通督活血汤治疗肾虚血瘀型腰椎间盘突出症的临床研究  

Clinical Study on Tongdu Huoxue Decoction in Treating Prolapse of Lumbar Intervertebral Disc with Kidney Deficiency and Blood Stasis

作　　者：钟传棋 杨功旭[1,2] 吴斌[1,2] 霍雄涛[1,2] 金军[1,2] ZHONG Chuanqi;YANG Gongxu;WU Bin;HUO Xiongtao;JIN Jun(Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430061,China;Hubei Province Academy of Traditional Chinese Medicine,Wuhan 430074,China.)

机构地区：[1]湖北省中医院,武汉430061 [2]湖北省中医药研究院

出　　处：《中国中医骨伤科杂志》2020年第10期13-16,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：中央级公益性科研院所基本科研业务费专项资金资助(YZ-1752)。

摘　　要：目的:观察通督活血汤治疗肾虚血瘀型腰椎间盘突出症的疗效及对患者外周血清中白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)的影响。方法:选择2017年7月至2018年7月在湖北省中医院骨伤科治疗的肾虚血瘀型腰椎间盘突出症患者80例,随机分为治疗组和对照组,每组各40例,对照组采用推拿治疗,治疗组采用口服通督活血汤结合推拿治疗,4周为1个疗程,比较两组治疗前后视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、日本骨科医师协会神经功能评分(JOA)变化,采用酶联免疫法(ELISA)测定治疗前后患者血清中IL-1β,TNF-α的变化。结果:治疗组总有效率为92.5%,对照组为70.0%,治疗组患者总有效率高于对照组,差异有统计学意义(P<0.05);治疗后两组VAS评分、ODI指数均低于治疗前,JOA评分高于治疗前,差异有统计学意义(P<0.05),且治疗后治疗组患者ODI指数低于对照组,JOA评分高于对照组,差异有统计学意义(P<0.05);治疗后两组患者血清中IL-1β,TNF-α水平均下调,差异有统计学意义(P<0.05)。结论:通督活血汤治疗腰椎间盘突出症具有较好疗效,能降低外周血清IL-1β,TNF-α水平。Objective:To observe the effect of Tongdu Huoxue decoction on lumbar disc herniation with kidney deficiency and blood stasis and its effect on the levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in the peripheral serum of patients.Methods:80lumbar disc herniation patients with kidney deficiency and blood stasis were treated in the Department of Orthopedics,Hubei Provincial Hospital of Traditional Chinese Medicine from July 2017to July 2018,randomly divided into treatment group and control group,each group 40cases,the control group was treated with massage therapy,the treatment group was treated with oral Tongdu Huoxue decoction combined with massage therapy,4weeks as a course of treatment.The changes of visual analog score(VAS),Oswestry dysfunction index(ODI)and Japanese orthopaedic association neurofunction score(JOA)were compared before and after treatment.The serum levels of IL-1βand TNF-αwere measured by enzyme-linked immunoassay(ELISA)before and after treatment.Results:The total effective rate of the treatment group was 92.5%,and that of the control group was 70.0%.The total effective rate of patients in the treatment group was higher than that of the control group(P<0.05).After treatment,the scores of VAS and ODI in the two groups were lower than before treatment,and the JOA were higher than before treatment,the difference was statistically significant(P<0.05).The levels of IL-1βand TNF-αin serum were down-regulated(P<0.05),and the treatment group was better than the control group(P<0.05).Conclusion:Tongdu Huoxue decoction has a good curative effect on the treatment of lumbar disc herniation,and can reduce the level of peripheral serum IL-1βand TNF-α.

关 键 词：腰椎间盘突出症 通督活血汤 炎症因子 ODI指数 JOA评分 

分 类 号：R681.5[医药卫生—骨科学]