五福饮加减治疗盘源性腰痛的临床研究  

A clinical study of Wufu Yin Jiajian(五福饮加减)for treatment of discogenic back pain

作　　者：沈兴潮 夏炳江[1] 凌义龙[1] 韦金忠[1] 许杨[1] SHEN Xingchao;XIA Bingjiang;LING Yilong;WEI Jinzhong;XU Yang(Shaoxing Hospital of Traditional Chinese Medicine,Shaoxing 312000,Zhejiang,China)

机构地区：[1]绍兴市中医院,浙江绍兴312000

出　　处：《中医正骨》2020年第2期23-29,共7页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：浙江省自然科学基金项目(LQ18H270006);浙江省中医药科技计划项目(2017ZB091,2018ZA125)。

摘　　要：目的:观察五福饮加减治疗盘源性腰痛(discogenic back pain,DBP)的临床疗效和安全性,并探讨其可能的作用机制。方法:将符合要求的100例DBP患者随机分为五福饮组和塞来昔布组,每组50例。五福饮组采用五福饮加减治疗,每日1剂,分早晚2次空腹温服。塞来昔布组采用口服塞来昔布胶囊治疗,每日2次,每次200 mg。每个疗程均为7 d,均连续治疗4个疗程。治疗期间2组均进行适度腰背肌和腹肌功能锻炼。测定患者的腰部疼痛视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、血清β-catenin含量,评估腰椎间盘MRI分级,观察记录试验期间2组并发症的发生情况。结果:①腰部疼痛VAS评分。时间因素和分组因素不存在交互效应(F=1.734,P=0.171)。五福饮组的腰部疼痛VAS评分总体低于塞来昔布组(F=8.658,P=0.009)。治疗前后不同时点间腰部疼痛VAS评分的差异有统计学意义,即存在时间效应(F=29.821,P=0.000);2组患者的腰部疼痛VAS评分随时间变化均呈降低趋势,但2组的降低趋势不完全一致[(6.20±1.93)分,(3.30±0.67)分,(3.00±0.82)分,(2.00±0.67)分,F=24.572,P=0.000;(6.50±2.17)分,(4.20±1.40)分,(4.30±1.25)分,(4.00±1.05)分,F=5.784,P=0.002];治疗前,2组患者的腰部疼痛VAS评分比较,差异无统计学意义(t=0.326,P=0.748);治疗后1个月、3个月、6个月时,五福饮组的腰部疼痛VAS评分均低于塞来昔布组(t=2.633,P=0.043;t=2.751,P=0.013;t=5.071,P=0.000)。②ODI。时间因素和分组因素存在交互效应(F=2.775,P=0.049)。2组患者的ODI总体比较,组间差异无统计学意义,即不存在分组效应(F=1.815,P=0.195)。治疗前后不同时点间ODI的差异有统计学意义,即存在时间效应(F=85.320,P=0.000);2组患者的ODI随时间变化均呈先降低后升高的趋势,但2组的变化趋势不完全一致[(68.90±19.68)%,(33.30±9.88)%,(34.50±9.28)%,(38.50±9.42)%,F=17.281,P=0.000;(68.50±22.60)%,(43.10�Objective:To observe the clinical curative effects and safety of Wufu Yin Jiajian(五福饮加减,WFYJJ)in treatment of discogenic back pain(DBP)and to explore its possible mechanism of actions.Methods:One hundred patients with DBP were enrolled in the study and were randomly divided into WFY group and celecoxib group,50 cases in each group.The patients in WFY group were treated with oral application of WFYJJ,one dose a day in the morning and evening respectively on an empty stomach for consecutive 4 courses of treatment,7 days for each course;while the others in celecoxib group were treated with oral application of celecoxib capsules,twice a day,200 mg at a time for consecutive 4 courses of treatment,7 days for each course.Meanwhile,moderate lumbodorsal muscle exercises and abdominal muscle exercises were conducted in patients in the 2 groups during the treatment period.The low back pain visual analogue scale(VAS)scores,Oswestry disability index(ODI)and serum content ofβ-catenin were measured and compared between the 2 groups,and the MRI grading of lumbar intervertebral disc was evaluated.Moreover,the complication incidences were observed and recorded during the trial.Results:There was no interaction between time factor and group factor in low back pain VAS scores(F=1.734,P=0.171).The low back pain VAS scores were lower in WFY group compared to celecoxib group in general(F=8.658,P=0.009).There was statistical difference in low back pain VAS scores between different timepoints before and after the treatment,in other words,there was time effect(F=29.821,P=0.000).The low back pain VAS scores presented a time-dependent decreasing trend in both of the 2 groups,while the 2 groups were inconsistent with each other in the variation tendency(6.20+/-1.93,3.30+/-0.67,3.00+/-0.82,2.00+/-0.67 points,F=24.572,P=0.000;6.50+/-2.17,4.20+/-1.40,4.30+/-1.25,4.00+/-1.05 points,F=5.784,P=0.002).There was no statistical difference in low back pain VAS scores between the 2 groups before treatment(t=0.326,P=0.748).The low back pain VA

关 键 词：腰痛 五福饮 临床试验 

分 类 号：R274.9[医药卫生—中西医结合]