Abstract
Objective
To observe the efficacy of herbal cake-partitioned moxibustion for lumbar disc herniation (LDH) due to kidney deficiency and blood stasis and observe the influence of this method on lumbar functions and inflammatory factors in patients with this condition.
Methods
A total of 120 LDH patients who met the inclusion criteria were randomly divided into three groups, including a herbal cake-partitioned moxibustion group, a flour cake-partitioned moxibustion group, and a Western medication group, with 40 patients in each group. The patients in the Western medication group were treated with diflunisal tablets, 0.5 g per dose, 2 doses a day. Those in the herbal cake-partitioned moxibustion group were treated with additional herbal cake-partitioned moxibustion group at Back-Shu Points and Jiaji (EX-B2) Points once a day. Those in the flour cake-partitioned moxibustion group were treated with the same methods as in the herbal cake-partitioned moxibustion group, except that the herbal cake was replaced by a flour cake. All the patients were treated for 10 d. After treatment, the scores of the visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) and the changes of the interleukin (IL)-6, tumor necrosis factor (TNF)-α, and substance P (SP) levels were observed, and the efficacy was evaluated.
Results
After treatment, the VAS score and the levels of IL-6, TNF-α, and SP were lower than those before treatment, and the JOA score was higher than that before treatment in the three groups, indicating intra-group statistical significance (P<0.05). The VAS score and the levels of IL-6, TNF-α, and SP of the herbal cake-partitioned moxibustion group were lower than those of the flour cake-partitioned moxibustion group and the Western medication group, while the JOA score of the herbal cake-partitioned moxibustion group was higher than that of the other two groups, indicating inter-group statistical significance (P<0.05). The total effective rate of the herbal cake-partitioned moxibustion group was 92.5%, higher than that of the flour cake-partitioned moxibustion group (80.0%) and the Western medication group (72.5%), indicating inter-group statistical significance (P<0.05).
Conclusion
On the basis of Western oral medication, additional herbal cake-partitioned moxibustion can alleviate the pain and improve the lumbar functions in patients with LDH due to kidney deficiency and blood stasis. The efficacy of the integrated method is better than that of either flour cake-partitioned moxibustion or Western medication alone, which may be related to the reduction of serum inflammatory factors.
摘要
目的
观察隔药饼灸治疗肾虚血瘀腰椎间盘突出症(LDH)的临床疗效及其对腰椎功能和炎症因子的影响.
方法
将120例符合纳入标准的LDH患者按随机数字表法分为隔药饼灸组、 隔面饼灸组和西药组, 每组40例. 西药组予口服二氟尼柳片, 0.5 g/次, 2次/d. 隔药饼灸组在此基础上加用隔药饼灸背俞穴和夹脊穴, 1次/d. 隔面饼灸组操作同隔药饼灸组, 仅将药饼换成面饼. 三组均治疗10 d.治疗后观察视觉模拟量表(VAS)评分、 日本骨科协会(JOA)评分及血清白介素(IL)-6、 肿瘤坏死因子(TNF)-α及P物质水平变化, 并评价临床疗效.
结果
治疗后, 三组患者VAS评分, 血清 IL-6、TNF-α及P物质水平均较本组治疗前下降, JOA评分均较本组治疗前升高, 组内差异均有统计学意义(P<0.05). 隔药饼灸组VAS评分及血清IL-6、 TNF-α及P物质水平低于隔面饼灸组及西药组, 而JOA评分高于隔面饼灸组及西药组, 组间差异均有统计学意义(P<0.05). 隔药饼灸组的总有效率为92.5%, 高于隔面饼灸组的80.0%和西药组的72.5%, 组间差异均有统计学意义(P<0.05).
结论
在口服西药基础上加用隔药饼灸能减轻肾虚血瘀LDH患者疼痛, 改善腰椎功能, 疗效优于隔面饼灸和单独西药治疗, 其作用机制可能与降低血清炎症因子水平有关.
Similar content being viewed by others
References
YANG X, LI F, XIN D, HUANG Z, XUE J, WANG B, DA Y, XING W, ZHU Y. Investigation of the STOX1 polymorphism on lumbar disc herniation. Mol Genet Genomic Med, 2020, 8(1): e1038.
YU N T, LIU Y D, XIONG S B, XU C H, LU J. Observation on therapeutic effect of acupuncture at abdomen acupoints plus Tuina for lumbar intervertebral disc herniation. J Acupunct Tuina Sci, 2019, 17(1): 56–61.
ZIELINSKA N, PODGÓRSKI M, HAŁADAJ R, POLGUJ M, OLEWNIK Ł. Risk factors of intervertebral disc pathology: a point of view formerly and today: a review. J Clin Med, 2021, 10(3): 409.
Chinese Orthopaedic Association of Spinal Surgery Group; Chinese Orthopaedic Association of Orthopaedic Rehabilitation Group. Clinical practice guideline for diagnosis and treatment of lumbar disc herniation. Zhonghua Guke Zazhi, 2020, 40(8): 477–487.
Ministry of Health of the People’s Republic of China. Guiding Principles for Clinical Study of New Chinese Medicines. Beijing: China Medical Science Press, 1997: 145–146.
ALQURASHI Y D, DAWIDZIUK A, ALQARNI A, KELLY J, MOSS J, POLKEY M I, MORRELL M J. A visual analog scale for the assessment of mild sleepiness in patients with obstructive sleep apnea and healthy participants. Ann Thorac Med, 2021, 16(2): 141–147.
OSHIMA Y, TAKESHITA K, KATO S, DOI T, MATSUBAYASHI Y, TANIGUCHI Y, NAKAJIMA K, OGUCHI F, OKAMOTO N, SAKAMOTO R, TANAKA S. Comparison between the Japanese Orthopaedic Association (JOA) score and Patient-reported JOA (PRO-JOA) score to evaluate surgical outcomes of degenerative cervical myelopathy. Global Spine J, 2020, 12(5): 795–800.
Ministry of Health of the People’s Republic of China. Guiding Principles for Clinical Study of New Chinese Medicines. Beijing: China Medical Science Press, 2002: 383–389.
NAGHDI N, MOHSENI-BANDPEI M A, TAGHIPOUR M, RAHMANI N. Lumbar multifidus muscle morphology changes in patient with different degrees of lumbar disc herniation: an ultrasonographic study. Medicina (Kaunas), 2021, 57(7): 699.
REN C, JU L, CHEN S J, DENG A H, WEI Y H. Acupuncture at Beishu point and Jiaji point for treatment of lumbar intervertebral disc protrusion in the elderly. Shijie Zhongxiyi Jiehe Zazhi, 2021, 16(6): 1147–1150.
CHANG X R, LIU M, YAN J, YI S X, YUE Z H, ZHANG G S, LIU M L, SUN G J, WANG L L, HU L, WU H G. Research on mechanisms and principles of warm-unblock and warm-tonic effects on moxibustion. Shijie Zhongyiyao, 2013, 8(8): 875–879.
YANG S, YANG X F, JIANG Y, XIANG K W, LI H Y. Effect of medicinal-cake-separated moxibustion on functional activity of back-leg and plasma substance P level in patients with lumbar disc herniation. Zhen Ci Yan Jiu, 2014, 39(6): 491–495.
ZHU C Z. Comparative Study on Transdermal Absorption Performance of Different Drugs for Transdermal Enhancers. Changsha: Master Thesis of Hunan University of Chinese Medicine, 2015.
SONG J W, LIU Z J. Effect of acupuncture plus kinesiotherapy on analgesia, lumbar function and inflammatory cytokines in patients with lumbar intervertebral disc herniation. Shanghai Zhenjiu Zazhi, 2020, 39(8): 1073–1077.
YAN J H, HAN Q, DAI S C, LIU Z W, LI G W, LI Q B, LUO J, LUO C G. Overview of clinical assessment of lumbar disc herniation. Anmo Yu Kangfu Yixue, 2015, 6(1): 4–5.
SHAO Y Y, TENG J Y, DING D G, PAN H L, SHEN W X. Observation on efficacy of herbal cake-partitioned moxibustion group plus electroacupuncture for lumbar disc herniation with pattern of cold and dampness. Hubei Zhongyi Zazhi, 2021, 43(7): 48–51.
XIAO S W, LIU F, LIU H J, PENG S Q, LIU Q Y, YU L Q. Systematic evaluation and meta analysis of rehabilitation effect of moxibustion on lumbar disc herniation. Guizhou Zhongyiyao Daxue Xuebao, 2020, 42(5): 77–83, 103.
WANG F, CUI Y P. Expression and significance of inflammatory factors, TGF-β and PGE2 of intervertebral disc tissue in patients with lumbar disc herniation. Shandong Yiyao, 2016, 56(32): 56–58.
HOU G H, LI Q, XIE Y. Correlation of inflammatory factors and MMPs/TIMPs expression in intervertebral disc with protrusion of lumbar intervertebral disc. Zhongguo Shiyan Zhenduanxue, 2018, 22(5): 791–794.
SHU J C, TANG X S. Relationship of substance P, interleukin-6 with low back pain due to lumbar disc herniation. Zhongguo Gu Yu Guanjie Sunshang Zazhi, 2013, 28(9): 825–827.
HAO F, WU L B, HU J, LIU L, WU Z J, CAI R L, HU L, YANG X C, WANG J, YU Q, HE L. Effect of moxibustion on PI3K/Akt/mTOR signaling pathway in foot-pad synovium in rats with rheumatoid arthritis. Zhongguo Zhen Jiu, 2020, 40(11): 1211–1216.
Acknowledgments
This work was supported by Project of Hunan Provincial Natural Science Foundation of China (湖南省自然科学基 金项目, No. 2021JJ40396); Scientific Research Project of Department of Education of Hunan Province (湖南省教育 厅科学研究项目, No. 19C1397).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The authors declare that there is no potential conflict of interest in this article.
Additional information
Statement of Informed Consent
Informed consent was obtained from all individual participants.
First Author: BI Dingyan, M.D., lecturer, attending physician
Rights and permissions
About this article
Cite this article
Bi, D., Li, H., He, D. et al. Influence of herbal cake-partitioned moxibustion on lumbar functions and inflammatory factors in patients with lumbar disc herniation due to kidney deficiency and blood stasis. J. Acupunct. Tuina. Sci. 20, 370–375 (2022). https://doi.org/10.1007/s11726-022-1337-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11726-022-1337-1
Keywords
- Moxibustion Therapy
- Indirect Moxibustion
- Medicinal Cake-partitioned Moxibustion
- Inflammatory Factors
- Pain Measurement
- Intervertebral Disc Displacement
- Low Back Pain