枳壳甘草汤在腰椎间盘突出症患者经皮椎间孔镜下椎间盘髓核摘除术后应用的临床研究  

Clinical observation on the use of Zhiqiao-Gancao decoction on lumbar disc herniation with percutaneous intervertebral discectomy

作　　者：朱杰[1] 李宇卫 向桂玲 方静 姚遥[5] ZHU Jie;LI Yuwei;XIANG Guiling(2015 - Grade Master of Nanjing University of Traditional Chinese Medicine, Jiangsu, Nanjing 210046)

机构地区：[1]南京中医药大学 [2]上海中医药大学附属苏州市中医医院骨伤科,江苏苏州215003 [3]青岛大学附属医院呼吸内科,山东青岛266003 [4]上海中医药大学附属苏州市中医医院脾胃科,江苏苏州215003 [5]武汉大学人民医院手术室,湖北武汉430060

出　　处：《河北中医》2018年第5期667-672,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：苏州市卫生和计划生育委员会2015年度苏州市临床重点病种诊疗技术专项项目(编号:LCZX201513)

摘　　要：目的观察枳壳甘草汤在腰椎间盘突出症(LDH)患者经皮椎间孔镜下椎间盘髓核摘除术(PTED)后的临床应用。方法将100例LDH患者随机分为2组,均行PTED。术后对照组50例予常规治疗;治疗组50例在对照组治疗基础上加服枳壳甘草汤。2组术后均连续治疗4周,疗程结束后进行随访,术后3个月观察疗效。比较2组术前、术后3个月疼痛视觉模拟评分法(VAS)评分、日本骨科协会评估治疗评分(JOA)、Oswestry功能障碍指数(ODI)变化,比较2组术前、术后3个月血清丙二醛(MDA)、超氧化物歧化酶(SOD)、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)变化。结果 2组术后3个月,疼痛VAS评分均较本组术前降低(P<0.05),且治疗组疼痛VAS评分低于对照组(P<0.05);JOA评分均较本组术前升高(P<0.05),且治疗组JOA评分高于对照组(P<0.05);ODI指数均较本组术前降低(P<0.05),且治疗组ODI指数低于对照组(P<0.05);2组术后3个月MDA均较本组术前降低(P<0.05),SOD升高(P<0.05);且治疗组MDA低于对照组(P<0.05),SOD高于对照组(P<0.05);血清TNF-α、IL-6水平均较本组术前降低(P<0.05),且治疗组血清TNF-α、IL-6水平均低于对照组(P<0.05)。结论枳壳甘草汤对LDH患者PTED术后疗效突出,可有效抑制炎症因子表达,减轻炎症反应与细胞损害。Objective To observe the clinical effects of the use of Zhiqiao-Gancao decoction on lumbar disc herniation（ LDH） with percutaneous intervertebral discectomy（ PTED） and its therapeutic mechanism. Methods100 patients with LDH were divided into two groups according to the random number table method. The PTED technique was used to complete the removal of the nucleus pulposus of the intervertebral disc. 50 cases in control group were treated by conventional treatment after operation. 50 cases in treatment group were treated by Zhiqiao-Gancao decoction on the basis of control group,continuously treated for 4 weeks. Follow-up after treatment and obserration of curative effect after 3 months of operation. The scores of pain visual analogue score（ VAS）,assessment of treatment score of the Japanese department of orthopedics（ JOA）,Oswestry Disability Index（ ODI） before and after treatment were compared between the two groups. The serum levels of malondialdehyde（ MDA）,superoxide dismutase（ SOD）,tumor necrosis factor alpha（ TNF-α） and interleukin 6（ IL-6） were measured before and after treatment in two groups. Results The VAS scores of pain of two groups after 3 months of operation were lower than those before treatment（ P〈0. 05）. The VAS scores of pain in treatment group after treatment were lower than that of the control group（ P〈0. 05）. The JOA scores of two groups after 3 months of operation were higher than those before treatment（ P〈0. 05）. The JOA scores in treatment group after treatment were higher than that of the control group（ P〈0. 05）. The ODI index of two groups after 3 months of operation were lower than those before treatment（ P〈0. 05）. The ODI index in treatment group after treatment were lower than that of the control group（ P〈0. 05）. The MDA of two groups after 3 months of operation were lower than that before the treatment（ P〈0. 05） and SOD increased（ P〈0. 05）,and MDA in the treatment group was lower than that of the contro

关 键 词：腰椎 椎间盘移位 中药疗法 

分 类 号：R681.530.5[医药卫生—骨科学] R289.6[医药卫生—外科学]