泽兰合剂治疗不同突出位置类型的血瘀型腰椎间盘突出症的临床研究  

Clinical study on the treatment of lumbar disc herniation with different types of protruding locations caused by blood stasis with Zelan Mixture

作　　者：李治骑 向刚刚 童猛 王恩辉 付义[1] 曹鹏 Li Zhiqi;Xiang Ganggang;Tong meng;Wang Enhui;Fu Yi;Cao Peng(Department of Orthopedics and Traumatology,Kunming Hospital of Traditional Chinese Medicine,Kunming Yunnan 650051;Department of Orthopedics and Traumatology,Xuanhan County Hospital of Traditional Chinese Medicine,XuanhanSichuan 636150)

机构地区：[1]昆明市中医医院骨伤科,云南昆明650051 [2]宣汉县中医院骨伤科,四川宣汉636150

出　　处：《山西中医药大学学报》2023年第4期450-455,共6页Journal of Shanxi University of Chinese Medicine

基　　金：云南省中医(骨伤)临床医学中心建设项目(20210701)。

摘　　要：目的:观察泽兰合剂治疗血瘀型腰椎间盘突出症(lumbar disc herniation,LDH)的临床疗效,并探究其治疗不同突出位置类型血瘀型LDH的疗效及对白细胞介素-6(Interleukin-6,IL-6)的影响。方法:选取2018年12月—2022年12月在云南中医药大学第三附属医院(昆明市中医医院)诊治的1286例血瘀型LDH患者作为研究对象,按照治疗方式将其分为对照组和治疗组,对照组648例,治疗组638例。对照组在行相关功能锻炼及卧床休息的基础上配合塞来昔布进行治疗,治疗组则将塞来昔布替换为泽兰合剂进行治疗,并将两组按照椎间盘突出位置分型(中央型、旁中央型、旁侧型、极外侧型),分为4个亚组,对比各组间及亚组间治疗前、治疗第7天及治疗第14天的视觉模拟评分(visual analogue scale,VAS)、日本骨科协会评估治疗评分(Japanese Orthopaedic Association scores,JOA)及治疗前后IL-6含量的变化情况。结果:(1)对照组、治疗组组间、组内亚组间治疗前VAS评分、JOA评分比较,差异无统计学意义(P>0.05)。治疗第7天、第14天,两组VAS评分、JOA评分均较每次治疗前降低(P<0.05);治疗组中央型亚组的VAS评分、JOA评分与组内各亚组、组间中央型亚组比较,差异具有统计学意义(P<0.05)。(2)治疗前各个亚组之间IL-6含量比较,差异均无统计学意义(P>0.05)。对照组、治疗组IL-6含量在治疗14 d后均降低(P<0.05);且治疗组中央型亚组IL-6水平与组内各亚组、组间中央型亚组比较,差异具有统计学意义(P<0.05)。结论:泽兰合剂对血瘀型LDH有着确切的疗效,尤其针对中央型血瘀型LDH,能更好地降低此类患者体内IL-6水平。Objective:To observe the clinical efficacy of Zelan Mixture in the treatment of lumbar disc herniation(LDH)caused by blood stasis,and to investigate its efficacy in the treatment of LDH with different types of protrusion locations caused by blood stasis and its effect on IL-6 index.Methods:1286 patients with LDH caused by blood stasis who were treated in the third affiliated hospital of Yunnan University of Chinese Medicine(Kunming Hospital of Traditional Chinese Medicine)from December 2018 to December 2022 were selected for the research,and they were divided into control group and treatment group(648 in the control group and 638 in the treatment group)according to the treatment modality.The control group was treated with celecoxib on the basis of related functional workouts and bed rest,while the treatment group was treated by replacing celecoxib with Zelan Mixture.The two groups were divided into four subgroups according to the location of disc herniation(central type,paracentral type,lateral type,far lateral type).The visual analogue scale(VAS),the Japanese Orthopaedic Association score(JOA)were compared between two groups and among subgroups before treatment,on the 7th day and the 14th day of the treatment and the change of IL-6 index before and after treatment was also compared.Results:(1)There was no significant difference in VAS score and JOA score before treatment between the control group and the treatment group,and between the subgroups within the group(P>0.05).VAS scores and JOA scores were lower in both groups on the 7th day and 14th day of the treatment compared to those before each treatment(P<0.05).And the VAS score and JOA score of the central type subgroup in the treatment group were statistically different from those of the other subgroups within the same group and between the central type subgroups(P<0.05).(2)The differences in IL-6 content among subgroups before treatment were not statistically significant(P>0.05).IL-6 indexes in control group and treatment group were significantly decreased a

关 键 词：血瘀型腰椎间盘突出症 泽兰合剂 突出位置分型 白细胞介素-6 

分 类 号：R274.9[医药卫生—中西医结合]