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“长蛇灸”对伴有负性情绪的寒湿型慢性非特异性腰痛患者的临床疗效

[Clinical effectiveness of "long snake moxibustion" for cold-dampness type chronic non-specific low back pain patients with negative emotions].

作者信息

Tang Li-Mei, Deng Chen-Ying, Huang Hui, Liu Hang, Huang Ping, Jiang Xiao-Ming, Gao Jie, Zhu Xiao-Yan, Qiu Fen-Fen, Hu Xiu-Wu

机构信息

Department of Acupuncture and Moxibustion, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang 330006, China.

Department of Rehabilitation, Jiangxi Integrated Traditional Chinese and Wes-tern Medicine Hospital, Nanchang 330004.

出版信息

Zhen Ci Yan Jiu. 2020 Dec 25;45(12):1014-8. doi: 10.13702/j.1000-0607.200061.

Abstract

OBJECTIVE

To observe the clinical efficacy of long snake moxibustion and Ashi-point moxibustion in the treatment of cold-dampness type chronic non-specific low back pain (CNLBP) patients.

METHODS

A total of 120 cold-dampness type CNLBP patients who signed the informed consent were randomly and equally divided into control, long snake moxibustion and Ashi-point moxibustion groups. Ginger-separated moxibustion was applied to the region between Dazhui (GV14) and Yaoshu (GV2) for patients of the long-snake moxibustion group, or to the tenderness spot of the waist for patients of the Ashi-point moxibustion group. The treatment was conducted for 40 min each time, once every other day for a total of 8 sessions. Patients of the control group did not receive any intervention. The visual analogue scale (VAS) was used to assess low back pain severity. The Oswestry Disability Index (ODI) was employed to assess ten aspects of patients' daily-life activities (pain intensity, personal care, lif-ting, walking, sitting, standing, sleeping, sex life, social life, and traveling). The cold-damp syndrome scores (pain property, symptoms, ranges of motion, waist palpation, tongue and pulse condition) were achieved by consulting the textbook "Differential Diagnostics of Traditional Chinese Medicine Syndromes". The Hospital Anxiety and Depression Scale (HADS, a self-made assessment instrument) was used to assess the patients' severity of emotional disorder.The plasma cortisol level was detected by ELISA.

RESULTS

Before treatment, there were no significant differences among the three groups in the levels of all the indexes (>0.05). After moxibustion, the VAS scores during rest and movement, ODI score, cold-damp syndrome score and anxiety score in both long snake moxibustion and Ashi-point moxibustion groups, and the HADS depression score and plasma cortisol content in the long snake moxibustion group were significantly reduced compared with their own pre-treatment (<0.05). The difference values between pre and post-treatment of VAS scores during rest and movement, ODI score, cold-damp syndrome score, anxiety score, depression score and cortisol content were obviously higher in the long snake moxibustion and Ashi-point moxibustion groups than those in the control group. The difference values between pre- and post-treatment of VAS scores during rest and movement, ODI score, cold-damp syndrome score, anxiety score, depression score and cortisol content were obviously higher in the long snake moxibustion group than in the Ashi-point group (<0.05).

CONCLUSION

Both ginger-separated long snake moxibustion and Ashi-point moxibustion can relieve low back pain, daily-life activities, cold-damp syndrome, negative emotions, and reducing cortisol level in cold-dampness type CNLBP patients,and the therapeutic efficacy of long snake moxibustion is obviously better.

摘要

目的

观察长蛇灸和阿是穴艾灸治疗寒湿型慢性非特异性下腰痛(CNLBP)患者的临床疗效。

方法

将120例签署知情同意书的寒湿型CNLBP患者随机等分为对照组、长蛇灸组和阿是穴艾灸组。长蛇灸组患者于大椎(GV14)至腰俞(GV2)区域行隔姜灸,阿是穴艾灸组患者于腰部压痛点行隔姜灸。每次治疗40分钟,隔日1次,共治疗8次。对照组患者不接受任何干预。采用视觉模拟评分法(VAS)评估腰痛严重程度。采用Oswestry功能障碍指数(ODI)评估患者日常生活活动的十个方面(疼痛强度、个人护理、提物、行走、坐立、站立、睡眠、性生活、社交生活和出行)。参照《中医证候鉴别诊断学》教材获取寒湿证评分(疼痛性质、症状、活动范围、腰部触诊、舌象和脉象)。采用医院焦虑抑郁量表(HADS,自制评估工具)评估患者情绪障碍严重程度。采用酶联免疫吸附测定法检测血浆皮质醇水平。

结果

治疗前,三组各项指标水平比较,差异均无统计学意义(>0.05)。艾灸后,长蛇灸组和阿是穴艾灸组静息和活动时的VAS评分、ODI评分、寒湿证评分及焦虑评分,以及长蛇灸组的HADS抑郁评分和血浆皮质醇含量均较治疗前显著降低(<0.05)。长蛇灸组和阿是穴艾灸组静息和活动时的VAS评分、ODI评分、寒湿证评分、焦虑评分、抑郁评分及皮质醇含量治疗前后差值明显高于对照组。长蛇灸组静息和活动时的VAS评分、ODI评分、寒湿证评分、焦虑评分、抑郁评分及皮质醇含量治疗前后差值明显高于阿是穴艾灸组(<0.05)。

结论

隔姜长蛇灸和阿是穴艾灸均可缓解寒湿型CNLBP患者的腰痛、日常生活活动、寒湿证、负性情绪,并降低皮质醇水平,且长蛇灸的治疗效果明显更佳。

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