蠲痹汤加减联合双氯芬酸钠治疗腰椎间盘突出症肾虚寒湿证的疗效观察  

Effect of Modified Yibitang Combined with Diclofenac Sodium in Treating Lumbar Disc Herniation with Kidney Deficiency Syndrome

作　　者：袁冬 李慧英 YUAN Dong;LI Hui-ying(The First Hospital Affiliated of Henan University of Chinese Medicine, Zhengzhou 450002, Chin)

机构地区：[1]河南中医药大学第一附属医院

出　　处：《中国实验方剂学杂志》2018年第9期184-189,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省科技攻关项目(122102310186)

摘　　要：目的：观察蠲痹汤加减联合双氯芬酸钠治疗腰椎间盘突出症（LDH）肾虚寒湿证的疗效及安全性。方法：将228例LDH肾虚寒湿证患者按1∶1∶1比例随机分为中药组、西药组和联合组,每组76例。分别给予蠲痹汤加减,双氯芬酸钠,蠲痹汤加减联合双氯芬酸钠治疗,疗程均为8周。观察各组治疗前后Oswestry腰功能障碍指数问卷评分量表（ODI）,中医辨证LDH肾虚寒湿证积分量表（中医证候）,改良日本骨科学会腰痛评分法（M-JOA）的积分;检测治疗前后各组血清肿瘤坏死因子-α（TNF-α）,白细胞介素-1（IL-1）,白细胞介素-6（IL-6）和C-反应蛋白（CRP）的含量;比较各组有效率、复发率和不良反应发生率。结果：治疗后联合组总有效率97.2%,高于中药组的82.4%和西药组的80.3%（P〈0.05）;中药组和西药组相比,无明显差异;联合组ODI,中医证候,M-JOA积分,血清TNF-α,IL-1,IL-6和CRP的含量较中药组和西药组改善更为明显（P〈0.05）;复发率比较,联合组（1.7%）〈中药组（9.3%）〈西药组（22.6%）（P〈0.05）。不良反应发生率比较,中药组（2.7%）〈联合组（9.5%）〈西药组（24.6%）（P〈0.05）。结论：蠲痹汤加减治疗LDH肾虚寒湿证的疗效与西药双氯芬酸钠无明显差异,说明其具有有效性,且不良反应和复发率较双氯芬酸钠低;蠲痹汤加减联合双氯芬酸钠治疗LDH肾虚寒湿证具有协同增效的作用,疗效优于单用蠲痹汤加减和双氯芬酸钠。Objective：To explore the therapeutic effect and safety of modified Yibitang combined with diclofenac sodium in treating lumbar disc herniation（LDH） with kidney deficiency syndrome.Method：A total of228 cases of LDH with kidney deficiency syndrome were randomly divided into the traditional Chinese medicine（TCM） group,the chemical medicine group and the Chinese and western medicine group,with 76 cases in each group.The TCM group was treated with modified Yibitang; the diclofenac sodium was applied in chemical medicine group; Yibitang and diclofenac sodium were adopted in the Chinese and western medicine group.One course of treatment was 8 weeks.The Oswestry disability index（ODI）,the scale for differentiation of syndromes of lumbar disc herniation（TCM symptom）,and the integration of the Japanese orthopaedic association waist pain score（MJOA） were observed.The serum tumor necrosis factor-α（TNF-α）,interleukin-1（IL-1）,interleukin-6（IL-6）and C-reactive protein（CRP） were detected before and after treatment.The rates of effective,recurrence and adverse reactions were compared.Result：The efficiency of the Chinese and western medicine group was 97.2%,which was better than 82.4% of the TCM group and 80.3% of the chemical medicine group（P 〈 0.05）.ODI,TCM symptom,M-JOA,serum TNF-α,IL-1,IL-6 and CRP were significantly higher than those in Chinese medicine group and western medicine group（P 〈 0.05）.In terms of the recurrence rate,the order of the groups was Chinese and western medicine group（1.7%） the TCM group（9.3%） the chemical medicine group（22.6%,P 〈 0.05）.In adverse reaction rates,the order of the groups was the TCM group（2.7%） the Chinese and western medicine group（9.5%） the chemical medicine group（24.6%,P 〈 0.05）.Conclusion：Modified Yibitang has no obvious difference from chemical medicine diclofenac sodium in terms of the effect in the treatment of LDH case with Kidney deficiency syndrome,with a lower incidence of adverse events and

关 键 词：蠲痹汤加减 腰椎间盘突出症 肾虚寒湿证 双氯芬酸钠 

分 类 号：R22[医药卫生—中医基础理论] R24[医药卫生—中医学]