自拟通络止痛汤治疗对巨大型腰椎间盘突出症患者腰椎功能、疼痛介质及炎症因子水平的影响  

Effects of self-designed tongluo zhitong decoction on lumbar function,pain mediators levels,and inflammatory factors levels in patients with giant lumbar disc herniation

作　　者：池红万[1] 刘益兵[2] 朱敬云[3] 李翔[4] 袁蕊 CHI Hongwan;LIU Yibing;ZHU Jingyun;LI Xiang;YUAN Rui(Department of Rehabilitation Medicine,Zhengzhou Orthopaedics Hospital,Zhengzhou 450009,Henan Province,China;The Second Department,Department of neck,shoulder,waist and leg pain,Zhengzhou Orthopaedics Hospital,Zhengzhou 450009,Henan Province,China;Department of Acupuncture and Moxibustion,The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,Henan Province,China;Department of Minimally Invasive Orthopedics,Zhengzhou Orthopaedics Hospital,Zhengzhou 450009,Henan Province,China;Department of Rehabilitation,Zhengzhou Orthopaedics Hospital,Zhengzhou 450009,Henan Province,China)

机构地区：[1]郑州市骨科医院康复医学科,河南省郑州市450009 [2]郑州市骨科医院颈肩腰腿痛科Ⅱ科,河南省郑州市450009 [3]郑州大学第二附属医院针灸科,河南省郑州市450003 [4]郑州市骨科医院微创骨科,河南省郑州市450009 [5]郑州市骨科医院康复科,河南省郑州市450009

出　　处：《内科》2022年第2期149-152,194,共5页Internal Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191139)。

摘　　要：目的探讨在络病理论指导下,自拟通络止痛汤治疗对巨大型腰椎间盘突出症(LDH)患者腰椎功能、疼痛介质及炎症因子水平的影响。方法选取郑州市骨科医院收治的巨大型LDH患者127例作为研究对象,采用随机数字法分为对照组(63例)和观察组(64例)。对照组患者接受平乐按摩理筋治疗,观察组患者在对照组的基础上联合自拟通络止痛汤治疗。治疗6周后,比较两组患者的临床疗效和不良反应情况;检测比较两组患者治疗前、治疗6周后的腰椎功能、血清疼痛介质水平、血清炎症因子水平。结果治疗6周,观察组患者的治疗总有效率(87.50%)明显高于对照组(69.84%),差异有统计学意义(P<0.05)。治疗6周后,两组患者的功能障碍指数(ODI)评分均显著降低,日本骨科协会评估量表(JOA)评分均显著升高;观察组患者的ODI评分显著低于对照组,JOA评分显著高于对照组,差异有统计学意义(P<0.05);两组患者β-内啡肽(β-EP)水平均显著升高,前列腺素E2(PGE2)、5-羟色胺(5-HT)水平均显著降低;观察组患者的β-EP水平显著高于对照组,PGE2、5-HT水平显著低于对照组,差异有统计学意义(P<0.05);两组患者的IL-6、CRP、TNF-α水平均显著降低;观察组患者的IL-6、CRP、TNF-α水平均显著低于对照组,差异有统计学意义(P<0.05)。结论在络病理论指导下,自拟通络止痛汤治疗巨大型腰椎间盘突出症患者临床效果确切,能够有效调节患者疼痛介质水平,降低患者的炎症因子水平,改善患者腰椎功能,无明显不良反应发生,值得临床推广应用。Objective To investigate the effects of self-designed tongluo zhitong decoction on lumbar function,pain mediators levels,and inflammatory factors levels in patients with giant lumbar disc herniation(LDH)under the guidance of collateral disease theory.Methods 127 patients with giant LDH admitted to Zhengzhou orthopaedics hospital were selected as the research objects,and they were divided into control group(63 cases)and observation group(64 cases)by the random number method.Patients in the control group received pingle massage tendon therapy,while the patients in the observation group were treated with self-designed tongluo zhitong decoction based on the control group.After 6 weeks of treatment,the clinical efficacy,and adverse reactions of the two groups were compared.The lumbar function,serum pain mediators levels and serum inflammatory factors levels were detected and compared between the two groups before treatment and 6 weeks after treatment.Results With 6 weeks of treatment,the total effective rate of treatment of the observation group(87.50%)was significantly higher than that of the control group(69.84%),with a statistically significant difference(P<0.05).After 6 weeks of treatment,the Oswestry Disability Index(ODI)scores decreased significantly,and the Japanese Orthopaedic Association(JOA)scores increased significantly in both groups.The observation group reached lower ODI score and higher JOA score as compared with the control group,with statistically significant differences(P<0.05).The levels of serumβ-endorphin(β-EP)increased significantly in the patients of both groups,while the levels of prostaglandin E2(PGE2)and 5-hydroxytryptamine(5-HT)significantly decreased.The observation group reached higher level ofβ-EP,and lower levels of PGE2 and 5-HT as compared with the control group,with statistically significant differences(P<0.05).The levels of interleukin-6(IL-6),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)in the two groups decreased significantly,and the levels of IL-6,CRP and TNF-αi

关 键 词：巨大型腰椎间盘突出 络病理论 自拟通络止痛汤 腰椎功能 

分 类 号：R681.53[医药卫生—骨科学]