目的：观察腕踝针疗法联合塞来昔布对腰椎术后疼痛患者临床疗效和疼痛介质的影响。方法：将60例腰椎术后疼痛患者按随机数字表法分为对照组与观察组各30例，对照组使用塞来昔布治疗，观察组在对照组基础上联合腕踝针治疗，比较两组治疗前后视觉模拟评分法（VAS）评分、血清疼痛介质[前列腺素E2(PGE2)、P物质（SP）、β内啡肽（β-EP）]水平、日本骨科协会（JOA）评分、并发症发生情况、患者满意度。结果：两组VAS评分均随治疗时间推移而下降，术后1 d、2 d、3 d、7 d观察组VAS评分均低于对照组（P<0.05）；两组PGE2、SP水平均随时间的推移先上升后下降（P<0.05），术后1 d、2 d、3 d、7 d观察组血清PGE2、SP水平均低于对照组（P<0.05）；两组β-EP水平均随时间的推移先下降后上升（P<0.05），术后1 d、2 d、3 d、7 d观察组β-EP水平均高于对照组（P<0.05）；两组JOA评分均较治疗前升高，且观察组术后7 d JOA评分明显高于对照组（P<0.05）；观察组并发症发生率与对照组比较，差异无统计学意义（P>0.05）；观察组术后疼痛管理方案满意度高于对照组（P<0.05）。结论：腕踝针疗法联合塞来昔布可以明显减轻腰椎术后疼痛，降低相关疼痛介质表达，改善腰椎功能。

Objective:To observe the effect of wrist and ankle acupuncture combined with celecoxib on the clinical efficacy and pain mediators after lumbar spine surgery. Methods : Sixty patients with postoperative pain in lumbar spine were divided into the control group and the observation group by using random number table method,with 30 cases in each group. The control group was treated with celecoxib,and the observation group was treated with wrist and ankle acupuncture on the basis of the treatment of the control group. Visual analogue scale(VAS) scores,pain mediators [serum prostaglandin E2(PGE2),substance P(SP),β-endorphin(β-EP) ],Japanese Orthopaedic Association(JOA)scores,complications,and patient satisfaction before and after treatment were compared between the two groups. Results:The VAS score of the two groups decreased with the passage of time,and the VAS score of the observation group was lower than that of the control group on day 1,2,3and 7 after surgery(P<0.05). The level of PGE2 、SP in the two groups was firstly increased and then decreased with the passage of time(P<0.05),but the serum level of PGE2、SP in the observation group was lower than that in the control group on day 1,2,3 and 7 after surgery(P<0.05). The β-EP level of two groups firstly decreased and then increased as time went by(P<0.05),and the β-EP level of the observation group was higher than that of the control group on day 1,2,3 and 7 after surgery(P<0.05). JOA scores were improved in both groups,but the JOA score of the observation group was significantly higher than that of the control group on day 7 after surgery(P<0.05). There was no significant difference in the incidence of complications between the observation group and the control group(P>0.05). The satisfaction with postoperative pain management plan of the observation group was higher than that of the control group(P<0.05).Conclusion:Wrist and ankle acupuncture combined with celecoxib can significantly reduce postoperative pain,reduce the expression of related pain mediators,and improve spinal function.