腕踝针联合西药治疗急性腰椎间盘突出症的疗效观察OA

Objective To observe the clinical efficacy of wrist-ankle acupuncture combined with western medicine in the treatment of acute lumbar disc herniation.Methods A total of 116 patients diagnosed with acute lumbar disc herniation admitted to the Department of Pain Medicine and the Department of Tuina at Foshan Hospital of Traditional Chinese Medicine from January 2025 to June 2025 were selected as study subjects.The patients were randomly divided into an observation group and a control group using a random number table method,with 58 cases in each group.The control group received conventional western medicine treatment,while the observation group received wrist-ankle acupuncture in addition to the treatment given to the control group.Both groups were treated continuously for 2 weeks.After 2 weeks of treatment,clinical efficacy was evaluated in both groups.Changes in the Short-Form McGill Pain Questionnaire(SF-MPQ)score,Japanese Orthopaedic Association(JOA)score,and Oswestry Disability Index(ODI)score were observed before and after treatment,as well as the maximum range of motion for lumbar flexion,extension,and lateral flexion.The average electromyography(AEMG)values during the flexion process,extension process,and flexion-relaxation ratio(FRR)of the erector spinae muscle at the L4-5 level were measured.Changes in serum levels of prostaglandin E2(PGE2),substance P(SP),5-hydroxytryptamine(5-HT),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),matrix metalloproteinases(MMPs),and tissue inhibitors of metalloproteinases(TIMPs)were compared between the two groups before and after treatment.Results(1)The total effective rate was 94.83%(55/58)in the observation group and 82.76%(48/58)in the control group,with the observation group showing significantly better efficacy than the control group,the difference being statistically significant(P＜0.05).(2)After treatment,JOA scores,ODI scores,and SF-MPQ scores were significantly improved in both groups(P＜0.05),and the observation group demonstrated significantly greater improvements in JOA scores,ODI scores,and SF-MPQ scores compared with the control group,the difference being statistically significant(P＜0.05).(3)After treatment,flexion AEMG,extension AEMG,and FRR were significantly improved in both groups(P＜0.05),and the observation group showed significantly greater improvements in flexion AEMG,extension AEMG,and FRR compared with the control group,the difference being statistically significant(P＜0.05).(4)After treatment,ranges of motion for flexion,extension,and lateral flexion were significantly improved in both groups(P＜0.05),and the observation group demonstrated significantly greater improvements in flexion,extension,and lateral flexion ranges of motion compared with the control group,the difference being statistically significant(P＜0.05).(5)After treatment,serum levels of PGE2,SP,and 5-HT were significantly improved in both groups(P＜0.05),and the observation group,the difference being statistically significant showed significantly greater improvements in serum levels of PGE2,SP,and 5-HT compared with the control group(P＜0.05).(6)After treatment,serum levels of IL-1β,TNF-α,IL-6,MMPs,and TIMPs were significantly improved in both groups(P＜0.05),and the observation group demonstrated significantly greater improvements in serum levels of IL-1β,TNF-α,IL-6,MMPs,and TIMPs compared with the control group,the difference being statistically significant(P＜0.05).Conclusion Wrist-ankle acupuncture combined with western medicine in the treatment of acute lumbar disc herniation can effectively alleviate pain symptoms,improve lumbar function and range of motion,regulate pain mediator and inflammatory factor levels,correct the MMPs/TIMPs imbalance,and restore normal electromyographic activity of the back muscles,demonstrating definite therapeutic efficacy.