Clinical Observation On Acupuncture Intervention For Chronic Nonspecific Low Back Pain With Comorbid Depression And Anxiet

Objective:1.To observe the incidence of depression and/or anxiety in patients with CNLBP and analyze the correlation between demographic characteristics,pain characteristics and comorbid depression and/or anxiety in CNLBP.2.To compare the therapeutic effects of acupuncture combined with routine acupuncture and simple routine acupuncture on depression and/or anxiety in CNLBP,so as to expand the clinical treatment scope of acupuncture with calming the heart and regulating the mind,provide ideas for clinical treatment of depression and/or anxiety in CNLBP and CNLBP,and improve the curative effect.Methods:This study is divided into two parts:questionnaire survey and clinical research,and SPSS26.0 is used for data analysis.(1)The first part of questionnaire survey:CNLBP patients who visited the First Affiliated Hospital of Hunan University of Chinese Medicine from March 2021 to October 2022 were taken as subjects.Firstly,the data of patients were collected and evaluated by questionnaire,and a database was established to observe the incidence of depression and/or anxiety in CNLBP patients,and then the correlation between demographic characteristics,pain characteristics and depression and/or anxiety in CNLBP comorbidity was analyzed.(2)The second part of clinical research:In the first part,60 patients with CNLBP comorbidity depression and/or anxiety were screened in strict accordance with the inclusion and exclusion criteria,and randomly divided into the experimental group of calming the heart and regulating the mind combined with routine acupuncture and the control group of simple routine acupuncture,with five treatments per week and one course of treatment per week,with a total of two courses.Observe and compare the changes of VAS score,JOA score,HAMD score and HAMA score of CNLBP patients before and after treatment,and calculate and compare the clinical efficacy of the two groups.Results:1 Questionnaire survey(1)109 valid questionnaires were collected.The survey results showed that 74(67.89%)of the 109 patients with CNLBP were comorbid with depression and/or anxiety,including 14 patients with simple depression(12.84%),28 patients with simple anxiety(25.69%)and 32 patients with depression and anxiety(29.36%).(2)Questionnaire survey and analysis of CNLBP comorbidity depression and/or anxiety:There was no significant difference in age,weight,education level,occupation,marital status,smoking,drinking and pain between the depression and/or anxiety group and the non-depression and anxiety group(P>0.05).There were significant differences in sex,pain frequency,pain course,VAS score and JO A score(P<0.05).2 Clinical research(1)B efore treatment,the baseline data of the two groups were comparable,and there was no significant difference in VAS score,JOA score,HAMD score and HAMA score(P>0.05).(2)VAS score:①Intra-group comparison:Compared with before treatment,the VAS score of both groups decreased after treatment(P<0.05).②Comparison between groups:The improvement of VAS score in the experimental group was better than that in the control group(P<0.05).(3)JOA score:①Intra-group comparison:Compared with before treatment,the JOA scores of both groups increased after treatment(P<0.05).②Comparison between groups:The improvement of JOA score in the experimental group was better than that in the control group(P<0.05).(4)HAMD score:①Intra-group comparison:Compared with before treatment,the HAMD score of both groups decreased after treatment(P<0.05).②comparison between groups:the improvement of HAMD score in the experimental group was better than that in the control group(P<0.05).(5)HAMA score:①Intra-group comparison:Compared with before treatment,HAMA score of both groups decreased after treatment(P<0.05);②Comparison between groups:The improvement of HAMA score in the experimental group was better than that in the control group(P<0.05).(6)Clinical efficacy:The markedly effective rate and total effective rate in the experimental group were 56.67%and 93.33%respectively;The markedly effective rate and total effective rate in the control group were 30.00%and 8 3.33%respectively.The comprehensive efficacy of the experimental group in relieving pain symptoms and improving lumbar function of CNLBP patients is better than that of the control group(P<0.05)。Conclusion:1.In this study,CNLBP has a high comorbidity rate with depression and anxiety,in which the incidence of depression combined with anxiety>simple anxiety>simple depression.2.The higher the VAS score and the lower the JOA score,the higher the risk of comorbid depression and/or anxiety is for CNLBP patients who are female,have frequent and persistent pain,have a pain course of more than one year.3.Acupuncture combined with routine acupuncture and simple routine acupuncture can effectively relieve the pain of CNLBP patients,improve lumbar function and improve depression and anxiety,but acupuncture combined with routine acupuncture is more effective.4.There may be a two-way relationship between the degree of pain,lumbar function and depression and anxiety in CNLBP patients.The relief of depression and anxiety in CNLBP patients may promote the relief of pain and the recovery of lumbar function;The pain relief and functional recovery of CNLBP patients may reduce the degree of depression and anxiety.