Clinical effect of electroacupuncture on gluteal nerve entrapment syndrome
HE Mingwei1 CAO Jing2 PANG Jinlei1 WANG Chengbin1 SUN Haiyan1 LIU Jinde2
1.Department of Pain, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;
2.Department of Pain, Huabei Petroleum Administration Bureau General Hospital, Hebei Province, Renqiu 062552, China
Abstract：Objective To observe the efficacy and safety of electroacupuncture in the treatment of gluteal nerve entrapment syndrome. Methods A total of 80 patients with gluteal epithelial nerve entrapment syndrome treated in the Department of pain, Beijing Anzhen Hospital, Capital Medical University and North China Petroleum Administration General Hospital from May 2020 to May 2021 were divided into internal heat acupuncture group and internal heat acupuncture combined with electric acupuncture group (combined acupuncture group) according to random number table method, with 40 cases in each group. Each group was treated twice a week for two consecutive weeks, a total of four times. Visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) score, interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF) -α were compared before and after treatment between the two groups. Results The clinical effect of combination acupuncture group was better than that of internal heat acupuncture group, and the difference was statistically significant (P＜0.05). After treatment, VAS scores of the two groups were lower than before treatment, while that of the combined acupuncture group was lower than that of the internal heat acupuncture group; JOA score of two groups were higher than that before treatment, while that of the combination acupuncture group was higher than that of the internal heat acupuncture group, and the differences were statistically significant (P＜0.05). After treatment, serum IL-6, IL-8, and TNF-α in two groups were lower than before treatment, while those of combined injection group were lower than those of internal heat injection group, and the differences were statistically significant (P＜0.05). The incidence of adverse reactions in combination acupuncture group was lower than that in internal heat acupuncture group, and the difference was statistically significant (P＜0.05). Conclusion Compared with internal heat acupuncture, electroacupuncture combined with internal heat acupuncture is safe and effective in the treatment of patients with gluteal epithelial nerve entrapment syndrome, and can significantly improve clinical symptoms and daily activity ability of patients. The mechanism of action may be related to the reduction of IL-6, IL-8, and TNF-α levels.
何明伟1 曹静2 庞金磊1 王成彬1 孙海燕1 刘进德2. 电针治疗臀上皮神经卡压综合征的临床效果[J]. 中国医药导报, 2023, 20(5): 63-66.
HE Mingwei1 CAO Jing2 PANG Jinlei1 WANG Chengbin1 SUN Haiyan1 LIU Jinde2. Clinical effect of electroacupuncture on gluteal nerve entrapment syndrome. 中国医药导报, 2023, 20(5): 63-66.
[1] Iwanaga J，Simonds E，Schumacher M，et al. Anatomic Study of the Superior Cluneal Nerve and Its Related Groove on the Iliac Crest [J]. World Neurosurg，2019，125：e925-e928.
[2] Miki K，Kim K，Isu T，et al. Characteristics of Low Back Pain due to Superior Cluneal Nerve Entrapment Neuropathy [J]. Asian Spine J，2019，13（5）：772-778.
[3] 陈志礼，卢锦钊，罗伟华，等.内热针联合偏振光对腰椎间盘突出症患者腰腿疼痛及血清MMP-3、MMP-7的影响[J].广东医科大学学报，2021，39（2）：164-166.
[4] 付彪斌.内热针软组织松解术治疗肩周炎临床观察[J].中医临床研究，2020，12（23）：101-104.
[5] 刘武，戴甫成，张维，等.内热针联合体外冲击波对腰背肌筋膜炎疗效及血清SP和TNF-α水平的影响[J].系统医学，2020，5（17）：34-37.
[6] 龚辉，欧阳丽萍.内热针改善神经根型颈椎病患者临床症状及生活能力的作用分析[J].中医外治杂志，2019，28（6）：22-23.
[7] 尹晶，李熳，张照庆，等.内热针治疗早期膝骨性关节炎患者38例临床观察[J].中医杂志，2019，60（18）：1578- 1582.
[8] 董福慧，郭振芳，张春美，等.皮神经卡压综合征[M].北京：科学技术出版社，2002：133-135.
[9] 中华医学会.临床诊疗指南疼痛学分册[M].北京：人民卫生出版社，2007：14-15.
[10] Aksekili MA，Aktekin L，Korkmazer S，et al. The Japanese orthopedic association back pain evaluation questionnaire：A Turkish validation study [J]. Orthop Sci，2016，21（6）：718-722.
[11] 国家中医药管理局.中医病症诊断疗效标准[M].南京：南京大学出版社，1994：204.
[12] Karri J，Singh M，Orhurhu V，et al. Pain syndromes secondary to cluneal nerve entrapment [J]. Curr Pain Headache Rep，2020，24（10）：61.
[13] Isu T，Kim K，Morimoto D，et al. Superior and Middle Cluneal Nerve Entrapment as a Cause of Low Back Pain [J]. Neurospine，2018，15（1）：25-32.
[14] Kuniya H，Aota Y，Kawai T，et al. Prospective study of superior cluneal nerve disorder as a potential cause of low back pain and leg symptoms [J]. J Orthop Surg Res，2014，9：139.
[15] Anderson D，Szarvas D，Koontz C，et al. A Comprehensive Review of Cluneal Neuralgia as a Cause of Lower Back Pain [J]. Orthop Rev （Pavia），2022，14（4）：35505.
[16] Knight M，Karangoda I，Nadeem Ahmed R，et al. A radiofrequency treatment pathway for cluneal nerve disorders [J]. EC Orthopaedics，2020，11：1-19.
[17] Visnjevac O，Pastrak M，Ma F，et al. Radiofrequency Ablation of the Superior Cluneal Nerve：A Novel Minimally Invasive Approach Adopting Recent Anatomic and Neurosurgical Data [J]. Pain Ther，2022，11（2）：655-665.
[18] Chauhan G，Levy I，DeChellis D，et al. Superior cluneal neuralgia treated with wireless peripheral nerve stimulation [J]. Cureus，2022，14（3）：e23711.
[19] Morimoto D，Isu T，Kim K，et al. Long-term outcome of surgical treatment for superior cluneal nerve entrapment neuropathy [J]. Spine （Phila Pa 1976），2017，42：783-78.
[20] 王顺成，朱俊.针灸治疗臀上皮神经损伤的研究进展[J].按摩与康复医学，2021，12（23）：80-82.
[21] 李媛，吴凡，程珂，等.针刺对炎性疼痛的镇痛机制[J].针刺研究，2018，43（8）：467-475.
[22] 田心保，许建峰，黄媛，等.内热针干预激素性股骨头缺血性坏死模型大鼠抑制破骨及促进新骨形成[J].中国组织工程研究，2022，26（17）：2642-2648.
[23] Carvalho B，Lemmens HJ，Ting V，et al. Postoperative subcutaneous instillation of low-dose ketorolac but not hydromorphone reduces wound exudate concentrations of interleukin-6 and interleukin-10 and improves analgesia following cesarean delivery [J]. J Pain，2013，14（1）：48-56.
[24] Sutovsky J，Benco M，Sutovska M，et al. Cytokine and chemokine profile changes in patients with lower segment lumbar degenerative spondylolisthesis [J]. Int J Surg，2017， 43：163-170.
[25] Mendieta D，De la Cruz-Aguilera DL，Barrera-Villalpando MI，et al. IL-8 and IL-6 primarily mediate the inflammatory response in fibromyalgia patients [J]. J Neuroimmunol，2016，15，290：22-5.
[26] Chakrabarti S，Hore Z，Pattison L A，et al. Sensitization of knee-innervating sensory neurons by tumor necrosis factor-α activated fibroblast-like synoviocytes：an in vitro，co-culture model of inflammatory pain [J]. Pain，2020，161（9）：2129-2141.
[27] Chen T，Zhang WW，Chu YX，et al. Acupuncture for pain management：Molecular mechanisms of action [J]. Am J Chin Med，2020，48：793-811.
京公网安备 11010502046598号