针刺刺激筋膜联合再灌注活动对腰椎间盘突出症患者腰大肌与腰多裂肌横截面面积的影响

马余鸿; 高晓龙; 曹烈虎; 王玲; 吴沙沙; 陈强; 张永琪

文章摘要

马余鸿，高晓龙，曹烈虎，王玲，吴沙沙，陈强，张永琪.针刺刺激筋膜联合再灌注活动对腰椎间盘突出症患者腰大肌与腰多裂肌横截面面积的影响[J].中医药信息,2026,43(6):64-70

针刺刺激筋膜联合再灌注活动对腰椎间盘突出症患者腰大肌与腰多裂肌横截面面积的影响

The Effects of Fascia－Stimulating Acupuncture Combined with Reperfusion Activities on the Cross－Sectional Area of the Psoas Major and Lumbar Multifidus Muscles in Patients of Lumbar Disc Herniation

投稿时间：2025-12-09 录用日期：2026-01-01

DOI：10.19656/j.cnki.1002-2406.20260610

中文关键词: 针刺刺激筋膜再灌注活动腰椎间盘突出症腰大肌腰多裂肌横截面面积

英文关键词: Fascia－stimulating acupuncture Reperfusion activities Lumbar disc herniation Psoas major muscle Lumbar multifidus muscle Cross－sectional area

基金项目:

作者	单位
马余鸿，高晓龙，曹烈虎，王玲，吴沙沙，陈强，张永琪

摘要点击次数: 120

全文下载次数: 69

中文摘要:

目的观察针刺刺激筋膜联合再灌注活动的治疗对腰椎间盘突出症（LDH）患者腰大肌、腰多裂肌横截面面积及临床疗效的影响。方法选取上海市宝山区罗店医院中医针推伤科2022年10月—2024年8月门诊收治的80例LDH患者，采用随机数字表法分为治疗组和对照组，每组各40例。治疗组采用针刺刺激筋膜联合再灌注活动治疗，对照组采用常规针刺治疗。比较两组患者临床疗效，以及治疗前、治疗两周后、治疗4周后的腰大肌与腰多裂肌横截面面积、视觉模拟评分法（VAS）评分、日本骨科协会（JOA）下腰痛评分、腰椎功能障碍指数（ODI）。采用多元线性回归分析腰大肌、多裂肌横截面面积与VAS、JOA、ODI评分的相关性；Log－binomial回归分析两组患者的不良情况。结果治疗组总有效率95%（38/40）高于对照组77.5%（31/40）（P < 0.05）。治疗4周后，治疗组腰大肌、腰多裂肌横截面面积均高于对照组，且两组治疗后均随时间升高，治疗组升高幅度更大（P < 0.05）；重复测量方差分析显示，组间、时间、组别－时间交互效应均有统计学意义（P < 0.05）。JOA、VAS、ODI评分的组间、时间、组别－时间交互效应均有统计学意义（P < 0.05）；治疗4周后，治疗组JOA评分高于对照组，VAS、ODI评分低于对照组，且两组治疗后JOA随时间升高，VAS、ODI随时间降低，治疗组变化幅度更大（P < 0.05）。多元线性回归分析显示，腰大肌、多裂肌横截面面积升高对VAS、JOA、ODI评分变化的影响达30%以上（P < 0.05）。两组不良反应总发生率比较，差异无统计学意义（P > 0.05）。对照组未愈人数多于治疗组，未愈者多为年龄≥ 45岁、LDH急性期、膨出型/突出型、VAS ≥ 3分、JOA < 18分、ODI ≥ 20分（P > 0.05）。结论针刺刺激筋膜联合再灌注活动治疗可有效增加LDH患者腰大肌与腰多裂肌横截面面积，改善腰椎功能，缓解疼痛，临床疗效优于常规针刺治疗，且安全性良好。

英文摘要:

Objective To observe the clinical efficacy of Buqi Tongmai Formula combined with acupuncture on patients of peripheral vascular lesions of lower limbs in type 2 diabetes with qi deficiency and blood stasis pattern.Methods Patients of peripheral vascular lesions of lower limbs in type 2 diabetes who met the inclusion criteria were randomly divided into an observation group and a control group according to a random number table， with 53 cases in each group. The control group received conventional treatment， including blood glucose and blood lipids control， and lower limb circulation improvement， while the observation group received Buqi Tongmai Formula combined with acupuncture on the basis of the treatment in the control group. The treatment lasted for 12 days. Changes in the traditional Chinese medicine （TCM） syndrome scores before and after treatment of two groups were compared， as well as the clinical efficacy. The toe－brachial index （TBI）， ankle－brachial index （ABI）， as well as the intravascular diameter and blood flow velocity of the dorsalis pedis artery， common femoral artery， and popliteal artery were measured by color Doppler ultrasound. Enzyme－linked immunosorbent assay （ELISA） was employed to measure serum levels of serine protease inhibitor （Vaspin）， transforming growth factor－β1 （TGF－β1）， and angiopoietin－like protein 4 （ANGPTL4）. Lower limb symptoms in both groups were evaluated before and after treatment using the Toronto Clinical Scoring System （TCSS）.Results The total effective rate of observation group was 92.5% （49/53）， which was higher than 75.5% （40/53） in the control group （P < 0.01）. After treatment， both groups showed a significant decrease in TCM syndrome scores， with scores in the treatment group being lower than those in the control group （P < 0.05）. The TBI and ABI were markedly increased in both groups after the treatment （P < 0.05）， with the observation group demonstrating significantly higher values than the control group （P < 0.01）. The intravascular diameter and blood flow velocity of the dorsalis pedis artery， common femoral artery， and popliteal artery were evidently increased in both groups after the treatment （P < 0.05）， with the observation group showing a significantly greater improvement than the control group （P < 0.05）. Compared to the treatment before， serum levels of Vaspin and ANGPTL4 increased in both groups （P < 0.05）， while TGF－β1 decreased in both groups （P < 0.05）. Moreover， these changes were more pronounced in the treatment group compared to the control group （P < 0.01）.Conclusion Buqi Tongmai Formula combined with acupuncture can alleviate clinical symptoms， reduce blood viscosity， and mitigate vascular injury in the treatment of peripheral vascular disease of lower limbs in type 2 diabetes with qi deficiency and blood stasis pattern.

查看全文查看/发表评论下载PDF阅读器

关闭