抗骨增生汤治疗腰椎骨质增生性腰痛肝肾不足证的临床观察  

Clinical Efficacy of Kanggu Zengsheng Decoction in Treatment of Lumbar Hyperosteogeny Lumbago with Liver and Kidney Deficiency Syndrome

作　　者：陆志夫 吴清琳 周宗波 

机构地区：[1]海口市中医医院,海口570216

出　　处：《中国实验方剂学杂志》2016年第16期190-194,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：海口市重点科技计划项目(2013-65)

摘　　要：目的：观察抗骨增生汤治疗肝肾不足型腰椎骨质增生性腰痛的疗效以及对血清Dickkopf-1（DKK1）和硬骨素（SOST）水平的影响。方法：收集符合研究条件的病例108例,将所有患者随机分为观察组和对照组,各54例。两组患者均给予牵引疗法干预,25 min/次,1次/d,连续治疗3周。对照组口服腰痛宁胶囊,4~6粒/次,1次/d,睡前半小时服用;观察组在对照组基础上给予抗骨增生汤治疗,1剂/d,常规早晚水煎2次,以人参汤调服;两组患者均治疗8周。两组患者腰功能采取Oswestry功能障碍指数问卷表（ODI）评分;应用简化Mc Gill量表评分评价两组患者疼痛分级指数（PRI）,疼痛视觉模拟尺（VAS）以及现时疼痛强度（PPI）;比较两组患者X射线检查评分;检测两组患者血清DKK1和SOST水平。结果：治疗后观察组总有效率高于对照组（P〈0.05）。治疗后第4,8周,观察组ODI评分低于对照组（P〈0.01）;观察组治疗后简化Mc Gill量表（PRI,VAS,PPI）评分均低于对照组（P〈0.01）,观察组血清DKK1和SOST水平均高于对照组同期（P〈0.01）。观察组治疗后8周X射线评分低于对照组（P〈0.01）。结论：在常规治疗基础上,抗骨增生汤治疗肝肾不足型腰椎骨质增生性腰痛可明显改善腰功能,降低Mc Gill量表评分和X射线评分,提高临床疗效,上调血清DKK1和SOST可能与其上述治疗效果密切相关。Objective： To observe the clinical efficacy of Kanggu Zengsheng decoction in the treatment of lumbar hyperosteogeny lumbago with liver and kidney deficiency syndrome, and investigate its effect on serum Dickkopf-1 （DKK1） and sclerostin（SOST） levels. Method： One hundred and eight eligible patients were randomly divided into control group （54 cases） and observation group （54 cases）. All patients in both groups received traction treatment for three weeks, 25 min/time, 1 time/d. Patients in control group were treated with Yaotongning capsule half an hour before sleep by orally taking, 4-6 capsules/time, 1time/d. The patients in observation group were also treated with Kanggu Zengsheng decoction by mixing with ginseng decoction （1 dose/d, bid） based on the treatment of control group. The treatment course was 8 weeks for both groups. Questionnaire of Oswestry Disability Index （ODI） was used to evaluate lumbar function in two groups. The pain Visual Analog Scale （VAS）, Present Pain Intensity （PPI） and Pain Rating Index（PRI） were evaluated by short-form McGill questionnaire. Scores of X-ray inspection were compared between two groups. The serum DKK1 and SOST levels were detected in two groups. Result： The total effective rate in observation group was higher than that in control group （P〈0.05）. The ODI scores in observation group were lower than those in control group after 4 and 8 weeks treatment （P〈0.01）. The short-form McGill questionnaire scores （PRI,VAS and PPI） in observation group were lower than those in control group after treatment （P〈0.01）. X-ray score of the observation group was lower than that of control group after 8 weeks treatment （P〈0.01）. The serum DKK1 and SOST levels in observation group were higher than those in control group of the same period （P〈0.01）. Conclusion： On the basis of conventional treatment, Kanggu Zengsheng decoction could obviously improve the function of the lumbar, decrease scores of McGill questionnaire a

关 键 词：抗骨增生汤 腰椎骨质增生 腰痛 肝肾不足证 DICKKOPF-1 硬骨素 

分 类 号：R287[医药卫生—中药学]