机分为对照组（n = 56）和治疗组（n = 58）。对照组采用针刺主穴夹脊（EX - B 2）、环跳（患侧GB 30）、承山（患侧BL 57）、昆仑（患侧BL 60），并辅以穴位阳陵泉（GB 34）、委中（BL 40）、足三里（ST 36），同时在主穴行隔面粉饼灸；治疗组采用隔药饼（川乌、草乌、乳香等）灸联合上述相同穴位的针刺手法。针刺治疗30分钟，随后艾灸15分钟。每日治疗1次，共10天。分别采用直腿抬高试验评估患者腰腿部功能活动能力，采用视觉模拟评分法（VAS）和日本骨科学会（JOA）评分评估疼痛状态。参照1994年发布的《中医病证诊断疗效标准》评价疗效，采用放射免疫法检测血浆SP含量。
治疗后，两组患者的腰腿部活动评分及JOA评分均显著高于同组治疗前（P < 0.05，P < 0.01），且治疗组高于对照组（P < 0.05）。治疗组VAS评分显著低于对照组（P < 0.01）。治疗后，治疗组血浆SP含量明显低于对照组（P < 0.05）。
隔药饼灸疗法可改善腰椎间盘突出症腰腿痛患者的疼痛程度和腰腿部功能活动，其机制可能与降低血浆SP水平有关。
