温阳祛痹通络方治疗肾阳亏虚兼寒湿血瘀型腰椎间盘突出症椎间孔镜髓核摘除后残留症状临床研究  

Clinical effect of Wenyang Qubi Tongluo Formula for postoperative residual symptoms of transforaminal endoscopic lumbar discectomy with kidney-yang deficiency and cold-dampness and blood stasis type

作　　者：纪刚[1] 刘俊[1] 周宏亮 JI Gang;LIU Jun;ZHOU Hongliang(Department of Orthopedics,Rugao Hospital of Traditional Chinese Medicine,Rugao,Jiangsu 226500)

机构地区：[1]江苏省如皋市中医院骨伤科,江苏如皋226500

出　　处：《河北中医》2022年第8期1308-1312,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察温阳祛痹通络方治疗肾阳亏虚兼寒湿血瘀型腰椎间盘突出症椎间孔镜髓核摘除后残留症状的临床疗效。方法选择60例腰椎间盘突出症椎间孔镜髓核摘除后残留症状患者,均为肾阳亏虚兼寒湿血瘀证,采用随机数字表法均分为对照组和观察组。对照组30例采用消炎镇痛、神经营养药物常规治疗,观察组30例在对照组治疗基础上予温阳祛痹通络方治疗,均连续治疗4周后统计临床疗效。比较2组治疗前后Oswestry功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)、中医证候积分及血清炎症指标[白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)]、疼痛介质[前列腺素E_(2)(PGE_(2))、5-羟色胺(5-HT)]水平。结果治疗后,2组ODI、疼痛VAS及中医证候主症、次症积分均较本组治疗前显著降低(P<0.05),且观察组均显著低于对照组(P<0.05)。治疗后,2组血清IL-6、hs-CRP、PGE_(2)、5-HT水平均较本组治疗前显著降低(P<0.05),且观察组均显著低于对照组(P<0.05)。观察组总有效率93.33%(28/30),对照组总有效率73.33%(22/30),观察组总有效率显著高于对照组(P<0.05)。结论温阳祛痹通络方能有效减轻腰椎间盘突出症椎间孔镜髓核摘除后残留症状,改善腰椎功能障碍,降低血清炎症相关因子、疼痛介质水平,综合疗效更佳。Objective To observe the clinical effect of Wenyang Qubi Tongluo Formula for postoperative residual symptoms of transforaminal endoscopic lumbar discectomy(TELD)with kidney-yang deficiency and cold-dampness and blood-stasis type.Methods Totally 60 patients underwent TELD,these patients diagnosed postoperative residual symptoms(kidney-essence deficiency and cold-dampness and blood-stasis type),thay randomly assigned into the observation group(n=30)and the control group(n=30).All patients were managed by conventional therapy(anti-inflammatory and analgesic,neurotrophic drugs),and those in the observation group were additionally treated with Wenyang Qubi Tongluo Formula.A 4-week treatment was performed to compare Oswestry dysfunction index(ODI),visual analogue scale(VAS)for pain,traditional Chinese medicine(TCM)symptom scores,serum inflammatory markers(interleukin-6[IL-6],high-sensitivity c-reactive protein[hs-CRP]),pain mediator(prostaglandin E_(2)[PGE_(2)],5-hydroxytryptamine[5-HT]);the curative effect was assessed.Results After treatment,ODI,VAS,TCM syndrome scores in groups were significantly decreased(P<0.05),which were significantly lower in the observation group than the control group(P<0.05);IL-6,hs-CRP,PGE_(2),5-HT in groups were remarkably decreased(P<0.05),the observation group was more prevalent(P<0.05).The overall effective rate was significantly higher in the observation group than that in the control group(93.33%[28/30]vs 73.33%[22/30],P<0.05,respectively).Conclusion Wenyang Qubi Tongluo Formula can effectively relieve postoperative residual symptoms of TELD,improve lumbar dysfunction,reduce inflammation-related factors and pain mediator,and with better comprehensive curative effect.

关 键 词：椎间盘移位 腰椎 椎间盘切除术 术后残留症状 中医疗法 

分 类 号：R681.533.105.31[医药卫生—骨科学]