桃红四物汤联合手法治疗急性腰椎间盘突出症临床研究  

Clinical research of manipulation combined with the Taohong-Siwu decoction in the treatment of acute lumbar disc herniation

作　　者：崔玉蓬[1] 姜梅卿[1] 周福波[1] 杜永成[1] 

机构地区：[1]山东省烟台市莱阳中心医院骨科,265200

出　　处：《国际中医中药杂志》2018年第1期30-33,共4页International Journal of Traditional Chinese Medicine

摘　　要：目的 评价桃红四物汤联合手法治疗急性腰椎间盘突出症（lumbar disc herniation, LDH）的疗效。方法 将符合入选标准的102例急性LDH患者，采用随机数表法分为2组，每组51例。对照组采用牵引结合非甾体抗炎药物治疗，研究组采用手法联合桃红四物汤治疗。2组均治疗1个月。采用VAS评分评价疼痛程度，采用日本骨科协会评分（Japanese Orthopedic Association Scores, JOA）评价腰痛疗效，采用ELISA法检测血清IL-1β、IL-6、TNF-a水平，评价临床疗效。结果 研究组总有效率[90.20%（46/51）比43.14%（22/51），χ2＝19.329]高于对照组（P＜0.05）。治疗后，研究组VAS评分[（4.26±0.56）分比（5.13±0.87）分，t＝4.843]低于对照组（P＜0.05），而JOA评分[（18.42±3.92）分比（17.33±4.21）分，t＝5.127]高于对照组（P＜0.05）；研究组血清IL-1β[（0.57±0.11）μg/L比（0.90±0.13）mg/L，t＝5.429]、IL-6[（112.26±15.17）mg/L比（130.38±18.29）mg/L，t＝6.317]、TNF-a[（2.01±0.34）mg/L比（2.37±0.51）mg/L，t＝5.011]水平均低于对照组（P＜0.05）。结论 桃红四物汤联合手法可有效减轻急性LDH患者疼痛症状，降低炎性细胞因子水平。Objective To explore the clinical curative effect of the Taohong-Siwu decoction combined with manipulation in the treatment of the acute phase of lumbar disc herniation （LDH） and its effect on serum inflammatory factors. Methods According to the random number table method, 102 patients with the acute phase of LDH were divided into control group and research group from May 2014 to September 2016, 51 cases in each group. Patients in control group were treated by traction and non-steroidal anti-inflammatory drug for a month, while patients in research group were treated by manipulation combined with Taohong-Siwu decoction for a month. After treatment, the overall efficacy was observed. The Visual analogous scale （VAS） and JOA scores were recorded before and after the treatment. The IL-1β, IL-6 and TNF-α levels of inflammatory factors were detected by enzyme-linked immunosorbent assay. Results The total effective rate of patients in research roup was significantly higher than that of the control group [90.20% （46/51） vs. 43.14% （22/51）, χ2=19.329, P=0.006]. After treatment, the VAS scores of patients in both groups were significantly decreased, and JOA score increased markedly, which the differences were statistically significant （Ps〈0.05）. After treatment, the VAS score of research group was significantly lower than the control group （4.26 ± 0.56 vs. 5.13 ± 0.87; t=4.843, P=0.027）, and JOA score was significantly higher than the control group （18.42 ± 3.92 vs. 17.33 ± 4.21; t=5.127, P=0.022）. After treatment, the IL-1β, IL-6 and TNF-α levels of of patients in the research group were significantly lower than those of the control group （0.57 ± 0.11 μg/L vs. 0.90 ± 0.13 μg/L, 112.26 ± 15.17 μg/L vs. 130.38 ± 18.29 μg/L, 2.01 ± 0.34 μg/L vs. 2.37 ± 0.51 μg/L; t=5.429, 6.317, 5.011, P〈0.05）. Conclusions The Taohong-Siwu decoction combined with manipulation on treatment of the acute phase of LDH was effective. The combined therapy can improve the VAS score and JOA s

关 键 词：椎间盘移位 舒筋整复手法 桃红四物汤 白细胞介素-1Β 白细胞介素-6 肿瘤坏死因子α 

分 类 号：R274.9[医药卫生—中西医结合]