补骨合剂协定方联合功能锻炼改善退行性腰椎管狭窄症患者腰椎功能的临床效果及对椎管内血液微循环、微炎状态的影响  

Clinical Effects of Buguheji Decoction Combined with Functional Exercise on the Improvement of Lumbar Vertebral Function in Patients with Degenerative Lumbar Vertebral Canal Stenosis( Syndrome of Blood Stasis due to Qi Deficiency) and its Effects on the Mi

作　　者：钟海波 郭祥[1] 邢晓伟 Zhong Haibo;Guo Xiang;Xing Xiaowei(Department of Orthopedics,Haikou Hospital Affiliated to Xiangya Medical College,Central South University,Haikou 570208,China;Department of Orthopaedics,Haikou Orthopaedics and Diabetes Hospital,Haikou 570311,China)

机构地区：[1]中南大学湘雅医学院附属海口医院骨科,海口570208 [2]海口骨科与糖尿病医院骨科,海口570311

出　　处：《世界中医药》2019年第5期1227-1231,共5页World Chinese Medicine

基　　金：海南省卫生厅基金资助项目琼卫(2012PT-103)

摘　　要：目的:探讨补骨合剂协定方联合功能锻炼改善退行性腰椎管狭窄症患者腰椎功能的临床效果及对椎管内血液微循环、微炎状态的影响。方法:选取2017年2月至2018年5月中南大学湘雅医学院附属海口医院收治的退行性腰椎管狭窄症(气虚血瘀证)患者118例作为研究对象,随机分为对照组和观察组,每组59例。对照组患者给予氨糖美辛肠溶片联合功能锻炼治疗,观察组患者在对照组治疗的基础上给予补骨合剂协定方内服治疗,比较2组治疗的临床效果,观察患者治疗前后腰椎功能、腰椎疼痛程度及腰痛对日常生活能力的影响情况,测定患者的血液流变学指标,检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1α(IL-1α)、单核细胞趋化蛋白-1(Monocyte Chemotactic Protein-1,MCP-1)、降钙素原(procalcitonin,PCT)水平。结果:对照组有效率为74.6%,明显低于观察组有效率91.5%,差异有统计学意义( P <0.05);治疗后,观察组的腰椎功能JOA评分较对照组升高明显,疼痛视觉模拟评分(VAS),Oswestry功能障碍指数(ODI)评分则较对照组更低,差异有统计学意义( P <0.05);观察组的血液流变学指标改善更明显,其全血黏度、血浆黏度、血细胞比容、纤维蛋白原均低于对照组,差异有统计学意义( P <0.05);观察组的机体微炎状态改善更明显,其TNF-α、IL-1α、MCP-1、PCT等炎性反应递质水平明显低于对照组,差异有统计学意义( P <0.05)。结论:加用补骨合剂协定方联合功能锻炼利于提高腰椎功能,减轻腰椎疼痛,提高日常生活能力。Objective: To investigate the clinical efficacy of Buguheji Decoction combined with functional exercise on the improvement of lumbar vertebral function in patients with degenerative lumbar vertebral canal stenosis (syndrome of blood stasis due to qi deficiency) and its effects on the microcirculation and micro inflammatory state of the spinal canal. Methods: A total of 118 patients diagnosed with degenerative lumbar spinal stenosis (Syndrome of Blood Stasis due to Qi Deficiency) in Department of Orthopedics,Haikou Hospital Affiliated to Xiangya Medical College,Central South University from February 2017 to May 2018 were randomly divided into a control group of 59 cases and an observation group of 59 cases.Patients in the control group were given aminose mexin enteric-coated tablets combined with functional exercise,while patients in the observation group were treated with Buguheji Decoction on the basis of the treatment in control group.The clinical curative effect of the 2 groups after 1 month treatment was compared.The lumbar function,degree of lumbar pain and lumbago influence on daily life ability were observed.The hemorheology indexes was determined,and the level of TNF-α,IL-1α,MCP-1 and PCT were determined to reflect microinflammation in the body. Results: The effective rate of the control group was 74.6%,which was significantly lower than that of the treatment group of 91.5%( P <0.05).After treatment,the JOA score of lumbar vertebra function in the observation group was increased more significantly than that of the control group,while VAS and ODI scores were lower than that of the control group ( P <0.05).The hemorheological indexes of the observation group were improved more significantly,such as the total blood viscosity,plasma viscosity,erythrocyte deposition and fibrinogen were lower than those of the control group ( P <0.05).The microinflammatory state of the organism was ameliorated more significantly in the observation group,and the level of inflammatory mediators,such as TNF-α,IL-1α,MCP-1 and P

关 键 词：退行性腰椎管狭窄症 气虚血瘀证 补骨合剂协定方 功能锻炼 腰椎功能 血液流变学 微炎状态 

分 类 号：R289.5[医药卫生—方剂学] R681[医药卫生—中药学]