Observation On The Short-term Clinical Efficacy Of ERAS Concept Combined With Wrist-ankle Acupuncture Intervention After Lumbar Spine Surger

Objective:To investigate the clinical effects of wrist-ankle acupuncture based on ERAS concept in the treatment of pain and functional limitation after transforaminal lumbar interbody fusion.Methods:from November 2020 to June 2021,60 patients who were diagnosed as LDH and underwent single segment posterior lumbar interbody fusion(PLIF)in Dongzhimen Hospital of Beijing University of traditional Chinese Medicine were selected strictly according to the inclusion and exclusion criteria and randomly divided into two groups.The control group received perioperative enhanced recovery after surgery(ERAS)management and treatment,including diet management,internal medicine management and analgesia treatment.On the basis of treatment in the control group,the observation group was treated with wrist-ankle acupuncture,30 minutes per time,once a day.VAS score and peripheral blood IL-6 index were collected before operation,1st day,3rd day and 7th day after operation,JOA score and ODI index before operation,3rd day and 7th day after operation.The data of the two groups were compared and analyzed to evaluate the role of wrist-ankle acupuncture in the treatment of pain and functional limitation in patients with PLIF.Results:57 cases were included in the study,including 16 males and 41 females,29 in the observation group and 28 in the control group.There was no significant difference in sex,age,surgical segment and other general data between the two groups(P>0.05).The main observation indicators are as follows:1.In terms of pain improvement:the VAS scores of the two groups on the 3rd and 7th day after operation were significantly better than those before operation and 1st day after operation,and on 7th day after operation were better than 3rd day after operation,the difference was statistically significant.There was no significant difference in VAS score between the two groups before operation on the 1st and 3rd day after operation,but there was significant difference in VAS score between the two groups on 7th day after operation,and the observation group was better than the control group.2.Lumbar function improvement:compared with JOA score and ODI index at each time point,there was significant difference between the two groups at 7th day after operation compared with those before operation and 3rd day after operation,but there was no significant difference in JOA and ODI index on 3rd day after operation.There was no significant difference in JOA score and ODI index between the two groups before operation and 3rd day after operation,but there was significant difference between the two groups on the 7th day after operation.3.Inflammatory index:the overall IL-6 level of the two groups increased significantly on the first day after operation,and then decreased gradually.There were significant differences at each time point(P<0.05).There was no significant difference in the level of IL-6 between the two groups before operation.There was no significant difference in IL-6 between the two groups on the 1st and 3rd day after operation,but on the 7th day after operation,the IL-6 index in the observation group was lower than that in the control group.(P<0.05).The levels of CRP in the two groups were significantly higher than those before operation on the 1st,3rd and 7th day after operation(P<0.05),but there was no significant difference between the two groups at each time point after operation(P>0.05).There was no significant difference in the level of CRP between the two groups before operation,1st and 3rd day after operation(P>0.05),but on the 7th day after operation,the level of CRP in the observation group was lower than that in the control group(P<0.05).Conclusion:wrist-ankle acupuncture can effectively improve the pain symptoms and inflammatory reaction of patients after lumbar vertebra operation,help to reduce or eliminate the physical and mental disorders caused by pain,enable patients to participate in functional exercise early,help to speed up the process of postoperative rehabilitation,in line with the concept of ERAS,at the same time,wrist-ankle acupuncture pain is easy to accept,simple and convenient operation,so it is worthy of clinical application.