独活寄生汤联合温通针法治疗退行性腰椎管狭窄症患者的临床疗效  

Clinical Efficacy of Duhuo Jisheng Decoction Combined with Wentong Acupuncture Therapy on Degenerative Lumbar Spinal Stenosis

作　　者：雷小平[1] 杨永辉[1] 尚荣安[1] 刘东钱 LEI Xiaoping;YANG Yonghui;SHANG Rongan;LIU Dongqian(Baoji Traditional Chinese Medicine Hospital of Shaanxi Province,Baoji 721000,China)

机构地区：[1]陕西省宝鸡市中医医院,宝鸡721000

出　　处：《世界中医药》2020年第21期3313-3317,共5页World Chinese Medicine

基　　金：陕西省自然科学基金资助项目(Y2002C35);陕西省科技厅项目(2013JM4058);宝鸡市卫计局项目(2017-16)。

摘　　要：目的:探讨独活寄生汤联合温通针法治疗退行性腰椎管狭窄症(DLSS)的临床效果。方法:选取2017年5月至2018年7月陕西省宝鸡市中医医院收治的DLSS患者68例作为研究对象,随机分为对照组和观察组,每组34例。观察组给予独活寄生汤联合温通针法治疗,对照组采取常规西药治疗,连续治疗1个月后评价2组疗效及安全性。结果:观察组治疗有效率为97.06%(33/34),与对照组的76.47%(26/34)比较显著升高,差异有统计学意义(P<0.05)。与治疗前比较,2组治疗后腰腿痛视觉模拟评分法(VAS)和腰椎日本骨科协会(JOA)评分均显著改善,差异有统计学意义(P<0.05),全血黏度高切、中切和低切及血浆黏度、纤维蛋白原、红细胞比容均显著降低,差异有统计学意义(P<0.05),血清白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)水平均显著下降,差异有统计学意义(P<0.05),血清IL-4、IL-10水平均显著升高,差异有统计学意义(P<0.05);且观察组比对照组对上述指标的改善更显著,差异有统计学意义(P<0.05)。2组均无严重不良反应发生。结论:独活寄生汤联合温通针法治疗DLSS能有效缓解腰腿痛症状、调控炎性因子表达及改善血液高凝状态。Objective:To investigate the clinical efficacy of Duhuo Jisheng Decoction combined with WenTong acupuncture therapy on degenerative lumbar spinal stenosis(DLSS).Methods:A total of 68 DLSS patients admitted to Baoji Traditional Chinese Medicine Hospital ofShaanxi Province from May 2017 to July 2018,were selected as the research objects and were randomly divided into a control group and an observation group,with 34 cases in each group.The observation group was administrated with Duhuo Jisheng Decoction combined with WenTong acupuncture therapy,while the control group was treated with conventional Western medicine.After 1 month treatment for both groups,clinical efficacy and safety of the 2 groups was evaluated.Results:The overall effective rate of the observation group was 97.06%(33/34),much higher than 76.47%(26/34)of the control group(P<0.05).Compared with those groups before treatment,the visual analogue scale(VAS)and the Japanese Orthopaedic Association(JOA)scores in the 2 groups were significantly improved after treatment(P<0.05).High-viscosity,mid-cut and low-cut,plasma viscosity,fibrinogen,hematocrit were significantly reduced(P<0.05),serum interleukin(IL)-6,tumor necrosis factor-α(tumor necrosis factor-α),the concentrations of TNF-αand TNF-αwere significantly decreased(P<0.05),and the levels of serum IL-4 and IL-10 were significantly increased(P<0.05);the above indicators improved more significantly in the observation group than in the control group(P<0.05).No serious adverse reactions occurred in the 2 groups.Conclusion:Duhuojii Decoction combined with Wentong acupuncture in the treatment of DLSS can effectively relieve the symptoms of pain in waist and lower extremities,regulate the expression of inflammatory factors and improve the state of blood hypercoagulability.

关 键 词：独活寄生汤 温通针法 退行性腰椎管狭窄症 血液高凝状态 炎性反应递质 抗炎因子 腰椎功能 安全性 

分 类 号：R289.5[医药卫生—方剂学] R245[医药卫生—中药学]