五子方热熨联合血府逐瘀汤口服治疗腰椎间盘突出症气滞血瘀证临床研究  

Clinical study of Wuzi Recipe combined with Xuefu Zhuyu Decoction on lumbar disc herniation with qi-blood stagnation syndrome

作　　者：李琦[1] 杨蓉蓉 盛文博 李四波[1] 殷磊[1] 沈黎辉[1] 姜海涛[1] LI Qi;YANG Rongrong;SHENG Wenbo;LI Sibo;YIN Lei;SHEN Lihui;JIANG Haitao(Department of Orthopaedics,Shanghai Seventh People's Hospital,Shanghai 200137)

机构地区：[1]上海市第七人民医院骨科,上海200137

出　　处：《河北中医》2023年第7期1102-1105,1110,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市卫生健康委员会科研课题(编号:20194Y0211)。

摘　　要：目的观察五子方热熨联合血府逐瘀汤口服治疗腰椎间盘突出症(LDH)气滞血瘀证的临床疗效。方法选取90例LDH气滞血瘀证患者,按照随机数字表法分为2组,在均予西医常规治疗的基础上,对照组45例予血府逐瘀汤口服治疗,治疗组45例予五子方热熨联合血府逐瘀汤口服治疗。2组均治疗4周后统计疗效,比较2组治疗前后中医症状(包括腰痛、下肢掣痛、不能转侧)评分、日本骨科协会(JOA)评估治疗分数、腰椎Oswestry功能障碍指数(ODI)评分、疼痛视觉模拟评分(VAS)、血清炎症因子[包括白细胞介素-1β(IL-1β)及肿瘤坏死因子α(TNF-α)]水平及下肢神经[包括腓总神经及胫神经]传导速度变化情况。结果治疗组总有效率95.56%(43/45),对照组总有效率77.78%(35/45),治疗组疗效优于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状腰痛、下肢掣痛及不能转侧评分均降低(P<0.05),且治疗组治疗后中医症状腰痛、下肢掣痛及不能转侧评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后JOA评估治疗分数均升高(P<0.05),ODI评分均降低(P<0.05),且治疗组治疗后JOA评估治疗分数高于对照组(P<0.05),ODI评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后疼痛VAS均降低(P<0.05),且治疗组治疗后疼痛VAS低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血清炎症因子IL-1β及TNF-α水平均降低(P<0.05),且治疗组治疗后IL-1β及TNF-α水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后下肢腓总神经及胫神经传导速度均升高(P<0.05),且治疗组治疗后下肢腓总神经及胫神经传导速度高于对照组(P<0.05)。结论五子方热熨与血府逐瘀汤口服联合治疗LDH气滞血瘀证可起到协同作用,进一步提高临床疗效,改善患者症状,减轻疼痛,提高腰椎功能,减轻炎性反应,提高下肢神经传导速度。Objective To explore the influences of Wuzi Recipe combined with Xuefu Zhuyu Decoction on lumbar disc herniation(LDH)with qi-blood stagnation syndrome.Methods A total of 90 LDH patients with qi-blood stagnation syndrome were collected and randomly allocated to the control group(n=45)and the treatment group(n=45).All patients were managed by routine western medicine,the patients in the control group were treated with Xuefu Zhuyu Decoction,and the patients in the treatment group were treated with Wuzi Recipe combined with Xuefu Zhuyu Decoction.The efficacy of the two groups was counted after 4 weeks of treatment.The traditional Chinese medicine(TCM)symptoms scores(including low back pain,lower limb pain and non-rotation),Japanese Orthopaedic Association(JOA)score,lumbar Oswestry Disability Index(ODI)score,visual analogue scale(VAS)score,serum inflammatory factor levels(including interleukin-1β[IL-1β]and tumor necrosis factor-α[TNF-α],as well as lower extremity nerve conduction velocity(including common peroneal nerve conduction velocity(CPNMCV),tibial nerve conduction velocity[TNMCV])were included as comparisons between the two groups before and after treatment.Results After treatment,the total effective rate in the treatment group was better than that in the control group(95.56%[43/45]vs 77.78%[35/45],P<0.05).The TCM scores of low back pain,lower limb pain and non-rotation in the two groups were decreased(P<0.05),which were lower in the treatment group than in the control group(P<0.05).The increased JOA scores and decreased ODI scores were detected in the two groups(both P<0.05),and the treatment group was superior to the control group for JOA and ODI score(both P<0.05).The VAS scores in the two groups were decreased(P<0.05),and the decrease in the treatment group was more pronounced(P<0.05).The serum levels of IL-1β,TNF-αin both groups decreased(P<0.05),and the decreases in the treatment were more significant(P<0.05);the levels of CPNMCV and TNMCV in both groups increased(P<0.05),and which were higher in th

关 键 词：椎间盘移位 腰椎 气虚血瘀 中药疗法 辨证论治 

分 类 号：R681.533.1[医药卫生—骨科学]