加味补肾活血汤治疗老年腰椎间盘突出症后遗坐骨神经损害60例  

Sixty Cases of Sequelae Sciatic Nerve Damage After Lumbar Disc Herniation in the Elderly Treated with Supplemented Kidney-Tonifying and Blood-Activating Decoction

作　　者：孟魏魏 龚政 MENG Wei-wei;GONG Zheng(Shanghai Changning Tianshan Traditional Chinese Medicine Hospital,Shanghai,China,200051)

机构地区：[1]上海市长宁区天山中医医院,上海200051

出　　处：《河南中医》2021年第10期1559-1563,共5页Henan Traditional Chinese Medicine

基　　金：上海市卫生健康委员会科研项目(2018LP044);上海市进一步加快中医药事业发展三年(2018-2020年)行动计划项目[ZY(2018-2020-ZYBZ-26)]。

摘　　要：目的:观察加味补肾活血汤治疗老年腰椎间盘突出症后遗坐骨神经损害的临床疗效。方法:将120例老年腰椎间盘突出症后遗坐骨神经损害患者按照随机数字表法分为治疗组和对照组,每组各60例。治疗组给予加味补肾活血汤颗粒剂口服,对照组予甲钴胺片口服,观察两组治疗前后神经肌电图及定量感觉的改变。结果:两组患者治疗后H反射差值、神经传导速度组间与组内比较,差异均无统计学意义(P>0.05)。治疗组足背、小腿外缘冷觉阈值高于对照组,足背热痛觉阈值、小腿外缘热痛觉阈值、温觉阈值低于对照组,差异具有统计学意义(P<0.05);治疗组振动觉低于对照组,差异具有统计学意义(P<0.05)。结论:加味补肾活血汤能有效改善老年LDH后遗坐骨神经损害患者下肢皮肤冷觉、热觉、痛觉及外踝振动等临床症状,但不能改善神经干的电生理指标,作用机制可能与促进周围感觉神经的修复和再生有关。Objective:To inquire into the clinical curative effect of Supplemented Kidney-Tonifying and Blood-Activating Decoction on sequelae sciatic nerve damage after lumbar disc herniation(LDH)in the elderly.Methods:A total of 120 elderly patients with sequelae sciatic nerve damage after lumbar disc herniation were randomly divided into the treatment group and the control group,with 60 cases in each group.The treatment group was treated with Supplemented Kidney-Tonifying and Blood-Activating Decoction granules for oral administration and the control group was treated with Mecobalamin Tablets.The changes of neuroelectromyography and quantitative sensation before and after treatment were observed.Results:There were no significant differences in H-reflex difference and nerve conduction velocity between and within the two groups(P>0.05).The cold sensation threshold of dorsum of foot and outer edge of lower leg in the treatment group was higher than that in the control group,while the heat and pain sensation threshold of the dorsum of the foot,and the outer edge of the leg,and the warm sensation threshold of the control group were significantly lower than those of the control group,and all the differences were statistically significant(P<0.05).The vibration sense of lateral malleolus in the treatment group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Supplemented Kidney-Tonifying and Blood-Activating Decoction can effectively improve the clinical symptoms of lower limb skin cold sensation,heat sensation,pain sensation and lateral malleolus vibration sensation in elderly patients with sequelae sciatic nerve damage after LDH,but it cannot improve the electrophysiological indexes of nerve stem.The mechanism may be related to promoting the repair and regeneration of peripheral sensory nerve.

关 键 词：腰椎间盘突出症 后遗坐骨神经损害 老年 加味补肾活血汤 甲钴胺 

分 类 号：R274.981.5[医药卫生—中西医结合]