赤凤迎源针法联合推拿治疗气滞血瘀型慢性非特异性下腰痛的临床研究OA

Objective To observe the clinical efficacy of Chifeng Yingyuan acupuncture method combined with Tuina in the treatment of chronic nonspecific low back pain(CNLBP),and to analyze its effects on infrared thermography temperature,lumbar range of motion,inflammatory and pain mediators,as well as electromyographic signals of the erector spinae and multifidus muscles.Methods Eighty-two patients of CNLBP who met the inclusion criteria were divided into a control group and an observation group using random number table method,with forty-one cases in each group.Both groups received basic treatment such as health education,lifestyle intervention,pain management,lumbar protection,and behavioral intervention.Furthermore,the control group was treated with Tuina,and the observation group was treated with Chifeng Yingyuan acupuncture method on the basis of control group.Both groups were treated for 4 weeks.The Modified Japanese Orthopaedic Association(M-JOA)score was employed to evaluate lumbar symptoms.The Oswestry Disability Index(ODI)was used to assess functional impairment.Pain intensity was measured by the Numeric Rating Scale(NRS),and quality of life was assessed using the Short Form-36 Health Survey(SF-36).Surface electromyography signals of the erector spinae and multifidus muscles were collected using a surface electromyograph.Lumbar infrared thermograms were obtained using a short-focus uncooled infrared thermal imager,and the average temperature was recorded.Lumbar range of motion during flexion,extension,lateral bending,and rotation was measured using a goniometer.Enzyme-linked immunosorbent assay was employed to measure serum levels of inflammatory and pain-related mediators,including tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6),prostaglandin E2(PGE2),and β-endorphin(β-EP).The clinical efficacy,adverse reactions,and the 1-year recurrence rate were compared between the two groups.Results The total effective rate in the observation group was 95.12%(39/41),which was significantly higher than 75.61%(31/41)in the control group(P<0.05).Compared with pre-treatment,both groups showed significant increases in scores of M-JOA and SF-36,the bilateral RMS of the erector spinae and multifidus muscles,infrared thermal imaging temperatures,as well as the lumbar spine range of motion in flexion,extension,lateral flexion and rotation,and the serum level of β-EP(P<0.05).Furthermore,post-treatment values for these indicators were significantly higher in the observation group than in the control group(P<0.05),whereas the ODI and NRS scores,along with serum levels of TNF-α,IL-6,and PGE2,were significantly lower in the observation group(P<0.05).No significant differences were observed in adverse reactions or the 1-year recurrence rate between the two groups(P>0.05).Conclusion Chifeng Yingyuan acupuncture method combined with Tuina in the treatment of CNLBP can improve clinical efficacy,inhibit the release of inflammatory factors,reduce pain,improve lumbar function,enhance the quality of life,and is associated with a low recurrence rate.