利筋健腰协定方联合硬膜外封闭治疗腰椎间盘突出症临床研究  

Clinical Study on Precompounded Lijin Jianyao Prescription Combined with Epidural Block for Lumbar Disc Herniation

作　　者：宋海伟 SONG Haiwei

机构地区：[1]余姚市中医医院

出　　处：《新中医》2020年第2期85-88,共4页New Chinese Medicine

摘　　要：目的:观察利筋健腰协定方联合硬膜外封闭治疗腰椎间盘突出症(LDH)的临床疗效。方法:选取88例LDH患者为研究对象,按随机数字表法分为对照组和观察组各44例。对照组给予硬膜外封闭治疗,观察组在此基础上给予利筋健腰协定方治疗,2组均治疗2周。治疗后比较2组腰椎功能优良率,评价患者治疗前后的腰椎功能、痛感及日常生活能力,检测患者治疗前后血清中β-内啡肽(β-EP)、P物质(SP)、单核细胞趋化蛋白-1(MCP-1)、前列腺素E2(PGE2)水平。结果:观察组、对照组腰椎功能优良率分别为70.45%、38.64%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组日本整形外科协会(JOA)评分均较治疗前上升,视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分均较治疗前下降(P<0.05);观察组JOA评分高于对照组,VAS评分、ODI评分均低于对照组(P<0.05)。治疗后,2组β-EP水平均较治疗前上升(P<0.05),SP、MCP-1、PGE2水平均较治疗前下降(P<0.05);观察组β-EP水平高于对照组(P<0.05),SP、MCP-1、PGE2水平均低于对照组(P<0.05)。结论:利筋健腰协定方联合硬膜外封闭治疗有利于改善LDH患者的临床症状,缓解疼痛,提高腰椎功能,其作用机制可能与调控血清中β-EP、SP、MCP-1、PGE2等细胞因子水平有关。Objective:To observe the clinical effect of precompounded Lijin Jianyao prescription combined with epidural block for lumbar disc herniation(LDH).Methods:A total of 88 cases of LDH patients were selected as the study subjects,and were divided into the control group and the observation group according to the random number table method,44 cases in each group.The control group was treated with epidural block,and the observation group was additionally treated with precompounded Lijin Jianyao prescription based on the treatment of the control group.Both groups were treated for two weeks.The excellent and good rate of the lumbar function in the two groups after treatment were compared;lumbar function,sense of pain and activity of daily living before and after treatment were evaluated;the levels ofβ-endorphin(β-EP),substance P(SP),monocyte chemotactic protein 1(MCP-1)and prostaglandin E2(PGE2)in serum before and after treatment were detected.Results:The excellent and good rate was 70.45%in the observation group and 38.64%in the control group,the difference being significant(P<0.05).After treatment,the scores of Japanese Orthopaedic Association(JOA)in the two groups were increased when compared with those before treatment,and the scores of Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)were decreased when compared with those before treatment(P<0.05);the score of JOA in the observation group was higher than that in the control group,and the scores of VAS and ODI were lower than those in the control group respectively(P<0.05).After treatment,the levels ofβ-EP in the two groups were increased when compared with those before treatment(P<0.05),and the levels of SP,MCP-1 and PGE2 were decreased when compared with those before treatment(P<0.05);the level ofβ-EP in the observation group was higher than that in the control group(P<0.05),and the levels of SP,MCP-1 and PGE2 were lower than those in the control group respectively(P<0.05).Conclusion:The therapy of precompounded Lijin Jianyao prescription combined wit

关 键 词：腰椎间盘突出症(LDH) 利筋健腰协定方 硬膜外封闭 疼痛 腰椎功能 细胞因子 

分 类 号：R681.53[医药卫生—骨科学]