右归丸联合硬膜外封闭治疗腰椎间盘突出症患者的疗效及对血清TNF-α、hs-CRP和疼痛介质的影响  

Efficacy of Yougui Pills Combined with Epidural Closure on Patients with Lumbar Intervertebral Disc Protrusion and the Effects on Serum TNF-α,hs-CRP and Medium Pain

作　　者：毕殿海 曾欢高 廖勇 廖水生 

机构地区：[1]江西省新余市中医院,江西新余338000

出　　处：《中国医学创新》2017年第30期12-15,共4页Medical Innovation of China

基　　金：新余市科技项目(20133090801)

摘　　要：目的:探讨右归丸联合硬膜外封闭治疗腰椎间盘突出症的效果及对血清肿瘤坏死因子(TNF-α)、超敏C反应蛋白(hs-CRP)和疼痛介质的影响。方法:将2014年2月-2017年3月因腰椎间盘突出症(肾阳虚型)于本院行硬膜外封闭的患者82例纳入研究,并依据随机数字表法分为对照组和观察组,各41例。对照组单纯行硬膜外封闭治疗,观察组在对照组基础上联合右归丸治疗。比较两组治疗前后疼痛介质前列腺素E2(PGE2)、5-羟色胺(5-HT)和炎症指标TNF-α、hs-CRP,以及腰腿痛评分(JOA评分)的改善情况、临床疗效。结果:治疗后,观察组的疼痛介质PGE2、5-HT和炎症指标TNF-α、hs-CRP水平均低于对照组(P<0.05)。治疗后,观察组JOA评分高于对照组(P<0.05)。治疗后,观察组总有效率为95.12%(39/41),高于对照组的75.61%(31/41),差异有统计学意义(x^2=6.248,P<0.05)。结论:右归丸联合硬膜外封闭治疗腰椎间盘突出症效果显著,可更好地改善症状及炎症反应,降低炎症介质,值得推广。Objective：To study the efficacy of Yougui Pills combined with epidural blockade on lumbar disc herniation and the effects on serum tumor necrosis factor（TNF-α）,hypersensitive C-reactive protein（hs-CRP） and medium pain.Method：From February 2014 to March 2017,82 patients who underwent epidural anesthesia due to lumbar disc herniation（Kidney-yang deficiency）,according to the random number table method,they were divided into control group and observation group,41 cases in each group.The control group was treated with epidural closure,the observation group was based on control group to combined with Yougui Pills.The improvement of medium pain of prostaglandin E2（PGE2）,5-hydroxytryptamine（5-HT）,the inflammatory mediators of TNF-α,hs-CRP,the lumbago and leg pain score（JOA score） were compared between two groups before and after treatment,and the clinical efficacy were observed.Result： After treatment,the levels of medium pain such as PGE2 and 5-HT,the inflammatory indexes such as TNF-α and hs-CRP in observation group were lower than those of control group（P〈0.05）.After treatment,the JOA score in observation group was higher than that of control group（P〈0.05）.The total effective rate of observation group was 95.12%（39/41）,which was higher than 75.61%（31/41） in control group（ 字2=6.248,P〈0.05）.Conclusion：The efficacy of Yougui Pills combined with epidural closure for treatment of lumbar disc herniation is significant,can better improve the symptoms and inflammatory response,reduce the inflammatory mediators,it is worth promoting.

关 键 词：右归丸 硬膜外封闭 腰椎间盘突出症 炎症因子 疼痛介质 

分 类 号：R681.53[医药卫生—骨科学]