加味肾着汤对腰椎间盘突出症患者椎间孔镜术后残余腰腿痛及腰椎功能的影响  

Effects of modified Shenzhe decoction on residual back and leg pain and lumbar function in patients with lumbar disc herniation after foraminoscopy

作　　者：白晶晶 苏小强 刘诗若 王向阳 BAI Jingjing;SU Xiaoqiang;LIU Shiruo;WANG Xiangyang(Spinal Section,Orthopedics and Traumatology Department,Xi’an Hospital of Traditional Chinese Medicine,Xi’an 710016,China)

机构地区：[1]西安市中医医院骨伤科脊柱病区,陕西西安710016

出　　处：《陕西中医》2023年第12期1753-1757,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：西安市中医药科研项目(SZL202210)。

摘　　要：目的:探讨加味肾着汤治疗寒湿痹阻型腰椎间盘突出症椎间孔镜术后残余腰腿痛的疗效。方法:选择112例腰椎间盘突出症椎间孔镜术后患者并对其临床资料进行回顾性研究,术后根据不同用药方案将受试者分为对照组和研究组,每组56例。对照组患者术后给予常规西药治疗,研究组患者则在对照组基础上联合加味肾着汤治疗。比较两组疗效、肌骨超声与表面肌电参数、压痛阈、炎症因子与脂肪细胞因子水平、腰椎功能与中医症候评分。结果:治疗后两组患者多裂肌与竖脊肌厚度、平均功率频率(MPF)、积分肌电(IEMG)、压力疼痛感觉阈(PPDT)与压力疼痛耐受阈(PPTO)较治疗前明显升高,且研究组升高较对照组更为显著(均P<0.05)。治疗后两组患者各炎症因子与脂肪细胞因子水平、JOA评分、VAS评分及中医症候评分较治疗前明显改善,且研究组各指标改善较对照组更为显著(均P<0.05)。研究组患者治疗总有效率较对照组高(P<0.05)。结论:对寒湿痹阻型腰椎间盘突出症椎间孔镜术后残余腰腿痛患者应用加味肾着汤有助于抑制机体炎症,缓解术后残余腰腿痛,促进腰椎功能恢复。Objective:To investigate the curative effect of modified Shenzhe decoction on residual lumbar and leg pain and lumbar function recovery in patients with lumbar disc herniation after foraminoscopy.Methods:112 patients with lumbar disc herniation were selected and their clinical data were retrospectively studied.All patients received foraminoscopic surgery,and subjects were divided into control group and study group according to different medication regiments after surgery,56 cases in each group.The control group was treated with conventional western medicine after operation,and the study group was treated with modified Shenzhe decoction on the basis of control group.The therapeutic effect,musculoskeletal ultrasound and surface electromyography parameters,tenderness threshold,inflammatory factors and adipocytokines levels,lumbar function and TCM symptom score were compared between the two groups.Results:After treatment,the multifidus and erector spinalis muscle thickness,MPF,IEMG,PPDT and PPTO values in both groups were significantly higher than before treatment,and the increases in the study group were more significant than those in the control group(all P<0.05).After treatment,the levels of inflammatory factors and adipocytokines,JOA score,VAS score,TCM symptom score of the two groups were significantly improved compared with before treatment,and the improvement of indicators in the study group was more significant than those in the control group(all P<0.05).The total effective rate of the study group was higher than that of the control group(P<0.05).Conclusion:The application of modified Shenzhe decoction in patients with lumbar disc herniation after foraminoscopy can inhibit inflammation,relieve residual back and leg pain,and promote the recovery of lumbar function.

关 键 词：腰椎间盘突出症 加味肾着汤 寒湿痹阻 残余腰腿痛 压痛阈 脂肪细胞因子 

分 类 号：R681.5[医药卫生—骨科学]