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作 者:黄小霞 周杰 张帅 刘康 沈琪幸 尹萌辰[2] 莫文[2] 石瑛[3] HUANG Xiao-xia;ZHOU Jie;ZHANG Shuai;LIU Kang;SHEN Qi-xing;YIN Meng-chen;MO Wen;SHI Ying(Shanghai Pudong New Area Hospital of traditional Chinese Medicine,Shanghai200120,China;Department of Orthopedics and Traumatology,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Department of Orthopedics and Traumatology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
机构地区:[1]上海市浦东新区中医医院非药物中心,上海200120 [2]上海中医药大学附属龙华医院骨伤科,上海200032 [3]上海中医药大学附属曙光医院骨伤科,上海201203
出 处:《颈腰痛杂志》2023年第5期739-743,共5页The Journal of Cervicodynia and Lumbodynia
基 金:上海市浦东新区卫生健康委员会优秀青年医学人才培养(编号:PWRq2020-56);上海市卫生健康委员会科研课题(编号:202040131)。
摘 要:目的探索加味麻黄附子细辛汤治疗腰椎间盘突出症疗效优势人群和和使用禁忌,凸显六经辨证特色和优势。方法选取2019年3月~2020年3月就诊于上海市浦东新区中医医院骨伤门诊患者,采用队列研究分析将运用加味麻黄附子细辛汤结合中医综合治疗的腰椎间盘突出症与单纯采用中医综合治疗的腰椎间盘突出症患者分为暴露组和对照组,比较两组患者临床疗效,并将暴露组根据性别、年龄、二十四节气、体质量指数(body mass index,BMI)等因素进一步分亚组比较,探索麻黄附子细辛汤疗效优势人群和使用禁忌。结果共收集204例患者,一般资料分析证实各项数据差异均有可比性。经统计分析,所有亚组均可改善腰椎间盘突出症症状;其中年龄>50岁、BMI<26.9 kg/m^(2)、病程<3年、轻中劳动强度、冬春季组为加味麻黄附子细辛汤的疗效优势人群;回归分析显示,患者年龄越大,加味麻黄附子细辛汤疗效越好;病程越长,加味麻黄附子细辛汤疗效越差;高血压具有双向影响机制。结论①加味麻黄附子细辛汤可改善太阳少阴合病腰椎间盘突出症患者的症状;②加味麻黄附子细辛汤具有特定的疗效优势人群,在临床中,应选择有相应特征的患者使用。Objective To explore the therapeutic effect and contraindications of modified Mahuang Fuzi Xixin Decoction in the treatment of lumbar disc herniation,and highlight the characteristics and advantages of syndrome differentiation of six meridians.Methods From March 2019 to March 2020,patients in the Orthopedics Department of Traditional Chinese Medicine of Shanghai Pudong New Area Hospital of Traditional Chinese Medicine were selected.The patients in the two groups were divided into the exposure group and the control group by using the combination of modified Mahuang Fuzi Xixin Decoction and traditional Chinese medicine comprehensive treatment and traditional Chinese medicine comprehensive treatment.The clinical effects of the two groups were compared,and the exposure group was divided into the exposure group according to gender,age,24 solar terms,BMI Index and other factors were further divided into subgroups to explore the efficacy advantage population of Mahuang Fuzi Xixin Decoctionand contraindications.Results A total of 204 patients were collected,and the differences in general data were comparable.According to statistical analysis,all subgroups could improve the symptoms of lumbar protrusion;age>50 years old,BMI<26.9 kg/m^(2),course of disease<3 years,light and medium labor intensity,winter and spring groups were the dominant groups.The regression analysis showed that the older the patients were,the better the effect of modified Mahuang Fuzi Xixin Decoction was;on the contrary,the longer the course of disease,the worse the effect of modified Mahuang Fuzi Xixin Decoction was,and hypertension had a two-way influence mechanism.Conclusion①Modified Mahuang Fuzi Xixin Decoction can relieve the pain of the patients with lumbar disc herniation with Taiyang and Shaoyin combined disease.②Modified Mahuang Fuzi Xixin Decoction has a specific effect advantage population,and we should select the patients with corresponding characteristics to use in clinic.
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