消肿定痛合剂治疗急性腰椎间盘突出症90例临床观察及对肿瘤坏死因子-α、α-颗粒膜糖蛋白、白细胞-1β、MMP-3的干预作用  

Observation of Therapeutic Effect of Xiaozhong Dingtong Heji in Treatment of Acute Lumbar Disc Herniation and The Influence on TNF-α,CD62p,IL-1βand MMP-3

作　　者：焦锋 唐望 黄荷 刘栋华 张宏艺 JIAO Feng;TANG Wang;HUANG He;LIU Donghua;ZHANG Hongyi(Guangzhou Hospital of Integrated Chinese and Western Medicine,Guangzhou 510800,Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China)

机构地区：[1]广州市中西医结合医院,广东广州510800 [2]广州中医药大学,广东广州510405

出　　处：《辽宁中医杂志》2020年第2期117-120,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：广州市科技计划项目(201904010231)。

摘　　要：目的观察消肿定痛合剂对急性腰椎间盘突出症患者的疗效及对血清肿瘤坏死因子-α(TNF-α)、α-颗粒膜糖蛋白(CD62p)、白细胞介素-1β(IL-1β)和人基质金属蛋白酶3(MMP-3)含量的影响。方法将2016年10月—2018年10月医院收治的急性腰椎间盘突出患者90例患者作为研究对象,按照随机数字表法分为3组(消肿定痛合剂A组、西乐葆B组、消肿定痛合剂+西乐葆C组),每组30例,3组均给予常规治疗和健康教育等基础干预,并在治疗前后分别测定各组患者的血清TNF-α、CD62p、IL-1β及MMP-3水平,观察3组1个疗程(7 d)后的疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、评分和日本骨科协会评估治疗分数(JOA)评分,并统计不良反应发生情况。结果3组治疗后临床症状(腰部疼痛、步行困难、腰椎活动度及直腿抬高试验评分)较治疗前均降低(P <0. 05),其中C组降低程度大于其他两组;3组VAS评分、ODI评分较治疗前均降低(P <0. 05),其中C组降低程度大于其他两组;3组JOA评分较治疗前均升高(P <0. 05),其中C组升高程度显著高于治疗组。3组血清TNF-α、CD62p、IL-1β及MMP-3水平较治疗前显著降低(P <0. 05),且C组低于对照组(P <0. 05);3组治疗后均未见明显不良反应发生。结论消肿定痛治疗急性腰椎间盘突出,可改善临床症状与体征,降低ODI、VAS评分,提高JOA评分,改善血清TNF-α、CD62p、IL-1β、MMP-3水平。Objective To observe the therapeutic effect of Xiaozhong Dingtong Heji in the treatment of acute lumbar disc herniation and the influence on TNF-α,CD62p,IL-1βand MMP-3.Methods Ninety cases with acute lumbar disc herniationwere enrolled in our institution from October 2016 to October 2018.They were randomly divided into three groups according to the random number method,with 30 cases in each group.All the groups were treated with routine treatment,health education and other basic intervention.Besides,group A was treated with Xiaozhong Dingtong Heji while group B was treated with celecoxib.And the group C was treated with Xiaozhong Dingtong Heji combined with celecoxib.The serum levels of TNF-α,CD62p,IL-1βand MMP-3 were detected.The VAS,ODI and JOA scores were observed before and after treatment.Theadverse reactions were recorded.Results After treatment,symptom scores were significantly lower than those before treatment in the all groups(P<0.05),and those in the C group were significantly lower than those in other group(P<0.05).The VAS and ODI scores were lower than that before treatment in three groups while the JOA scores were increased.In addition,both VAS andJOA scores of the group C were significantly superior to those of the other two groups(P<0.05).Furthermore,levels of serum TNF-α,CD62p,IL-1βand MMP-3 were also lower than those before treatment.And the improvement in the group C was better than that of the other two groups.Conclusion Xiaozhong Dingtong Heji can effectively improve the clinical symptomsof acute lumbar disc herniation and decrease the serumlevels of TNF-α,CD62p,IL-1βand MMP-3 remarkably.

关 键 词：消肿定痛合剂 急性腰椎间盘突出 TNF-α CD62P IL-1Β MMP-3 

分 类 号：R681.53[医药卫生—骨科学]