活血益气通经汤联合美洛昔康对腰椎间盘突出症患者炎症反应及下腰痛的影响  

Effects of Huoxue Yiqi Tongjing Decoction Combined with Meloxicam on Inflammatory Reaction and Low Back Pain in Patients with Lumbar Disc Herniation

作　　者：肖德浪 焦敏 匡萃芳 XIAO Delang;JIAO Min;KUANG Cuifang(Department of Orthopedics,First People's Hospital of Ji’an City,Ji’an 343000,China;不详)

机构地区：[1]吉安市第一人民医院骨科,江西吉安343000 [2]井冈山大学附属医院中医科,江西吉安343000 [3]吉安市第一人民医院中医骨伤科,江西吉安343000

出　　处：《中国医学创新》2024年第4期70-74,共5页Medical Innovation of China

摘　　要：目的:探讨活血益气通经汤联合美洛昔康在腰椎间盘突出症(LDH)患者中的应用价值。方法:选择2020年1月—2023年1月吉安市第一人民医院收治的LDH患者60例,按随机数字表法分为两组。对照组(n=30)采用美洛昔康治疗,观察组(n=30)采用活血益气通经汤联合美洛昔康治疗,两组均治疗14 d。对比分析两组炎症反应、下腰痛程度、腰椎功能、临床疗效、不良反应。结果:治疗后,观察组C反应蛋白(CRP)[(7.53±0.86)mg/L]、白介素(IL)-6[(92.43±10.07)μg/L]、IL-1β[(5.17±0.94)ng/L]、肿瘤坏死因子-α(TNF-α)[(1.14±0.21)ng/L]及视觉模拟评分法(VAS)评分[(2.75±0.69)分]均低于对照组[(9.03±1.04)mg/L、(107.03±14.25)μg/L、(6.04±1.13)ng/L、(1.87±0.29)ng/L、(4.30±1.18)分],日本骨科协会评估治疗分数(JOA)评分中主观症状评分[(7.59±0.67)分]、客观体征评分[(5.20±0.41)分]、日常生活受限度评分[(12.07±0.84)分]及总分[(24.86±2.01)分]均高于对照组[(6.63±1.04)、(4.31±0.54)、(10.23±1.26)、(21.17±2.86)分],差异均有统计学意义(P<0.05);观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05);两组治疗期间均未出现不良反应。结论:活血益气通经汤联合美洛昔康可下调LDH患者CRP、IL-6、IL-1β、TNF-α水平,减轻下腰痛,改善腰椎功能,且安全可靠。Objective:To explore the application value of Huoxue Yiqi Tongjing Decoction combined with Meloxicam in patients with lumbar disc herniation(LDH).Method:A total of 60 patients with LDH admitted to First People's Hospital of Ji’an City from January 2020 to January 2023 were selected and divided into two groups according to random number table method.The control group(n=30)was treated with Meloxicam,and the observation group(n=30)was treated with Huoxue Yiqi Tongjing Decoction combined with Meloxicam,both groups were treated for 14 days.The inflammatory reaction,degree of low back pain,lumbar function,clinical efficacy and adverse reactions were compared between the two groups.Result:After treatment,the C reactive protein(CRP)[(7.53±0.86)mg/L],interleukin(IL)-6[(92.43±10.07)μg/L],IL-1β[(5.17±0.94)ng/L],tumor necrosis factor-α(TNF-α)[(1.14±0.21)ng/L]and visual analogue scale(VAS)score[(2.75±0.69)scores]in observation group were lower than those in control group[(9.03±1.04)mg/L、(107.03±14.25)μg/L,(6.04±1.13)ng/L,(1.87±0.29)ng/L,(4.30±1.18)scores],and the subjective symptom score[(7.59±0.67)scores],objective sign score[(5.20±0.41)scores],daily life limitation score[(12.07±0.84)scores]and total scores[(24.86±2.01)scores]of Japanese orthopaedic association scores(JOA)in observation group were higher than those in control group[(6.63±1.04),(4.31±0.54),(10.23±1.26),(21.17±2.86)scores],the differences were statistically significant(P<0.05).The total effective rate in the observation group was 93.33%,which was higher than 73.33%in the control group,the difference was statistically significant(P<0.05).There were no adverse reactions in the two groups during treatment.Conclusion:Huoxue Yiqi Tongjing Decoction combined with Meloxicam can reduce the levels of CRP,IL-6,IL-1βand TNF-αin LDH patients,alleviate low back pain and improve lumbar function,and is safe and reliable.

关 键 词：腰椎间盘突出症 美洛昔康 活血益气通经汤 炎症反应 下腰痛 

分 类 号：R681.53[医药卫生—骨科学]